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中国湖北省 2011-2021 年肺结核的时空分析。

Spatial-temporal analysis of pulmonary tuberculosis in Hubei Province, China, 2011-2021.

机构信息

Department of Tuberculosis Control and Prevention, Hubei Provincial Center for Disease Control and Prevention, Wuhan, Hubei, China.

出版信息

PLoS One. 2023 Feb 7;18(2):e0281479. doi: 10.1371/journal.pone.0281479. eCollection 2023.

Abstract

BACKGROUND

Pulmonary tuberculosis (PTB) is an infectious disease of major public health problem, China is one of the PTB high burden counties in the word. Hubei is one of the provinces having the highest notification rate of tuberculosis in China. This study analyzed the temporal and spatial distribution characteristics of PTB in Hubei province for targeted intervention on TB epidemics.

METHODS

The data on PTB cases were extracted from the National Tuberculosis Information Management System correspond to population in 103 counties of Hubei Province from 2011 to 2021. The effect of PTB control was measured by variation trend of bacteriologically confirmed PTB notification rate and total PTB notification rate. Time series, spatial autonomic correlation and spatial-temporal scanning methods were used to identify the temporal trends and spatial patterns at county level of Hubei.

RESULTS

A total of 436,955 cases were included in this study. The total PTB notification rate decreased significantly from 81.66 per 100,000 population in 2011 to 52.25 per 100,000 population in 2021. The peak of PTB notification occurred in late spring and early summer annually. This disease was spatially clustering with Global Moran's I values ranged from 0.34 to 0.63 (P< 0.01). Local spatial autocorrelation analysis indicated that the hot spots are mainly distributed in the southwest and southeast of Hubei Province. Using the SaTScan 10.0.2 software, results from the staged spatial-temporal analysis identified sixteen clusters.

CONCLUSIONS

This study identified seasonal patterns and spatial-temporal clusters of PTB cases in Hubei province. High-risk areas in southwestern Hubei still exist, and need to focus on and take targeted control and prevention measures.

摘要

背景

肺结核(PTB)是一种具有重大公共卫生问题的传染病,中国是结核病高负担国家之一。湖北省是中国结核病报告发病率最高的省份之一。本研究分析了湖北省结核病的时空分布特征,以便对结核病疫情进行有针对性的干预。

方法

从国家结核病信息管理系统中提取了 2011 年至 2021 年对应湖北省 103 个县的肺结核病例数据。通过细菌学确诊肺结核报告发病率和总肺结核报告发病率的变化趋势来衡量结核病控制效果。采用时间序列、空间自相关和时空扫描方法,确定湖北省县级结核病的时间趋势和空间模式。

结果

本研究共纳入 436955 例病例。总肺结核报告发病率从 2011 年的 81.66/10 万下降到 2021 年的 52.25/10 万。肺结核报告发病率的高峰出现在每年的晚春和初夏。该疾病具有空间聚集性,全局 Moran's I 值范围为 0.34 至 0.63(P<0.01)。局部空间自相关分析表明,热点主要分布在湖北省西南部和东南部。使用 SaTScan 10.0.2 软件,分期时空分析结果确定了 16 个聚集区。

结论

本研究确定了湖北省肺结核病例的季节性模式和时空聚集特征。湖北省西南部的高风险地区仍然存在,需要重点关注并采取有针对性的控制和预防措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0198/9904469/a6bb68a9cf8e/pone.0281479.g001.jpg

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