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基于贝叶斯中断时间序列模型的中国血吸虫病报告病例时空特征

[Spatial and temporal characteristics of reported schistosomiasis cases in China based on a Bayesian interrupted time-series model].

作者信息

Wen C C, Zhao T T, Hu W H, Cao W R, Lai Y S

机构信息

Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou 510000, China.

出版信息

Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi. 2021 Jan 12;33(1):15-21. doi: 10.16250/j.32.1374.2020241.

Abstract

OBJECTIVE

To investigate the spatial-temporal characteristics of reported schistosomiasis cases in China from 2004 to 2017, so as to provide insights into the development of different schistosomiasis control strategies at various stages.

METHODS

The monthly data of reported schistosomiasis cases at a provincial level of China from 2004 to 2017 were collected from the Public Health Science Data Center, and the spatial-temporal distribution of reported schistosomiasis cases was preliminarily identified using a descriptive statistical method. According to the goals at different stages proposed by , a Bayesian interrupted time-series model was established to analyze the provincial reported incidence, time trend and seasonal variations of schistosomiasis in China at different stages.

RESULTS

The reported schistosomiasis cases were mainly concentrated in 5 provinces of Anhui, Jiangsu, Jiangxi, Hubei and Hunan and 2 provinces of Sichuan and Yunnan in China from 2004 to 2017, and the number of reported cases in endemic areas decreased gradually. The incidence of reported schistosomiasis cases predominantly peaked during the period from May to September in the marshland and lake regions, while no regular seasonality was seen in hilly regions. Bayesian interrupted time-series analysis showed the peak incidence of reported schistosomiasis cases in 4 provinces of Anhui, Hubei, Hunan and Jiangxi between May and September and in Jiangsu Province from July to November; however, no regular seasonal cycle was identified in hilly regions. The number of reported schistosomiasis cases showed a tendency towards an increase in 2 provinces of Hubei and Hunan from 2008 to 2014, with a minor peak during the period between March and April, and since 2015, the seasonality was not remarkable any longer in 3 provinces of Anhui, Jiangsu and Jiangxi with a decline in the incidence of reported schistosomiasis cases, while the seasonality remained in Hubei Province.

CONCLUSIONS

The spatial-temporal characteristics of schistosomiasis in China, notably seasonality, vary at different control stages. Bayesian interrupted time-series model is effective to identify the spatial-temporal changes of schistosomiasis, and the schistosomiasis control strategy may be adjusted according to the spatial-temporal changes to improve the schistosomiasis control efficiency.

摘要

目的

探讨2004年至2017年中国血吸虫病报告病例的时空特征,为不同阶段血吸虫病防治策略的制定提供参考。

方法

收集2004年至2017年中国省级血吸虫病报告病例的月度数据,来源于公共卫生科学数据中心,采用描述性统计方法初步分析报告病例的时空分布。根据相关研究提出的不同阶段目标,建立贝叶斯中断时间序列模型,分析中国不同阶段血吸虫病省级报告发病率、时间趋势和季节变化。

结果

2004年至2017年中国血吸虫病报告病例主要集中在安徽、江苏、江西、湖北、湖南5省以及四川和云南2省,流行区报告病例数逐渐减少。在沼泽地和湖区,报告病例发病率主要在5月至9月达到高峰,而在丘陵地区未见明显季节性规律。贝叶斯中断时间序列分析显示,安徽、湖北、湖南和江西4省报告病例发病率高峰在5月至9月,江苏省在7月至11月;然而,丘陵地区未发现规律的季节性周期。2008年至2014年,湖北和湖南2省报告病例数呈上升趋势,3月至4月出现一个小高峰,自2015年以来,安徽、江苏和江西3省报告病例发病率下降,季节性不再明显,而湖北省仍存在季节性。

结论

中国血吸虫病的时空特征,尤其是季节性特征,在不同防治阶段有所不同。贝叶斯中断时间序列模型可有效识别血吸虫病的时空变化,可根据时空变化调整血吸虫病防治策略,提高防治效率。

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