Abstract: Objective　To investigate the spatiotemporal clustering characteristics of the reported incidence of visceral leishmaniasis (VL) in Gansu Province from 1993 to 2023, so as to provide insights into the containment of VL and prevention of VL recurrence. Methods　County (district)⁃level epidemical data of VL in Gansu Province from 1993 to 2023 were collected, and the geographical information database of reported VL incidence in Gansu Province was created according to the county⁃level administrative code and electronic maps in Gansu Province. In addition, the spatial autocorrelation analysis and hot spot analysis of the reported VL incidence were performed in Gansu Province using the software ArcGIS 10.8. Results　A total of 2 597 VL cases were reported in Gansu Province from 1993 to 2023, with an annual average incidence rate of 3.036/105. Spatial autocorrelation analysis showed spatial clustering of the reported VL incidence in Gansu Province (Moran’s I = 0.605, Z = 5.240, P < 0.001), appearing high⁃high clustering features (Getis⁃Ord G = 0.080, Z = 4.137, P < 0.001), and high⁃high clustering of the reported incidence of VL was identified in Diebu County, Dangchang County, Zhouqu County and Wenxian County. Hot spot analysis showed hot⁃spot areas of the reported VL incidence in Dangchang County, Zhouqu County, Wudu District and Wen County along the Bailong River basins and cold⁃spot areas in Qin’an County and Gangu County. Conclusions　There was spatial clustering and hot spots of the reported VL incidence in Gansu Province from 1993 to 2023. Intensified surveillance and control is required to prevent the spread of VL.

Key words: Visceral leishmaniasis, Epidemiological characteristic, Spatiotemporal cluster, Spatial autocorrelation analysis, Hot spot analysis, Gansu Province

摘要： 目的　分析1993—2023年甘肃省内脏利什曼病报告发病率时空聚集特征及分布热点，为控制该病流行、防止疫情复燃提供参考。方法　以县（区）为单位收集1993—2023年甘肃省内脏利什曼病疫情资料，结合甘肃省县级行政编码信息及电子地图构建甘肃省内脏利什曼病报告发病率地理信息数据库，采用ArcGIS 10.8软件进行甘肃省内脏利什曼病报告发病率空间自相关和热点分析。结果　1993—2023年，甘肃省累计报告2 597例内脏利什曼病病例，年均发病率为3.036/105。空间自相关分析发现，甘肃省内脏利什曼病报告发病率呈空间聚集性分布（Moran’s I = 0.605，Z = 5.240，P < 0.001），且为高值聚集（Getis⁃Ord G = 0.080，Z = 4.137，P < 0.001）；其中迭部县、宕昌县、舟曲县和文县为内脏利什曼病报告发病率高⁃高聚集区。热点分析发现，1993—2023年甘肃省内脏利什曼病报告发病率热点区域分布于白龙江沿岸宕昌县、舟曲县、武都区和文县，冷点区主要分布于秦安县和甘谷县。结论　1993—2023年甘肃省内脏利什曼病报告发病率呈空间聚集性分布，且部分流行区存在分布热点。应加强内脏利什曼病疫情监测与防治投入力度，防止疫情蔓延。

关键词: 内脏利什曼病, 流行特征, 时空聚集, 空间自相关分析, 热点分析, 甘肃省