Institute for Global Health & Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
University of North Carolina Project-China, Guangzhou, Guangdong, China.
Sci Rep. 2018 Jun 14;8(1):9090. doi: 10.1038/s41598-018-27173-y.
There was a varied spatial distribution of reported syphilis cases across cities in South China. This study aims to identify and describe spatiotemporal clusters of primary and secondary syphilis (P/S) cases in this region. Reported syphilis cases in Guangdong Province, China, from January 2014 to June 2015 were collected from the national centralized reporting system. Spatiotemporal clusters of P/S were identified and cross-validated by calculating local Moran's I, performing hotspot analysis (Getis-Ord Gi*), and constructing a discrete Poisson model in SaTScan. Reported cases within and outside the clusters were compared by bivariable and multivariable logistic regression. Out of 17,691 reported P/S cases, 11% were in the identified spatiotemporal clusters. The monthly P/S notification rate (per 100,000 persons) ranged between 0.6 and 1. The identified clusters were located in 14, out of 126, counties in eight, out of 21, cities. Cases of older age, living in rural area and taking self-initiated syphilis test were more likely to be in the clusters. Some areas bore a greater burden of P/S in Guangdong Province. Routine spatiotemporal analysis of P/S cases may be useful for enhancing syphilis control programs by strategic location-based service planning.
中国南方城市的梅毒报告病例存在多样的空间分布。本研究旨在确定和描述该地区原发性和继发性梅毒（P/S）病例的时空聚集。从 2014 年 1 月至 2015 年 6 月，从国家集中报告系统中收集了中国广东省的梅毒报告病例。通过计算局部 Moran's I、进行热点分析（Getis-Ord Gi*）以及在 SaTScan 中构建离散泊松模型，确定并交叉验证了 P/S 的时空聚集。通过双变量和多变量逻辑回归比较了聚集内和聚集外的报告病例。在 17691 例报告的 P/S 病例中，11% 位于确定的时空聚集内。每月 P/S 通知率（每 10 万人）在 0.6 到 1 之间。确定的聚集位于 21 个城市中的 8 个、126 个县中的 14 个。年龄较大、居住在农村地区和主动进行梅毒检测的病例更有可能处于聚集状态。广东省的一些地区 P/S 负担较重。对 P/S 病例进行常规时空分析可能有助于通过基于地理位置的服务规划来加强梅毒控制项目。
