湖南省钩体病流行态势及空间分析

发布时间：2018-06-19 16:57

本文选题：钩体病 + 描述性分析　；参考：《中南大学》2010年硕士论文

【摘要】： 目的：了解湖南省钩端螺旋体病(Leptospirosis,简称钩体病)的三间分布规律及钩体病主要传播宿主(鼠类)在不同时间、地区内密度、种类和带毒率变化情况；采用空间分析方法,揭示钩体病的空间分布特点探讨钩体病的时空聚集性,为湖南省以后的钩端螺旋体病防治提供新的研究手段和依据。方法：利用Excel软件制作图、表,对湖南省2003-2008年钩体病疫情资料及鼠类监测资料进行描述,并采用卡方检验分析其差异；利用克里金插值分析(Kriging Interpolation Analysis),形成钩体病分布预测地图和预测误差地图；运用扫描统计量分析,得出钩体病聚类的时间、地区以及不同年份间各县域的发病相对危险度,并实现可视化。结果：研究期间湖南省钩体病发病率和死亡率均总体表现为下降趋势,但2007年有所反弹。2003年到2008年湖南共报告钩体病例703例,平均发病率为0.180/10万。死亡41例,平均死亡率为0.011/10万,病死率为5.832/10万。该病具有明显的季节性特征,虽然不同年份间发病高峰期有所提前和延后,但基本集中于6-10月间,一般为单峰分布,但个别年份表现为双峰分布。病例报告以农业劳动者为主,其次是学生,年龄集中于10-59岁之间,男性多于女性；宿主动物流行病学调查显示,鼠密度及鼠带菌率最高的年份为2007年,鼠密度最高的监测点为沅江市,鼠带菌率最高的监测点为双峰县。不同年份间,不同监测点间鼠密度及鼠带菌率差异有统计学意义(P0.0001)。湖南省钩体鼠类优势鼠种为黑线姬鼠,占总捕获数的45.85%,其次为小家鼠和褐家鼠,分别为25.69%,22.32%。不同年份间,不同监测点、不同年份间鼠种构成差异有统计学意义(P0.0001)；克里金插值数据探索分析结果表明,采用基于球状模型的二阶析取克里金插值法得出的平均发病率地图精度最高,且根据球状模型公式可知在变程123994范围内,湖南省钩体病平均发病率具有中度自相关性,其中由空间自相关引起的变异占总变异的49.97%。时空扫描统计分析结果揭示了在研究期间内湖南省钩体病的发病不是随机性分布,存在三个有统计学意义的时空聚类区(P0.00001)。湖南省钩体病预测分布图及扫描统计量分析结果均表明：钩体病高发区域主要位于中东部丘陵地带、西北和西南部山区,其中各年度风险地图表现为：整体上高风险分布地区与低风险分布地区相对固定,某些地区高风险区域与低风险区域相间分布,高风险波及地区年度间分布不均匀。结论：湖南省2003-2008年钩体病疫情总体表现为下降趋势,钩体病发病男性多于女性,以农民为主的青壮年为多,呈现明显的季节性。不同时间,不同监测点间鼠密度,优势鼠种分布及带菌率均不同。湖南省钩体病并非随机分布,存在时空聚集性,其高发区域主要位于中东部丘陵地带、西北和西南部山区。
[Abstract]:Objective: to study the distribution of Leptospirosis (Leptospirosis) in Hunan Province, and the changes of density, species and viral rate of Leptospirosis, the main host of leptospirosis (rodent) in different time and region. To reveal the spatial distribution characteristics of leptospirosis and to explore the space-time aggregation of leptospirosis, and to provide a new research method and basis for the prevention and control of leptospirosis in Hunan Province. Methods: the data of epidemic situation of leptospirosis and the surveillance data of rodents in Hunan Province from 2003 to 2008 were described by using Excel software, and the differences were analyzed by chi-square test. The Kriging Interpolation Analysis was used to form the prediction map and prediction error map of Leptospira disease distribution, and the relative risk of Leptospira disease clustering was obtained by scanning statistical analysis. And realize visualization. Results: the incidence rate and mortality rate of leptospirosis in Hunan Province decreased in general, but rebounded in 2007. From 2003 to 2008, 703 cases of leptospirosis were reported in Hunan Province, with an average incidence of 0.180 / 100 000. There were 41 deaths, with an average mortality rate of 0.011 / 100, 000 and a mortality rate of 58,832 / 100, 000. Although the peak period of the disease was earlier and delayed in different years, it was mainly concentrated in the period of June to October, which was a single peak distribution, but a double peak distribution in a few years. Case reports were mainly agricultural workers, followed by students, aged between 10 and 59 years, with more males than females. Epidemiological surveys of host animals showed that the highest rodent density and rat carrying rate were in 2007. The highest density of mice is Yuanjiang City, and the highest rate of mice carrying bacteria is Shuangfeng County. There were significant differences in rat density and rat carrying rate among different monitoring sites in different years (P 0.0001). The dominant species of Leptospira rodents in Hunan Province were Apodemus agrarius, which accounted for 45.85% of the total captured number, followed by mice and Rattus norvegicus, which were 25.699.22. 32cm, respectively. There were significant differences in the composition of rodent species between different years, different monitoring points and different years, and the results of Kriging interpolation data analysis showed that, The map accuracy of the mean incidence rate obtained by the second order precipitation Kriging interpolation method based on the spherical model is the highest, and according to the spherical model formula, the average incidence of leptospirosis in Hunan Province has moderate autocorrelation in the range of variable range 123994. The variation caused by spatial autocorrelation accounted for 49.97% of the total variation. The statistical analysis of space-time scanning revealed that the incidence of leptospirosis in Hunan Province was not random distribution during the study period, and there were three statistically significant spatial and temporal clustering regions (P0.00001). The predication map of leptospirosis in Hunan Province and the analysis of scanning statistics showed that the high incidence area of leptospirosis was mainly located in the hilly region of the central and eastern part, northwest and southwest mountain areas. The annual risk map shows that the high risk distribution area and the low risk distribution area are relatively fixed on the whole, the high risk area and the low risk area are distributed in some areas, and the high risk area and the low risk area are not evenly distributed in each year. Conclusion: the epidemic situation of leptospirosis in Hunan Province from 2003 to 2008 showed a downward trend. The incidence of leptospirosis in men was more than that in women. The density of rodents, the distribution of dominant rodent species and the rate of carrying bacteria were different at different time and different monitoring points. Leptospirosis is not a random distribution in Hunan Province, and it has spatio-temporal aggregation.
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R181.3;R514.4

【引证文献】