| Objectives: This study is designed to investigate the prevalence of notifiable infectious diseases in Tongxin county of Ningxia Hui Autonomous Region and analyze the epidemic characteristics and spatial aggregation characteristics of major infectious diseases,which will provide the scientific basis for formulating precise strategies for the prevention of infectious diseases and improving people's health effectively.Methods: In this research,the data of notifiable infectious diseases in Tongxin county were from the “China diseases prevention and control information system”.The number of population was obtained by public security bureau of Tongxin county and electronic maps of administrative areas from the government of Tongxin county.The research methods include:(1)The time,sex,age and occupation distribution of legal infectious diseases and major infectious diseases in Tongxin county were analyzed by general descriptive method.(2)Moran's I and LISA values were used to analyze the global auto-correlation and regional incidence distribution patterns of major infectious diseases(3)A retrospective discrete Poisson spatiotemporal scanning statistic was used to detect the aggregation area,range and time of major infectious diseases,and the risk degree of the aggregation area was evaluated quantitatively.Results: From 2008-2017,a total of 10,015 cases of notifiable infectious diseases were reported in 13 townships of Tongxin county,with an annual incidence of 259.59/100,000.Among them,no Class A infection diseases were reported.5,701 cases of Class B infection disease were reported,with an annual incidence of 147.7/100,000.There were 4314 cases of Class C infection diseases reported,with an annual incidence of 111.82/100,000.Excepting for 2009,2010 and 2012,the annual reported incidence of Class B infectious diseases was significantly higher than that of Class C.Viral hepatitis,tuberculosis,mumps,other infectious diarrhea,and brucellosis influenced people's health more.(1)Viral hepatitis: From 2008 to 2017,1,792 cases of viral hepatitis were reported in thiscounty.The average annual incidence of the disease was 47.02/100,000.During the 10 years,there were no obvious seasonal features.Male patients accounted for 50.08%,and the male-female ratio was 1.15:1.The patients aged 15-34 accounting for 48.28%.Most patients were farmers,which accounted for 84.04%.The highest annual incidence was found in Xinglong town(80.37/100,000),Hexi town(66.30/100,000)and Dingtang town(63.20/100,000).There was a positive global auto-correlation in 2011 and 2014-2016(the global Moran's I between 0.4612 and 0.5884,P<0.05).The High-High gathering areas were mainly located in the western part of the county,involving Xinglong,Dingtang,Hexi,Yuhai and Shishi management committee.Low-Low gathering areas were mainly concentrated in Xiamaguan and Yuwang town.Three clustering areas were detected by spatial-temporal scanning.The first-order aggregation area(LLR=159.236761,RR=3.73)centered on Hexi,with a radius of 13.85 km,and the aggregation time was 2015-2016,aggregation range included Dingtang town.(2)Tuberculosis: From 2008 to 2017,a total of 1,479 cases of tuberculosis were reported in this county,with an average annual incidence of 38.37/100,000.During the 10 years,More cases were reported in winter.The average annual incidence of males(42.84/100,000)was significantly higher than that of females(33.74/100,000),with a gender ratio of 1.15:1.The majority of the patients were aged 15-24 and 60-79.The incidence was highest among farmers,accounting for86.69%.No cases were reported in Tianlaozhuang.Yaoshan administrative committee(150.70/100,000)had the highest annual report rate.There was a negative global auto-correlation between the incidence of tuberculosis in the county from 2012 to 2016(the absolute value of overall Moran's I was between 0.4251 and 0.7251,P<0.05),showing a dispersed distribution.The High-Low gathering areas are mainly located in Yaoshan administrative committee.Low-High gathering areas were mainly distributed in Tianlaozhuang township,Hexi town and Weizhou town.Two clustering regions were detected by spatial-temporal scanning,among which the first concentration area was located in Yaoshan administrative committee(LLR=19.365282 and RR=2.87).The aggregation time was 2012-2016,which was basically consistent with the hot spot area of local spatial autocorrelation analysis.(3)Mumps: In the past 10 years,1,486 cases of mumps were reported.The average annual incidence was 37.92/100,000.More cases happened from May to July.Males accounted for63.32% of the reported cases,and the male-female ratio was 1.70:1.The average annual incidence of the disease in males(47.15/100,000)was significantly higher than that in females(28.34/100,000).The age group from 0 to 14 years old had a high incidence,accounting for94.95%.In the past 10 years,The three towns with the highest annual incidence were Yuhai(190.00/100,000),Xinglong(81.10/100,000)and Magaozhuang(70.84/ 100,000).The lowest wasXiamaguan(9.82/100,000).From the perspective of spatial distribution: There was a positive global auto-correlation in 2017(the overall Moran's I is 0.3444,P < 0.05),showing a global spatial aggregation distribution.The spatial correlation of other years was not obvious,and it was random distribution.The result of the local spatial autocorrelation analysis showed that the High-High distribution pattern was mainly located in the west of the county,involving Xinglong township,Dingtang town and Hexi town.Low-Low gathering areas were mainly concentrated in Xiamaguan town and Yaoshan management committee.Four spatial-temporal clustering areas were detected by space-time scanning.The first concentration areawas located in Xinglong town with a radius of 11.38 km(LLR RR are 361.908202 and 5.39,respectively).The aggregation time of 2009-2013.The aggregation range included Yuhai town.Some areas coincide with hot spots in local spatial auto-correlation.(4)Other infectious diarrhea: A total of 1,059 cases of other infectious diarrhea were reported,with an average annual incidence of 27.50/100,000.More cases were reported between June and September.The proportion of male patients was 60.84%,and the ratio of male to female was1.55:1.The average annual incidence of male patients(32.76/100,000)was significantly higher than that of female patients(22.03/100,000).Aged 0-4 years,accounting for 52.12%.Students and children living in the diaspora were the majority,accounting for 88.49%.During the past 10 years,Hexi town(48.31/100,000),Wangtuan town(42.17/100,000),Yaoshan management committee(41.96/100,000)and Xinglong town(38.14/100,000)had higher average annual incidence,while Weizhou town had the lowest(8.00/100,000).From the perspective of spatial distribution.The global spatial correlation of incidence from 2008 to 2017 was not significant,and the incidence was randomly distributed.The result of the local spatial autocorrelation analysis showed that the High-High gathering area is mainly located in Dingtang,Shishi management committee and Yuhai town.Low-Low gathering area mainly concentrated in Xiamaguan town.Four clustering areas were detected by spatial-temporal scanning,involving more than half of the towns in Tongxin,and the clustering time was inconsistent.(5)Brucellosis: A total of 946 cases of brucellosis were reported,with an average annual incidence of 25.07/100,000.More cases happened from April to July.The average annual incidence of male patients(35.23/100,000)was significantly higher than that of females(14.49/100,000).The sex ratio between males and females was 2.54.The patient's age was mainly between 25 to 54(63.01%).The number of reported cases in farmers accounted for 90.52%.Tianlaozhuang(58.13/100,000),Xiamaguan(33.35/100,000),Zhangjiayuan township(33.34/100,000)and Wangtuan township(32.30/100,000)had the highest average annual report rate.The lower ones were Yuhai town(14.13/100,000),Xinglong town(14.13/100,000)andWeizhou town(10.12/100,000).From the perspective of spatial distribution: The global spatial autocorrelation analysis showed that the incidence rates in 2008,2012 and 2015 showed positive global auto-correlation(the overall Moran's I > 0,P < 0.05),.The result of local spatial auto-correlation analysis showed that the concentration area of the High-High distribution mode is located in Yaoshan administrative committee,Yuwang town and Xiamaguan town.Low-Low gathering areas are mainly concentrated in Xinglong township and Hexi town.Two clustering areas were detected by space-time scanning.The first-grade aggregation area(LLR=110.77452,RR=2.12)centered on Yaoshan management committee,with a radius of 19.89 km and an aggregation time of 2015-2016.The aggregation area included Dingtang town,Tianlaozhuang and Shishi management committee.Some areas coincide with hot spots in local spatial auto-correlation.Conclusions : From 2008 to 2017,the incidence of notifiable infectious diseases in this county had decreased than that of before.The prevention and control effect of infectious diseases was good.Viral hepatitis,tuberculosis,mumps,other infectious diarrhea and brucellosis were the main notifiable infectious diseases that endanger the health of the county residents.(1)Except that the average annual incidence of brucellosis is significantly higher than the national level and the average annual incidence of mumps is significantly higher than that of other regions during the same period,the average annual incidence of the other three major infectious diseases is relatively low.(2)The characteristics of time,population and spatial distributionwere basically consistent with the results of other regions in China,and there were obvious differences in the spatial distribution of each town.It is necessary to take prevention and control measures according to local conditions of the epidemic characteristics of different infectious diseases. |
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