山东省流行性腮腺炎时空分布与气象因素关系研究

发布时间：2018-02-02 12:30

本文关键词： 流行性腮腺炎时空聚类气象因素广义相加模型　出处：《山东大学》2017年硕士论文　论文类型：学位论文

【摘要】：流行性腮腺炎(mumps,流腮)仍然是严重的公共卫生问题,对公众的健康构成重大威胁,已经成为防控的重点。一些研究表明,流腮的空间分布是非随机的且具有聚集性的特点。气候变化提高了传染病和病毒的传播,因此研究流腮的时空分布就显得尤为重要。随着气候条件的改变传染性疾病的分布也发生了变化,气候变化可能和健康效应有关。进一步了解气象因素与流腮发病之间的关系有助于改善疾病的预防预测。本研究利用山东省2005-2014年流腮发病数据,通过描述流行病学方法分析流腮的流行病学特征;利用空间自相关和时空扫描分析研究流腮的空间依赖性和发病聚集区;同时利用山东济宁市2009-2013年流腮发病数据和同期气象数据,基于暴露反应关系曲线,采用广义相加模型来定量研究气象因素和流腮之间的短期效应。本研究结果可以为流腮的重点防控、卫生资源的合理分配和利用提供依据。主要研究结果:1.2005-2014年,山东省共报告流腮115745例。女性39312例,男性76433例,男女性别比为1.94,5-9岁儿童所占比例最大,为40.799%(47215例)。流腮主要发生在春季,占全部报告病例的32.17%(37231例)。2.山东省2005-2014年流腮的空间分布是非随机的,且每年的Moran's Ⅰ值都有统计学意义。Moran's Ⅰ值的范围为0.15到0.46(P0.005),提示山东省流腮的分布具有空间异质性。局部空间自相关分析显示了发病的高聚集区。空间扫描分析显示了一个最大可能聚集区和十个次级聚集区。基于泊松模型的时空扫描显示存在一个最大可能和九个次级聚集区。空间扫描和时空扫描结果表明,山东省的中西部和部分沿海地区(青岛市和威海市)是高风险地区,特别是在济宁市中心以及东营市、滨州市和淄博市三市的交汇处。3.济宁市2009-2013年共报告8520例流腮病例。本研究发现日平均温度、日照持续时间和相对湿度与流腮的发病呈非线性关系。当平均温度高于4℃、滞后当天日平均温度每增加1℃,超额风险(ER)为2.72%,95%CI:2.38%,3.05%;相对湿度大于54%、滞后14天湿度每增加1%,ER为-1.86%,95%CI:-2.06%,-1.65%;日照时间高于5h/d,滞后1天日照时间每增加1h/d ER为12.91%,95%CI:11.38%,14.47%;风速和流腮的发病呈线性,滞后13天ER为2.98%,95%CI:2.71%,3.26%。结论:1.山东省流腮发病数男性多于女性,5-9岁儿童所占比例最大,流腮发病具有明显季节性,春季高发。2.山东省流腮空间分布具有空间异质性且存在高发聚集区,主要集中在山东省的中西部和部分沿海地区(青岛市和威海市),特别是在济宁市中心以及东营市、滨州市和淄博市三市的交汇处。3.济宁市日平均温度、日照时间和相对湿度与流腮发病呈非线性关系且存在短期滞后效应。温度、相对湿度和日照时间的阈值分别为4℃、54%和5 h/d。风速与流腮发病效应不存在阈值。日平均温度大于4℃时,流腮发病随着温度升高而增加(从滞后当天到滞后14天)。滞后当天到滞后19天相对湿度与流腮发病呈负相关。风速和日照时间的正相关效应分别在在滞后13天和滞后1天达到最大。
[Abstract]:Mumps (mumps, mumps) is still a serious public health problem, pose a major threat to public health, prevention and control has become the focus. Some studies show that the distribution of mumps space is non random and has the characteristics of aggregation. Climate change improves the spread of infectious diseases and viruses, it is particularly important so the research on the temporal and spatial distribution of mumps. With the change in the distribution of infectious diseases, climatic conditions have changed, and may be related to climate change. To further understand the health effects of prevention the relationship between meteorological factors and the incidence of mumps is helpful to improve the prediction of disease. The incidence of mumps data in Shandong province for 2005-2014 years, through the method of descriptive epidemiology analysis the epidemiological characteristics of mumps; by using spatial autocorrelation and spatial scanning analysis of spatial dependence and the incidence of mumps and the gathering area; 2009-2013 years the incidence of mumps data and meteorological data of Shandong in Jining City, exposure response curves based on the generalized additive model to the short-term effect between meteorological factors and quantitative study of mumps. The results of this study is to focus on prevention and control of mumps, provide the basis for the rational allocation of health resources and utilization. The main results: 1.2005-2014 years in Shandong province 115745 mumps cases were reported. 39312 cases were female, 76433 were male, male and female sex ratio for children aged 1.94,5-9 accounted for the largest proportion, 40.799% (47215 cases). Mumps occurred mainly in spring, the total 32.17% cases (37231 cases) distribution of mumps.2. in Shandong province 2005-2014 years of space is non random, Moran's and every year I have significant value range of.Moran's I value is 0.15 to 0.46 (P0.005), Shandong province has the mumps distribution suggest that spatial heterogeneity of local spatial autocorrelation points. Analysis shows the clustering of high incidence. Analysis of spatial scan shows a maximum possible gathering area and ten secondary areas. Spatial scanning of the Poisson model showed that there was a maximum and nine secondary areas. Based on spatial scanning and spatial scanning results show that Shandong province in the central and western regions and coastal areas (Qingdao City and Weihai city) is a high risk area, especially in Jining City, Dongying City, Binzhou city and Zibo City, three city at the intersection of.3. 2009-2013 years in Jining City, reported a total of 8520 cases of mumps. The study found that the average daily temperature, the incidence of non-linear relationship between sunshine duration and relative humidity and mumps. When the average the temperature is above 4 DEG C, the lag of daily average temperature increases 1 degrees, excess risk (ER) 2.72%, 95%CI:2.38%, 3.05%; the relative humidity is greater than 54%, each additional 14 days lag humidity 1%, ER -1.86%, 95%CI:-2.06%, -1 .65%; sunshine time is higher than 5h/d, sunshine time lag of 1 days for each additional 1h/d ER 12.91%, 95%CI:11.38%, 14.47%; the incidence of mumps and wind speed is linear, lag of 13 days ER 2.98%, 95%CI:2.71%, 3.26%.. Conclusion: 1. the incidence of mumps in Shandong Province, the number of male was more than female, 5-9 years old children accounted for the largest proportion, with the incidence of mumps the obvious seasonal, spring in Shandong province.2. from spatial distribution of spatial heterogeneity and high accumulation area, mainly concentrated in the central and Western Shandong province and coastal areas (Qingdao and Weihai), especially in the center of Jining City, Dongying City, Jining City, at the intersection of.3. daily average temperature in Binzhou city and Zibo City three city, sunshine time and relative humidity and the incidence of mumps is nonlinear and has short lag effect. Temperature, relative humidity and sunshine time threshold was 4 degrees, 54% and 5 h/d. wind speed and the incidence of mumps. There should be no threshold. The average daily temperature greater than 4 DEG C, the incidence of mumps and increased with the increase of temperature (from day to day lag lag 14). The lag that day to the 19 day lag relative humidity and the incidence of mumps was negatively correlated. Positive correlation between wind and sunshine time lag in respectively in 13 days and 1 days to reach the lag the biggest.

【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R512.1

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