Spatio-temporal distribution and socioenvironmental factors of acute hemorrhagic conjunctivitis in China
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摘要:
目的 通过分析急性出血性结膜炎(acute hemorrhagic conjunctivitis, AHC)时空分布特征以及研究影响其发病的社会环境影响因素，为该疾病防控策略提供科学依据。 方法 本研究以中国2011-2017年31个省(自治区、直辖市)的AHC发病数据为基础，运用空间自相关分析方法探求疾病时空分布特征，并且使用地理探测器分析各环境因子对疾病的影响。 结果 2011-2017年AHC年发病率波动较小，发病主要集中在夏秋季；空间上集中于中南地区以及华东地区；AHC发病率存在空间正相关，湖南省从高高聚集到低高聚集，防控力度要继续保持，贵州省从低高聚集到高高聚集，要注意周围省份疾病传播；气象、社会发展、经济文化等因素均不同程度影响AHC的发病，且因子的两两交互作用增强了发病风险，其中年均气温与其他因子的相互作用增加效应较强。 结论 AHC发病时空分布不均匀，并且受各种社会环境因素的影响，空间自相关分析以及地理探测器模型的运用能有效地探索其时空特征以及影响因素，为AHC进行有重点的、有针对性的预防与控制发挥了重要的作用。 Abstract:Objective To understand the spatio-temporal distribution and socioenvironmental factors of acute hemorrhagic conjunctivitis (AHC), and to provide a scientific basis for the prevention and control. Methods Based on the AHC incidence data in 31 provinces (autonomous regions and municipalities directly under the Central Government) in China from 2011 to 2017, spatial autocorrelation analysis was used to explore the spatio-temporal distribution characteristics, and geographical detector was used to analyze the influence of socioenvironmental factors. Results The annual incidence was relatively flat from 2011 to 2017 that mainly occurred in summer and autumn. The incidence of AHC concentrated in central and southern China and eastern China and had obvious spatial positive correlation. The incidence in Hunan Province was from high to low and high aggregation, and prevention and control efforts should be maintained. The incidence in Guizhou Province was from low to high aggregation, and attention should be paid to the spread of disease in surrounding provinces. Meteorological, social development, economic-cultural factors all affected AHC incidence to varying degrees, and the interaction of these increased the incidence risk, among which the interaction between average annual temperature and other factors has strong strengthening effect. Conclusions The spatial and temporal distribution of AHC incidence is not uneven and was affected by various social and environmental factors. The spatial autocorrelation analysis and geographical detector model can effectively explore the spatiotemporal characteristics and influencing factors of AHC, which perform important roles in the focused and targeted prevention and control. -
图 1 2011-2017年中国大陆AHC发病时间分布
Figure 1. The incidence time distribution of AHC in China from 2011 to 2017
图 2 2011-2017年中国大陆AHC发病空间分布
Figure 2. Spatial distribution of AHC in China from 2011 to 2017
图 3 2011-2017年AHC发病率的LISA聚集图
Figure 3. LISA aggregation of incidence of AHC from 2011 to 2017
图 4 各环境因子对AHC发病的解释力
Figure 4. The explanatory power of environmental factors on the incidence of AHC
表 1 急性出血性结膜炎环境影响因子指标描述
Table 1. Description of environmental factors for acute hemorrhagic conjunctivitis
目标层 维度层 指标层 AHC社会环境影响因子 社会发展 X1：人口密度(人/km2) X2：城镇人口比重(%) 经济文化 X3：人均GDP(元) X4：人均受教育年限(年) 卫生医疗 X5：医疗卫生机构数(个) X6：卫生技术人员(万人) 气象条件 X7：年均气温(℃) X8：年均相对湿度(%) X9：年均降雨量(mm) X10：年均日照时数(h) 注：GDP：国内生产总值(gross domestic product)。 
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表 2 2011-2017年AHC发病率全局自相关分析
Table 2. Global autocorrelation analysis of the incidence of AHC from 2011 to 2017
年份(年) Moran's I值 Z值 P值 2011 0.154 1 2.620 9 0.008 8 2012 0.179 3 2.902 9 0.003 7 2013 0.169 8 2.835 2 0.004 5 2014 0.203 9 3.243 9 0.001 2 2015 0.166 9 2.810 8 0.004 9 2016 0.149 1 2.562 6 0.010 4 2017 0.157 6 2.799 8 0.005 1 2011-2017 0.186 6 3.060 7 0.002 2
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表 3 AHC各环境因子的发病风险
Table 3. The risk of environmental factors for the incidence of AHC
因子 高发区(取值范围) 高发区发病率均值 与高发区有显著差异的分区 人口密度(人/km2) 3(229.31~446.47) 3.651 0 1、2、4、5 城镇人口比重(%) 3(36.41~48.87) 3.330 4 1、2、5 人均GDP(元) 5(16 413~34 674) 3.325 2 1、2、4 人均受教育年限(年) 1(7.52~8.65) 3.103 6 2、4、5 医疗卫生机构数(个) 5(30 998~49 874) 3.641 5 1、2、3 卫生技术人员(万人) 3(24.60~37.59) 3.924 2 1、2、4 年均气温(℃) 5(20.69~25.43) 8.906 8 1、2、3、4 年均相对湿度(%) 1(77.89~86.49) 5.863 0 2、3、4、5 年均降雨量(mm) 4(1 898.53~2 412.58) 6.823 9 1、2、5 年均日照时数(h) 5(930.64~1 385.29) 4.020 0 2、3
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表 4 AHC不同环境因子交互作用
Table 4. Interaction of different environmental factors in AHC
因子 人口密度(人/km2) 城镇人口比重(%) 人均GDP (元) 人均受教育年限(年) 医疗卫生机构数(个) 卫生技术人员(万人) 年均气温(℃) 年均相对湿度(%) 年均降雨量(mm) 年均日照时数(h) 人口密度 0.096 9 城镇人口比重 0.206 0 0.100 7 人均GDP 0.170 6 0.141 2 0.104 9 人均受教育年限 0.157 6 0.115 5 0.155 0 0.088 2 医疗卫生机构数 0.629 9 0.377 1 0.236 2 0.406 7 0.048 6 卫生技术人员 0.475 2 0.286 4 0.243 3 0.392 0 0.146 9 0.066 9 年均气温 0.749 1 0.743 4 0.766 8 0.618 1 0.639 5 0.733 9 0.548 7 年均相对湿度 0.403 5 0.450 6 0.477 5 0.400 6 0.521 4 0.579 1 0.613 5 0.313 7 年均降雨量 0.581 4 0.548 5 0.518 3 0.389 5 0.492 1 0.585 8 0.615 6 0.358 1 0.293 6 年均日照时数 0.331 4 0.352 2 0.317 9 0.242 5 0.373 3 0.433 9 0.627 6 0.445 5 0.513 4 0.146 9
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