2011—2019年不同时期荆州市一二期梅毒时空特征对比分析

目的 分析荆州市不同时期一二期梅毒的时空分布变化情况,为合理配置卫生资源提供参考。方法 收集2011—2019年荆州市一二期梅毒疫情资料,根据发病率高低,将荆州市一二期梅毒疫情分为2011—2013年（高）、2014—2016年（中）、2017—2019年（低）3个时期,采取趋势面、空间自相关和时空扫描分析3个时期一二期梅毒在时空上的变化趋势。结果 2011—2019年,荆州市累计报告一二期梅毒4 715例,年均发病率为9.19/10万,发病率呈下降趋势（P<0.01）。趋势面分析得出荆州市一二期梅毒的高发区域逐步从西北部（2011—2013年）向中部转移（2017—2019年）。全局空间自相关分析显示,荆州市一二期梅毒发病率在2011—2013年、2014—2016年呈正相关,且有空间聚集性（Moran’s I=0.333 6、0.210 5,均P<0.01）。局部空间自相关分析显示,一二期梅毒高值聚集区2011—2013年主要集中在公安县、荆州区、沙市区、江陵县的部分乡镇（P<0.05）,2014—2016年主要集中在荆州区、沙市区、监利县的部分乡镇（P<0.05）,2017—2019年主要集中在监利县、沙市区的部分乡镇（P<0.05）。时空扫描结果显示,主聚集区在公安县、江陵县,共24个乡镇（街道）,聚集时间为2011年4月11日至2011年8月15日（RR=4.14,LLR=93.55）。结论 3个时期荆州市一二期梅毒均存在空间聚集性,高发区域逐步缩小,2017—2019年监利县、沙市区的部分乡镇为疫情高发地区,应加强对该地区的防控工作。

Comparative analysis of temporal and spatial characteristics of primary and secondary syphilis in Jingzhou City,2011-2019

Objective To analyze the temporal and spatial distribution of primary and secondary(P&S)syphilis in different periods in Jingzhou City,so as to provide reference for rational allocation of health resources.Methods The data of P&S syphilis cases in Jingzhou City from 2011 to 2019 were collected.According to the incidence rate,the epidemic stages of P&S syphilis in Jingzhou City were divided into three periods:2011-2013(high),2014-2016(middle),2017-2019(low).The temporal and spatial trends of P&S syphilis were analyzed by trend surface analysis,spatial autocorrelation analysis and spatio-temporal scanning.Results From 2011 to 2019,4715 cases of P&S syphilis were reported in Jingzhou City,with an average annual incidence rate of 9.19/100,000,and the incidence rate was decreasing(P<0.01).Trend surface analysis showed that the high incidence area of P&S syphilis in Jingzhou City gradually shifted from Northwest(2011-2013)to Central(2017-2019).The global spatial autocorrelation analysis showed that the incidence rate of P&S syphilis in Jingzhou City was positively correlated in 2011-2013 and 2014-2016,and there was spatial clustering(Moran’s I=0.3336,0.2105,both P<0.01).Local spatial autocorrelation analysis showed that the P&S syphilis high-value clustering areas mainly concentrated in some towns of Gongan County,Jingzhou District,Shashi District and Jiangling County in 2011-2013(P<0.05),mainly concentrated in some towns of Jingzhou District,Shashi District and Jianli County in 2014-2016(P<0.05),and mainly concentrated in some towns of Jianli County and Shashi District in2017-2019(P<0.05).Spatio-temporal scanning showed that main clustering area was in Gongan County and Jiangling County,with a total of 24 townships(streets),the clustering time was from April 11,2011 to August 15,2011(RR=4.14,LLR=93.55).Conclusion During the three periods,there is spatial aggregation of P&S syphilis in Jingzhou City,and the high incidence area is gradually reduced.From 2017 to 2019,some towns in Jianli County and Shashi District are high incidence areas,and prevention and control of the area should be strengthened.