Li T, He J G, Yang C H, Li J, Xiao Y, Li Y K, Chen C, Wu J L
Sichuan Provincial Center for Disease Control and Prevention, Chengdu 610041, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2020 Feb 10;41(2):207-212. doi: 10.3760/cma.j.issn.0254-6450.2020.02.013.
To detect the spatial clustering and high risk areas of pulmonary tuberculosis (PTB) in Sichuan province in 2018 and, to compare the effects of application on both SaTScan 9.4.1 software and FleXScan 3.1.2 software to detect the PTB spatial clusters. Geographic information database was established by using the incidence data of PTB and demographic data reported in the 'China disease prevention of infectious disease reporting information management system' in Sichuan province in 2018. Spatial clustering analysis was conducted using the Poisson model in software SaTScan 9.4.1 and FleXScan 3.1.2 to detect the high risk areas of PTB by software ArcGIS 10.5. Differences of clusters locations and scopes in the two scanning methods were compared. The reported incidence rate of PTB was 57.34/100 000 (47 601 cases) in Sichuan province in 2018, presenting an obvious clustering distribution. SaTScan and FleXScan scanned 8 and 10 clusters showed statistically significant differences (<0.05), with log-likelihood ratio () as 24.62-2 416.05 and 1.48-2 618.96, respectively. Results from scanning of the two methods showed that the most likely clusters appeared in the Daliangshan and Xiaoliangshan of Liangshan Yi ethnic aggregation areas. The other clustering areas would include some minority areas in the western Sichuan plateau, detected by both two methods differences in the shape and scope of the clustering were detected by both methods. The clustering scopes detected by SaTScan covered some counties, in which the actual incidence was not high. FleXScan could distinguish the clusters and detect more irregular shaped clusters. Obvious spatial clusters of PTB distribution were found in Sichuan in 2018. Areas of Daliangshan, Xiaoliangshan and the minority areas in Western Sichuan plateau appeared at high risk, suggesting these were the key areas for prevention and control. FleXScan seemed more conducive in accurately distinguishing the "cold spot" areas in the highly aggregated areas, and more suitable for the application of spatial clustering detection for TB, in Sichuan province.
检测2018年四川省肺结核（PTB）的空间聚集性及高风险区域，并比较应用SaTScan 9.4.1软件和FleXScan 3.1.2软件检测PTB空间聚集性的效果。利用四川省2018年“中国疾病预防控制信息系统”上报的PTB发病数据和人口学数据建立地理信息数据库。在软件SaTScan 9.4.1和FleXScan 3.1.2中采用泊松模型进行空间聚集性分析，通过软件ArcGIS 10.5检测PTB高风险区域。比较两种扫描方法中聚集区域位置和范围的差异。2018年四川省PTB报告发病率为57.34/10万（47601例），呈现明显的聚集性分布。SaTScan和FleXScan分别扫描出8个和10个聚集区域，差异有统计学意义（<0.05），对数似然比分别为24.62 - 2416.05和1.48 - 2618.96。两种方法扫描结果显示，最可能的聚集区域出现在凉山彝族聚居区的大凉山和小凉山。其他聚集区域包括川西高原的一些少数民族地区，两种方法均检测到聚集区域在形状和范围上存在差异。SaTScan检测到的聚集范围覆盖了一些实际发病率不高的县。FleXScan能够区分聚集区域并检测到更多形状不规则的聚集区域。2018年在四川发现了明显的PTB分布空间聚集现象。大凉山、小凉山及川西高原少数民族地区为高风险区域，提示这些是防控的重点地区。FleXScan似乎更有助于准确区分高度聚集区域中的“冷点”区域，更适合四川省结核病空间聚集性检测的应用。
