空间分析技术在我国艾滋病流行形势和趋势判断中的应用
发布时间：2018-08-18 11:06
【摘要】：研究背景 受艾滋病疫情发展速度和地区社会条件等因素的影响,艾滋病疫情在地理分布上明显不均衡。正确认识我国艾滋病报告疫情的空间分布,并进一步根据实际情况合理地划分亚流行区,对艾滋病防治工作有重要的指导意义。 研究目的 分析我国艾滋病报告病例的空间聚集性及其变化趋势；探讨与我国艾滋病报告疫情地区差异性分布相关的社会宏观因素；根据我国不同地区艾滋病流行水平和特点,对所有省份划分亚流行区,为分类指导艾滋病防治工作提供信息和依据。 研究方法 收集我国1985年至2011年底历年发现并报告的艾滋病病毒感染者或艾滋病病人(HIV/AIDS)的数据信息,各省份经济、人口和卫生等社会因素数据资料。首先,分别在省份水平和县区水平利用时空扫描统计量法和空间自相关分析方法分析艾滋病报告病例聚集性分布的时间和空间及其变迁情况。然后,利用主成分分析方法提取社会宏观因素综合变量,利用两水平负二项分布模型分析县区艾滋病报告现患率与省份社会宏观因素的关系。最后,将反映各省份艾滋病早期流行情况、流行扩散与发展、现阶段流行程度以及社会宏观因素的若干变量纳入聚类分析方法,在省份水平划分亚流行区。 研究结果 1.省份水平和县区水平的空间分析均发现,截至每年报告病例均存在显著聚集性且聚集区域不断变化。1995年到2003年疫情从云南、新疆等地向中部地区扩散,聚集性降低(全局Moran's I值0.1596,Z=15.9926,P0.05),但从2005年开始,西南地区的报告疫情又占优势,聚集性再次加强。分不同传播途径分析后发现,注吸和异性途径病例主要集中于云南、广西和新疆等省份；采血途径病例主要聚集于2004年的中原省份；同性途径病例发生聚集时间较晚(2008至2011年),聚集区域较为分散,多属经济较发达地区。 2.两水平负二项分布模型分析发现,水平2(省份)单位下各水平1(县区)单位的艾滋病报告现患率存在聚集性,即调整性别和年龄因素后,各省份间艾滋病报告现患率仍存在显著差异(σu20。=2.612,P0.05)。纳入水平2的社会宏观因素变量进行单因素和多因素分析均发现,人口流动水平高或经济生活水平低(N3)、少数民族人口比例高(M4)、HIV筛检人次数多(M5)与艾滋病报告现患率呈正相关(P0.05)。 3.综合艾滋病流行早期情况、流行扩散与发展速度、现流行阶段总体疫情以及社会宏观影响因素社四个方面共13个变量特征,将31个省份划分为A、B、C三大类亚流行区。亚流行区A疾病负担最重,截至2011年底全人群报告患病率9.3/万人；早期疫情覆盖范围已较广,且存在明显聚集性流行；近年来艾滋病报告病例数平均发展速度最慢,截至2011年底包含了全国县区水平75.4%的热点县区；经济生活水平最低。B区疫情属中等水平(1.8/万人)；早期流行以异性传播途径为主,1995年至2005年报告病例在县区水平地理空间内扩散最快,近年报告病例数的上升速度也较快,截至2011年底占全部同性途径热点县区的50.0%；经济生活水平和人口流动水平最高。C区包含14个省份,虽病例在县区间的扩散速度和近年报告病例数的发展速度均处于较高水平,但由于总体疫情水平低,其对全国疫情贡献仍较小(0.8/万人)。 研究结论 我国艾滋病不同流行时期具有不同的地理空间分布特征,各省艾滋病流行特点各异；并且,各地区艾滋病流行形势与其社会宏观因素密切相关。综合考虑各省份艾滋病流行水平差异和地区的社会背景,进行亚流行区的化分更科学,突出各亚流行区独特的疫情流行模式,有利于针对性开展分类防治工作。
[Abstract]:Research background
Influenced by the development speed of AIDS epidemic and regional social conditions, the geographical distribution of AIDS epidemic is obviously unbalanced. It is of great significance to understand the spatial distribution of reported AIDS epidemic in China and to divide sub-epidemic areas rationally according to the actual situation.
research objective
To analyze the spatial clustering and changing trend of reported AIDS cases in China; to explore the social macro-factors related to the regional differential distribution of reported AIDS cases in China; to divide all provinces into sub-epidemic areas according to the epidemic level and characteristics of AIDS in different regions of China, so as to provide information and guidance for the prevention and treatment of AIDS by classification. Basis.
research method
To collect the data of HIV/AIDS patients found and reported in China from 1985 to the end of 2011, and the data of economic, demographic and health factors in various provinces. Firstly, the spatial-temporal scanning statistics and spatial autocorrelation analysis were used to analyze AIDS at provincial and county levels respectively. Then, the comprehensive variables of social macro-factors were extracted by principal component analysis, and the relationship between the prevalence rate of AIDS reports in county and social macro-factors in province was analyzed by two-level negative binomial distribution model. Several variables of epidemic spread and development, current epidemic degree and social macro-factors are included in the cluster analysis method, and sub-epidemic areas are divided at the provincial level.
Research results
1. Spatial analysis at the provincial and county levels showed that the reported cases had significant aggregation and the aggregation areas were constantly changing. From 1995 to 2003, the epidemic spread from Yunnan and Xinjiang to the central region, and the aggregation decreased (global Moran's I value 0.1596, Z = 15.9926, P 0.05), but from 2005, the reported epidemic in southwest China began. According to the analysis of different transmission routes, the cases of injection-inhalation and heterosexual routes were mainly concentrated in Yunnan, Guangxi and Xinjiang provinces; the cases of blood collection routes were mainly concentrated in the Central Plains in 2004; the cases of homosexual routes occurred late (2008-2011), and the aggregation areas were scattered, mostly belonging to the genus. Economically developed areas.
2. Two-level negative binomial distribution model analysis found that the level 2 (provincial) units of the level 1 (county) unit of the current prevalence of AIDS report there is an aggregation, that is, adjusted for gender and age factors, the prevalence of AIDS report among provinces still exists significant differences (u20. = 2.612, P 0.05). The social macro-factors included in Level 2 variables for a single. Factors and multivariate analysis showed that high level of population mobility or low economic living standard (N3), high proportion of ethnic minorities (M4), and high number of HIV screening (M5) were positively correlated with the prevalence of AIDS (P 0.05).
3. According to the early epidemic situation, epidemic spread and development speed, the epidemic situation and the social macro-influencing factors, there are 13 variables in the epidemic stage. Thirty-one provinces are divided into three sub-epidemic areas: A, B and C. Epidemic coverage has been wider, and there is a significant clustering epidemic; in recent years, the average rate of development of AIDS cases is the slowest, including 75.4% of the country's county level by the end of 2011 hot counties; the lowest economic living standard. District B epidemic is a medium level (18/10000); the early epidemic mainly heterosexual transmission routes, 1995 By the end of 2011, 50.0% of all hotspot counties had been reported in the same sex routes. The economic living standard and the level of population mobility were the highest. District C included 14 provinces, although the rate of case spread in the county and the number of reported cases in recent years were fast. The rate of development is at a high level, but its contribution to the national epidemic situation is still small (0.8/10000) due to the low level of the overall epidemic situation.
research conclusion
There are different geographical and spatial distribution characteristics in different epidemic periods of AIDS in China, and the epidemic characteristics of AIDS in different provinces are different. Moreover, the epidemic situation of AIDS in different regions is closely related to its social macro-factors. The unique epidemic patterns of sub epidemic areas are conducive to targeted prevention and control.
【学位授予单位】：中国疾病预防控制中心
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R512.91
本文编号：2189278
[Abstract]:Research background
Influenced by the development speed of AIDS epidemic and regional social conditions, the geographical distribution of AIDS epidemic is obviously unbalanced. It is of great significance to understand the spatial distribution of reported AIDS epidemic in China and to divide sub-epidemic areas rationally according to the actual situation.
research objective
To analyze the spatial clustering and changing trend of reported AIDS cases in China; to explore the social macro-factors related to the regional differential distribution of reported AIDS cases in China; to divide all provinces into sub-epidemic areas according to the epidemic level and characteristics of AIDS in different regions of China, so as to provide information and guidance for the prevention and treatment of AIDS by classification. Basis.
research method
To collect the data of HIV/AIDS patients found and reported in China from 1985 to the end of 2011, and the data of economic, demographic and health factors in various provinces. Firstly, the spatial-temporal scanning statistics and spatial autocorrelation analysis were used to analyze AIDS at provincial and county levels respectively. Then, the comprehensive variables of social macro-factors were extracted by principal component analysis, and the relationship between the prevalence rate of AIDS reports in county and social macro-factors in province was analyzed by two-level negative binomial distribution model. Several variables of epidemic spread and development, current epidemic degree and social macro-factors are included in the cluster analysis method, and sub-epidemic areas are divided at the provincial level.
Research results
1. Spatial analysis at the provincial and county levels showed that the reported cases had significant aggregation and the aggregation areas were constantly changing. From 1995 to 2003, the epidemic spread from Yunnan and Xinjiang to the central region, and the aggregation decreased (global Moran's I value 0.1596, Z = 15.9926, P 0.05), but from 2005, the reported epidemic in southwest China began. According to the analysis of different transmission routes, the cases of injection-inhalation and heterosexual routes were mainly concentrated in Yunnan, Guangxi and Xinjiang provinces; the cases of blood collection routes were mainly concentrated in the Central Plains in 2004; the cases of homosexual routes occurred late (2008-2011), and the aggregation areas were scattered, mostly belonging to the genus. Economically developed areas.
2. Two-level negative binomial distribution model analysis found that the level 2 (provincial) units of the level 1 (county) unit of the current prevalence of AIDS report there is an aggregation, that is, adjusted for gender and age factors, the prevalence of AIDS report among provinces still exists significant differences (u20. = 2.612, P 0.05). The social macro-factors included in Level 2 variables for a single. Factors and multivariate analysis showed that high level of population mobility or low economic living standard (N3), high proportion of ethnic minorities (M4), and high number of HIV screening (M5) were positively correlated with the prevalence of AIDS (P 0.05).
3. According to the early epidemic situation, epidemic spread and development speed, the epidemic situation and the social macro-influencing factors, there are 13 variables in the epidemic stage. Thirty-one provinces are divided into three sub-epidemic areas: A, B and C. Epidemic coverage has been wider, and there is a significant clustering epidemic; in recent years, the average rate of development of AIDS cases is the slowest, including 75.4% of the country's county level by the end of 2011 hot counties; the lowest economic living standard. District B epidemic is a medium level (18/10000); the early epidemic mainly heterosexual transmission routes, 1995 By the end of 2011, 50.0% of all hotspot counties had been reported in the same sex routes. The economic living standard and the level of population mobility were the highest. District C included 14 provinces, although the rate of case spread in the county and the number of reported cases in recent years were fast. The rate of development is at a high level, but its contribution to the national epidemic situation is still small (0.8/10000) due to the low level of the overall epidemic situation.
research conclusion
There are different geographical and spatial distribution characteristics in different epidemic periods of AIDS in China, and the epidemic characteristics of AIDS in different provinces are different. Moreover, the epidemic situation of AIDS in different regions is closely related to its social macro-factors. The unique epidemic patterns of sub epidemic areas are conducive to targeted prevention and control.
【学位授予单位】：中国疾病预防控制中心
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R512.91
【参考文献】
相关期刊论文 前10条
1 曾毅,王必tz,汤得骥,周绍聪,范江,张钦,郑锡文;血友病患者血清中淋巴腺病病毒/人T细胞Ⅲ型病毒抗体检测[J];病毒学报;1986年02期
2 汪宁;;中国艾滋病流行病学特点[J];传染病信息;2007年06期
3 马玉桂;雅西;;西藏主要城市男男性行为人群HIV感染及高危行为状况调查[J];中国社会医学杂志;2010年04期
4 王勇;唐振柱;朱秋映;刘伟;朱金辉;郑文彬;;广西2009—2011年艾滋病流行特征分析[J];华南预防医学;2013年01期
5 徐洪吕;陆林;闵向东;章任重;贾曼红;;昆明市男男性行为人群与艾滋病相关的社会需求分析[J];中国社会医学杂志;2013年01期
6 陆朝国,蒋巧英;贵阳市HIV/AIDS流行病学特点及防制对策[J];贵州医药;2000年10期
7 李宁;王哲;孙定勇;薛晓玲;孙国清;郭大城;朱谦;;河南省艾滋病流行现状分析[J];医药论坛杂志;2007年19期
8 凌华,钱天学,于友建,韩梅,王俊;重庆市2000年吸毒人员艾滋病哨点监测结果分析[J];疾病监测;2001年09期
9 吴尊友;;中国艾滋病疫情监测面临的挑战[J];疾病监测;2009年11期
10 李雷;还锡萍;徐金水;徐晓琴;羊海涛;;江苏省2006年～2008年艾滋病高危人群哨点监测报告[J];江苏预防医学;2010年02期
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