可变形空间扫描法用于广州市街道层面的肺结核聚集性分析  

Application of the flexible spatial scan statistic to analyzing the clustering of pulmonary tuberculosis based on the street level in Guangzhou

作　　者：何立乾 罗浩[1] 杨洁莹 赖铿 杨朔 谌思阳 杜雨华 张晋昕[1] HE Liqian;LUO Hao;YANG Jieying;LAI Keng;YANG Shuo;CHEN Siyang;DU Yuhua;ZHANG Jinxin(Department of Medical Statistics,School of Public Health,Sun Yat-sen University,Guangzhou,Guangdong 510080,China;Guangzhou Chest Hospital,Guangzhou,Guangdong 510095,China)

机构地区：[1]中山大学公共卫生学院医学统计学系,广东广州510080 [2]广州市胸科医院,广东广州510095

出　　处：《实用预防医学》2024年第12期1418-1423,共6页Practical Preventive Medicine

基　　金：广东省基础与应用基础研究基金(2023A1515011951);广州市科技计划项目(2024A03J0588)

摘　　要：目的 探索2015—2022年广州市街道层面肺结核聚集性分布情况,识别高风险区域并找出其变化趋势,为疾病防控工作的部署提供依据。方法 基于中国疾病预防控制信息系统中2015—2022年广州市肺结核疫情数据和广州市统计年鉴中的人口数据,建立地理信息系统数据库,探测肺结核聚集区。结果 2015—2022年广州市肺结核总体疫情呈下降趋势(APC=-7.65,95%CI:-8.90~-6.39,t=-14.299,P<0.001)。全市各街道肺结核呈局部聚集性分布,2015—2022年分别探测到8、5、7、5、5、6、4和5个肺结核发病空间聚集区,分别涉及38、30、31、33、36、39、33和34个街道。2015—2018、2020、2022年一级聚集区集中在越秀区,LLR分别为439.36、377.15、275.06、33.92、21.89、21.91;2019年则集中在海珠区的凤阳街道及毗邻的南洲街道和江海街道,LLR为30.22;2021年则集中在黄埔区萝岗街道及其毗邻的部分街道,LLR为29.92。结论 2015—2022年广州市街道层面肺结核疫情存在明显的局部空间聚集性,聚集情况未完全呈现逐年好转的趋势,应对不同特征的聚集性街道采取针对性措施,以控制街道层面的肺结核疫情。Objective To explore the distribution of pulmonary tuberculosis aggregation at the street level in Guangzhou from 2015 to 2022,to identify the high-risk areas and find out the changing trends,and to provide a basis for the deployment of disease prevention and control.Methods A geographic information system database was established based on the epidemic data of pulmonary tuberculosis reported in Guangzhou City during 2015-2022 from the China Information System for Disease Control and Prevention and the population data from the Guangzhou Statistical Yearbook,and the pulmonary tuberculosis aggregation areas were detected.Results The overall epidemic of pulmonary tuberculosis in Guangzhou City from 2015 to 2022 showed a decreasing trend(APC=-7.65,95%CI:-8.90--6.39,t=-14.299,P<0.001).There was a local aggregated distribution of pulmonary tuberculosis across streets in the city,with 8,5,7,5,5,6,4 and 5 spatial clusters of pulmonary tuberculosis incidence detected in 2015-2022,involving a total of 38,30,31,33,36,39,33 and 34 streets respectively.The most likely clusters in 2015-2018,2020 and 2022 were concentrated in Yuexiu District,with the log likelihood ratio(LLR)being 439.36,377.15,275.06,33.92,21.89 and 21.91 respectively,those in 2019 were concentrated in Fengyang Street and adjacent Nanzhou and Jianghai Streets in Haizhu District,with the LLR of 30.22,and those in 2021 were concentrated in Luogang Street and some adjacent streets in Huangpu District,with the LLR of 29.92.Conclusion There was an obvious local spatial aggregation of pulmonary tuberculosis in Guangzhou City from 2015 to 2022,and the aggregation situation had not shown a year-on-year trend of improvement.Targeted measures should be taken in clustered streets with different characteristics so as to control the pulmonary tuberculosis epidemic at the street level.

关 键 词：肺结核 可变形空间扫描 聚集分析 街道层面 广州市 

分 类 号：R52[医药卫生—内科学] R181.3[医药卫生—临床医学]