2013－2022年山东省6～14岁学生水痘流行特征及时空聚集性

代炳芹; 郝凤; 张艺馨; 张吉玉; 王舒姿; 刘少楠; 孙源; 马吉祥; 孙成玺

doi:10.3784/jbjc.202403100176

2013－2022年山东省6～14岁学生水痘流行特征及时空聚集性

Epidemiological characteristics and spatiotemporal clustering of varicella in students aged 6−14 in Shandong, 2013−2022

摘要

摘要:
目的探讨2013—2022年山东省6～14岁学生水痘流行特征及时空聚集性，为合理制定防控策略提供参考依据。
方法通过中国疾病预防控制信息系统收集数据，运用Geoda 1.1.8软件对水痘发病率进行全局空间自相关和局部空间自相关分析，SaTScan 9.6软件对水痘发病数、人口数、地理经纬度进行时空扫描分析，ArcGis 10.7软件绘制地图并对病例时空分布进行可视化展示。
结果 2013—2022年山东省共报告6～14岁学生水痘病例70 328例，年均发病率为66.72/10万，男女性别比为1.43∶1。 11月至次年1月高发，占报告病例总数的40.56%（28 523/70 328）。全局空间自相关分析结果显示，各年度莫兰指数（Moran's I）介于0.21～0.49（P＜0.05），提示存在空间聚集性。局部空间自相关结果显示，“高–高”聚集区主要分布在济南市、青岛市、枣庄市及济宁市的部分地区。时空扫描分析发现一类聚集区以枣庄市滕州市为中心，聚集时间为2015年1月至2019年12月，覆盖枣庄市、济宁市的9个省际交界及其周边县（市、区）［相对危险度（RR）＝3.86，对数似然比（LLR）＝4 497.44，Ｐ＜0.05］；二类聚集区分布在济南市、青岛市的主城区及东营市、滨州市的部分地区。
结论 2013—2022年山东省6～14岁学生水痘冬季高发，聚集区域集中在省际交界县（市、区）及大型城市的主城区，应加强对重点地区的监测、防控工作。

Abstract:
Objective To analyze the epidemiological characteristics and spatiotemporal clustering of varicella in students aged 6−14 years in Shandong province from 2013 to 2022, and provide reference for the effective prevention and control of varicella.
Methods The incidence data of varicella in students aged 6−14 years in Shandong during this period were collected from the Chinese Disease Prevention and Control Information System, software Geoda1.1.8 was used for global spatial autocorrelation and local spatial autocorrelation analysis on varicella incidence, and software SaTScan 9.6 was used for spatiotemporal scanning analysis on varicella case count, population size, and geographical latitude and longitude, and ArcGis 10.7 software was used to map and visually display the spatiotemporal distribution of cases.
Results A total of 70 328 cases of varicella were reported in students aged 6−14 years in Shandong from 2013 to 2022, with an average annual incidence of 66.72/100 000. The male to female ratio of the cases was 1.43∶1, the incidence peak was during November - January, with reported cases accounting for 40.56% (28 523/70 328).The results of global spatial autocorrelation analysis showed that the Moran's I index of each year ranged from 0.21 to 0.49 (P<0.05), indicating the existence of spatial clustering. The results of local spatial autocorrelation showed that the “high-high” clustering areas were mainly distributed in parts of Jinan, Qingdao, Zaozhuang and Jining. Spatiotemporal scanning analysis showed that the first class clustering areas were mainly distributed in Tengzhou, covering 9 inter-provincial border areas and the surrounding counties of Zaozhuang and Jining, from January 2015 to December 2019 (relative risk=3.86, log likelihood ratio=4497.44, P<0.05) .The second class clustering areas were distributed in the urban areas of Jinan and Qingdao and part areas of Dongying and Binzhou.
Conclusion From 2013 to 2022, the incidence of varicella was high in students aged 6 to 14 years in winter in Shandong, and the clustering areas were mainly distributed in the counties bordering other provinces and the urban areas of large cities. It is necessary to strengthen the varicella surveillance and prevention in key areas.

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