中国2011年梅毒疫情空间分布模式初探

摘要

目的 探讨梅毒流行的空间分布模式,为梅毒监测与防治提供新方法.方法 建立2011年中国各县区梅毒疫情地理信息系统数据库,使用探索性空间分析方法对中国梅毒疫情进行频数分布、全局和局部空间自相关分析,探索其空间分布特征.结果 2011年全国2 925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).全局空间自相关分析显示中国县区级梅毒疫情呈正空间自相关(全局Moran指数为0.5762,P＜0.001),空间分布模式为“高-高”聚集(全局G系数为0.0331,P＜0.001).通过局部自相关分析输出了中国县区级梅毒疫情分布的热点地图,确认了117个一、二期梅毒疫情的热点县区(其发病率均超过50/10万),主要分布于华东、西北、东北和华南等地区.结论 地理信息系统和探索性空间分析方法具有可视化和精确定位等优点,可作为一种新的重要工具用于梅毒监测和防治.%Objective To characterize the spatial distribution pattern of syphilis at the county level in China,and to provide a new method for syphilis surveillance and control.Methods A national geographic information system (GIS) database was developed based on reported cases of syphilis from all counties in China,2011.Exploratory spatial data analysis (ESDA) methods were used to study the frequency distribution of incidence,global and local spatial autocorrelation,of syphilis.Results The median incidence rate of syphilis was 21.17/100 000 (range:0.00-515.34/100 000; 25th percentile 9.28/100 000,75th percentile 43.00/100 000) in 2 925 counties in the mainland of China in 2011,with a highly positively skewed distribution (skewness =3.11).The global spatial autocorrelation analysis showed a positive spatial autocorrelation of syphilis incidence at the county level in China (global Moran's index =0.576 2,P ＜ 0.001),with the type of correlation being high-high cluster (General G index =0.033 1,P ＜ 0.001).The local spatial autocorrelation analysis delineated hot spots of syphilis (including primary and secondary syphilis,latent syphilis) at the county level.Totally,117 counties,which were mainly distributed in the Yangtze River delta region,northwest,northeastern and south China,were identified as hot spots for syphilis,with the incidence rate of primary or secondary syphilis being higher than 50/100 000.Conclusions The GIS and exploratory spatial data analysis,with the advantages of visualization and accurate localization,may serve as an important novel tool for syphilis surveillance and control.