Chin J Schisto Control ›› 2019, Vol. 31 ›› Issue (3): 269-.

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Spatial-temporal clustering analysis of schistosomiasis transmission risk in Yunnan Province from 2004 to 2015

HAO Yu-Wan1, GAO Feng-Hua2, XUE Jing-Bo1, XU Jun-Fang3, WANG Qiang1, ZHANG Yun4, WANG Li-Fang4, DONG Yi4*, LI Shi-Zhu1*   

  1. 1 National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, WHO Collaborating Center for Tropical Diseases, Chinese Center for Tropical Diseases Research, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Key Laboratory of Parasite and Vector Biology, National Health Commission, Shanghai 200025, China; 2 Anhui Institute of Parasitic Diseases, China; 3 Hubei Minzu University, China; 4 Yunnan Institute of Endemic Diseases Control and Prevention, China
  • Online:2019-08-28 Published:2019-08-28

2004–2015年云南省血吸虫病传播风险 时空聚集性分析

郝瑜婉1,高风华2,薛靖波1,徐俊芳3,王强1,张云4,王丽芳4,董毅4*,李石柱1*   

  1. 1 中国疾病预防控制中心寄生虫病预防控制所、WHO热带病合作中心、国家热带病研究中心、科技部国家级热带病国际联合研究中心、国家卫生健康委员会寄生虫病原与媒介生物学重点实验室(上海 200025);2安徽省血吸虫病防治研究所;3湖北民族大学;4 云南省地方病防治研究
  • 作者简介:郝瑜婉,女,助理研究员。研究方向:寄生虫病控制与免疫诊断
  • 基金资助:
    国家科技重大专项(2018ZX10101002-002);上海市公共卫生三年行动计划(GWIV-29)

Abstract: Objective To explore the spatial?temporal clustering distribution of schistosomiasis transmission risk in Yunnan Province from 2004 to 2015, so as to provide scientific evidence for the future schistosomiasis control and consolidation of the control achievements. Methods All data pertaining to endemic situation of human and bovine schistosomiasis and snail survey at a township level in Yunnan Province from 2004 to 2015 were collected. A descriptive epidemiological method and Joinpoint model were used to describe the changing trends of Schistosoma japonicum infections in humans, bovine and snails, and the hotspots and clusters of schistosomiasis transmission risk were identified using spatial autocorrelation analysis, hotspots analysis and retrospective space?time scan statistic in Yunnan Province from 2004 to 2015. Results The prevalence of S. japonicum infections appeared a continuous decline in humans, bovine and snails in Yunnan Province from 2004 to 2015, and the estimated number of schistosomiasis cases reduced from 43 056 in 2004 to 756 in 2015, with a decline rate of 98.24%. There were no acute cases since 2008 and no infected snails since 2014 in Yunnan Province. There were significant differences in the changing trends of human and bovine S. japonicum infections in Yunnan Province between 2012 and 2015 and between 2013 and 2015, respectively using the Joinpoint model (P < 0.05). In addition, there was a spatial autocorrelation in human S. japonicum infections in Yunnan Province from 2004 to 2013 (P < 0.01), and the hotspots areas for human S. japonicum infections were mainly distributed in some townships from Dali City, Weishan County and Eryuan County. Retrospective spatial?temporal scanning revealed that S. japonicum human, bovine and snail infections were clustered in 23, 15, 4 townships from Dali City, Weishan County, Eryuan County, Nanjian County and Heqing County, respectively, with relative risks of 6.25 to 28.75 (P < 0.01), which was almost consistent with the cluster areas detected by hotspots analysis. Conclusions The endemic situation of schistosomiasis significantly reduced in Yunnan Province from 2004 to 2015; however, there is still a risk of schistosomiasis transmission. The monitoring and control of schistosomiasis should be intensified in the future in Yunnan Province.

Key words: Schistosomiasis, Transmission risk, Spatial?temporal clustering, Yunnan Province

摘要: 目的 探测2004–2015年云南省血吸虫病传播风险时空聚集特征,为进一步控制血吸虫病流行、巩固已有防控成果提供科学依据。方法 以乡(镇)为单位收集、整理2004–2015年云南省人群、耕牛血吸虫病疫情及钉螺调查等资料,应用描述流行病学方法和Joinpoint模型分析人群、耕牛和钉螺血吸虫感染率变化趋势;应用空间自相关和热点分析方法、回顾性时空扫描统计量方法对2004–2015年云南省血吸虫病传播风险热点和聚集区域进行探测。结果 2004–2015年云南省人群、耕牛和钉螺血吸虫感染率呈连续下降趋势,全省血吸虫病推算病人数由2004年的43 056例降至2015年的756例,下降了98.24%;全省自2008年起无急性血吸虫病病例,自2014年起未发现感染性钉螺。Joinpoint模型分析显示,云南省人群和耕牛血吸虫感染率分别在2012–2015年和2013–2015年变化趋势有统计学意义(P < 0.05)。空间自相关Moran’s I指数检验发现,2004–2013年云南省人群血吸虫感染率存在空间自相关性(P < 0.01),探测出的感染风险热点区域主要集中于大理市、巍山县和洱源县的部分乡(镇)。回顾性时空扫描聚类分析发现,人群、耕牛和钉螺血吸虫感染各有2个风险聚集区域,分别聚集在23、15个和4个乡(镇),主要分布在大理市、巍山县、洱源县、南涧县和鹤庆县,相对危险度为6.25~28.75(P < 0.01),与热点探测出的聚集区域基本一致。结论 2004–2015年云南省血吸虫病疫情下降明显,但血吸虫病传播风险在一定范围内仍然存在,仍需继续强化监测和防控力度。

关键词: 血吸虫病, 传播风险, 时空聚集性, 云南省

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