2015-2019年北京市肺结核时空聚集性分析

刘洋; 高燕琳; 史芸萍; 王超; 谢春艳; 虎霄

doi:10.16462/j.cnki.zhjbkz.2021.08.006

2015-2019年北京市肺结核时空聚集性分析

doi: 10.16462/j.cnki.zhjbkz.2021.08.006

刘洋^{1, 2},
高燕琳^1, ,,
史芸萍¹,
王超¹,
谢春艳¹,
虎霄¹

1.
100013 北京，北京市疾病预防控制中心信息统计中心
2.
100013 北京，北京市预防医学研究中心信息统计中心

详细信息

通讯作者:
高燕琳，E-mail: gaoyl@bjcdc.org

中图分类号: R521
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- 被引次数: 0
出版历程
- 收稿日期: 2021-02-23
- 修回日期: 2021-05-07
- 网络出版日期: 2021-08-24
- 刊出日期: 2021-08-10

Temporal-spatial clustering analysis of pulmonary tuberculosis in Beijing from 2015 to 2019

1.
Center for Information and Statistics, Beijing Center for Disease Prevention and Control, Beijing 100013, China
2.
Center for Information and Statistics, Beijing Center for Disease Preventive Medical Research, Beijing 100013, China

More Information

Corresponding author: GAO Yan-lin, E-mail: gaoyl@bjcdc.org

摘要

摘要: 目的探讨2015-2019年北京市肺结核发病时空分布特征，掌握高发重点区域，为预防控制肺结核提供理论依据。方法分析2015-2019年北京市报告的肺结核病例流行病学特征，利用回顾性时空重排扫描，探索病例的时空分布特征。结果 2015-2019年期间北京市共报告了34 271例肺结核，年均报告发病率为31.67/10万。每年3-9月为高发期，11-12月又出现一个小的高峰后迅速下降，至次年2月达到最低水平。报告发病率最高的地区为门头沟区，其次为通州区。时空扫描分析探测到了时空聚集区域，扫描半径为5 km时候最易发生聚集的区域均为朝阳区(RR值分别为5.96、5.86、5.88、6.12和7.17，均有P＜0.001)。随着扫描半径的增加，聚集性区域往西南方向发展，扩展至东城区、西城区、丰台区和石景山区。结论北京市肺结核有明显的时空簇，高发地区为朝阳区、西城区、东城区、丰台区和石景山区，有向临区扩散的趋势。应加强重点地区的监测，开展有针对性的防控措施。
- 肺结核 /
- 流行病学特征 /
- 时空聚集分析 /
- 空间分布
Abstract: Objective To understand the spatial and temporal distributions and the clustering areas of pulmonary tuberculosis in Beijing from 2015 to 2019, and to provide evidence for the disease prevention and control. Methods Descriptive epidemiologic methods were used to analyze pulmonary tuberculosis data in Beijing from 2015 to 2019 from the Chinese Disease Surveillance Information Reporting System. Time-space rescheduling scanning analysis was used to explore the spatio-temporal distribution characteristics. Results In total, 34 271 cases of pulmonary tuberculosis were reported in Beijing from 2015 to 2019, the annual incidence was 31.67 per 100 000. The high incidence period was from March to September every year, then decreased rapidly after a small peak in November and December, and reached the lowest level in February of the following year. The area with the highest reported incidence was Mentougou District, followed by Tongzhou District. The spatio-temporal scanning analysis detected the spatio-temporal aggregation area, when the scanning radius was 5km, the most likely clusters were detected all in Chaoyang district (RR=5.96, 5.86, 5.88, 6.12, 7.17, respectively. all P < 0.001). With the increase of scaning radius, Spatio-temporal clusters of pulmonary tuberculosis tended to move to the south west: Dongcheng, Xicheng, Fengtai and Shijingshan. Conclusions There were obvious spatiotemporal clusters of pulmonary tuberculosis in Beijing from 2015 to 2019. The high incidence areas were Chaoyang, Xicheng, Dongcheng, Fengtai and Shijingshan, and there was a trend of diffution in neighboring areas of the most likely gathering districts. Monitoring in key areas should be strengthened, and targeted prevention and control measures should be carried out.
- Pulmonary tuberculosis /
- Epidemiological characteristics /
- Spatial-temporal aggregation analysis /
- Spatial distribution

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图 1 2015-2019年北京市肺结核发病时间分布情况

Figure 1. Time distribution of pulmonary tuberculosis in Beijing from 2015 to 2019

下载: 全尺寸图片幻灯片

图 2 2015-2019年北京市各区肺结核病监测数据热图

Figure 2. The heatmap of surveillance data for pulmonary tuberculosis by county of Beijing from 2015 to 2019

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图 3 2015-2019年北京市肺结核报告发病率(/10万)空间分布

Figure 3. Distribution of reported incidence rate for pulmonary tuberculosis in Beijing from 2015 to 2019 (/100 000)

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图 4 2015-2019年北京市肺结核病例时空聚集地区分布图(扫描半径5 km)

Figure 4. Spatial-temporal clusters distribution map of pulmonary tuberculos cases in Beijing from 2015 to 2019 (spatial cluster radius was 5 km)

下载: 全尺寸图片幻灯片

图 5 2015-2019年北京市肺结核病例时空聚集地区分布图(扫描半径10 km)

Figure 5. Spatial-temporal clusters distribution map of pulmonary tuberculos cases in Beijing from 2015 to 2019 (spatial cluster radius was 10 km)

下载: 全尺寸图片幻灯片

图 6 2015-2019年北京市肺结核病例时空聚集地区分布图(扫描半径15 km)

Figure 6. Spatial-temporal clusters distribution map of pulmonary tuberculos cases in Beijing from 2015 to 2019 (spatial cluster radius was 15 km)

下载: 全尺寸图片幻灯片

表 1 2015-2019年北京市报告肺结核的流行病学特征

Table 1. Epidemiological features of pulmonary tuberculosis in Beijing from 2015 to 2019

特征	肺结核病例数(n=34 271)	构成比(%)
年龄(岁)
0~＜10	79	0.23
10~＜20	1 360	3.97
20~＜30	9 422	27.49
30~＜40	5 487	16.01
40~＜50	3 644	10.63
50~＜60	4 547	13.27
60~＜70	3 924	11.45
≥70	5 808	16.95
性别
男	22 307	65.09
女	11 964	34.91

下载: 导出CSV

表 2 2015-2019年北京市肺结核时空扫描聚集情况

Table 2. The clusters of pulmonary tuberculosis in Beijing from 2015 to 2019 by spatial-temporal scan

年份	空间扫描半径(km)	最有可能聚集区域	实际病例数	理论病例数	LLR值	RR值	P值
2015	5	朝阳区	1 346	266.40	1 187.17	5.96	＜0.001
	10	朝阳区、西城区、东城区	2 059	430.79	1 800.43	6.24	＜0.001
	15	朝阳区、西城区、东城区、丰台区和石景山区	3 023	636.94	2 804.79	7.34	＜0.001
	20	朝阳区、西城区、东城区、丰台区和石景山区	3 023	636.94	2 804.79	7.34	＜0.001
2016	5	朝阳区	1 305	262.31	1 133.93	5.86	＜0.001
	10	朝阳区、西城区、东城区	1 893	408.42	1 594.65	5.94	＜0.001
	15	朝阳区、西城区、东城区、丰台区和石景山区	2 801	605.80	2 509.38	6.94	＜0.001
	20	朝阳区、西城区、东城区、丰台区和石景山区	2 801	605.80	2 509.38	6.94	＜0.001
2017	5	朝阳区	1 380	276.49	1 202.85	5.88	＜0.001
	10	东城区、西城区、朝阳区	1 964	430.50	1 624.82	5.81	＜0.001
	15	朝阳区、西城区、东城区、丰台区和石景山区	2 827	638.55	2 405.12	6.46	＜0.001
	20	朝阳区、西城区、东城区、丰台区和石景山区	2 827	638.55	2 405.12	6.46	＜0.001
2018	5	朝阳区	1 272	244.63	1 150.73	6.12	＜0.001
	10	东城区、西城区、朝阳区	1 863	380.13	1 655.28	6.29	＜0.001
	15	朝阳区、西城区、东城区、丰台区和石景山区	2 673	563.19	2 437.09	7.01	＜0.001
	20	朝阳区、西城区、东城区、丰台区和石景山区	2 673	563.19	2 437.09	7.01	＜0.001
2019	5	朝阳区	1 487	250.18	1 525.92	7.17	＜0.001
	10	东城区、西城区、朝阳区	2 093	389.05	2 041.31	7.08	＜0.001
	15	朝阳区、西城区、东城区、丰台区和石景山区	2 981	576.08	2 973.54	7.94	＜0.001
	20	朝阳区、西城区、东城区、丰台区和石景山区	2 981	576.08	2 973.54	7.94	＜0.001

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参考文献(22)

[1]	World Health Organization. Global tuberculosis report 2020[EB/OL]. (2020-10-14)[2020-12-23]. https://www.who.int/tb/publications/global_report/en/.
[2]	Yang S, Gao Y, Luo W, et al. Spatiotemporal distribution of tuberculosis during urbanization in the New Urban Area of Nanchang City, China, 2010-2018[J]. Int J Environ Res Public Health, 2019, 16(22): 4395. DOI: 10.3390/ijerph16224395.
[3]	Chen JO, Qiu YB, Yang R, et al. The characteristics of spatial-temporal distribution and cluster of tuberculosis in Yunnan Province, China, 2005-2018[J]. BMC Public Health, 2019, 19(1): 1715. DOI: 10.1186/s12889-019-7993-5.
[4]	林玫, 崔哲哲, 林定文, 等. 广西壮族自治区2010-2015年传染性肺结核时空特征分析[J]. 中华流行病学杂志, 2017, 38(9): 1206-1211. DOI: 10.3760/cma.j.issn.0254-6450.2017.09.013. Lin M, Cui ZZ, Lin DW, et al. Visual-spatial and temporal characteristics related to infectious tuberculosis epidemics in Guangxi Zhuang Autonomous Region, 2012-2015[J]. Chin J Epidemiol, 2017, 38(9): 1206-1211. DOI: 10.3760/cma.j.issn.0254-6450.2017.09.013.
[5]	孙闪华, 高志东, 赵飞, 等. 北京市2005-2015年肺结核发病时空特征分析[J]. 中华流行病学杂志, 2018, 39(6): 816-820. DOI: 10.3760/cma.j.issn.0254-6450.2018.06.023. Sun SH, Gao ZD, Zhao F, et al. Spatial-temporal analysis on pulmonary tuberculosis in Beijing during 2005-2015[J]. Chin J Epidemiol, 2018, 39(6): 816-820. DOI: 10.3760/cma.J.issn.0254-6450.2018.06.023.
[6]	孙闪华, 高志东, 李亚敏, 等. 2005-2014年北京市肺结核流行特征分析[J]. 公共卫生与预防医学, 2016, 27(4): 6-9. https://www.cnki.com.cn/Article/CJFDTOTAL-FBYF201604002.htm Sun SH, Gao ZD, Li YM, et al. Epidemiological characteristics of pulmonary tuberculosis in Beijing (2005-2014)[J]. J of Pub Health and Prev Med, 2016, 27(4): 6-9. https://www.cnki.com.cn/Article/CJFDTOTAL-FBYF201604002.htm
[7]	王培安, 罗卫华, 白永平. 基于空间自相关和时空扫描统计量的聚集比较分析[J]. 人文地理, 2012, 27(2): 119-127. DOI: 10.13959/j.issn.1003-2398.2012.02.023. Wang PA, Luo WH, Bai YP. Comparative analysis of aggregation detection based on spatial autocorrelation and spatial temporal scan statistics[J]. Human Geography, 2012, 27(2): 119-127. DOI: 10.13959/j.issn.1003-2398.2012.02.023.
[8]	Kulldorff M, Athas WF, Feuer EJ, et al. Evaluating cluster alarms: a space-time scan statistic and brain cancer in Los Alamos, New Mexico. [J]. Am J Public Health, 1998, 88(9): 1377-1380. DOI: 10.2105/ajph.88.9.1377.
[9]	Kulldorff M. SaTScan user guide for version 9.0[EB/OL]. (2010-12-30)[2010-07-01]. http://www.satscan.org/techdoc.html.
[10]	殷菲, 冯子健, 李晓松, 等. 基于前瞻性时空重排扫描统计量的传染病早期预警系统[J]. 卫生研究, 2007, 36(4): 455-458. DOI: 10.3969/j.issn.1000-8020.2007.04.012. Yin F, Feng ZJ, Li XS, et al. The early warning system based on the prospective space-time permutation statistic[J]. J Hygiene Res, 2007, 36(4): 455-458. DOI: 10.3969/j.issn.1000-8020.2007.04.012.
[11]	刘家起, 姜婧, 王亮, 等. 2008-2017年全国肺结核发病的时空分布特征分析[J]. 现代预防医学, 2020, 47(19): 3461-3464. https://www.cnki.com.cn/Article/CJFDTOTAL-XDYF202019002.htm Liu JQ, Jiang J, Wang L, et al. Spatial and temporal distribution of pulmonary tuberculosis in China, 2008-2017[J]. Modern Prevent Med, 2020, 47(19): 3461-3464. https://www.cnki.com.cn/Article/CJFDTOTAL-XDYF202019002.htm
[12]	胡文穗, 刘伟, 侯建荣, 等. 2010-2019年广州市肺结核流行特征及时空聚集性[J]. 中华疾病控制杂志, 2020, 24(9): 1037-1041. DOI: 10.16462/j.cnki.zhjbkz.2020.09.009. Hu WS, Liu W, Hou JR, et al. Epidemiological characteristics and temporal-spatial clustering analysis of tuberculosis in Guangzhou from 2010 to 2019[J]. Chin J Dis Control Prev, 2020, 24(9): 1037-1041. DOI: 10.16462/j.cnki.zhjbkz.2020.09.009.
[13]	Willis MD, Winston CA, Heilig CM, et al. Seasonality of tuberculosis in the United States, 1993-2008[J]. Clin Infect Dis, 2012, 54(11): 1553-1560. DOI: 10.1093/cid/cis235.
[14]	Moosazadeh M, Khanjani N, Bahrampour A. Seasonality and temporal variations of tuberculosis in the north of iran[J]. Tanaffos, 2013, 12(4): 35-41. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4153266/
[15]	李永文, 程俊, 王浩, 等. 山东省2015年肺结核发病时空特征分析[J]. 中华流行病学杂志, 2016, 37(9): 1257-1261. DOI: 10.3760/cma.j.issn.0254-6450.2016.09.015. Li YW, Cheng J, Wang H, et al. Spatial-temporal analysis of pulmonary tuberculosis in Shandong Province, 2015[J]. Chin J Epidemiol, 2016, 37(9): 1257-1261. DOI: 10.3760/cma.j.issn.0254-6450.2016.09.015.
[16]	陈伟, 王雪静, 王黎霞, 等. 全国五省结核病与性别关系的研究[J]. 中国防痨杂志, 2010, 32(9): 534-539. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFLZ201009017.htm Chen W, Wang XJ, Wang LX, et al. TB and gender in five provinces of China[J]. Chin J Antituberc, 2010, 32(9): 534-539. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFLZ201009017.htm
[17]	张正斌, 鲁周琴, 谢红, 等. 结核病季节性分布特征及影响因素[J]. 中华流行病学杂志, 2016, 37(8): 1183-1186. DOI: 10.3760/cma.j.issn.0254-6450.2016.08.025. Zhang ZB, Lu ZQ, Xie H, et al. Seasonal variation and related influencing factors for tuberculosis[J]. Chin J Epidemiol, 2016, 37(8): 1183-1186. DOI: 10.3760/cma.j.issn.0254-6450.2016.08.025.
[18]	黄莉, 许琳, 李石柱. 扫描统计量方法在肺结核发病分布中的应用进展[J]. 实用预防医学, 2017, 24(6): 766-769. DOI: 10.3969/j.Issn.1006-3110.2017.06.037. Huang L, Xu L, Li SZ. Progress in application of scan statistic in the distribution of pulmonary tuberculosis[J]. Pract Prev Med, 2017, 24(6): 766-769. DOI: 10.3969/j.Issn.1006-3110.2017.06.037.
[19]	Liu Y, Li X, Wang W, et al. Investigation of space-time clusters and geospatial hot spots for the occurrence of tuberculosis in Beijing[J]. Int J Tuberc Lung Dis, 2012, 16(4): 486-491. DOI: 10.5588/ijtld.11.0255.
[20]	鲁奇, 黄英, 孟健, 等. 流动人口在北京中心区和近远郊区分布差异的调查研究[J]. 地理科学, 2005, 25(6): 655-663. DOI: 10.3969/j.issn.1000-0690.2005.06.002. Lu Q, Huang Y, Meng J, et al. Distribution differentiation of imigrants in central part, near suburb and outer suburb of Beijing[J]. Scientia Geographica Sinica, 2005, 25(6): 655-663. DOI: 10.3969/j.issn.1000-0690.2005.06.002.
[21]	安燕生, 张立兴, 屠德华. 流动(非北京市户籍)人口对北京市结核病流行的影响[J]. 中国防痨杂志, 2004, 26(6): 319-321. DOI: 10.3969/j.issn.1000-6621.2004.06.001. An YS, Zhang LX, Tu DH. Impact of immigrants on epidemic of tuberculosis in Beijing[J]. Chin J Antituberc, 2004, 26(6): 319-321. DOI: 10.3969/j.issn.1000-6621.2004.06.001.
[22]	李新旭, 周晓农, 王黎霞. 结核病空间分布特征及影响因素研究进展[J]. 中国公共卫生, 2014, 30(1): 102-106. DOI: 10.11847/zgggws2014-30-01-31. Li XX, Zhou XN, Wang LX. Research progress on spatial distribution characteristics and influencing factors of tuberculosis[J]. Chin J Public Health, 2014, 30(1): 102-106. DOI: 10.11847/zgggws2014-30-01-31.