中国梅毒发病率的时空分布特征分析

doi:10.3969/j.issn.1674-8115.2021.05.015

摘要/Abstract

摘要：

目的·了解2017年中国内地31个省、直辖市、自治区梅毒流行的时空分布。方法·由中国公共卫生科学数据中心获取2017年中国内地31个省、直辖市、自治区梅毒的发病数据，描述发病率的时间变化特征。采用全局莫兰指数和安瑟伦局部莫兰指数来分析梅毒病例的空间聚集特征，采用基于泊松分布模型的时空扫描分析探索其时空分布特征。结果·2017年中国内地31个省、直辖市、自治区梅毒总发病数为475 860例，年发病率为34.49/10万，其中隐性梅毒占比最大，达到76.78%（365 353/475 860），8月份发病率最高。从空间分布上看，梅毒发病率最高的省级单位为新疆维吾尔自治区，达91.80/10万。隐性、二期、三期、胎传梅毒均呈现空间正自相关（均P<0.05）。上海市、江苏省、浙江省表现为二期、三期梅毒高-高聚集（均P<0.05），而新疆维吾尔自治区、西藏自治区则表现为胎传梅毒高-高聚集（P=0.000）。时空扫描分析发现4月至9月，福建省、江西省、浙江省、上海市、江苏省、湖南省、安徽省和广东省是梅毒发病主聚集区域（P=0.000），此聚集区内梅毒发病风险是聚集区外的1.59倍。结论·中国内地梅毒发病率较高；各省、直辖市、自治区重点防控的梅毒类型和时段存在差异，其中4月至9月，福建省、江西省、浙江省、上海市、江苏省、湖南省、安徽省和广东省是中国内地梅毒防控的重点区域。

关键词: 梅毒, 时空分析, 疾病监测

Abstract:

Objective·To get the spatio-temporal distribution of the syphilis epidemic in 31 provinces, municipalities directly under the Central Government and autonomous regions of the mainland of China in 2017.

Methods·The data of syphilis incidence in 31 provinces, municipalities and autonomous regions of the mainland of China in 2017 were obtained from the China Public Health Science Data Center, and the time distrbution characteristics of the incidence rates were described. The global Moran′s I index and Anselin local Moran′s I index were used to analyze the spatial cluster characteristics of the syphilis cases, and then space-time scan analysis based on Poisson distribution was used to explore the spatio-temporal distribution characteristics.

Results·In 2017, the number of syphilis cases in the 31 provinces, municipalities, and autonomous regions of the mainland of China was 475 860, and the incidence rate was 34.49/100 000. Latent syphilis accounted for most of the cases, reaching 76.78% (365 353/475 860). August had the highest incidence rate. For the spatial distribution, Xinjiang Uygur Autonomous Region was the provincial-level unit with the highest incidence rate of syphilis, reaching 91.80/100 000. The incidence rates of latent, secondary, tertiary, and congenital syphilis appeared with positive spatial autocorrelation (all P<0.05). The high-high clusters of secondary and tertiary syphilis appeared in Shanghai, Jiangsu, and Zhejiang (all P<0.05), respectively, while the high-high clusters of congenital syphilis appeared in Xinjiang and Tibet (P=0.000). The results of space-time scan analysis showed that the main cluster appeared from April to September in Fujian, Jiangxi, Zhejiang, Shanghai, Jiangsu, Hunan, Anhui, and Guangdong (P=0.000). Compared with the outside area, the relative risk of syphilis in this cluster was 1.59 times.

Conclusion·The incidence rate of syphilis in China is relatively high. There are differences in the types and periods of syphilis prevention and control among provinces, municipalities and autonomous regions. From April to September, Fujian, Jiangxi, Zhejiang, Shanghai, Jiangsu, Hunan, Anhui and Guangdong are the key areas for syphilis prevention and control in the mainland of China.

Key words: syphilis, spatio-temporal analysis, disease surveillance

中图分类号:

R188.2/.7

田婷婷, 侯雅宣, 李雨晴, 祁鸿姣, 陈默, 吕美霞. 中国梅毒发病率的时空分布特征分析[J]. 上海交通大学学报(医学版), 2021, 41(5): 648-652.

Ting-ting TIAN, Ya-xuan HOU, Yu-qing LI, Hong-jiao QI, Mo CHEN, Mei-xia LÜ. Spatio-temporal analysis of incidence rate of syphilis in China[J]. JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE), 2021, 41(5): 648-652.

图/表 4

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Syphilis	Moran's I	Z value	P value	High-high cluster	High-low cluster	Low-high cluster	Low-low cluster
All	0.10	1.56	0.119	?	?	?	Jilin, Hebei, Tianjin, Shandong
Latent	0.19	2.55	0.011	?	?	Guangxi	Jilin, Hebei, Tianjin, Shandong
Primary	0.06	1.29	0.195	?	?	?	?
Secondary	0.24	3.33	0.000	Shanghai, Jiangsu, Zhejiang	?	?	Guizhou
Tertiary	0.23	3.24	0.001	Shanghai, Jiangsu, Zhejiang, Fujian	?	?	?
Congenital	0.37	4.78	0.000	Xinjiang, Tibet	Guizhou	?	?

Syphilis	Moran's I	Z value	P value	High-high cluster	High-low cluster	Low-high cluster	Low-low cluster
All	0.10	1.56	0.119	?	?	?	Jilin, Hebei, Tianjin, Shandong
Latent	0.19	2.55	0.011	?	?	Guangxi	Jilin, Hebei, Tianjin, Shandong
Primary	0.06	1.29	0.195	?	?	?	?
Secondary	0.24	3.33	0.000	Shanghai, Jiangsu, Zhejiang	?	?	Guizhou
Tertiary	0.23	3.24	0.001	Shanghai, Jiangsu, Zhejiang, Fujian	?	?	?
Congenital	0.37	4.78	0.000	Xinjiang, Tibet	Guizhou	?	?

Syphilis	Period	Cluster	LLR	RR	P value
All	April to September	Fujian, Jiangxi, Zhejiang, Shanghai, Jiangsu, Hunan, Anhui, Guangdong	9 010.19	1.59	0.000
	July to December	Qinghai, Xinjiang	4 337.68	2.58	0.000
	May to October	Chongqing	1 843.08	1.96	0.000
	January to June	Ningxia	227.91	1.69	0.000
	August to December	Inner Mongolia	147.79	1.30	0.000
	February to July	Liaoning	96.29	1.17	0.000
Latent	May to October	Guangdong, Hainan, Guangxi, Hunan, Jiangxi, Fujian, Guizhou, Hubei, Chongqing, Anhui, Zhejiang, Yunnan	9 333.80	1.65	0.000
	July to December	Qinghai, Xinjiang	3 045.23	2.50	0.000
	January to June	Ningxia	268.81	1.88	0.000
	August to December	Inner Mongolia	11.12	1.09	0.008
Primary	February to July	Qinghai, Xinjiang	2 349.54	5.02	0.000
	May to October	Zhejiang, Shanghai, Jiangsu, Anhui	954.78	1.77	0.000
	March to August	Heilongjiang, Jilin, Liaoning	324.13	1.60	0.000
	June to November	Inner Mongolia	319.40	2.31	0.000
Secondary	March to August	Zhejiang, Shanghai, Jiangsu, Anhui	2 460.80	2.54	0.000
	March to August	Xinjiang	13.26	1.27	0.001
	May to September	Chongqing	12.35	1.25	0.002
Tertiary	February to July	Shanghai, Jiangsu, Jiangxi, Anhui, Fujian, Zhejiang	215.38	2.57	0.000
Congenital	May to October	Chongqing, Sichuan, Guizhou, Shaanxi	158.66	2.43	0.000
	April to September	Fujian	41.51	2.51	0.000
	February to July	Inner Mongolia, Shanxi	38.92	2.13	0.000

Syphilis	Period	Cluster	LLR	RR	P value
All	April to September	Fujian, Jiangxi, Zhejiang, Shanghai, Jiangsu, Hunan, Anhui, Guangdong	9 010.19	1.59	0.000
	July to December	Qinghai, Xinjiang	4 337.68	2.58	0.000
	May to October	Chongqing	1 843.08	1.96	0.000
	January to June	Ningxia	227.91	1.69	0.000
	August to December	Inner Mongolia	147.79	1.30	0.000
	February to July	Liaoning	96.29	1.17	0.000
Latent	May to October	Guangdong, Hainan, Guangxi, Hunan, Jiangxi, Fujian, Guizhou, Hubei, Chongqing, Anhui, Zhejiang, Yunnan	9 333.80	1.65	0.000
	July to December	Qinghai, Xinjiang	3 045.23	2.50	0.000
	January to June	Ningxia	268.81	1.88	0.000
	August to December	Inner Mongolia	11.12	1.09	0.008
Primary	February to July	Qinghai, Xinjiang	2 349.54	5.02	0.000
	May to October	Zhejiang, Shanghai, Jiangsu, Anhui	954.78	1.77	0.000
	March to August	Heilongjiang, Jilin, Liaoning	324.13	1.60	0.000
	June to November	Inner Mongolia	319.40	2.31	0.000
Secondary	March to August	Zhejiang, Shanghai, Jiangsu, Anhui	2 460.80	2.54	0.000
	March to August	Xinjiang	13.26	1.27	0.001
	May to September	Chongqing	12.35	1.25	0.002
Tertiary	February to July	Shanghai, Jiangsu, Jiangxi, Anhui, Fujian, Zhejiang	215.38	2.57	0.000
Congenital	May to October	Chongqing, Sichuan, Guizhou, Shaanxi	158.66	2.43	0.000
	April to September	Fujian	41.51	2.51	0.000
	February to July	Inner Mongolia, Shanxi	38.92	2.13	0.000

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