Prevalence and spatial-temporal clustering of typical notifiable intestinal infectious diseases in China, 2005 – 2015

  Objective  To analyze prevalence trends and spatial-temporal cluster features of typical notifiable intestinal infectious diseases (hepatitis A, dysentery, typhoid and paratyphoid) in China from 2005 through 2015 and to provide evidences for developing region-oriented prevention and control measures.

  Methods  We collected data on incidence rates of hepatitis A, dysentery, typhoid and paratyphoid for 31 provinces, municipalities and autonomous regions across China between 2005 and 2015 from China Health Statistical Yearbook and China Health and Family Planning Statistical Yearbook for trend analysis on the rates. Global and local spatial autocorrelation and maps were used to identify and visualize spatial-temporal clustering of the three notifiable intestinal infectious diseases′ incidence.

  Results  The incidence of hepatitis A, dysentery, and typhoid and paratyphoid decreased in all the regions during the 11-year period (P < 0.01 for all). Global spatial autocorrelation analysis revealed that positive spatial autocorrelation was the strongest for hepatitis A incidence but the autocorrelation tended to alleviate, with the Moran′s I value decreasing from 0.505 in 2005 to 0.445 in 2010 and 0.404 in 2015; while the correlation intensity was the lowest for typhoid and paratyphoid incidence, with the Moran′s I value decreasing from 0.236 in 2005 to 0.135 in 2010 first and then increasing to 0.222 in 2015; the correlation intensity of the incidence of dysentery increased during the period, with the Moran′s I value increasing from 0.367 in 2005 to 0.404 in 2010 and 0.443 in 2015. Local spatial autocorrelation analysis demonstrated that the incidence of hepatitis A was of a slightly fluctuating high-high cluster feature in Qinghai province and in Xinjiang Uygur Autonomous Region and Tibet Autonomous Region at all the time points; the incidence of dysentery presented a continuous high-high cluster feature in Beijing and Tianjin municipality, and in some regions of Hebei province. The high-high clustering of typhoid and paratyphoid incidence was identified mainly in Southwest China.

  Conclusion  The incidence of typical notifiable intestinal infectious diseases displayed a downward trend and the strongest spatial clustering for hepatitis A incidents in China from 2005 to 2015. Spatial-temporal clustering and its variation trend should be considered when developing targeted strategies for the prevention of intestinal infectious diseases.