鄱阳县新报告晚期日本血吸虫病的时空分布特征分析

目的 分析鄱阳县新报告晚期血吸虫病(晚血)病例的时空分布特征及规律,为控制晚血的发生提供科学依据。方法 以基于行政村的空间数据库,利用SaTScan对2009-2019年晚血发病率按空间、时间和时间-空间3种扫描探测模式进行统计分析,并通过ArcMap将分析结果可视化。结果 2009—2019年鄱阳县累计报告晚血病例932例,年报告晚血发病率呈逐年下降趋势,其中最高年份集中在2010—2013年,疫情控制阶段晚血发病率高于传播控制阶段(F=9.617, P=0.013);单纯空间扫描显示,疫情控制阶段出现2个一类聚集区域,传播控制阶段出现4个二类聚集区域;单纯时间扫描显示,疫情控制阶段晚血发病率高峰集中在2012—2013年(RR=64.44, P=0.001),传播控制阶段集中在2018年(RR=11.23, P=0.001);时间-空间扫描显示,2009—2019共探测到2个一类聚集区域和1个二类聚集区域,均沿鄱阳湖分布;在传播控制阶段无一类聚集区域。结论 虽然随着疫情的降低,晚血发病率也逐年下降,但在空间分布上依然存在多个集聚区域,针对此类区域在今后的防治工作中,应进一步加大晚血筛查和救治力度。

Analysis of the temporal and spatial distribution characteristics of newly reported advanced schistosomiasis in Poyang County

This study aimed to analyze the temporal and spatial distribution characteristics of newly reported advanced schistosomiasis cases in Poyang County to provide a scientific basis for controlling advanced schistosomiasis. On the basis of a spatial database of the endemic administrative village area, we performed statistical analysis of advanced schistosomiasis cases reported from 2009 to 2019 by using SaTScan spatiotemporal scanning statistical software according to three scanning detection modes: space, time and time-space. The results were visualized with ArcMap. From 2009 to 2019, a total of 932 cases of advanced schistosomiasis were reported in Poyang County, and the annual occurrence rate showed a downward trend each year. Most cases appeared in 2010-2013. The occurrence rate of advanced schistosomiasis cases in the epidemic control stage was significantly higher than that in the transmission control stage (F=9.617, P=0.013). Simple spatial scanning revealed two clustered areas of category I, which appeared in the epidemic control stage, and four clustered areas of category II, which appeared in the transmission control stage. Simple time scanning showed that advanced schistosomiasis cases were concentrated in 2012-2013 (RR=64.44, P=0.001) at the epidemic control stage and in 2018 (RR=11.23, P=0.001) at the transmission control stage. Time-space scanning showed a total of two category I high-risk areas and one category II high-risk area in 2009-2019, all of which were distributed along Poyang Lake. No category I high-risk area was found in the transmission control stage. With the control of the epidemic, the number of advanced schistosomiasis cases also decreased gradually, but several high-risk areas remained in the spatial distribution. For those areas, screening and treatment measures for advanced cases should be further strengthened.