Lin Hualiang, Liu Qiyong, Guo Junqiao, Zhang Jibo, Wang Jinfeng, Chen Huaxin
National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
BMC Public Health. 2007 Aug 15;7:207. doi: 10.1186/1471-2458-7-207.
Hemorrhagic fever with renal syndrome (HFRS) is endemic in Liaoning Province, China, and this province was the most serious area affected by HFRS during 2004 to 2005. In this study, we conducted a spatial analysis of HFRS cases with the objective to determine the distribution of HFRS cases and to identify key areas for future public health planning and resource allocation in Liaoning Province.
The annual average incidence at the county level was calculated using HFRS cases reported between 2000 and 2005 in Liaoning Province. GIS-based spatial analyses were conducted to detect spatial distribution and clustering of HFRS incidence at the county level, and the difference of relative humidity and forestation between the cluster areas and non-cluster areas was analyzed.
Spatial distribution of HFRS cases in Liaoning Province from 2000 to 2005 was mapped at the county level to show crude incidence, excess hazard, and spatial smoothed incidence. Spatial cluster analysis suggested 16 and 41 counties were at increased risk for HFRS (p < 0.01) with the maximum spatial cluster sizes at < or = 50% and < or = 30% of the total population, respectively, and the analysis showed relative humidity and forestation in the cluster areas were significantly higher than in other areas.
Some clustering of HFRS cases in Liaoning Province may be etiologically linked. There was strong evidence some HFRS cases in Liaoning Province formed clusters, but the mechanism underlying it remains unknown. In this study we found the clustering was consistent with the relative humidity and amount of forestation, and showed data indicating there may be some significant relationships.
肾综合征出血热（HFRS）在中国辽宁省呈地方性流行，该省在2004年至2005年期间是受HFRS影响最严重的地区。在本研究中，我们对HFRS病例进行了空间分析，目的是确定HFRS病例的分布情况，并确定辽宁省未来公共卫生规划和资源分配的关键区域。
利用辽宁省2000年至2005年报告的HFRS病例计算县级年平均发病率。进行基于地理信息系统（GIS）的空间分析，以检测县级HFRS发病率的空间分布和聚集情况，并分析聚集区和非聚集区之间相对湿度和森林覆盖率的差异。
绘制了2000年至2005年辽宁省HFRS病例的县级空间分布图，以显示粗发病率、超额危险度和空间平滑发病率。空间聚集分析表明，16个和41个县的HFRS发病风险增加（p<0.01），最大空间聚集规模分别占总人口的≤50%和≤30%，分析显示聚集区的相对湿度和森林覆盖率显著高于其他地区。
辽宁省HFRS病例的一些聚集现象可能存在病因学联系。有强有力的证据表明辽宁省的一些HFRS病例形成了聚集，但其潜在机制尚不清楚。在本研究中，我们发现这种聚集与相对湿度和森林覆盖量一致，并显示出可能存在一些显著关系的数据。
