中国2011 — 2015年甲乙类法定报告传染病发病趋势及空间关联性分析

张淼; 暴磊; 王迪; 李一平; 岳中正; 郝长付; 画宝勇; 姚武

doi:10.11847/zgggws1117576

中国2011 — 2015年甲乙类法定报告传染病发病趋势及空间关联性分析

Incidence trend and spatial correlation of class A and B notifiable infectious diseases in China: 2011 – 2015

摘要

摘要:
目的分析中国31个省、市、自治区甲乙类法定报告传染病发病流行趋势及空间关联情况，为传染病的预防控制提供科学依据。
方法收集2012年《中国卫生统计年鉴》和2013 — 2016年《中国卫生和计划生育统计年鉴》中甲乙类法定报告传染病的发病资料，应用趋势性χ²检验和地理信息系统空间统计分析功能对中国2011 — 2015年甲乙类法定报告传染病进行流行趋势、空间分布及关联性分析。
结果中国2011、2012、2013、2014、2015年甲乙类法定报告传染病发病率分别为241.44/10万、238.76/10万、225.80/10万、226.98/10万、223.60/10万，总体呈下降趋势（χ²_趋势 = 13 249.52，P < 0.05），在地域上呈西高东低趋势，全国多数地区呈平稳下降趋势，部分地区发病率呈现高低波动状态，其中山东、海南、重庆、安徽、云南、西藏和新疆的发病率均呈上升趋势（均P < 0.05）；全局空间自相关分析结果显示，中国2011、2012、2013、2014、2015年甲乙类法定报告传染病发病率的Moran's I值分别为0.092、0.086、0.106、0.124、0.155（均P < 0.05）；局部空间自相关分析结果显示，中国2011 — 2015年甲乙类法定报告传染病发病均存在“低 – 低”关联模式区域，且均位于东部地区，“高 – 高”关联模式区域仅存在于2015年的新疆和西藏；中国2011 — 2015年甲乙类法定报告传染病发病的热点区域集中在西部地区的新疆、西藏，冷点区域主要集中在北京、天津、河北、河南、山东、江苏、河北、上海及其周边省份。
结论中国2011 — 2015年甲乙类法定报告传染病得到较好控制，但要加强对西部热点区域的传染病防治卫生资源配置。

Abstract:
Objective To analyze incidence trend and spatial distribution of class A and B notifiable infectious diseases across China and to provide evidences for the prevention and control of infectious disease.
Methods We collected data on incidences of class A and B notifiable infectious diseases from 2011 through 2015 across China from " China Yearbook of Health and Family Planning Statistics”. Chi-square test for trend and geographic spatial statistical analysis were used to analyze incidence trend and spatial distribution and correlation of class A and B notifiable infectious diseases.
Results From 2011 to 2015, the overall incidence rate of class A and B notifiable infectious diseases in China was 241.44, 238.76, 225.80, 226.98, and 223.60 per 100 000 population, with a significant decrease trend (χ²_trend = 13249.52, P < 0.05). During the 5-year period in China, the regional incidence rate of class A and B notifiable infectious diseases presented a steady decline in most regions, a fluctuation pattern in some regions, and a significant increase trend in Shandong, Hainan, Anhui, Yunnan province, Chongqing municipality, and Tibet Autonomous Region (Tibet) and Xinjiang Uygur Autonomous Region (Xinjiang) (P < 0.05), with higher rate in the Western regions and lower rate in the Eastern regions. Global spatial autocorrelation analysis on the incidence rates of class A and B notifiable infectious diseases resulted in significant Moran's I coefficients of 0.092, 0.086, 0.106, 0.124, and 0.155 for the year from 2011 to 2015 (all P < 0.05); the local spatial autocorrelation analysis revealed low-low clusters of the incidences in eastern China during the 5-year period but high-high clusters in Tibet and Xinjiang only in 2015. The hot spots for class A and B notifiable infectious disease incidence were mainly observed in Tibet and Xinjiang; whereas, the cold spots were observed in Beijing and Tianjin municipality, Hebei, Henan, Shangdong, Jiangsu province, and Shanghai municipality and its adjacent provinces.
Conclusion The epidemics of class A and B notifiable infectious diseases were under efficient control in China during the period from 2011 to 2015 but health resources allocation needs to be improved in the Western China for infectious diseases prevention and treatment.

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