温州市2008—2017年学生肺结核病时空流行病学分析  

Epidemiological analysis on the spatiotemporal clustering of students' pulmonary tuberculosis in Wenzhou from 2008 to 2017

作　　者：单志力[1] 毛玲琼[1] 朱小梅[1] 李君[1] SHAN Zhili;MAO Lingqiong;ZHU Xiaomei;LI Jun(Wenzhou Center for Disease Control and Prevention,Wenzhou（325001）,Zhejiang Province,China)

机构地区：[1]浙江省温州市疾病预防控制中心,325001

出　　处：《中国学校卫生》2018年第7期1066-1068,1072,共4页Chinese Journal of School Health

基　　金：浙江省医药卫生科技计划项目(2017KY635)

摘　　要：目的探讨2008—2017年温州市学生肺结核病时空分布特征,为学生结核病防控提供依据。方法利用Arc GIS 10.1和Sa TScan 9.3软件对温州市2008—2017年以乡镇级为单位的学生肺结核病进行时空聚集性分析,呈现学生肺结核病时空聚集区域。结果 2008—2017年温州市学生肺结核病登记率总体呈现下降趋势。全局空间自相关和时空扫描分析发现,学生结核病存在明显聚集现象,温州大学城所在地茶山街道为学生肺结核病主要聚集区域,单纯空间扫描分析实际病例数83例(RR=4.67,LLR=61.77,P<0.01);永嘉中部以及北部、乐清市南部3个区域较其他地区高发,为次要聚集区域,单纯空间扫描分析实际病例数分别为139,159,179例(RR值分别为2.31,1.49,1.43,LLR值分别为36.14,10.48,9.49,P值均<0.01)。时间聚集性扫描发现,每年4—5月为学生肺结核病例高发时段,时间扫描分析实际病例数688例(RR=2.12,LLR=121.48,P<0.01)。结论时空扫描分析方法可以较好地应用于学生肺结核病高发重点区域分析,结合地理信息系统,能够更加直观、全面地展示发病聚集区域。Objective To analyze the spatiotemporal distribution of students pulmonary tuberculosis（ PTB） cases in Wenzhou from 2008 to 2017,and to provide the scientific basis for TB control.Methods Arc GIS and Sa TScan applications was used to analyze the spatiotemporal clustering of PTB in students at the township level from 2008 to 2017,and to present the spatial and temporal clustering areas of PTB in students by Arc GIS.Results The students＇ PTB incidence rate in Wenzhou presented declining trend from 2008 to 2017.Global spatial autocorrelation with Sa TScan showed that there were the obvious clustering for students PTB.Chashan Street,where Wenzhou college town is located,was the main clustering areas for pulmonary tuberculosis.The true registered number of cases was 83（ RR = 4.67,LLR = 61.77,P〈0.01）.The secondary clustering areas were 3 districts in middle and northern of Yong Jia,and southern of Yue Qing,The true registered number of cases was 139,159,179（ RR = 2.31,1.49,1.43,LLR = 36.14,10.48,9.49,P〈0.01）.The purely temporal scan statistics showed the temporal cluster with a two-month period from April to May.The real registered number of cases was 688（ RR = 2.12,LLR = 121.48,P〈0.01）.Conclusion The Spatiotemporal scanning analysis method can be very well applied to analyze hot spots of PTB in students.In combination with geographic information systems,it can better intuitively and comprehensively display the areas of disease clustering and provide scientific reference for future targeted prevention and control measures.

关 键 词：结核 学生 流行病学 时空聚类分析 

分 类 号：R521[医药卫生—内科学]