2002-2010年我国疟疾疫情时空变化分析
发布时间：2018-08-22 08:33
【摘要】：目的： 通过展示我国2002-2010年疟疾疫情时空演变,并分析近10年来疟疾发病的时空分布特征,为我国消除疟疾工作提供时空数据支持。 方法： 12002-2010年我国本地疟疾疫情时空变化分析 1.1利用我国2002-2010年疟疾疫情年报数据和期间全国行政区划经纬度、人口等数据,通过ArcGIS软件,整理年报数据并提取本地病例数据库,并将其与全国行政区划经纬度、人口等数据库根据相同字段进行连接,建立本地病例地理信息数据库。 1.2在分析全国本地疟疾发病率的发展变化趋势基础上,运用时间扫描统计量法探索本地疟疾疫情的时间聚集性特征。 1.3利用ArcGIS10.0软件的图像渲染功能,按照WHO全球疟疾报告的发病率分类标准,以可视化地图展示全国范围内本地疟疾病例不同发病率等级的分布,并进一步分析各等级县、区空间分布变化。 1.4参考1.3的结果将2002-2010年疟疾流行划分的不同阶段,将各个阶段的全国本地疟疾病例数据库分别导入SaTScan9.1软件进行空间扫描聚类分析,分析其演变趋势,并对主要流行省份进行局部时空扫描聚类分析,探索小尺度下疟疾疫情时空聚集区。 22002-2010年我国输入疟疾疫情时空变化分析 2.1利用我国2002-2010年疟疾疫情年报数据和期间全国行政区划经纬度、人口等数据,通过ArcGIS软件,整理年报数据并提取输入病例数据库,并将其与全国行政区划经纬度、人口等数据库根据相同字段进行连接,建立输入病例地理信息数据库。 2.2在分析全国输入疟疾发病率的发展变化趋势的基础上,运用时间扫描统计量法探索输入疫情的时间聚集性特征。 2.3利用ArcGIS10.0软件的图像渲染功能,按照WHO全球疟疾报告的发病率分类标准,显示全国范围内输入病例不同发病率等级的分布,并进一步分析各等级县、区的空间分布变化。 2.4参考2.3的结果将2002-2010年疟疾流行划分的不同阶段,将各个阶段的全国输入疟疾病例数据库分别导入SaTScan9.1软件进行空间扫描聚类分析,分析其演变趋势,并对主要流行的地区进行局部时空扫描聚类分析,探索小尺度下输入疟疾疫情的时空聚集区。 结果： 12002-2010年我国本地疟疾疫情时空变化分析 1.12002-2010年全国本地疟疾发病率的变化大致分为三个阶段：2002-2004年、2005-2007年、2008-2010年,总体上呈稳定-上升-下降的趋势。时间扫描聚类分析结果显示,2002-2010年全国本地疟疾疫情在时间上并非随机分布,而是呈明显的聚集性。发病高峰时间为2006-2007年,年均发病率3.1/10万,相对危险度为1.97,P值0.01。 1.2全国本地疟疾疫情空间分布变化分为三个阶段：2002-2004年、2005-2007年、2008-2010年。2002-2004年全国本地疟疾发病率在千分之一以上的县、区有73个,万分之一至千分之一的有169个,零至万分之一的有1166个。2005-2007年各等级县、区数量变化不大,千分之一以上和零至万分之一的县、区数较上一阶段分别下降2.7%和9.8%,万分之一至千分之一增加2.4%。2008-2010年各等级县区数量均有减少,较上一阶段分别下降91.5%、30.6%和25.1%。全国本地疟疾发病率与有本地疟疾病例报告县、区数的变化不一：2002-2004年两者均在较高水平小幅波动,2005-2007年全国本地疟疾发病率上升至高峰,但各个发病率等级的县、区数波动不大,2008-2010年两者均减少。 1.3空间聚类分析显示,疫情集中于2005-2007年,而且地理上并非随机分布,主要集中在云南、海南和安徽省。空间聚集区在三个阶段呈现出南部-中部-消散的演变趋势。2002-2004年聚集区主要分布在云南西南、海南南部、安徽北部与河南湖北交界,其中南部聚集区的面积与发病率都超过中部,疫情较为严重,对全国疫情有主要影响,2005-2007年南部聚集区面积与发病率都降低,但安徽省北部聚集区面积与发病率均增大,全国疫情总体加重,疫情转移至中部,2008-2010年各聚集区发病率降低,全国范围内疫情呈下降趋势。时空扫描聚类分析显示各聚集区均集中于2002-2008年,2009-2010年未发现新时空聚集区。其中云南省出现时空聚集区的时间为2002-2007年,包括30个县、区,主要分布于中缅边境地区；海南省出现时空聚集区的时间为2002-2005年,包括9个县、区,分布于海南岛南部；安徽省出现时空聚集区的时间为2005-2008年,包括12个县、区,分布于安徽省北部。 2.2002-2010年我国输入疟疾疫情时空变化分析 2.12002-2010年全国输入疟疾发病率的变化大致分为三个阶段：2002-2004年、2005-2007年、2008-2010年,发病率总体上呈稳定-上升-下降的趋势。时间扫描聚类分析结果显示,2002-2010年全国输入疟疾病例在时间上并非随机分布,而是呈明显的聚集性。发病高峰时间为2005-2006年,年均发病率0.7/10万,相对危险度为2.36,P值0.01。 2.2全国输入疟疾疫情空间分布变化分为三个阶段：2002-2004年、2005-2007年、2008-2010年。2002-2004年全国输入疟疾发病率在千分之一以上的县、区有9个,万分之一至千分之一的有46个,零至万分之一的有1209个。2005-2007年千分之一以上县、区数增加88.9%,但全国有输入疟疾病例报告的县、区数量总体变化不大。2008-2010年千分之一以上县、区数减少52.9%,但全国有输入疟疾病例报告的县、区数量仍无减少。全国输入疟疾发病率与有输入疟疾病例报告县、区数的变化不一：2002-2004年两者均处于小幅波动状态,2005-2007年全国输入疟疾发病率上升至高峰,千分之一以上县数大幅增加,但有输入疟疾病例报告的县数总体上变化不大,2008-2010年全国输入疟疾发病率下降,千分之一以上县数同时减少,但有输入疟疾病例县数仍没有减少。 2.3空间聚类分析显示,空间聚集区集中于2005-2007年,而且地理上并非随机分布,主要集中在云南、湖南-贵州-广西交界和浙江省,聚集区未出现明显消散的趋势。2002-2004年聚集区分布在云南西南、湖南贵州广西交界和浙江省,云南西南部疫情对全国输入疟疾疫情有重要影响,2005-2007年云南省聚集区发病率增加,聚集程度上升,全国输入疟疾疫情上升,2008-2010年各聚集区发病率降低,但输入性病例分布仍然广泛。时空扫描聚类分析显示各聚集区均发生于2002-2008年,2009-2010年未发现新时空聚集区。其中云南省有两个时空聚集区,一级聚集区位于云南省西部边境,包括10个县区,时间为2004-2007年,二级聚集区位于云南省南部边境,包括2个县区,时间为2002-2005年,湖南-贵州-广西交界聚集区的时间为2002-2005年,包括79个县区,浙江省聚集区时间为2006-2008年,包括29各县区,分布于浙江省东部。 结论： 2002-2010年我国疟疾传播的时空演变分析结果,显示我国本地疟疾病例已经无明显聚集性分布特征。到2010年,全国70%以上县、区已无本地病例,发病率下降至0.03／万,疟疾传播得到了有效的控制,疟防工作进入消除阶段。但输入病例报告地区不断扩大,虽未出现聚集性分布,但仍应是疟疾监测工作的重点,以及时发现聚集性输入病例,防止继发传播。
[Abstract]:Objective:
By showing the temporal and spatial evolution of malaria epidemic situation in China from 2002 to 2010, and analyzing the spatial and temporal distribution characteristics of malaria incidence in recent 10 years, the spatial and temporal data for malaria eradication in China were provided.
Method:
Temporal and spatial variation of malaria in China during the past 12002-2010 years
1.1 Using the annual report data of malaria epidemic in China from 2002 to 2010 and the data of longitude, latitude and population of the national administrative divisions during the period of 2002-2010, the data of annual report are sorted out and the local case database is extracted by ArcGIS software. The data of local case geographic information is established by connecting the data with the national administrative divisions longitude, latitude and population database according to the same field. Treasury.
1.2 On the basis of analyzing the development trend of the incidence of malaria in China, the temporal clustering characteristics of local malaria epidemics were explored by using time scan statistics.
1.3 Using the image rendering function of ArcGIS 10.0 software, according to the WHO global malaria incidence classification standard, the distribution of different incidence levels of malaria cases in the whole country was displayed by visual map, and the spatial distribution changes of counties and districts were further analyzed.
1.4 Referring to the results of 1.3, the different stages of malaria epidemic from 2002 to 2010 were divided into different stages, and the national local malaria case database of each stage was imported into SaTScan 9.1 software for spatial scanning clustering analysis, and its evolution trend was analyzed. The main epidemic provinces were analyzed by local space-time scanning clustering analysis to explore the space-time of malaria epidemic in small-scale. Congregate area.
Analysis of spatial and temporal variations of malaria epidemic in China in 22002-2010 years
2.1 Using the data of annual report of malaria epidemic in China from 2002 to 2010 and the data of longitude, latitude and population of national administrative divisions during the period of 2002-2010, the data of annual report are sorted out and the case database is extracted by ArcGIS software. The data of geographical information of imported cases are established by connecting the data with the data of longitude, latitude and population of national administrative divisions according to the same field. Treasury.
2.2 On the basis of analyzing the developing trend of the incidence of imported malaria in China, the temporal clustering characteristics of imported malaria epidemics were explored by time scan statistics.
2.3 Using the image rendering function of ArcGIS 10.0 software, according to the WHO global malaria incidence classification standard, the distribution of different incidence levels of imported cases in China was displayed, and the spatial distribution of counties and districts in different levels was further analyzed.
2.4 Referring to the results of 2.3, the different stages of malaria epidemic from 2002 to 2010 were divided, and the national imported malaria case database of each stage was imported into SaTScan 9.1 software for spatial scanning clustering analysis to analyze its evolution trend, and the main epidemic areas were analyzed by local space-time scanning clustering analysis to explore the small-scale imported malaria epidemic. The temporal and spatial gathering area of love.
Result:
Temporal and spatial variation of malaria in China during the past 12002-2010 years
1.12002-2010, the incidence of malaria in China can be roughly divided into three stages: 2002-2004, 2005-2007, 2008-2010, the overall trend is stable-up-down. Time scan clustering analysis shows that the local malaria epidemic in China in 2002-2010 is not random distribution in time, but an obvious clustering. The peak time is 2006-2007 years, the annual incidence is 3.1/10 million, the relative risk is 1.97, and the P value is 0.01.
1.2 The spatial distribution of malaria epidemics in China can be divided into three stages: from 2002 to 2004, from 2005 to 2007, from 2008 to 2010. From 2002 to 2004, the incidence of malaria in China was more than one thousandth of the counties, 73 districts, 169 districts ranging from one thousandth to one thousandth, and 1166 counties ranging from 0 to one thousandth. The number of districts in large, over one thousandth and zero to one thousandth counties decreased by 2.7% and 9.8% respectively, and increased by 2.4% from one thousandth to one thousandth respectively. Differences: In 2002-2004, both of them fluctuated slightly at a higher level, and the incidence of malaria rose to a peak in 2005-2007. However, the number of districts fluctuated slightly in counties with different incidence levels, and both decreased in 2008-2010.
1.3 Spatial cluster analysis showed that the epidemic situation was concentrated in 2005-2007, and geographically non-random distribution, mainly concentrated in Yunnan, Hainan and Anhui provinces. In 2005-2007, the area and incidence of the southern agglomeration areas were reduced. However, the area and incidence of the northern agglomeration areas in Anhui Province were increased. The epidemic situation in the whole country was aggravated. The epidemic situation transferred to the central region. In 2008-2010, the incidence of the disease in the southern agglomeration areas decreased. The spatial-temporal cluster analysis showed that all the agglomeration areas were concentrated in 2002-2008, and no new spatial-temporal agglomeration areas were found in 2009-2010. The spatial-temporal agglomeration areas in Yunnan Province occurred in 2002-2007, including 30 counties and districts, mainly distributed in the border areas between China and Myanmar. The time of the area is from 2002 to 2005, including 9 counties and districts in the south of Hainan Island, and the time of the time and space gathering area in Anhui Province is from 2005 to 2008, including 12 counties and districts in the north of Anhui Province.
Temporal and spatial variation of malaria epidemic in China during 2.2002-2010
The incidence of imported malaria in China from 2002 to 2010 can be divided into three stages: 2002-2004, 2005-2007, 2008-2010. The overall incidence of imported malaria shows a stable-rising-decreasing trend. Time scan cluster analysis shows that the imported malaria cases in China from 2002 to 2010 are not randomly distributed in time, but are obviously clustered. The peak time was 2005-2006 years. The annual incidence rate was 0.7/10 million, the relative risk was 2.36, and the P value was 0.01.
2.2 The spatial distribution of imported malaria in China is divided into three stages: from 2002 to 2004, from 2005 to 2007, from 2008 to 2010. From 2002 to 2004, the incidence of imported malaria in China was more than one-thousandth of the counties, there were 9 districts, 46 districts ranging from one-thousandth to one-thousandth, and 1209 districts ranging from zero to one-thousandth. The total number of counties with imported malaria cases reported in China has not changed much. From 2008 to 2010, the number of counties with imported malaria cases decreased by 52.9%, but the number of counties with imported malaria cases reported in China has not decreased. The incidence of imported malaria in China rose to a peak from 2005 to 2007, and the number of counties with more than one thousand imported malaria cases increased greatly. However, the number of counties with imported malaria cases reported did not change much. The incidence of imported malaria in China decreased from 2008 to 2010, and the number of counties with more than one thousand imported malaria cases decreased at the same time. No reduction has been made.
2.3 Spatial cluster analysis showed that the spatial agglomeration areas were concentrated in 2005-2007, and geographically non-random distribution, mainly concentrated in Yunnan, Hunan-Guizhou-Guangxi border and Zhejiang Province, the agglomeration areas did not show a significant trend of dissipation. 2002-2004, the agglomeration areas were distributed in southwestern Yunnan, Hunan-Guizhou-Guangxi border and Zhejiang Province, southwestern Yunnan epidemic. The incidence of imported malaria in Yunnan Province increased from 2005 to 2007, the degree of aggregation increased, the incidence of imported malaria increased, the incidence of imported malaria decreased from 2008 to 2010, but the distribution of imported cases was still widespread. There are two space-time agglomeration areas in Yunnan Province. The first-class agglomeration area is located in the western border of Yunnan Province, including 10 counties. The second-class agglomeration area is located in the southern border of Yunnan Province, including 2 counties. The time of 2002-2005 is Hunan-Guizhou-Guangxi border agglomeration area, including 2002-2005. The 79 counties and districts in Zhejiang province are 2006-2008 years, including 29 counties and districts, which are distributed in the eastern part of Zhejiang province.
Conclusion:
The spatial and temporal evolution of malaria transmission in China from 2002 to 2010 shows that there is no obvious clustering distribution of local malaria cases in China. By 2010, more than 70% of counties and districts in China have no local malaria cases, the incidence rate has dropped to 0.03/10,000, malaria transmission has been effectively controlled and malaria prevention has entered the elimination stage. Although there is no aggregate distribution in the area, it should be the focus of malaria surveillance and timely detection of aggregated imported cases to prevent secondary transmission.
【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】：R531.3
[Abstract]:Objective:
By showing the temporal and spatial evolution of malaria epidemic situation in China from 2002 to 2010, and analyzing the spatial and temporal distribution characteristics of malaria incidence in recent 10 years, the spatial and temporal data for malaria eradication in China were provided.
Method:
Temporal and spatial variation of malaria in China during the past 12002-2010 years
1.1 Using the annual report data of malaria epidemic in China from 2002 to 2010 and the data of longitude, latitude and population of the national administrative divisions during the period of 2002-2010, the data of annual report are sorted out and the local case database is extracted by ArcGIS software. The data of local case geographic information is established by connecting the data with the national administrative divisions longitude, latitude and population database according to the same field. Treasury.
1.2 On the basis of analyzing the development trend of the incidence of malaria in China, the temporal clustering characteristics of local malaria epidemics were explored by using time scan statistics.
1.3 Using the image rendering function of ArcGIS 10.0 software, according to the WHO global malaria incidence classification standard, the distribution of different incidence levels of malaria cases in the whole country was displayed by visual map, and the spatial distribution changes of counties and districts were further analyzed.
1.4 Referring to the results of 1.3, the different stages of malaria epidemic from 2002 to 2010 were divided into different stages, and the national local malaria case database of each stage was imported into SaTScan 9.1 software for spatial scanning clustering analysis, and its evolution trend was analyzed. The main epidemic provinces were analyzed by local space-time scanning clustering analysis to explore the space-time of malaria epidemic in small-scale. Congregate area.
Analysis of spatial and temporal variations of malaria epidemic in China in 22002-2010 years
2.1 Using the data of annual report of malaria epidemic in China from 2002 to 2010 and the data of longitude, latitude and population of national administrative divisions during the period of 2002-2010, the data of annual report are sorted out and the case database is extracted by ArcGIS software. The data of geographical information of imported cases are established by connecting the data with the data of longitude, latitude and population of national administrative divisions according to the same field. Treasury.
2.2 On the basis of analyzing the developing trend of the incidence of imported malaria in China, the temporal clustering characteristics of imported malaria epidemics were explored by time scan statistics.
2.3 Using the image rendering function of ArcGIS 10.0 software, according to the WHO global malaria incidence classification standard, the distribution of different incidence levels of imported cases in China was displayed, and the spatial distribution of counties and districts in different levels was further analyzed.
2.4 Referring to the results of 2.3, the different stages of malaria epidemic from 2002 to 2010 were divided, and the national imported malaria case database of each stage was imported into SaTScan 9.1 software for spatial scanning clustering analysis to analyze its evolution trend, and the main epidemic areas were analyzed by local space-time scanning clustering analysis to explore the small-scale imported malaria epidemic. The temporal and spatial gathering area of love.
Result:
Temporal and spatial variation of malaria in China during the past 12002-2010 years
1.12002-2010, the incidence of malaria in China can be roughly divided into three stages: 2002-2004, 2005-2007, 2008-2010, the overall trend is stable-up-down. Time scan clustering analysis shows that the local malaria epidemic in China in 2002-2010 is not random distribution in time, but an obvious clustering. The peak time is 2006-2007 years, the annual incidence is 3.1/10 million, the relative risk is 1.97, and the P value is 0.01.
1.2 The spatial distribution of malaria epidemics in China can be divided into three stages: from 2002 to 2004, from 2005 to 2007, from 2008 to 2010. From 2002 to 2004, the incidence of malaria in China was more than one thousandth of the counties, 73 districts, 169 districts ranging from one thousandth to one thousandth, and 1166 counties ranging from 0 to one thousandth. The number of districts in large, over one thousandth and zero to one thousandth counties decreased by 2.7% and 9.8% respectively, and increased by 2.4% from one thousandth to one thousandth respectively. Differences: In 2002-2004, both of them fluctuated slightly at a higher level, and the incidence of malaria rose to a peak in 2005-2007. However, the number of districts fluctuated slightly in counties with different incidence levels, and both decreased in 2008-2010.
1.3 Spatial cluster analysis showed that the epidemic situation was concentrated in 2005-2007, and geographically non-random distribution, mainly concentrated in Yunnan, Hainan and Anhui provinces. In 2005-2007, the area and incidence of the southern agglomeration areas were reduced. However, the area and incidence of the northern agglomeration areas in Anhui Province were increased. The epidemic situation in the whole country was aggravated. The epidemic situation transferred to the central region. In 2008-2010, the incidence of the disease in the southern agglomeration areas decreased. The spatial-temporal cluster analysis showed that all the agglomeration areas were concentrated in 2002-2008, and no new spatial-temporal agglomeration areas were found in 2009-2010. The spatial-temporal agglomeration areas in Yunnan Province occurred in 2002-2007, including 30 counties and districts, mainly distributed in the border areas between China and Myanmar. The time of the area is from 2002 to 2005, including 9 counties and districts in the south of Hainan Island, and the time of the time and space gathering area in Anhui Province is from 2005 to 2008, including 12 counties and districts in the north of Anhui Province.
Temporal and spatial variation of malaria epidemic in China during 2.2002-2010
The incidence of imported malaria in China from 2002 to 2010 can be divided into three stages: 2002-2004, 2005-2007, 2008-2010. The overall incidence of imported malaria shows a stable-rising-decreasing trend. Time scan cluster analysis shows that the imported malaria cases in China from 2002 to 2010 are not randomly distributed in time, but are obviously clustered. The peak time was 2005-2006 years. The annual incidence rate was 0.7/10 million, the relative risk was 2.36, and the P value was 0.01.
2.2 The spatial distribution of imported malaria in China is divided into three stages: from 2002 to 2004, from 2005 to 2007, from 2008 to 2010. From 2002 to 2004, the incidence of imported malaria in China was more than one-thousandth of the counties, there were 9 districts, 46 districts ranging from one-thousandth to one-thousandth, and 1209 districts ranging from zero to one-thousandth. The total number of counties with imported malaria cases reported in China has not changed much. From 2008 to 2010, the number of counties with imported malaria cases decreased by 52.9%, but the number of counties with imported malaria cases reported in China has not decreased. The incidence of imported malaria in China rose to a peak from 2005 to 2007, and the number of counties with more than one thousand imported malaria cases increased greatly. However, the number of counties with imported malaria cases reported did not change much. The incidence of imported malaria in China decreased from 2008 to 2010, and the number of counties with more than one thousand imported malaria cases decreased at the same time. No reduction has been made.
2.3 Spatial cluster analysis showed that the spatial agglomeration areas were concentrated in 2005-2007, and geographically non-random distribution, mainly concentrated in Yunnan, Hunan-Guizhou-Guangxi border and Zhejiang Province, the agglomeration areas did not show a significant trend of dissipation. 2002-2004, the agglomeration areas were distributed in southwestern Yunnan, Hunan-Guizhou-Guangxi border and Zhejiang Province, southwestern Yunnan epidemic. The incidence of imported malaria in Yunnan Province increased from 2005 to 2007, the degree of aggregation increased, the incidence of imported malaria increased, the incidence of imported malaria decreased from 2008 to 2010, but the distribution of imported cases was still widespread. There are two space-time agglomeration areas in Yunnan Province. The first-class agglomeration area is located in the western border of Yunnan Province, including 10 counties. The second-class agglomeration area is located in the southern border of Yunnan Province, including 2 counties. The time of 2002-2005 is Hunan-Guizhou-Guangxi border agglomeration area, including 2002-2005. The 79 counties and districts in Zhejiang province are 2006-2008 years, including 29 counties and districts, which are distributed in the eastern part of Zhejiang province.
Conclusion:
The spatial and temporal evolution of malaria transmission in China from 2002 to 2010 shows that there is no obvious clustering distribution of local malaria cases in China. By 2010, more than 70% of counties and districts in China have no local malaria cases, the incidence rate has dropped to 0.03/10,000, malaria transmission has been effectively controlled and malaria prevention has entered the elimination stage. Although there is no aggregate distribution in the area, it should be the focus of malaria surveillance and timely detection of aggregated imported cases to prevent secondary transmission.
【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】：R531.3
【参考文献】
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