基于核密度和地理探测器的南宁市手足口病空间聚集及影响因素

  目的  分析2008-2015年南宁市手足口病(hand, foot and mouth disease, HFMD)空间聚集及影响因素，为南宁市防控HFMD提供参考。  方法  收集南宁市2008-2015年HFMD疫情数据，通过核密度方法分析空间聚集，通过地理探测器分析气象因素与社会经济因素对发病的影响。  结果  2008-2015年南宁市累计报告HFMD 326 785例，年均发病率为505.24/10万，发病高峰主要集中在4-7月。核密度分析显示HFMD存在明显的空间聚集，其中8年均出现聚集的地区是兴宁区、青秀区、江南区、良庆区和西乡塘区五个区的交界处及马山县的部分地区；地理探测器分析发现气象因素的影响大于社会经济因素的影响，且因素间的交互作用大于它们的单独作用。气温和相对湿度的单独作用及交互作用均是最强的，交互作用最大q值可达0.71(P＜0.001)。  结论  2008-2015年南宁市HFMD受气象因素影响较大，社会经济因素的影响可能存在双向作用，中心城区和部分基层地区是防控的关注点。

Analysis of spatial clustering and influencing factors of hand,foot, and mouth disease in Nanning based on Nuclear Density and Geodetector

  Objective  To analyze the spatial clustering and influencing factors of hand, foot and mouth disease (HFMD) in Nanning during the period from 2008 to 2015, so as to provide reference for HFMD prevention and control in Nanning.  Methods  The information about HFMD in Nanning from 2008 to 2015 was collected, spatial clustering was analyzed by nuclear density, and the effects of meteorological factors and socioeconomic factors on HFMD incidence was analyzed by Geodetector.  Results  A total of 326 785 HFMD cases were reported from 2008 to 2015 in Nanning. The average annual incidence was 505.24/100 000 with the peak incidence concentrating from April to July. The nuclear density analysis showed that there was obvious spatial clustering of HFMD. The areas of clustering in all eight years were the junction of five districts: Xingning District, Qingxiu District, Jiangnan District, Liangqing District and Xixiangtang District, and the parts of Mashan County. The Geodetector analysis revealed that meteorological factors had stronger impact on HFMD than socioeconomic factors, and the interactive effects between factors were stronger than their individual effects. Both the individual and interactive effects of temperature and relative humidity were the strongest, with interactions up to a maximum q value of 0.71 (P < 0.001).  Conclusions  The meteorological factors could have stronger effects on the HFMD incidence in Nanning from 2008 to 2015, the effects of socioeconomic factors may be bi-directional, urban areas and some grassroots areas should be concerned for prevention and control.