中国五省(自治区)登革热发病的时空聚集性及其与绿地的关联性研究  

Spatiotemporal clustering of dengue fever and its association with greenspace in five provinces(autonomous region)of China

作　　者：曹英瑛 郭富 高杉杉 于文浩 楚尊燕 郭邦婕 刘起勇 于晓卿[3] 赵琦[2] CAO Ying-ying;GUO Fu;GAO Shan-shan;YU Wen-hao;CHU Zun-yan;GUO Bang-jie;LIU Qi-yong;YU Xiao-qing;ZHAO Qi(Department of Vector Control,School of Public Health,Cheeloo College of Medicine,Shandong University,Jinan 250012,China;Department of Epidemiology,School of Public Health,Cheeloo College of Medicine,Shandong University,Jinan 250012,China;Dezhou Center for Disease Control and Prevention;Department of Gastroenterology,The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital;Department of Occupational and Environmental Health,School of Public Health,Cheeloo College of Medicine,Shandong University;National Key Laboratory of Intelligent Tacking and Forecasting for Infectious Diseases/National Institute for Communicable Disease Control and Prevention,Chinese Center for Disease Control and Prevention)

机构地区：[1]山东大学齐鲁医学院公共卫生学院媒介生物控制学系,济南250012 [2]山东大学齐鲁医学院公共卫生学院流行病学系,济南250012 [3]德州市疾病预防控制中心 [4]山东第一医科大学第一附属医院(山东省千佛山医院)消化科 [5]山东大学齐鲁医学院公共卫生学院劳动卫生与环境卫生学系 [6]传染病溯源预警与智能决策全国重点实验室/中国疾病预防控制中心传染病预防控制所

出　　处：《环境卫生学杂志》2025年第4期277-285,共9页JOURNAL OF ENVIRONMENTAL HYGIENE

基　　金：山东省优秀青年基金(海外,2022HWYQ-055);山东省自然科学基金(ZR2021QH318);山东省泰山学者青年专家项目(tsqn202306063)。

摘　　要：目的目前登革热时空聚集性研究缺乏大区域范围的精细尺度分析,且绿地效应的研究结论不一。本研究分析了中国五省(自治区)登革热发病的城市-区县时空聚集特征,并探讨绿地对其发病的影响。方法收集2017-2020年中国南方广东、广西、浙江、福建和云南的登革热病例监测、绿地、气象和社会经济数据。利用时空扫描分析登革热时空聚集区,使用层次贝叶斯时空模型分析绿地对登革热发病的影响。结果城市级时空分析探测到14个时空聚集区,其中一类聚集区为云南西双版纳傣族自治州(2019年8-10月),二类聚集区为西双版纳傣族自治州(2017年7月-2018年11月)和广东省西部、广西壮族自治区东部的19个城市(2019年9-10月)。区县级时空分析探测到17个时空聚集区,一类聚集区为云南省西南部的22个区县(2019年8-10月),二类聚集区为勐腊县、景洪市(2017年7月—2018年11月)和广东省西部、广西壮族自治区东部的110个区县(2019年9-10月)。归一化植被指数与登革热发病风险升高相关,相对危险度(relative risk,RR)及95%置信区间(confidence interval,CI)为1.58(1.27~1.97)。森林占比与高登革热发病风险相关(RR=1.36,95%CI:1.08~1.71),而耕地占比和草地占比与登革热发病风险无显著关联。结论我国登革热发病存在时空聚集性,森林覆盖与发病风险增加存在关联。Objective Existing studies on the spatiotemporal clustering of dengue fever lack fine-scale analysis covering large are-as,and conclusion on greenspace effects vary.This study explored the spatiotemporal clustering pattern of dengue fever at the city and county levels in five provinces(autonomous region)of China and the impact of greenspace on its incidence.Methods Data on dengue case surveillance,greenspace,and meteorological and socio-economic conditions were collected from Guangdong,Guangxi,Zhejiang,Fujian,and Yunnan in southern China from 2017 to 2020.A spatiotemporal scan analysis was employed to identify spatiotemporal clustering areas of dengue fever.Additionally,a hierarchical Bayesian spatiotemporal model was used to examine the impact of greenspace on dengue fever incidence.Results The city-level spatiotemporal analysis detected 14 spatiotemporal clustering areas,including a tier-1 clustering area(Xishuangbanna Dai Autonomous Prefecture in Yunnan[August to October 2019])and tier-2 clustering areas(Xishuangbanna Dai Autonomous Prefecture[July 2017 to November 2018]and 19 cities in western Guangdong province and eastern Guangxi Zhuang Autonomous Region[September to October 2019]).The county-level spatiotemporal analysis identified 17 spatiotem-poral clustering areas,including tier-1 clustering areas(22 counties in southwestern Yunnan province[August to October 2019])and tier-2 clustering areas(Mengla County and Jinghong city[July 2017 to November 2018]and 110 districts/counties in western Guang-dong province and eastern Guangxi Zhuang Autonomous Region[September to October 2019]).Normalized difference vegetation index was associated with an increased risk of dengue fever(relative risk[RR]=1.58,95%confidence interval[CI]:1.27-1.97).The proportion of forest was associated with an elevated risk of dengue fever(RR=1.36,95%CI:1.08-1.71),while the proportions of farmland and grassland were not significantly associated with the risk.Conclusion The incidence of dengue fever in China is characterized by spatiotemp

关 键 词：登革热 时空聚集性 绿地 层次贝叶斯时空模型 

分 类 号：R12[医药卫生—环境卫生学] R183.5[医药卫生—公共卫生与预防医学]