Analysis on spatial temporal epidemiological characteristics of hand, foot and mouth disease at township level in Jingzhou, Hubei, 2015-2017
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摘要: 目的 调查2015－2017年湖北省荆州市基于乡镇尺度上的手足口病时空聚集性，为手足口病的精准防控提供科学依据。方法 采用集中度值法分析手足口病的季节特征。基于乡镇尺度上，采用SaTScan 9.4.2软件对2015－2017年荆州市手足口病的报告发病率进行时空聚集性探测，比较以不同风险人口数为最大空间扫描窗口的探测效果，选择最优空间扫描窗口。采用Mapinfo 7.0 （试用版）软件对结果进行可视化呈现。结果 2015－2016年荆州市手足口病发病有一定季节性，2017年无季节性。以20%风险人口数为最大扫描窗口的扫描效果最优，时空扫描共探测到5个聚集区，其中一级聚集区以公安县孟家溪镇为中心，辖21个乡镇，聚集时间为2016年4月17日至5月16日（LLR=815.19，RR=7.24，P=0.000）。二级聚集区聚集时间为4－7月，涉及荆州区、沙市区、监利县和洪湖市。结论 荆州市手足口病存在时空聚集性，应以其为指导确定手足口病的重点防控区域，优化卫生资源配置。Abstract: Objective To study the spatial temporal clusters of hand foot and mouse disease (HFMD) at the township level in Jingzhou of Hubei province during 2015-2017,and provide evidence for the prevention and control of HFMD. Methods The muster distribution method was used to analyze the seasonal characteristics of HFMD. Software SaTScan 9.4.2 was used to detect the spatiotemporal clusters of HFMD at township level in Jingzhou during 2015-2017. The detection effects with different population size as biggest scan windows were compared to select the best scan window. The results were visualized with software SaTScan 7.0. Results HFMD had certain seasonality in Jingzhou during 2015-2016,but had no seasonality in 2017. Taking 20% of the population as the maximum spatial cluster size was the best mode. Five HFMD clusters were identified by the best model. The first level cluster was in Mengjiaxi town and its surrounding area,including 21 towns,from April 17,2016 to May 16,2016 (LLR=815.19, RR=7.24, P=0.000). The other clusters were distributed in Jingzhou,Shashi,Honghu and Jianli counties (district)from April to July 2016. Conclusion The incidence of HFMD had obvious a spatiotemporal distribution. It is necessary to conduct targeted HFMD prevention and control in key areas and allocate health resources reasonably.
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