江苏省盐城市沿海滩涂2005-2014年恙虫病时空分布特征及影响因素分析  

Spatio-temporal distribution of scrub typhus and related influencing factors in coastal beach area of Yancheng, China

作　　者：陈胤忠[1] 李峰[1] 徐慧[1] 黄连成[1] 顾振国[1] 孙中友[1] 严国进[2] 朱叶江 汤池 

机构地区：[1]江苏省盐城市疾病预防控制中心综合业务办公室,224002 [2]东台市疾病预防控制中心综合业务科,224200 [3]滨海县疾病预防控制中心传染病防制科,224500 [4]大丰市疾病预防控制中心卫生科,224100

出　　处：《中华流行病学杂志》2016年第2期232-237,共6页Chinese Journal of Epidemiology

基　　金：江苏省卫生厅预防医学项目（Y201012）

摘　　要：目的 分析2005-2014年盐城市沿海滩涂恙虫病的时空分布特征,并对气象、鼠类种群分布及生物学特点等影响因素进行相关性研究。方法 收集整理2005-2014年盐城市沿海滩涂地区恙虫病疫情、人口学以及气象学资料,并于2011年4月至2013年12月监测该地区鼠类种群分布及其密度、季节消长情况。采用Excel 2003、SPSS 16.0、MapInfo 11.0、Satscan 9.0和Stata/SE 10.0等软件,利用描述性方法、时空重排扫描统计量法、自相关及互相关等方法分析该地区恙虫病时空分布特征,及与鼠密度消长、气象因素变化的相关性,根据恙虫病发病数据建立Poisson回归模型。结果 （1）2005-2014年盐城市沿海滩涂地区恙虫病的发病呈间歇性逐年升高,2014年发病率为最高（5.81/10万）。呈现秋季高峰,11月发病率最高（12.02/10万）;滨海、大丰、响水县/市年均发病率最高,分别为3.30/10万、3.21/10万和2.79/10万,沿海地区的12个乡镇为高发,发病率为4.41/10万至10.03/10万。（2）恙虫病可能存在3个发病聚集区域,分别为2012年10-11月大丰、东台和射阳县/市的25个乡镇、2014年10-11月响水县的5个乡镇以及2006年11月滨海县的6个乡镇。（3）优势鼠种为黑线姬鼠（89.19%）。鼠密度呈冬季（1月）与夏季（5-8月）2个高峰,分别为5.05%（1月）和8.05%（8月）。发病月分布为每年的10-11月有一次发病高峰,每次发病高峰前1～2个月有一个鼠密度升高趋势,每次发病高峰前均有一个气温、降水量高峰。鼠密度消长、气温、降水量与恙虫病发病有统计学相关性。根据ZIP回归模型分析发病例数与降水、平均最低气温、滞后3个月平均最低气温呈正相关,与日照时长和相对湿度呈负相关。结论 盐城市沿海滩涂地区存在恙虫病疫区,且有时空聚集性,并存在媒介生物和气象等流行因素,应采取有效防控措施。Objective In order to provide better programs on monitoring, early warning and prevention of Scrub Typhus in the coastal beach area, temporal-spatial distribution characteristics of scrub typhus were summarized.Relationships between temporal-spatial clustering of Scrub Typhus, meteorological factors, rodent distribution and the biological characteristics in coastal beach area of Yancheng city, were studied.Methods Reports on network-based Scrub Typhus epidemics and information on population, weather situation through monitoring those stations, from 2005 to 2014 were collected and processed, in the coastal beach area of Yancheng city.Distribution, density of the population concerned and seasonal fluctuation on rodents were monitored in coastal beach area, from April 2011 to December, 2013.Methods as descriptive statistics, space-time permutation scantistics, autocorrelation and Cross-correlation analysis etc, were used to analyze the temporal-spatial distribution of Scrub Typhus and correlation with rodent distribution, density fluctuation and meteorological indexes.Zero-inflated Pearson（ZIP） regression model was contributed according to the distribution of related data.All Methods were calculated under Excel 2003, SPSS 16.0, Mapinfo 11.0, Satscan 9.0 and Stata/SE 10.0 softwares.Results （1） The incidence of Scrub Typhus was gradually increasing and the highest incidence of the year was seen in 2014, as 5.81/10 million.There was an autumn peak of Scrub typhus, with the highest incidence rate as 12.02/10 million in November.The incidence rate of Scrub typhus appeared high in Binhai, Dafeng and Xiangshui, with the average incidence rates appeared as 3.30/10 million, 3.21/10 million and 2.79/10 million, respectively.There were 12 towns with high incidence rates in the coastal beach area, with incidence rate showed between 4.41/10 and 10.03/10 million.（2） There were three incidence clusters of Scrub typhus seen in 25 towns, between October 2012 and November 2012 in Dongtai, Dafeng, Sheyang areas and 5 towns

关 键 词：恙虫病 时空分布 季节消长 气象因素 沿海滩涂 

分 类 号：R513.2[医药卫生—内科学] R181.3[医药卫生—临床医学]