Analysis on the spatial distribution and influencing factors of pulmonary tuberculosis among students in Nanning from 2015 to 2018
-
摘要:
目的 了解南宁市在校中小学生及大学生肺结核的流行特征，分析空间效应影响下影响因素的作用机制，为制定肺结核防控措施提供参考。 方法 通过空间扫描统计分析南宁市学生肺结核乡镇级别的报告发病情况，以描述疾病的空间聚集情况。并基于南宁市区县级别空间面板数据建立空间杜宾模型分析空间效应及影响因素。 结果 2015-2018年南宁市学生肺结核报告发病率总体呈增长趋势，病例年龄段主要集中在16~22岁。报告发病高峰期为3-5月和9-11月，低谷期为2月和6-7月。空间扫描分析发现学生肺结核的高发地区分布于市区中心及其周围地区，如朝阳街道、建政街道和华强街道。空间分布格局以六城区交界处为中心向周围的地区扩散，聚集热度也由中心向周围逐渐降低。影响因素分析发现各因素对报告发病率的影响受到空间效应的作用，其中大学生人口密度具有正向影响，人均卫生财政支出具有负向影响，人均国内生产总值(gross domestic product, GDP)具有间接效应，而每千人口卫生技术人员数既具有直接效应又具有间接效应。 结论 南宁市学生肺结核存在空间聚集，主要位于市区中心及其周围地区，报告发病率受到空间效应的作用。 Abstract:Objective To understand the epidemiological characteristics of pulmonary tuberculosis among students in Nanning, and to analyze the mechanism of the influencing factors under the influence of spatial effects, and to provide reference for the development of pulmonary tuberculosis prevention and control measures. Methods The reported incidence of pulmonary tuberculosis among students in Nanning at the township level was statistically analyzed by spatial scan to describe the spatial clustering of the disease. And the Spatial Durbin Model was established to analyze the spatial effects and influencing factors based on the spatial panel data at the district and county levels in Nanning. Results The reported incidence of pulmonary tuberculosis among students in Nanning showed an overall increasing trend from 2015 to 2018. The age of the cases was mainly between 16 and 22 years old. The peak periods of reported cases were from March to May and from September to November, and the trough periods were February and from June to July. Spatial scan analysis revealed that the high incidence of pulmonary tuberculosis among students was distributed in the urban center and its surrounding areas, such as Chaoyang Street, Jianzheng Street, and Huaqiang Street. The spatial distribution pattern was centered on the junction of the six urban areas as the center spreading to the surrounding areas, and the heat of gathering gradually decreasing from the center to the surrounding areas. The analysis of influencing factors found that the influence of each factor on reported incidence was subject to spatial effects. Among them, population density of college students had a positive effect, per capita health financial expenditure had a negative effect, per capita GDP had an indirect effect, and number of health technicians per 1 000 had both a direct and an indirect effect. Conclusions There is a spatial clustering of pulmonary tuberculosis among students in Nanning, mainly located in and around the urban center. The reported incidence rate is subject to spatial effects. -
Key words:
- Pulmonary tuberculosis /
- Students /
- Influencing factors /
- Spatial Durbin model
-
表 1 2015-2018年南宁市学生肺结核报告发病空间扫描聚类情况
Table 1. Spatial scan clustering of reported pulmonary tuberculosis incidence among students in Nanning from 2015 to 2018
年份 主要聚集区 P值 次要聚集区 P值 2015年 朝阳街道、建政街道、华强街道 0.001 大沙田街道、那马镇、长塘镇、蒲庙镇 0.019 2016年 朝阳街道、建政街道、华强街道、大沙田街道 0.001 三塘镇、太平镇、长塘镇、蒲庙镇 0.002 2017年 朝阳街道、建政街道、华强街道 0.001 大沙田街道、那马镇、长塘镇、蒲庙镇 0.001 2018年 朝阳街道、建政街道、华强街道、大沙田街道 0.001 长塘镇、蒲庙镇 0.001 
下载: 导出CSV
表 2 空间杜宾模型估计结果
Table 2. Estimation results of the spatial durbin model
变量 系数 P值 变量 系数 P值 人均GDP -0.080 0.823 W×人均GDP 1.792 0.026 在校大学生人口密度 0.263 0.004 W×在校大学生人口密度 -0.202 0.360 在校中学生人口密度 -0.321 0.126 W×在校中学生人口密度 -0.515 0.445 在校小学生人口密度 -0.020 0.924 W×在校小学生人口密度 0.584 0.477 人均卫生财政支出 -0.417 0.034 W×人均卫生财政支出 0.262 0.750 每千人口卫生技术人员数 0.278 0.051 W×每千人口卫生技术人员数 -1.007 0.043 注：W表示空间权重矩阵。
下载: 导出CSV
表 3 空间杜宾模型空间效应分解估计结果
Table 3. Estimation results of the spatial effect decomposition of the spatial durbin model
变量 直接效应 P值 间接效应 P值 人均GDP -0.259 0.432 1.493 0.010 在校大学生人口密度 0.290 0.001 -0.268 0.088 在校中学生人口密度 -0.276 0.258 -0.324 0.591 在校小学生人口密度 -0.085 0.713 0.538 0.426 人均卫生财政支出 -0.468 0.002 0.341 0.598 每千人口卫生技术人员数 0.407 0.010 -0.935 0.025
下载: 导出CSV
-
[1] 李鹃, 梁大斌, 黄敏莹, 等. 2013-2017年广西学生与非学生人群肺结核流行特征对比分析[J]. 应用预防医学, 2020, 26(2): 125-127. https://www.cnki.com.cn/Article/CJFDTOTAL-GXYX202002011.htmLi J, Liang DB, Huang MY, et al. Comparative analysis of tuberculosis prevalence characteristics between student and non-student populations in Guangxi from 2013 to 2017[J]. Applied Prev Med, 2020, 26(2): 125-127. https://www.cnki.com.cn/Article/CJFDTOTAL-GXYX202002011.htm [2] Murakami R, Matsuo N, Ueda K, et al. Epidemiological and spatial factors for tuberculosis: a matched case-control study in Nagata, Japan[J]. Int J Tuberc Lung Dis, 2019, 23(2): 181-186. DOI: 10.5588/ijtld.18.0369. [3] Belotti F, Hughes G, Mortari AP. Spatial panel data models using Stata[J]. CEIS Research Paper, 2016, 17(1): 139-180. [4] 王文琴, 梁日成, 余小华, 等. 大学生群体肺结核患病的流行病学研究, 以广西大学大学生为研究案例[J]. 基因组学与应用生物学, 2017, 36(6): 122-128. DOI: 10.13417/j.gab.036.002248.Wang WQ, Liang RC, Yu XH, et al. Epidemiological study of pulmonary tuberculosis among college students, case study of students in Guangxi University[J]. Genomics and Applied Biology, 2017, 36(6): 122-128. DOI: 10.13417/j.gab.036.002248. [5] 黄家运, 黎舒, 李小媛. 南宁市2011-2015年高校学生结核疫情分析[J]. 中国热带医学, 2017, 17(3): 296-298. DOI: 10.13604/j.cnki.46-1064/r.2017.03.21.Huang JY, Li S, Li XY. Epidemic situation of tuberculosis among college students in Nanning, 2011-2015[J]. China Tropical Medicine, 2017, 17(3): 296-298. DOI: 10.13604/j.cnki.46-1064/r.2017.03.21. [6] 余暘. 2012-2017年广西南宁市肺结核病流行特征及空间分析[D]. 南宁: 广西医科大学, 2018.Yu Y. Epidemiological characteristics and spatial analysis of pulmonary tuberculosis in Nanning, Guangxi, from 2012 to 2017[D]. Nanning: Guangxi Medical University, 2018. [7] 黄玉, 钟节鸣, 邱晓, 等. 浙江省2005-2012年学生结核病发病趋势及特征分析[J]. 中华疾病控制杂志, 2014, 18(1): 44-47. https://www.cnki.com.cn/Article/CJFDTOTAL-JBKZ201401012.htmHuang Y, Zhong JM, Qiu X, et al. Analysis on the epidemiological trend and characteristics of tuberculosis among students from 2005-2012 in Zhejiang Province, China[J]. Chin J Dis Control Prev, 2014, 18(1): 44-47. https://www.cnki.com.cn/Article/CJFDTOTAL-JBKZ201401012.htm [8] 林定文, 崔哲哲, 潘冬香, 等. 基于Flexible空间扫描统计量的广西学校结核病流行病学分析[J]. 中国防痨杂志, 2017, 39(11): 1212-1217. DOI: 10.3969/j.issn.1000-6621.2017.11.012.Lin DW, Cui ZZ, Pan DX, et al. Epidemiological analvsis of tuberculosis among students in Guangxi based on flexibly shaped spatial scan statistics[J]. Chin J Antituberc, 2017, 39(11): 1212-1217. DOI: 10.3969/j.issn.1000-6621.2017.11.012. [9] 唐嘉, 黄宝杨, 周平. 2015年广西柳州市某高校聚集性结核病疫情调查处置分析[J]. 医学动物防制, 2017, 33(7): 718-721. DOI: 10.7629/yxdwfz201707003.Tang J, Huang B Y, Zhou P. Investigation and analysis of tuberculosis accident in a university in Liuzhou City of Guangxi in 2015[J]. J Med Pest Control, 2017, 33(7): 718-721. DOI: 10.7629/yxdwfz201707003. [10] Liu J, Han Z, Veuthey J, et al. How investment in public health has impacted the prevalence of tuberculosis in China: A study of provincial variations between 2005 and 2015[J]. Int J Health Plann Manage, 2020, 35(6): 1546-1558. DOI: 10.1002/hpm.3034. [11] 李成程, 王前强, 任琴, 等. 广西卫生人力资源时空分异研究[J]. 卫生经济研究, 2021, 38(2): 62-66. DOI: 10.14055/j.cnki.33-1056/f.2021.02.018.Li CC, Wang QQ, Ren Q, et al. Study on spatial-temporal differentiation of health human resources in Guangxi[J]. Health Economics Research, 2021, 38(2): 62-66. DOI: 10.14055/j.cnki.33-1056/f.2021.02.018. [12] 罗慧, 农艺, 唐忠. 广西医疗卫生资源配置的空间分布及聚集性分析[J]. 中国卫生资源, 2017, 20(2): 114-117. DOI: 10.13688/j.cnki.chr.2017.16108.Luo H, Nong Y, Tang Z. Spatial distribution and clustering analysis of the health resource allocation in Guangxi[J]. Chinees Health Resources, 2017, 20(2): 114-117. DOI: 10.13688/j.cnki.chr.2017.16108. [13] 山珂. 肺结核发病空间聚集分布及影响因素研究[D]. 济南: 山东大学, 2014.Shan K. Study on the spatial clustered distribution oftuberculosis and its influential factors in china[D]. Jinan: Shandong University, 2014. [14] Wang Q, Guo L, Wang J, et al. Spatial distribution of tuberculosis and its socioeconomic influencing factors in mainland China 2013-2016[J]. Trop Med Int Health, 2019, 24(9): 1104-1113. DOI: 10.1111/tmi.13289. -
