基于SKATER聚类算法设计血吸虫病监测点的探索性研究

目的 探索建立血吸虫病监测点选点方法，提高疫情监测效率与质量。方法 采用基于最小生成树的SKATER聚类算法对安徽省31个历史血吸虫病流行县（区）进行空间约束聚类，从每个聚类中确定1个监测点，评估聚类监测点网络对安徽省血吸虫病疫情的代表性和监测效果，并比较其与当地国家血吸虫病监测点网络监测效果的优劣。结果 聚类监测点与聚类区域的环境因素无显著差异，同质性较高。在选择同样个数的监测点时，聚类监测点与国家血吸虫病监测点在整个地区血吸虫病疫情的平均水平和长期趋势的监测上无显著差异；但在未监测地区的疫情预测和估计上，聚类监测点的效果明显优于国家监测点。结论 基于SKATER聚类算法的血吸虫病监测点选择方法能够更好地代表整个地区的疫情水平，可作为传统监测点选择方法的有效补充。

Design of schistosomiasis surveillance sites based on Spatial Kluster Analysis by Tree Edge Removal (SKATER) method: an exploratory study

Objective　To develop a method for designing schistosomiasis surveillance sites, so as to improve the efficiency and quality of schitsosomiasis surveillance. Methods　By using the minimum spanning tree?based Spatial Kluster Analysis by Tree Edge Removal (SKATER) method, spatially constrained clustering was performed upon 31 historical schistosomiasis?endemic counties (districts) in Anhui Province. A surveillance site was selected from each cluster to evaluate the representativeness and surveillance efficiency of these cluster?based surveillance sites for the endemic situation of schistosomiassi in Anhui Province, and to compare the surveillance efficiency with local national schistosomiasis surveillance sites. Results　There was no significant difference in the environmental factors between the cluster?based schistosomiasis surveillance sites and the whole region, showing a high homogeneity. If the same number of schistosomiasis surveillance sites was selected, there was no significant difference between the cluster?based surveillance sites and national schistosomiasis surveillance sites in the efficiency of the mean risk and long?term trend of schistosomiasis surveillance in Anhui Province; however, the cluster?based surveillance sites were superior to the national schistosomiasis surveillance sites for the prediction and estimation of the endemic situation of schistosomiasis in the unmonitored areas. Conclusion　The SKATER?based selection of schistosomiasis surveillance sites may better represent the endemic situation of schistosomiasis in Anhui Province, which may serve as an effective supplement for the conventional method of selecting schistosomiasis surveillance sites.