摘要
目的对2010—2017年湖北省肾综合征出血热(HFRS)人间疫情监测资料进行总结分析,描述其人间、时间及空间流行病学特征,并对2018年HFRS的发病情况进行预测。方法应用描述性流行病学、空间流行病学和时间序列分析等方法,结合Sa TScan和Arc GIS、SPSS等软件,探讨2010—2017年湖北省HFRS人间疫情发病时空分布规律,预测发病趋势。结果 2010—2017年湖北省HFRS疫情总体呈高度散发态势,2017年总体发病水平高于以往年份,发病高峰存在明显的季节性,全省每年各月均有发病,5和12月有两个发病高峰,报告病例数变化趋势与鼠密度消长规律基本一致。2010—2015年,平均鼠密度总体呈上升趋势,2011年最低,之后逐年上升,2015年升至5.31%。聚集性区域探测显示HFRS发病存在一定时空聚集性,2017年聚集区域最明显,集中在湖北省中部地区;ARIMA(1,0,0)(0,1,1)模型拟合效果最好,残差通过白噪声检验,预测2018年1—6月湖北省HFRS发病数约为192例,为高发年份。结论近年湖北省HFRS发病呈升高趋势,且发病与鼠密度呈正相关,湖北省中部地区要结合ARIMA(1,0,0)(0,1,1)模型做好疫情趋势预测,并根据鼠密度和带病毒率监测结果,继续在热点地区开展以防治HFRS为主题的"监测、健教、灭鼠、免疫并重"的综合性防控策略。
Objective To analyze the surveillance data of hemorrhagic fever with renal syndrome(HFRS) in Hubei province from 2010 to 2017,describe the population,spatial and temporal distribution of HFRS,and make prediction of its incidence in2018.Methods Traditional epidemiology,space epidemiology,time series analysis and other methods were used in combination with software SaTScan,ArcGIS and SPSS to explore the spatiotemporal distribution of HFRS in Hubei from 2010 to 2017 and predict its incidence trend.Results The overall incidence of HFRS was highly sporadic from 2010 to 2017.The overall incidence was higher in 2017 than in other years.The disease occurred all the year round with two incidence peaks in May and December.The change trend of reported case number was basically consistent with rat density.From 2010 to 2015,the average rat density generally showed an upward trend.It increased year by year to 5.31% in 2015.There was some spatiotemporal clustering of HFRS in 2017,which was in central Hubei.The ARIMA(1,0,0)(0,1,1) model had the best fitting effect and the residual was white,The noise test can provide suggestions for the early monitoring and early warning of HFRS in Hubei.It is estimated that the case number of HFRS in Hubei from January to June of 2018 would be about 192,indicating a high incidence year.Conclusion The incidence of HFRS in Hubei was in increase in recent two years,and the incidence of HFRS had a positive correlation with rat density.The prediction of HFRS epidemic should be made in combination with the use of ARIMA(1,0,0)(0,1,1) model in central Hubei,and it is suggested to continue the comprehensive HFRS prevention and control,such as surveillance,health education,deratization and immunization,according to the rat density and virus carriage rate surveillance results.
引文
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