甘肃省2014-2018年三种自然疫源性疾病时空聚集性分布特征分析

目的 了解2014-2018年甘肃省布鲁氏菌病（布病）、流行性乙型脑炎（乙脑）和肾综合征出血热（HFRS）3种自然疫源性疾病流行特征及时空分布规律,为制定疫情防控措施提供参考依据。方法 建立2014-2018年甘肃省3种自然疫源性疾病发病数据库,采用ArcGIS 10.5软件进行三维趋势分析和结果的可视化呈现,应用SaTScan 9.6软件进行时空扫描分析。结果 三维趋势分析显示,甘肃省布病报告发病率由北向南逐渐降低,在东西方向上呈微弱的"U"形分布;乙脑报告发病率由南向北显著下降,东部地区发病率高于中、西部地区;HFRS报告发病率东西部地区差异不明显,南部地区略高于北部地区。时空分析结果显示,甘肃省3种自然疫源性疾病报告发病率存在时空聚集性。布病主要聚集区位于东部地区,包含19个县（区）,聚集时间为2014-2015年,次要聚集区位于河西地区,包含4个县（区）,聚集时间为2017-2018年;乙脑聚集区位于中部、东南部地区,包含32个县（区）,聚集时间为2017-2018年;HFRS主要聚集区位于定西市岷县,聚集时间为2018年,次要聚集区位于东部地区,包含8个县（区）,聚集时间为2018年。结论 2014-2018年甘肃省3种自然疫源性疾病报告发病率总体呈现上升趋势,且存在明显的时空聚集性。重点地区应根据不同疾病的特点,制定相应的防控措施。

Epidemiological and spatial-temporal distribution of several natural focus diseases in Gansu province, 2014-2018

Objective To analyze the epidemiological and spatial-temporal distribution of Brucellosis, epidemic encephalitis B and hemorrhagic fever with renal syndrome (HFRS) in Gansu province during 2014-2018 so as to provide evidence for the prevention and control of those diseases. Methods A database was established in Gansu province from 2014 to 2018, using the geographical information system. A spatial distribution map was drawn, with trend analysis and space-time clustering used to study the 3-dimention of the diseases, by using both ArcGIS 10.5 and SaTScan 9.6 softwares. Results Results from the trend surface analysis showed that the incidence of Brucellosis decreased gradually from north to south parts while the U type curve could reflect the distribution from the east to the west areas. Incidence of epidemic encephalitis B decreased significantly from south to north areas in the province, with incidence higher in the eastern than in the mid-west region. Difference on the incidence of HFRS was not significantly visible in the eastern and western regions,while the incidence was slightly higher in the southern than the northern parts of the province. Spatial and space-time clustering did exist among the 3 diseases in Gansu from 2014 to 2018. The areas with clusters of Brucellosis appeared in the eastern parts during 2014-2015, including 19 counties. The areas with secondary clusters of Brucellosis were seen in the Hexi district, including 4 counties, during 2017-2018. The areas with high incidence of epidemic encephalitis B were clustered in the middle and southeast areas, including 32 counties, during 2017-2018. Areas with most clusters of HFRS appeared in Min county of Dingxi city in 2018, with the areas of secondary clusters in 8 counties of the eastern areas in 2018. Conclusions The overall incidence rates of the 3 natural focus diseases were in a upward trend and showing obvious characteristics on spatial clustering. According to the distributive characteristics, effective measures should be developed accordingly.