Spatial, temporal and spatio-temporal clusters of measles incidence at the county level in Guangxi, China during 2004-2014: flexibly shaped scan statistics.
Spatial, temporal and spatio-temporal clusters of measles incidence at the county level in Guangxi, China during 2004-2014: flexibly shaped scan statistics.
复制标题
2004-2014年中国广西县级麻疹发病的时空及时空聚集性：灵活形状扫描统计
DOI：
10.1186/s12879-017-2357-1
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发表时间：
2017-04-04
影响因子：
3.7
通讯作者：
Zhong G
中科院分区：
文献类型：
--
作者：
Tang X;Geater A;McNeil E;Deng Q;Dong A;Zhong G
2013-2014年，广西省再次出现麻疹疫情，麻疹再次成为主要的公共卫生问题。更好地了解麻疹病例的模式将有助于确定高风险地区和时期，以优化预防战略，但这些模式在很大程度上仍然未知。因此，本研究旨在确定2004-2014年广西县（市）级麻疹聚集的空间、时间和时空分布特征。麻疹病例和人口规模的年度数据分别来自广西疾控中心和广西统计局。流行曲线和Kulldorff的时间扫描统计被用来确定季节性高峰和高风险期。Tango灵活的扫描统计被用来确定不规则的空间聚类。椭圆柱形状的时空集群检测Kulldorff的扫描统计。使用≤24个月儿童的人口归因风险百分比（PAR%）来识别麻疹负担沉重的地区。季节性高峰发生在4月至6月，2014年检测到了麻疹的时间性聚集。桂西、桂西南和桂中北部为空间集群。研究发现，相对风险高的时空集群有3个阶段：2004-2005年桂中、2007年桂中中西部、2013-2014年桂西和桂西南。PAR%高值区主要集中在桂西、桂西南、桂北和桂中。2010 - 2014年广西麻疹发病率呈上升趋势，2004-2009年呈下降趋势。热点地区由桂中向桂西和桂西南转移，这些地区麻疹负担过重。因此，加强对常规疫苗接种的及时性和完整性的监测，并实施麻疹补充免疫活动，应在这些地区的优先事项。
Outbreaks of measles re-emerged in Guangxi province during 2013–2014, where measles again became a major public health concern. A better understanding of the patterns of measles cases would help in identifying high-risk areas and periods for optimizing preventive strategies, yet these patterns remain largely unknown. Thus, this study aimed to determine the patterns of measles clusters in space, time and space-time at the county level over the period 2004–2014 in Guangxi. Annual data on measles cases and population sizes for each county were obtained from Guangxi CDC and Guangxi Bureau of Statistics, respectively. Epidemic curves and Kulldorff’s temporal scan statistics were used to identify seasonal peaks and high-risk periods. Tango’s flexible scan statistics were implemented to determine irregular spatial clusters. Spatio-temporal clusters in elliptical cylinder shapes were detected by Kulldorff’s scan statistics. Population attributable risk percent (PAR%) of children aged ≤24 months was used to identify regions with a heavy burden of measles. Seasonal peaks occurred between April and June, and a temporal measles cluster was detected in 2014. Spatial clusters were identified in West, Southwest and North Central Guangxi. Three phases of spatio-temporal clusters with high relative risk were detected: Central Guangxi during 2004–2005, Midwest Guangxi in 2007, and West and Southwest Guangxi during 2013–2014. Regions with high PAR% were mainly clustered in West, Southwest, North and Central Guangxi. A temporal uptrend of measles incidence existed in Guangxi between 2010 and 2014, while downtrend during 2004–2009. The hotspots shifted from Central to West and Southwest Guangxi, regions overburdened with measles. Thus, intensifying surveillance of timeliness and completeness of routine vaccination and implementing supplementary immunization activities for measles should prioritized in these regions.