我国梅毒疫情地理信息系统方法的建立与初步应用
发布时间：2018-08-06 08:41
【摘要】：背景：梅毒是由苍白密螺旋体苍白亚种感染人体所引起的一种严重危害人体健康的经典性病,是人类社会所面临的危害巨大的传染病之一。梅毒在我国已成为重要的公共卫生问题之一,位居法定甲乙类传染病发病排序第3位。传统的流行病学分析方法难于直观精确发现梅毒在我国的地理分布特征及其影响因素。近年发展起来的地理信息系统及空间分析方法可以弥补其不足,为梅毒疫情监测开辟新途径。如何在我国建立起梅毒疫情地理信息系统方法,并将其应用于梅毒疫情分析,是本课题需要研究的问题。 目的：建立我国梅毒疫情地理信息系统数据库,探索和揭示我国梅毒疫情空间分布特征,直观与精确地找出我国梅毒疫情热点地区；构建我国梅毒疫情空间回归模型,探讨影响梅毒疫情空间分布特征的因素；为实现梅毒的精确防治提供依据。 方法：使用地理信息系统MapInfo10.0软件建立2011年我国各县区梅毒疫情地理信息系统数据库；在此基础上,利用GeoDa1.46和ArcGIS软件,运用探索性空间分析方法,包括频数分布、全局趋势分析、全局和局部空间自相关分析,探索我国梅毒疫情空间分布特征；然后运用确认性空间分析方法构建我国梅毒疫情空间回归模型,分析其空间分布模式的成因。 结果：频数分布分析显示,2011年全国2925个县区梅毒发病率中位数为21.17/10万(25%分位数9.28/10万,75%分位数43.00/10万),最小为0.00,最大为515.34/10万,呈明显的正偏态分布(偏度为3.11),有126个县区梅毒发病率超过101/10万,为极端异常值。全局趋势分析表明,我国梅毒疫情分布从西北到东南方向呈现为“U”形变化趋势,显示西北和东南沿海地区高发。全局空间自相关分析显示,我国县区级梅毒疫情呈正空间自相关(全局Moran指数为0.5762,P0.001),空间分布模式为“高—高”聚集(全局G系数为0.0331,P0.001)。通过局部自相关分析输出了我国县区级梅毒疫情分布的热点地图,期和二期梅毒有5个核心区和117个热点县区(其发病率均超过50/10万),主要分布在新疆西南部、青海中东部、广西、东南沿海、东北(包括内蒙锡林郭勒盟)等地区。同时,对福建、广东和新疆3个梅毒高发省份进行探索性空间数据分析,找出了热点县区。我国地市级梅毒疫情空间滞后回归分析结果显示,空间回归模型具有显著的统计学意义(决定系数R2=0.48,空间自回归系数=0.55,P0.0001),人均GDP、性病医疗机构数量、流动人口、FSW和MSM人群的梅毒感染率是影响梅毒疫情空间分布的显著性因素,其空间回归系数分别为3.47、0.12、4.46、1.85、和0.71(P值均0.05)。 结论：我国梅毒疫情热点地区主要分布于新疆西南部、青海中东部、广西、东南沿海、东北(包括内蒙锡林郭勒盟)等地区,应突出重点,集中有限资源,采取有效措施加强对这些地区尤其是少数民族地区的梅毒防治工作,做到精确防治和科学防治。经济发达、流动人口和高危人群梅毒感染率高的地区,其梅毒报告发病率高；流动人口和FSW人群梅毒感染率较MSM和男性性病就诊者人群对梅毒发病率的影响更大,值得进一步研究。地理信息系统及空间分析方法具有可视化和精确定位等优点,应作为一种新的重要工具用于梅毒监测和防治。
[Abstract]:Background: syphilis is a classic venereal disease which is caused by the infection of the pallidum pallidum pallidum to human body. It is one of the most dangerous infectious diseases in human society. Syphilis has become one of the important public health problems in China. It is ranked third in the order of class A and B infectious disease. It is difficult to find the geographical distribution characteristics and influencing factors of syphilis in China. The geographic information system and spatial analysis method developed in recent years can make up for its shortcomings and open up a new way for the monitoring of syphilis epidemic situation. The analysis of epidemic situation of syphilis is a problem that needs to be studied in this topic.
Objective: to establish the geographic information system database of syphilis epidemic in China, to explore and reveal the spatial distribution characteristics of syphilis epidemic in China, to find out the hot areas of the syphilis epidemic in China, to establish the spatial regression model of the syphilis epidemic in China, to explore the factors affecting the spatial distribution of syphilis, and to achieve the accurate prevention and control of syphilis. Provide the basis.
Methods: the geographic information system database of syphilis epidemic in various counties of China in 2011 was set up using MapInfo10.0 software of geographic information system. On this basis, using GeoDa1.46 and ArcGIS software, exploratory spatial analysis was used, including frequency distribution, global trend analysis, global and local spatial autocorrelation analysis, to explore the syphilis epidemic in China. Secondly, the spatial distribution characteristics of syphilis epidemic in China were analyzed by using confirmatory spatial analysis method to construct the spatial regression model of syphilis epidemic in China.
Results: the frequency distribution analysis showed that the median of the incidence of syphilis in 2925 counties of the country in 2011 was 21.17/10 million (25% digits 9.28/10 million, 75% digits 43.00/10 million), the smallest was 0, and the maximum was 515.34/10 million, showing a significant positive partial distribution (3.11), and the incidence of syphilis in 126 counties was more than 101/10 million, the extreme anomaly value. The trend analysis shows that the distribution of syphilis in China shows a "U" change trend from northwest to Southeast, showing high incidence in Northwest and southeast coastal areas. Global spatial autocorrelation analysis shows that the epidemic situation of syphilis in the county level of China is positively spatial autocorrelation (global Moran index is 0.5762, P0.001), and the spatial distribution pattern is "high to high" aggregation. (global G coefficient is 0.0331, P0.001). Through local autocorrelation analysis, a hot map of the county level syphilis distribution in China is exported. There are 5 core regions and 117 hot spot counties (all over 50/10 million), mainly in southwestern Xinjiang, Middle East Qinghai, Guangxi, southeast coast, and Northeast (including Inner Mongolia tin Lin Guo). At the same time, 3 provinces with high incidence of syphilis in Fujian, Guangdong and Xinjiang were analyzed by exploratory spatial data analysis, and the hot spot counties were found. The spatial regression analysis results showed that the spatial regression model had significant statistical significance (determination coefficient R2=0.48, spatial autoregressive coefficient =0.55, P0.0001). GDP, the number of STD medical institutions, the flow population, the rate of syphilis infection in the population of FSW and MSM was a significant factor affecting the spatial distribution of syphilis, and the spatial regression coefficient was 3.47,0.12,4.46,1.85 and 0.71 (P value was 0.05).
Conclusion: the hot spots of syphilis in China are mainly distributed in the southwest of Xinjiang, in the Middle East of Qinghai, in Guangxi, in the southeast coast, in the Northeast (including Inner Mongolia and Xilinguole Meng). We should focus on the focus, concentrate the limited resources and take effective measures to strengthen the prevention and control of syphilis in these areas, especially in minority areas. The incidence of syphilis is higher in areas with high economic development and high rate of syphilis infection among the floating population and high risk population. The incidence of syphilis infection in the floating population and the FSW population is greater than that of the MSM and male STD patients. It is worth further study. The geographic information system and the spatial analysis method have the visualization and precision. The advantages of location and so on should be used as a new important tool for syphilis surveillance and control.
【学位授予单位】：北京协和医学院
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R759.1
本文编号：2167166
[Abstract]:Background: syphilis is a classic venereal disease which is caused by the infection of the pallidum pallidum pallidum to human body. It is one of the most dangerous infectious diseases in human society. Syphilis has become one of the important public health problems in China. It is ranked third in the order of class A and B infectious disease. It is difficult to find the geographical distribution characteristics and influencing factors of syphilis in China. The geographic information system and spatial analysis method developed in recent years can make up for its shortcomings and open up a new way for the monitoring of syphilis epidemic situation. The analysis of epidemic situation of syphilis is a problem that needs to be studied in this topic.
Objective: to establish the geographic information system database of syphilis epidemic in China, to explore and reveal the spatial distribution characteristics of syphilis epidemic in China, to find out the hot areas of the syphilis epidemic in China, to establish the spatial regression model of the syphilis epidemic in China, to explore the factors affecting the spatial distribution of syphilis, and to achieve the accurate prevention and control of syphilis. Provide the basis.
Methods: the geographic information system database of syphilis epidemic in various counties of China in 2011 was set up using MapInfo10.0 software of geographic information system. On this basis, using GeoDa1.46 and ArcGIS software, exploratory spatial analysis was used, including frequency distribution, global trend analysis, global and local spatial autocorrelation analysis, to explore the syphilis epidemic in China. Secondly, the spatial distribution characteristics of syphilis epidemic in China were analyzed by using confirmatory spatial analysis method to construct the spatial regression model of syphilis epidemic in China.
Results: the frequency distribution analysis showed that the median of the incidence of syphilis in 2925 counties of the country in 2011 was 21.17/10 million (25% digits 9.28/10 million, 75% digits 43.00/10 million), the smallest was 0, and the maximum was 515.34/10 million, showing a significant positive partial distribution (3.11), and the incidence of syphilis in 126 counties was more than 101/10 million, the extreme anomaly value. The trend analysis shows that the distribution of syphilis in China shows a "U" change trend from northwest to Southeast, showing high incidence in Northwest and southeast coastal areas. Global spatial autocorrelation analysis shows that the epidemic situation of syphilis in the county level of China is positively spatial autocorrelation (global Moran index is 0.5762, P0.001), and the spatial distribution pattern is "high to high" aggregation. (global G coefficient is 0.0331, P0.001). Through local autocorrelation analysis, a hot map of the county level syphilis distribution in China is exported. There are 5 core regions and 117 hot spot counties (all over 50/10 million), mainly in southwestern Xinjiang, Middle East Qinghai, Guangxi, southeast coast, and Northeast (including Inner Mongolia tin Lin Guo). At the same time, 3 provinces with high incidence of syphilis in Fujian, Guangdong and Xinjiang were analyzed by exploratory spatial data analysis, and the hot spot counties were found. The spatial regression analysis results showed that the spatial regression model had significant statistical significance (determination coefficient R2=0.48, spatial autoregressive coefficient =0.55, P0.0001). GDP, the number of STD medical institutions, the flow population, the rate of syphilis infection in the population of FSW and MSM was a significant factor affecting the spatial distribution of syphilis, and the spatial regression coefficient was 3.47,0.12,4.46,1.85 and 0.71 (P value was 0.05).
Conclusion: the hot spots of syphilis in China are mainly distributed in the southwest of Xinjiang, in the Middle East of Qinghai, in Guangxi, in the southeast coast, in the Northeast (including Inner Mongolia and Xilinguole Meng). We should focus on the focus, concentrate the limited resources and take effective measures to strengthen the prevention and control of syphilis in these areas, especially in minority areas. The incidence of syphilis is higher in areas with high economic development and high rate of syphilis infection among the floating population and high risk population. The incidence of syphilis infection in the floating population and the FSW population is greater than that of the MSM and male STD patients. It is worth further study. The geographic information system and the spatial analysis method have the visualization and precision. The advantages of location and so on should be used as a new important tool for syphilis surveillance and control.
【学位授予单位】：北京协和医学院
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R759.1
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