Temporal and Spatial Analysis of Neural Tube Defects and Detection of Geographical Factors in Shanxi Province, China.
Temporal and Spatial Analysis of Neural Tube Defects and Detection of Geographical Factors in Shanxi Province, China.
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中国山西省神经管缺陷时空分析及地理因素检测
DOI：
10.1371/journal.pone.0150332
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Xu B
中科院分区：
文献类型：
--
作者：
Liao Y;Zhang Y;He L;Wang J;Liu X;Zhang N;Xu B
神经管缺陷（NTD）是发生在中枢神经系统的先天性出生缺陷，在所有出生缺陷中发生率最高。中国的山西省是世界上被忽视的热带病发病率最高的省份。自20世纪90年代以来，中国政府开展了多项出生缺陷预防项目，包括计划生育、健康教育、遗传咨询、产前超声检查和血清学筛查等，以减少被忽视的热带疾病的发生。但经过干预后，山西省NTDs发病率仍高于世界平均发病率。此外，山西省煤炭储量丰富，是中国第一大煤炭生产省份。本研究的目的是确定中国山西省农村地区 NTD 发病率的时间和空间变化，并确定与风险地区 NTD 相关的地理环境因素。本研究选取NTDs高发地区山西省和顺县和原平县作为研究区域。采用两配对样本T检验从时间维度分析NTDs风险的变化。将 Ripley 的 k 函数和空间滤波与地理信息系统（GIS）软件相结合，从空间维度研究 NTD 风险的变化。此外，利用地理探测器识别研究区尤其是靠近煤矿区和主要道路的地区NTDs风险地理环境因素。和顺县和原平县NTDs发病率干预后均显着降低（P<0.05）。空间分析结果显示，两县均存在显着的空间异质性。经过干预后，在靠近煤场和主要道路的地区仍然发现了 NTD 群。本研究还表明，海拔、断层和土壤类型对我们研究地区 NTD 的发病率始终有较大影响。此外，在靠近煤场和主要道路的地区，距河流的距离是NTDs的一个危险因素。现有的干预措施可能对降低 NTD 的发病率发挥了重要作用。然而，使用传统干预方法后，两县仍存在空间异质性。政府需要采取更多措施，加强环境修复，防止NTD的发生，特别是靠近煤矿和主要道路的地区。本研究成果为政府预防NTDs的发生提供了重要的理论依据和技术支撑。
Neural tube defects (NTDs) are congenital birth defects that occur in the central nervous system, and they have the highest incidence among all birth defects. Shanxi Province in China has the world’s highest rate of NTDs. Since the 1990s, China’s government has worked on many birth defect prevention programs to reduce the occurrence of NTDs, such as pregnancy planning, health education, genetic counseling, antenatal ultrasonography and serological screening. However, the rate of NTDs in Shanxi Province is still higher than the world’s average morbidity rate after intervention. In addition, Shanxi Province has abundant coal reserves, and is the largest coal production province in China. The objectives of this study are to determine the temporal and spatial variation of the NTD rate in rural areas of Shanxi Province, China, and identify geographical environmental factors that were associated with NTDs in the risk area. In this study, Heshun County and Yuanping County in Shanxi Province, which have high incidence of NTDs, were selected as the study areas. Two paired sample T test was used to analyze the changes in the risk of NTDs from the time dimension. Ripley’s k function and spatial filtering were combined with geographic information system (GIS) software to study the changes in the risk of NTDs from the spatial dimension. In addition, geographical detectors were used to identify the risk geographical environmental factors of NTDs in the study areas, especially the areas close to the coal sites and main roads. In both Heshun County and Yuanping County, the incidence of NTDs was significantly (P<0.05) reduced after intervention. The results from spatial analysis showed that significant spatial heterogeneity existed in both counties. NTD clusters were still identified in areas close to coal sites and main roads after interventions. This study also revealed that the elevation, fault and soil types always had a larger influence on the incidence of NTDs in our study areas. In addition, distance to the river was a risk factor of NTDs in areas close to the coal sites and main roads. The existing interventions may have played an important role to reduce the incidence of NTDs. However, there is still spatial heterogeneity in both counties after using the traditional intervention methods. The government needs to take more measures to strengthen the environmental restoration to prevent the occurrence of NTDs, especially those areas close to coal sites and main roads. The outcome of this research provides an important theoretical basis and technical support for the government to prevent the occurrence of NTDs.