| Objective:In this study,the epidemiological characteristics of hepatitis B in Changchun City were elaborated in different aspects such as time,region,and population through statistics on the prevalence of hepatitis B in Changchun City during the decade from2011 to 2020;global spatial autocorrelation and local spatial autocorrelation were used for all cases to analyze whether there was aggregation of cases within Changchun City and in which regions and what type of aggregation was presented,and to analyze the temporal,spatial,and spatial scan statistics of hepatitis B cases in Changchun City from 2011 to 2020.The temporal,spatial and temporal-spatial scan statistics of hepatitis B cases in Changchun from 2011 to 2020 were analyzed to determine the spatial and temporal aggregation of cases,thus providing a scientific basis for the future prevention and control of hepatitis B in Changchun in three dimensions: spatial,temporal and population.Methods:The case information and demographic data of hepatitis B in Changchun City from 2011 to 2020 were obtained through the Chinese Disease Prevention and Control Information System.All data were organized using Excel to calculate the incidence rate and composition ratio of hepatitis B by county,age group and occupation in Changchun,and SPSS was used to compare the statistical differences in prevalence rates between different genders and to perform basic statistical descriptions and epidemiological characteristics analysis of case data.Arc GIS was used to visualize the spatial distribution of the disease and spatial autocorrelation analysis of the cases,and Sa TScan was used to analyze the scan statistics in time,space,and time.Global autocorrelation analysis and local autocorrelation analysis were used for spatial analysis,Moran’s I statistic and Moran scatter plot were calculated for global autocorrelation analysis,and LISA analysis and hotspot analysis were used for local autocorrelation analysis.Results:1.25,779 cases of hepatitis B were reported in Changchun from 2011 to 2020,with prevalence rates of 52.65/100,000,53.60/100,000,35.30/100,000,39.08/100,000,34.61/100,000,27.60/100,000,22.02/100,000,23.10/100,000,23.46/100,000,and20.26/100,000,respectively,for each year;and an average annual incidence of32.90/100,000.2.In terms of time distribution,the incidence of hepatitis B in Changchun has no obvious seasonal distribution characteristics,with cases in every month,but the highest number of cases presented in March in this decade;in terms of regional distribution,the average annual incidence of hepatitis B in most counties and districts in Changchun was below 30/100,000 from 2011 to 2020,with the highest annual incidence in Erdao District,with an incidence of 70.22/100,000,and the lowest annual incidence in Jinyue District,with an incidence of 11.91/100,000.The lowest incidence rate was in Jinyue District,with an incidence rate of 11.91/100,000,and the top three annual incidence rates were in Yushu City（56.57/100,000）and Nongan County（50.27/100,000）,in addition to Erdao District;in terms of population distribution,incidence of men was more than that of women,with a sex ratio of 1.62:1,and the differences in incidence between men and women in each year from 2011 to 2020 were statistically significant(c2values of The difference between men and women was statistically significant（c2 values were 337.65,261.94,176.09,201.53,129.92,27.46,36.36,57.02,54.45,72.91,p-values were less than 0.05）,and the risk for men was 0.817,0.678,0.689,0.706,0.571,0.257,0.340,0.340,and 0.257 times higher than that for women,respectively.The age group with the highest number of incidences was age of 40~49 group,followed by age of 30-39 group and age of 50-59 group,and the number of incidences in these three age groups accounted for 64.32%of the total number of incidences;farmers were among the group with the highest number of incidences,followed by domestic and non-working people and workers, and the number of incidences in these three occupations accounted for 75.12% of the total number of incidences.These three occupations accounted for 75.12% of the total number of cases.3.The results of global spatial autocorrelation analysis showed that the range of Moran’s I index from 2011 to 2020 was（-0.267-0.091）,and the p-values were all greater than 0.05,which was not statistically significant,indicating that the overall spatial incidence of hepatitis B in all counties of Changchun City fell into a random distribution pattern;the results of local autocorrelation LISA analysis showed that the results of local autocorrelation LISA analysis showed that there was a "high-low" outlier clustering of hepatitis B incidence in all counties of Changchun（P<0.05）,and the high clustering area was mainly in Nong’an County,followed by Erdao District,indicating that Nong’an County and Erdao District were high incidence areas of hepatitis B,and the surrounding counties were low incidence areas;the results of hot spot analysis showed that the hot spot areas were in Erdao District,Yushu City and Nong’an County,which was basically consistent with the results of LISA analysis.The results of LISA analysis showed that the hotspot areas were located in Erdao district,Yushu city and Nongan county,which were basically consistent with the results of LISA.4.The results of the temporal scan analysis in the scan statistic analysis showed that there was no specific time of hepatitis B incidence,and there were more incidences in the first half of the year,which coincided with the higher number of incidences in March,May and July in the temporal distribution;the results of the spatial scan analysis showed that the primary aggregation area of hepatitis B incidence in Changchun was mainly in Yushu City or Erdao District from 2011 to2019,and in Nongan County in 2020,with P values less than 0.001;the results of the temporal and the results of the scan showed that the primary aggregation area was Yushu city,the aggregation time was from 2011 to 2019,（LLR=1051.76,RR=2.02,P<0.001）,the secondary aggregation area was Erdao district,the aggregation time was from 2011 to 2016,（LLR=993.87,RR=3.11,P<0.001）,the tertiary aggregation area was Nong’an county,the aggregation time from 2011 to 2016（LLR=512.49,RR=1.85,P<0.001）.Conclusions:1.The overall incidence of hepatitis B in Changchun was decreasing from 2011 to 2020,and the average annual incidence was lower than the national incidence level of hepatitis B in 2020.2.During the ten years,hepatitis B in Changchun City had cases all year round,and the highest number of incidence was in March,but there was no obvious seasonal distribution;the number of cases was more in men than in women,farmers were the main case group,and age of 30-59 group was the high incidence age group;in terms of regional distribution,the high incidence areas of hepatitis B in Changchun City from 2011 to 2020 were mainly Erdao District,Yushu City and Nongan County,but after 2017 Erdao District the incidence rate decreased significantly.3.There was no global spatial autocorrelation of hepatitis B incidence in Changchun,and the overall incidence showed a random distribution pattern;however,the local spatial autocorrelation analysis showed that there were outliers,i.e.,"high-low" clusters,with high incidence areas mainly in Nongan and Erdao counties,and low incidence rates in their neighboring counties.The hot spot analysis found that Erdao District,Yushu City and Nongan County were the main hot spot areas.4.The results of spatial and temporal scan statistics showed that Yushu City,Erdao District,and Nong’an County were the main high-incidence areas in Changchun this decade,and were the most likely areas of concentration for the disease compared with other regions. |
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