School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, 710049, China.
Department of Public Policy, City University of Hong Kong, Hong Kong, 999077, China.
BMC Infect Dis. 2019 Sep 2;19(1):766. doi: 10.1186/s12879-019-4400-x.
Intestinal infectious diseases (IIDs) have caused numerous deaths worldwide, particularly among children. In China, eight IIDs are listed as notifiable infectious diseases, including cholera, poliomyelitis, dysentery, typhoid and paratyphoid (TAP), viral Hepatitis A, viral Hepatitis E, hand-foot-mouth disease (HFMD) and other infectious diarrhoeal diseases (OIDDs). The aim of the study is to analyse the spatio-temporal distribution of IIDs from 2006 to 2016.
Data on the incidence of IIDs from 2006 to 2016 were collected from the public health science data centre issued by the Chinese Center for Disease Control and Prevention. This study applied seasonal decomposition analysis, spatial autocorrelation analysis and space-time scan analysis. Plots and maps were constructed to visualize the spatio-temporal distribution of IIDs.
Regarding temporal analysis, the incidence of HFMD and Hepatitis E showed a distinct increasing trend, while the incidence of TAP, dysentery, and Hepatitis A presented decreasing trends over the last decade. The incidence of OIID remained steady. Summer is the season with the greatest number of cases of different IIDs. Regarding the spatial distribution, approximately all p values for the global Moran's I from 2006 to 2016 were less than 0.05, indicating that the incidences of the epidemics were unevenly distributed throughout the country. The high-risk areas for HFMD and OIDD were located in the Beijing-Tianjin-Tangshan (BTT) region and south China. The high-risk areas for TAP were located in some parts of southwest China. A higher incidence rates for dysentery and Hepatitis A were observed in the BTT region and some west provincial units. The high-risk areas for Hepatitis E were the BTT region and the Yangtze River Delta area.
Based on our temporal and spatial analysis of IIDs, we identified the high-risk periods and clusters of regions for the diseases. HFMD and OIDD exhibited high incidence rates, which reflected the negligence of Class C diseases by the government. At the same time, the incidence rate of Hepatitis E gradually surpassed Hepatitis A. The authorities should pay more attention to Class C diseases and Hepatitis E. Regardless of the various distribution patterns of IIDs, disease-specific, location-specific, and disease-combined interventions should be established.
肠道传染病（IIDs）在全球范围内已导致大量死亡，尤其是儿童。在中国，霍乱、脊髓灰质炎、痢疾、伤寒和副伤寒（TAP）、甲型病毒性肝炎、戊型病毒性肝炎、手足口病（HFMD）和其他感染性腹泻病（OIDDs）等 8 种 IIDs 被列为法定传染病。本研究旨在分析 2006 年至 2016 年 IIDs 的时空分布。
从中国疾病预防控制中心公共卫生科学数据中心收集 2006 年至 2016 年 IIDs 的发病率数据。本研究应用季节性分解分析、空间自相关分析和时空扫描分析。绘制图表和地图以可视化 IIDs 的时空分布。
关于时间分析，手足口病和戊型肝炎的发病率呈明显上升趋势，而 TAP、痢疾和甲型肝炎的发病率在过去十年呈下降趋势。OIDD 的发病率保持稳定。夏季是不同 IIDs 病例最多的季节。关于空间分布，2006 年至 2016 年全球 Moran's I 的所有 p 值均小于 0.05，表明全国疫情发病率分布不均。手足口病和 OIDD 的高风险地区位于京津唐（BTT）地区和华南地区。TAP 的高风险地区位于中国西南部的一些地区。痢疾和甲型肝炎的发病率较高的地区位于 BTT 地区和一些西部省份。戊型肝炎的高风险地区是 BTT 地区和长江三角洲地区。
基于我们对 IIDs 的时空分析，确定了疾病的高危期和区域聚集。手足口病和 OIDD 发病率高，反映了政府对 C 类疾病的忽视。同时，戊型肝炎的发病率逐渐超过了甲型肝炎。有关部门应更加重视 C 类疾病和戊型肝炎。无论 IIDs 的各种分布模式如何，都应制定针对特定疾病、特定地点和特定疾病的干预措施。
