山东省2009-2015年HIV/AIDS流行的时空分布特征

目的 分析山东省2009-2015年HIV/AIDS流行时空特征。方法 应用全局空间自相关性统计量（Moran''s I）和局部空间自相关性统计量（local indicators of spatial association）分析历年发现HIV/AIDS的空间聚集性，时空扫描（SatScan）统计量分析时空聚集性。结果 山东省2009-2015年累计发现HIV/AIDS有9 144例，病例的空间分布范围逐年扩大且局部地区分布集中。除2009年外，历年发现HIV/AIDS的空间分布在县区水平有空间自相关性，“热点”区域分布在济南市的天桥区、市中区和历城区及青岛市的市南区和崂山区。时空扫描发现1个一类时空聚集区，聚集地区覆盖济南市历下区、市中区、槐荫区和天桥区（RR=11.29，LLR=1 592.84，P<0.001）；4个二类时空聚集区，分别覆盖青岛市市南区、市北区和李沧区（RR=7.35，LLR=682.40，P<0.001）、潍坊市潍城区和奎文区（RR=7.33，LLR=363.49，P<0.001）、烟台市的芝罘区和莱山区（RR=7.66，LLR=117.63，P<0.001）及淄博市的周村区和张店区（RR=6.09，LLR=268.68，P<0.001）；聚集时间均为2013-2015年。结论 山东省HIV/AIDS的空间和时间分布均具有聚集性。济南、青岛、淄博、潍坊、烟台市较其他地区聚集性高，需重点防治。

Spatiotemporal characteristics of HIV/AIDS in Shandong province, 2009-2015

Objective To analyze the spatiotemporal characteristics of HIV/AIDS in Shandong province, 2009-2015. Methods Data on HIV/AIDS between 2009 and 2015 were derived from the Shandong provincial HIV/AIDS Comprehensive Response Information Management System at the end of 2015. All the data were geographically referenced based on 139 spatial units in the related counties of Shandong province. Electronic maps were obtained from China CDC. Global Moran''s I statistics and LISA statistics were used to detect the global and local spatial distribution patterns of HIV/AIDS in Shandong. Space-time scan statistics method, based on the Poisson Model, was used to detect the space-time clusters of HIV/AIDS. Results A total of 9 144 HIV/AIDS cases were reported during 2009-2015 in Shandong province. The scope of spatial distribution on HIV/AIDS expanded annually and concentrated in certain areas. Spatial distribution of HIV/AIDS in 2009 was randomized, and results showed spatial autocorrelation at the county level, during 2010-2015. Spatial hotspot-clusters mainly appeared in Tianqiao, Shizhong and Licheng districts of Jinan city, and Shinan, Laoshan districts of Qingdao city. Results from the Space-time scan analysis identified 5 spatiotemporal clusters in 2013-2015, including 1 most likely cluster and 4 secondary clusters which involving Lixia, Shizhong, Huaiyin and Tianqiao districts of Jinan city (RR=11.29, LLR=1 592.84, P<0.001). The covered counties in secondary clusters appeared in Shinan, Shibei and Licang districts of Qingdao city (RR=7.35, LLR=682.40, P<0.001), Weicheng and Kuiwen districts of Weifang city (RR=7.33, LLR=363.49, P<0.001), Zhifu and Laishan districts of Yantai city (RR=7.66, LLR=117.63, P<0.001), Zhoucun and Zhangdian districts of Zibo city (RR=6.09, LLR=268.68, P<0.001) respectively. Conclusion HIV/AIDS cases in Shandong province appeared clustering features in both dimensions of time and space. Prevention efforts were needed to focus on HIV/AIDS highly clustered areas, such as Jinan city, Qingdao city, Zibo city, Weifang city and Yantai city.