Shenzhen Center for Chronic Disease Control and Prevention, No.2021, Buxin Road, Luohu District, Shenzhen, Guangdong, China.
Sex Transm Infect. 2012 Aug;88(5):325-9. doi: 10.1136/sextrans-2011-050397. Epub 2012 Feb 29.
The present study investigates the varied spatial distribution of syphilis cases in Shenzhen, China, and explores the individual-, neighbourhood- and district-level factors affecting the distribution.
This study uses spatial analysis and multi-level generalised estimating equations to explore the spatial distribution of reported syphilis cases among individuals in Shenzhen, Guangdong Province, China. The spatial distribution of primary/secondary and latent cases was investigated using the Moran's I-statistic. Primary/secondary syphilis cases were compared with all syphilis cases using a three-level model with individual (n=6496), neighbourhood (n=55) and district (n=6) levels.
A total of 6496 syphilis cases were reported in 2009 with 35.8% primary and secondary syphilis cases. Both primary/secondary syphilis cases (Moran's I value=0.33, p<0.01) and latent syphilis cases (Moran's I value=0.19, p<0.01) showed significant spatial clustering at the neighbourhood level. Adjusting for the number of reporting hospitals, the best model found that the following characteristics were associated with primary/secondary syphilis infection: individuals who are younger in age (p=0.003), male (p<0.001), migrant labourers (p=0.047) and those who live in districts with a higher gross domestic product (p<0.001).
There is substantial clustering of primary and secondary syphilis cases at the neighbourhood level in Shenzhen, suggesting the need for greater STD health service provision in these clustered neighbourhoods. Spatially targeted syphilis control measures may be useful to optimise testing, treatment and partner services.
本研究调查了中国深圳梅毒病例的空间分布差异，并探讨了影响其分布的个体、社区和区级因素。
本研究采用空间分析和多水平广义估计方程，探讨了中国广东省深圳市报告梅毒病例的个体空间分布。采用 Moran's I 统计量调查了原发性/二期和潜伏性梅毒病例的空间分布。使用个体（n=6496）、社区（n=55）和区（n=6）三个水平的三级模型，将原发性/二期梅毒病例与所有梅毒病例进行比较。
2009 年共报告了 6496 例梅毒病例，其中 35.8%为原发性/二期梅毒病例。原发性/二期梅毒病例（Moran's I 值=0.33，p<0.01）和潜伏性梅毒病例（Moran's I 值=0.19，p<0.01）在社区水平均存在显著的空间聚集。在调整报告医院数量后，最佳模型发现以下特征与原发性/二期梅毒感染相关：年龄较小的个体（p=0.003）、男性（p<0.001）、外来务工人员（p=0.047）和国内生产总值较高的区的个体（p<0.001）。
深圳原发性和二期梅毒病例在社区层面存在显著聚集，表明需要在这些聚集的社区提供更多的性传播疾病健康服务。针对空间的梅毒控制措施可能有助于优化检测、治疗和性伴侣服务。
