2014―2023年云南省其他感染性腹泻病流行病学特征及时空聚集性

贾豫晨; 沈秀莲; 邬志薇; 黄甜; 李宁; 王紫鉴; 何继波; 郑尔达

doi:10.16462/j.cnki.zhjbkz.2025.09.014

2014―2023年云南省其他感染性腹泻病流行病学特征及时空聚集性

doi: 10.16462/j.cnki.zhjbkz.2025.09.014

云南省疾病预防控制中心疫情监测/突发公共卫生事件处置中心，昆明 650506

贾豫晨和沈秀莲为共同第一作者

基金项目:

云南省疾病预防控制中心科技计划项目 2023ZX011

详细信息

通讯作者:
郑尔达, E-mail: 755130864@qq.com

中图分类号: R512.57;R181
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出版历程
- 收稿日期: 2024-08-05
- 修回日期: 2024-11-11
- 网络出版日期: 2025-10-10
- 刊出日期: 2025-09-10

Epidemic characteristics and spatio-temporal clustering of other infectious diarrhea in Yunnan Province from 2014 to 2023

Center for Epidemic Surveillance/Public Health Emergency Preparedness and Response, Yunnan Center for Disease Control and Prevention, Kunming 650506, China

JIA Yuchen and SHEN Xiulian contributed equally to this article

Funds:

Science and Technology Project of Yunnan Center for Disease Control and Prevention 2023ZX011

More Information

Corresponding author: ZHENG Erda, E-mail:755130864@ qq.com

摘要

摘要: 目的分析2014―2023年云南省其他感染性腹泻病的流行特征及时空变化规律，为其他感染性腹泻病防控提供依据。方法采用描述流行病学研究方法对2014―2023年云南省其他感染性腹泻病数据进行研究，使用GeoDa 1.6.7软件进行空间自相关分析，运用SaTScan 9.5软件进行时空扫描分析。结果 2014―2023年云南省其他感染性腹泻病年均发病率为72.41/10万(χ²=31 945, P＜0.001)，发病人群以0~ < 10岁儿童为主(79.66%)(χ²=275 627, P＜0.001)，男性发病率(39.97/10万)高于女性(32.29/10万)(Z=0.831, P=0.406)，轮状病毒阳性率最高(91.18%)。2014―2023年云南省其他感染性腹泻病在县(市、区)级水平存在空间自相关(Moran's I＞0, P＜0.05);热点区域主要分布在昆明市、楚雄彝族自治州、玉溪市、红河哈尼族彝族自治州，且与高发病率区域一致，聚集时间从7―12月逐步变化为3―8月; Ⅰ类聚集区分别出现在以昆明市、玉溪市、红河哈尼族彝族自治州为中心的云南中部地区。结论 2014―2023年云南省其他感染性腹泻病发病呈现一定的时空聚集性，昆明市等中部地区聚集性高，需重点防控。
- 其他感染性腹泻病 /
- 流行病学特征 /
- 空间自相关 /
- 时空聚集性
Abstract: Objective To analyze the epidemiological characteristics and spatio-temporal distribution of other infectious diarrhea in Yunnan province from 2014 to 2023, and provide evidence for other infectious diarrhea prevention and control. Methods Descriptive epidemiological methods were used to study the data of other infectious diarrhea. GeoDa 1.6.7 and SaTScan 9.5 softwares were used for spatial autocorrelation analysis and spatio-temporal scan. Results The average annual incidence in Yunnan Province was 72.41 per 100 000 from 2014 to 2023 (χ²=31 945, P < 0.001). The cases were mainly children under the age of ten (79.66%) (χ²=275 627, P < 0.001), and the incidence in males (39.97 per 100 000) was higher than that in females (32.29 per 100 000) (Z=0.831, P=0.406). The positive rate of rotavirus (91.18%) was the highest among infections. Spatial autocorrelation existed at the county (district) level (Moran's I > 0, P < 0.05). The epidemic regions were mainly in Kunming, Chuxiong, Yuxi, Honghe, and the period of aggregation gradually changed from July to December and from March to August. The cluster areas of class I were found in the central regions of the province such as Kunming, Yuxi and Honghe Prefecture. Conclusions There is a distinct spatio-temporal distribution of the other infectious diarrhea in Yunnan. The other infectious diarrhea prevention and control measure should be strengthened in the central area of Yunnan.
- Other infectious diarrhea /
- Epidemiology characteristics /
- Spatial autocorrelation /
- Spatio-temporal clustering

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图 1 2014―2023年云南省其他感染性腹泻病流行特征

Figure 1. Epidemiological characteristics of other infectious diarrhea in Yunnan Province from 2014 to 2023

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图 2 2014―2023年云南省其他感染性腹泻病月分布

Figure 2. Monthly distribution of other infectious diarrhea in Yunnan Province from 2014 to 2023

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图 3 014―2023年云南省其他感染性腹泻病各重点州(市)的县(市、区)发病率变化趋势

Figure 3. Change trend of incidence rate of other infectious diarrhea in key prefectures (cities) and counties (city, districts) of Yunnan Province from 2014 to 2023

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图 4 2014―2023年云南省其他感染性腹泻病人群分类构成比变化趋势

Figure 4. Trend of changes in the classification composition ratio of other infectious diarrhea patient groups in Yunnan Province from 2014 to 2023

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表 1 2014―2023年云南省其他感染性腹泻病发病率

Table 1. Incidence of other infectious diarrhea in Yunnan Province from 2014 to 2023

州(市) Prefecture(City)	2014―2023年年均发病率 Annual average incidence rate/100 000^-1	2014―2018年年均发病率 Annual average incidence rate/100 000^-1	2019―2023年年均发病率 Annual average incidence rate/100 000^-1	2019年前后发病率升降幅度 Fluctuation in the incidence rate before and after 2019/%
玉溪市Yuxi City	154.34	102.64	206.42	50.28
昆明市Kunming City	137.59	122.71	150.68	18.56
西双版纳傣族自治州Xishuangbanna Prefecture	128.28	118.31	137.66	14.06
德宏傣族景颇族自治州Dehong Prefecture	101.46	56.54	144.41	60.85
楚雄彝族自治州Chuxiong Prefecture	93.16	47.65	141.12	66.23
红河哈尼族彝族自治州Honghe Prefecture	72.33	43.23	101.51	57.42
迪庆藏族自治州Diqing Prefecture	71.72	47.56	96.63	50.78
文山壮族苗族自治州Wenshan Prefecture	62.78	64.22	61.32	-4.74
丽江市Lijiang Prefecture	51.73	33.79	69.72	51.54
曲靖市Qujing City	47.85	20.97	74.88	71.99
临沧市Lincang City	41.24	23.32	59.76	60.97
怒江傈僳族自治州Nujiang Prefecture	40.92	25.81	55.90	53.82
昭通市Zhaotong City	35.37	22.60	48.24	53.15
大理白族自治州Dali Prefecture	33.51	19.63	47.69	58.84
保山市Baoshan City	32.88	19.93	46.03	56.70
普洱市Pu'er City	25.15	18.44	32.04	42.43

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表 2 2014―2023年云南省其他感染性腹泻病发病率空间自相关分析

Table 2. Spatial autocorrelation analysis results of other infectious diarrhea incidence rate in Yunnan Province from 2014 to 2023

年份 Year	全局莫兰指数 Global Moran's I	Z值 value	P值 value	局部空间自相关热点区域 Number of hot spot areas in local spatial autocorrelation	局部空间自相关冷点区域 Number of cold spots areas in local spatial autocorrelation
2014	0.264	4.925	0.002	禄丰县、富民县、易门县、安宁市、五华区、官渡区、盘龙区、西山区、澄江市、呈贡区、晋宁区、红塔区、通海县、开远市(14个) Lufeng County, Fumin County, Yimen County, Anning City, Wuhua District, Guandu District, Panlong District, Xishan District, Chengjiang City, Chenggong District, Jinning District, Hongta District, Tonghai County, Kaiyuan City (14)	泸水市、洱源县、永平县、漾濞县、大理市、昌宁县、凤庆县、巍山县、南涧县、临翔区、永德县、镇康县、沧源县、绿春县、盈江县、芒市(16个) Lushui City, Eryuan County, Yongping County, Yangbi County, Dali City, Changning County, Fengqing County, Weishan County, Nanjian County, Linxiang District, Yongde County, Zhenkang County, Cangyuan County, Luchun County, Yingjiang County, Mangshi (16)
2015	0.358	6.387	0.001	禄丰县、富民县、嵩明县、易门县、安宁市、五华区、官渡区、盘龙区、西山区、澄江市、呈贡区、晋宁区、红塔区、通海县、开远市(15个) Lufeng County, Fumin County, Songming County, Yimen County, Anning City, Wuhua District, Guandu District, Panlong District, Xishan District, Chengjiang City, Chenggong District, Jinning District, Hongta District, Tonghai County, Kaiyuan City (15)	泸水市、洱源县、永平县、漾濞县、大理市、昌宁县、凤庆县、巍山县、南涧县、临翔区、永德县、镇康县、沧源县、绿春县、麒麟区(15个) Lushui City, Eryuan County, Yongping County, Yangbi County, Dali City, Changning County, Fengqing County, Weishan County, Nanjian County, Linxiang District, Yongde County, Zhenkang County, Cangyuan County, Luchun County, Qilin District (15)
2016	0.331	6.713	0.001	禄丰县、富民县、嵩明县、安宁市、五华区、官渡区、盘龙区、西山区、澄江市、呈贡区、晋宁区(11个) Lufeng County, Fumin County, Songming County, Anning City, Wuhua District, Guandu District, Panlong District, Xishan District, Chengjiang City, Chenggong District, Jinning District (11)	泸水市、剑川县、洱源县、永平县、漾濞县、大理市、施甸县、昌宁县、凤庆县、巍山县、南涧县、弥渡县、临翔区、镇康县、沧源县、绿春县、元阳县、麒麟区(18个) Lushui City, Jianchuan County, Eryuan County, Yongping County, Yangbi County, Dali City, Shidian County, Changning County, Fengqing County, Weishan County, Nanjian County, Midu County, Linxiang District, Zhenkang County, Cangyuan County, Luchun County, Yuanyang County, Qilin District (18)
2017	0.420	7.804	0.001	禄丰县、富民县、易门县、安宁市、五华区、官渡区、盘龙区、西山区、澄江市、呈贡区、晋宁区、红塔区、通海县、开远市、峨山县、华宁县、宜良县、泸西县(18个) Lufeng County, Fumin County, Yimen County, Anning City, Wuhua District, Guandu District, Panlong District, Xishan District, Chengjiang City, Chenggong District, Jinning District, Hongta District, Tonghai County, Kaiyuan City, Eshan County, Huaning County, Yiliang County, Luxi County (18)	泸水市、兰坪县、云龙县、剑川县、洱源县、永平县、漾濞县、大理市、施甸县、昌宁县、凤庆县、巍山县、南涧县、弥渡县、临翔区、沧源县、绿春县、元阳县、麒麟区、麻栗坡县(20个) Lushui City, Lanping County, Yunlong County, Jianchuan County, Eryuan County, Yongping County, Yangbi County, Dali City, Shidian County, Changning County, Fengqing County, Weishan County, Nanjian County, Midu County, Linxiang District, Cangyuan County, Luchun County, Yuanyang County, Qilin District, Malipo County (20)
2018	0.340	6.402	0.001	禄丰县、富民县、易门县、嵩明县、安宁市、五华区、官渡区、盘龙区、西山区、呈贡区、晋宁区、宜良县、江川区、勐海县(14个) Lufeng County, Fumin County, Yimen County, Songming County, Anning City, Wuhua District, Guandu District, Panlong District, Xishan District, Chenggong District, Jinning District, Yiliang County, Jiangchuan District, Menghai County (14)	泸水市、云龙县、剑川县、隆阳区、大理市、昌宁县、凤庆县、巍山县、南涧县、临翔区、沧源县、绿春县、元阳县、麻栗坡县、昭阳区(15个) Lushui City, Yunlong County, Jianchuan County, Longyang District, Dali City, Changning County, Fengqing County, Weishan County, Nanjian County, Linxiang District, Cangyuan County, Luchun County, Yuanyang County, Malipo County, Zhaoyang District (15)
2019	0.401	7.662	0.001	禄丰县、富民县、嵩明县、安宁市、五华区、官渡区、盘龙区、西山区、呈贡区、晋宁区、瑞丽市(11个) Lufeng County, Fumin County, Songming County, Anning City, Wuhua District, Guandu District, Panlong District, Xishan District, Chenggong District, Jinning District, Ruili City (11)	泸水市、云龙县、剑川县、大理市、凤庆县、南涧县、弥渡县、临翔区、沧源县、西盟县、孟连县、绿春县、麻栗坡县、宣威市、昭阳区、彝良县(16个) Lushui City, Yunlong County, Jianchuan County, Dali City, Fengqing County, Nanjian County, Midu County, Linxiang District, Cangyuan County, Ximeng County, Menglian County, Luchun County, Malipo County, Xuanwei City, Zhaoyang District, Yiliang County (16)
2020	0.325	6.099	0.001	元谋县、武定县、禄丰县、富民县、嵩明县、安宁市、五华区、官渡区、盘龙区、西山区、呈贡区、晋宁区、宜良县、陆良县、峨山县、石屏县(16个) Yuanmou County, Wuding County, Lufeng County, Fumin County, Songming County, Anning City, Wuhua District, Guandu District, Panlong District, Xishan District, Chenggong District, Jinning District, Yiliang County, Luliang County, Eshan County, Shiping County (16)	剑川县、云龙县、隆阳区、永平县、漾濞县、大理市、施甸县、昌宁县、巍山县、镇康县、永德县、凤庆县、南涧县、临翔区、沧源县、西盟县、澜沧县、绿春县、麻栗坡县、彝良县(20个) Jianchuan County, Yunlong County, Longyang District, Yongping County, Yangbi County, Dali City, Shidian County, Changning County, Weishan County, Zhenkang County, Yongde County, Fengqing County, Nanjian County, Linxiang District, Cangyuan County, Ximeng County, Lancang County, Luchun County, Malipo County, Yiliang County (20)
2021	0.309	5.442	0.001	元谋县、禄丰县、安宁市、五华区、西山区、呈贡区、晋宁区、宜良县、双柏县、峨山县、新平县、红塔区、石屏县、华宁县、易门县、瑞丽市(16个) Yuanmou County, Lufeng County, Anning City, Wuhua District, Xishan District, Chenggong District, Jinning District, Yiliang County, Shuangbai County, Eshan County, Xinping County, Hongta District, Shiping County, Huaning County, Yimen County, Ruili City (16)	云龙县、剑川县、洱源县、大理市、临翔区、沧源县、西盟县、澜沧县、宁洱县、绿春县、麻栗坡县、昭阳区、大关县、彝良县(14个) Yunlong County, Jianchuan County, Eryuan County, Dali City, Linxiang District, Cangyuan County, Ximeng County, Lancang County, Ning'er County, Luchun County, Malipo County, Zhaoyang District, Daguan County, Yiliang County (14)
2022	0.290	5.603	0.001	禄丰县、晋宁区、澄江市、宜良县、红塔区、江川区、通海县、华宁县、石屏县、建水县、弥勒市(11个) Lufeng County, Jinning District, Chengjiang City, Yiliang County, Hongta District, Jiangchuan District, Tonghai County, Huaning County, Shiping County, Jianshui County, Maitreya City (11)	泸水市、云龙县、隆阳区、永平县、大理市、巍山县、南涧县、昌宁县、永德县、云县、镇康县、临翔区、沧源县、双江县、西盟县、孟连县、澜沧县、宁洱县、绿春县、金平县、麻栗坡县(21个) Lushui City, Yunlong County, Longyang District, Yongping County, Dali City, Weishan County, Nanjian County, Changning County, Yongde County, Yun County, Zhenkang County, Linxiang District, Cangyuan County, Shuangjiang County, Ximeng County, Menglian County, Lancang County, Ning'er County, Luchun County, Jinping County, Malipo County (21)
2023	0.257	4.864	0.001	禄丰县、晋宁区、澄江市、宜良县、红塔区、江川区、通海县、华宁县、陆良县、弥勒市、石屏县、瑞丽市(12个) Lufeng County, Jinning District, Chengjiang City, Yiliang County, Hongta District, Jiangchuan District, Tonghai County, Huaning County, Luliang County, Maitreya City, Shiping County, Ruili City (12)	泸水县、云龙县、隆阳区、永平县、大理市、巍山县、南涧县、昌宁县、凤庆县、永德县、临翔区、沧源县、西盟县、孟连县、澜沧县、思茅区、宁洱县、绿春县、河口县、西畴县、麻栗坡县(21个) Lushui County, Yunlong County, Longyang District, Yongping County, Dali City, Weishan County, Nanjian County, Changning County, Fengqing County, Yongde County, Linxiang District, Cangyuan County, Ximeng County, Menglian County, Lancang County, Simao District, Ning'er County, Luchun County, Hekou County, Xichou County, Malipo County (21)
注：漾濞县、南涧县、沧源县、巍山县、兰坪县、西盟县、孟连县、澜沧县、峨山县、新平县、宁洱县、双江县、金平县、河口县全称依次为漾濞彝族自治县、南涧彝族自治县、沧源佤族自治县、巍山彝族回族自治县、兰坪白族普米族自治县、西盟佤族自治县、孟连傣族拉祜族佤族自治县、澜沧拉祜族自治县、峨山彝族自治县、新平彝族傣族自治县、宁洱哈尼族彝族自治县、双江拉祜族佤族布朗族傣族自治县、金平苗族瑶族傣族自治县、河口瑶族自治县。 Note: The full names of Yangbi County, Nanjian County, Cangyuan County, Weishan County, Lanping County, Ximeng County, Menglian County, Lancang County, Eshan County, Xinping County, Ning'er County, Shuangjiang County, Jinping County, and Hekou County are respectively: Yangbi Yi Autonomous County, Nanjian Yi Autonomous County, Cangyuan Wa Autonomous County, Weishan Yi and Hui Autonomous County, Lanping Bai and Pumi Autonomous County, Ximeng Wa Autonomous County, Menglian Dai, Lahu, and Wa Autonomous County, Lancang Lahu Autonomous County, Eshan Yi Autonomous County, Xinping Yi and Dai Autonomous County, Ning'er Hani and Yi Autonomous County, Shuangjiang Lahu, Wa, and Blang Dai Autonomous County, Jinping Miao and Yao and Dai Autonomous County, and Hekou Yao Autonomous County.

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表 3 2014―2023年云南省其他感染性腹泻病时空聚集性分析

Table 3. Spatio-temporal clustering analysis of other infectious diarrhea in Yunnan Province from 2014 to 2023

年份 Year	聚集类型 Type of clustering	聚集时间 /(月/日) Date of clustering /(month/day)	覆盖区域数 Number of coverage regions	聚集中心 Cluster center	报告病例数 Number of reported cases	期望病例数 Expected number of cases	RR值 value	LLR值 value	P值 value
2014	Ⅰ类Clade	7/1―12/31	14	(昆明市)晋宁区 (Kunming City) Jinning District	3 612	822.12	5.35	2 822.78	< 0.001
	Ⅱ类Clade	1/1―3/31	3	(西双版纳傣族自治州)景洪市 (Xishuangbanna Prefecture) Jinhong City	396	79.16	5.10	323.79	< 0.001
2015	Ⅰ类Clade	7/1―12/31	13	(昆明市)晋宁区 (Kunming City) Jinning District	3 937	911.51	5.19	3 005.29	< 0.001
	Ⅱ类Clade	1/1―6/30	2	(西双版纳傣族自治州)景洪市 (Xishuangbanna Prefecture) Jinhong City	877	136.10	6.71	907.93	< 0.001
2016	Ⅰ类Clade	1/1―6/30	32	(红河哈尼族彝族自治州)弥勒市 (Honghe Prefecture) Mile City	6 592	2 183.75	4.06	3 494.18	< 0.001
	Ⅱ类Clade	1/1―5/31	2	(西双版纳傣族自治州)景洪市 (Xishuangbanna Prefecture) Jinhong City	736	117.47	6.47	742.06	< 0.001
2017	Ⅰ类Clade	7/1―12/31	19	(玉溪市)澄江市 (Yuxi City) Chengjiang City	8 003	1 862.89	5.56	6 282.36	< 0.001
	Ⅱ类Clade	2/1―4/30	2	(西双版纳傣族自治州)勐海县 (Xishuangbanna Prefecture) Menghai County	527	102.74	5.21	440.53	< 0.001
2018	Ⅰ类Clade	11/1―12/31	17	(昆明市)嵩明县 (Kunming City) Songming County	5 515	1 091.28	5.74	4 788.36	< 0.001
2019	Ⅰ类Clade	1/1―5/31	49	(玉溪市)元江县 (Yuxi City) Yuanjiang County	21 744	9 832.19	3.11	7 260.80	< 0.001
2020	Ⅰ类Clade	1/1―1/31	36	(昆明市)富民县 (Kunming City) Fumin County	4 732	936.02	5.63	4 072.71	< 0.001
2021	Ⅰ类Clade	1/1―5/31	43	(玉溪市)澄江市 (Yuxi City) Chengjiang City	21 006	8 191.12	3.74	9 233.87	< 0.001
2022	Ⅰ类Clade	1/1―6/30	43	(玉溪市)澄江市 (Yuxi City) Chengjiang City	17 033	7 206.85	3.60	6 744.09	< 0.001
2023	Ⅰ类Clade	3/1―8/31	43	(玉溪市)澄江市 (Yuxi City) Chengjiang City	107 354	57 057.68	2.43	23 737.92	< 0.001

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