2004—2020年中国丙型病毒性肝炎流行特征和空间聚集性  

Epidemic characteristics and spatial cluster of hepatitis C in China,2004-2020

作　　者：杨仙湖 姚媛媛 刘兴荣[1] YANG Xian-hu;YAO Yuan-yuan;LIU Xing-rong(School of Public Health,Lanzhou University,Gansu 730000,China)

机构地区：[1]兰州大学公共卫生学院,甘肃兰州730000

出　　处：《中国感染控制杂志》2024年第12期1492-1498,共7页Chinese Journal of Infection Control

基　　金：兰州大学“一带一路”专项经费资助项目;甘肃省哲学社会科学规划项目(20ZD017)。

摘　　要：目的探讨2004—2020年全国丙型病毒性肝炎(丙肝)发病空间聚集性及聚集区域随时间变化趋势,为确定丙肝重点区域,开展科学防控提供依据。方法采用中国公共卫生科学数据中心网络直报系统资料,应用GeoDa软件对我国内地各省进行全局和局部空间聚集性分析。结果全局空间自相关系数Moran’s I均为正值(均P<0.05),表明该时段全国各省丙肝发病区域存在空间聚集性。局部空间自相关分析共探测到46个热点地区(丙肝发病高值聚集地区)和46个冷点地区(丙肝发病低值聚集地区)。热点地区主要集中在甘肃、西藏、黑龙江、内蒙古、吉林、宁夏和广西等地;而冷点地区主要集中在江苏、浙江、上海、安徽和江西等地。结论首先,国家应重点关注丙肝发病的热点区域,卫生资源应多倾向于经济欠发达省份,如甘肃、宁夏等地。同时,加强对入境人员的传染病监测,及时阻止传染病的跨境传播,防止成为丙肝高发区。再者,要加强公众健康教育,增强主动筛查意识,提高丙肝发现率和治愈率;最后,细化丙肝流行率、病死率、治疗率和治愈率的具体指标。结合实际国情,借鉴国际相关成功经验,助力实现世界卫生组织(WHO)2030年消除病毒性肝炎公共卫生危害的目标。Objective To explore the spatial cluster of incidence and changing trend of clustering area over time of hepatitis C in China from 2004 to 2020,so as to provide reference for identifying the key areas for scientific prevention and control of hepatitis C.Methods Data from the China Public Health Science Data Center Network Direct Reporting System were used for analysis.Software GeoDa was adopted to conduct the global and local spatial clustering analysis on various provinces in China's Mainland.Results The global spatial autocorrelation coefficients Moran’s I were all positive(all P<0.05),indicating that there was spatial cluster of hepatitis C incidence areas in various provinces across the country during this period.Local spatial autocorrelation analysis detected a total of 46 hot spots(areas with high incidence of hepatitis C)and 46 cold spots(areas with low incidence of hepatitis C).The hot spots concentrated mainly in Gansu,Tibet,Heilongjiang,Inner Mongolia,Jilin,Ningxia and Guangxi;while the cold spots were mainly in Jiangsu,Zhejiang,Shanghai,Anhui and Jiangxi.Conclusion Firstly,great attention should be paid to the hot spot areas of hepatitis C incidence,and less economically developed provinces as Gansu and Ningxia should have health resources priority.At the same time,surveillance on infectious disease of inbound personnel should be strengthened to stop cross-border transmission of infectious diseases timely,and prevent these area from becoming new high incidence areas of hepatitis C.Secondly,Public health education should be strengthened,awareness of active screening as well as increase of detection and cure rates of hepatitis C should be enhanced.Specific indicators for the prevalence,mortality,treatment and cure rates of hepatitis C should be refined.Based on the actual national conditions,the relevant successful international experiences can be drawn to help achieve the World Health Organization’s 2030 goal of eliminating the public health hazards of viral hepatitis.

关 键 词：丙型病毒性肝炎 全局自相关 局部自相关 聚集区域 流行特征 空间聚集性 

分 类 号：R512.63[医药卫生—内科学]