2004-2015年中国大陆地区肺结核流行的时空分布特征  

Characteristic of spatial-temporal distribution of pulmonary tuberculosis in China's Mainland from 2004 to 2015

作　　者：喻国旗 雷明智[1] 魏怡 龙冰霜 陈世艺[1] 唐咸艳[1] 张志勇 覃健[1] 

机构地区：[1]广西医科大学公共卫生学院,广西南宁530021 [2]桂林医学院,广西桂林541004

出　　处：《现代预防医学》2017年第20期3649-3654,共6页Modern Preventive Medicine

基　　金：国家自然科学基金(项目编号:81560523);广西科学研究与技术开发项目(项目编号:14124005-2-11)

摘　　要：目的探讨2004-2015年中国大陆结核病报告发病率的时空分布特征和流行趋势。方法收集2004-2015年中国大陆结核病报告发病率数据,应用地理信息软件Arcgis10.4和SaTScan9.4进行全局和局部空间自相关分析和时空扫描分析,探测发病的时空聚集性。结果中国大陆2004-2015年共报告结核病发病12 321 559例,死亡34 028例,发病率和死亡率整体上呈缓慢下降趋势。结核病在省级(自治区、直辖市)水平上年均发病情况差异较大,西北、西南和东北疫情严重。历年全局空间自相关分析显示,不同地区结核报告发病率呈空间正相关(均P<0.05),Moran指数稳定。局部自相关分析显示,31个省(自治区、直辖市,不包括香港、澳门、台湾地区)结核病报告发病率呈高高值聚集和低低值聚集且具有统计学意义(P<0.05)。时空聚集性分析共扫描出3个聚集区域,其中最大可能聚集区位于中西部地区(2005-2010年)。结论 2004-2015年中国大陆结核病发病存在明显的地区差异和空间聚集性,聚集范围不断扩大。西部的新疆、西藏、贵州、广西是重点防治区域。Objective To analyze the spatio-temporal distribution characteristics and trends of reported pulmonary tuberculosis （PTB） in China from 2004 to 2015. Methods The surveillance data of tuberculosis in China's Mainland between 2004 and 2015 were collected and analyzed by the geographic information system software ArcgislO.4 for global and local spatial autocorrelation analysis and SaTScan9.4 for spatio-temporal scanning was used to detect the spatial and temporal clustering. Results A total of 12 321 559 active PTB cases were reported and 34 028 deaths during this period. As the whole morbidity and mortality were slowly declining. The average incidence of reported tuberculosis in the provincial （autonomous regions and municipalities included） level were quite different and regions of northwestern, southwestern and northeastern were in serious epidemics. The spatial correlation analysis showed that the incidence of reported tuberculosis in different regions was positive spatial correlation and the value of Moran index was stable during different period （P〈0.05）. Local autocorrelation analysis showed that the incidence of reported tuberculosis in 31 provinces （autonomous regions and municipalities included） were high-high （HH） and low-low （LL） value aggregation and the difference was statistically significant （P〈0.05）. The results of spatial-temporal scanning indicated that there were three incidence clustering of tuberculosis. The largest possible gathering area was located at the central and western regions （2005-2010）. Conclusion There were obvious regional differences and spatial clustering in the incidence of tuberculosis in China from 2004 to 2015, and the scope of aggregation was expanding. The western region of Xinjiang, Tibet, Guizhou and Guangxi are all areas focus on prevention and control.

关 键 词：结核病 地理信息系统 空间自相关 时空扫描 

分 类 号：R181.2[医药卫生—流行病学]