目的 了解2005-2015年山西省大同市人间布鲁氏菌病(布病)的时空流行趋势及气象因素对布病的驱动效应,为防控工作提供科学依据.方法 收集大同市2005-2015年布病的报告发病资料和同期气象数据,描述疾病流行特征;通过拟合Quasi-Poisson分布滞后非线性模型(Distributed Lag Non-linear Models,DLNM),研究月值气象数据对布病发病季节性的驱动作用.结果 2005-2015年大同市共报告布病17 311例(死亡l例),年平均报告发病率为47.43/10万,总体呈上升趋势;季节性高峰集中在3-6月,占总病例数的48.40％;地区分布从东北部、东南部地区的传统流行区逐步向西扩大蔓延;DLNM分析结果显示布病发病在时间尺度上受蒸发量、降水量和气温影响显著,当月累积蒸发量为140 ～ 260mm、月累积降水量为20～60mm时,发病高峰滞后时间＜1个月,月平均气温为-13℃时发病高峰滞后4-5个月.结论 2005-2015年大同市布病发病率呈上升趋势,病例在季节、人群和空间上具有明显流行特征;气象因素蒸发量、降水、气温对疾病发生驱动作用明显.%Objective To explore the spatio-temporal epidemic trends and related driving effects of meteorological factors on brucellosis in Datong city,Shanxi province,from 2005 to 2015.Methods We collected the surveillance data on brucellosis and related meteorological data in Datong city from 2005 to 2015,to describe the epidemic characteristics of the disease.Quasi-Poisson distribution lag non-liner model (DLNM) was built to explore the driving effect of monthly meteorological data on the disease.Results From 2005 to 2015,Datong city reported a total of 17 311 cases of brucellosis including one death,with the annual average incidence as 47.43 per 100 000 persons.A rising trend was seen during the study period.The monthly incidence of Brucellosis presented an obvious curve with a major peak from March to June,accounted for 48.40％ of the total cases.The high incidence areas in the city gradually expanded from the northeast and southeast to the western areas.Results fiom the DLNM studies suggested that seasonality of brucellosis in Datong was significantly affected by metrological factors such as evaporation,rainfall and temperature.The peak of delayed effect appeared the highest when the monthly cumulative evaporation capacity was 140-260 mm and the monthly cumulative rainfall was 20-60 mm with lag less than 1 month or the monthly temperature was-13 ℃ with lag of 4-5 months.Conclusions The incidence of human brucellosis in Datong city increased significantly from 2005 to 2015.Meteorological factors such as evaporation,rainfall,temperature all showed significant driving effects on the disease.
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