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2015—2023年安徽省腹泻症候群空间自相关与发病趋势分析

Spatial autocorrelation and incidence trend of diarrhoea syndrome in Anhui, 2015–2023

    摘要
  • 摘要:
    目的  对2015—2023年安徽省腹泻症候群进行分析，了解安徽省腹泻症候群的发病趋势及时空分布特征，为制定针对性的防控措施提供依据。
    方法  从中国疾病预防控制信息系统获取2015—2023年安徽省腹泻症候群数据，进行描述性分析。采用Joinpoint 5.0.2软件构建Joinpoint回归模型进行发病趋势分析。应用ArcMap 10.8软件探索2015—2023年安徽省各区（县）的腹泻症候群空间聚集性。并描述由沙门菌、副溶血弧菌、致泻性大肠埃希菌、志贺菌和诺如病毒等5种病原体所致腹泻症候群情况。
    结果  2015—2023年安徽省腹泻症候群发病共822 220例，发病率最高为2023年（196.43/10万），最低为2015年（52.14/10万），发病高峰集中在6—8月。 2015—2017 年发病率呈上升趋势年度变化百分比（APC）=58.08%，95%CI：31.47%～90.08%，P=0.002，2017—2023 年上升趋势减缓（APC=4.77%，95%CI：1.56%～8.09%，P=0.014）。安徽省各区（县）发病均存在空间聚集性（均Moran's I>0且Z>1.96），高-高聚集区集中在安徽省南部。致泻性大肠埃希菌阳性病例集中在皖北地区，志贺菌在除皖北地区外的其他地区几乎没有检出，诺如病毒和沙门菌在皖南地区检出较多，且在2019—2023 年成为优势病原体。
    结论  安徽省腹泻症候群有空间聚集性，且各病原体在不同地区分布差异较大，应采取有针对性的防控措施，控制疾病传播发展。

     

    Abstract:
    Objective To understand the spatiotemporal distribution and incidence trends of diarrhoea syndrome in Anhui province from 2015 to 2023, and provide evidence for development of targeted prevention and control measures.
    Methods The incidence data of diarrhoea syndrome in Anhui from 2015 to 2023 were collected from Chinese Information System for Disease Control and Prevention for the descriptive analyses on the incidence of diarrhoea syndrome. A Joinpoint regression model was constructed by using software Joinpoint 5.0.2 to analyze the incidence trend. ArcMap 10.8 was applied to explore the spatial clustering of diarrhoea syndrome in counties of Anhui from 2015 to 2023. Additionally, the status of diarrhoea syndrome caused by five pathogens, including Salmonella, Vibrio parahaemolyticus, diarrheagenic Escherichia coli, Shigella, and norovirus, was described.
    Results From 2015 to 2023, a total of 822 220 cases of diarrhoea syndrome were reported in Anhui, with the highest incidence rate in 2023 (196.43/100 000) and the lowest incidence rate in 2015 (52.14/100 000). The annual incidence peak usually occurred between June and August. The incidence rate exhibited a significant upward trend annual percent change (APC)=58.08%, 95% CI: 31.47%～90.08%, P=0.002 from 2015 to 2017, but a slow increase from 2017 to 2023 (APC=4.77%, 95% CI: 1.56%～8.09%, P=0.014). Spatial analysis revealed significant clustering of cases across all the counties in Anhui during the study period (Moran's I>0, Z-score >1.96), with high-high clustering areas distributing in southern Anhui. Diarrheagenic E. coli was predominantly detected in northern Anhui, whereas Shigella was rarely detected in other areas besides northern Anhui. Norovirus and Salmonella were more frequently detected in southern Anhui, which became the predominant pathogens during 2019−2023.
    Conclusion There was spatial clustering of diarrhoea syndrome incidence in Anhui, and the distribution of the pathogens varied greatly in different areas. Targeted prevention and control measures should be taken to control the spread of the disease.

     

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