我國(guó)梅毒疫情地理信息系統(tǒng)方法的建立與初步應(yīng)用
發(fā)布時(shí)間：2018-08-06 08:41
【摘要】：背景：梅毒是由蒼白密螺旋體蒼白亞種感染人體所引起的一種嚴(yán)重危害人體健康的經(jīng)典性病,是人類社會(huì)所面臨的危害巨大的傳染病之一。梅毒在我國(guó)已成為重要的公共衛(wèi)生問題之一,位居法定甲乙類傳染病發(fā)病排序第3位。傳統(tǒng)的流行病學(xué)分析方法難于直觀精確發(fā)現(xiàn)梅毒在我國(guó)的地理分布特征及其影響因素。近年發(fā)展起來(lái)的地理信息系統(tǒng)及空間分析方法可以彌補(bǔ)其不足,為梅毒疫情監(jiān)測(cè)開辟新途徑。如何在我國(guó)建立起梅毒疫情地理信息系統(tǒng)方法,并將其應(yīng)用于梅毒疫情分析,是本課題需要研究的問題。 目的：建立我國(guó)梅毒疫情地理信息系統(tǒng)數(shù)據(jù)庫(kù),探索和揭示我國(guó)梅毒疫情空間分布特征,直觀與精確地找出我國(guó)梅毒疫情熱點(diǎn)地區(qū)；構(gòu)建我國(guó)梅毒疫情空間回歸模型,探討影響梅毒疫情空間分布特征的因素；為實(shí)現(xiàn)梅毒的精確防治提供依據(jù)。 方法：使用地理信息系統(tǒng)MapInfo10.0軟件建立2011年我國(guó)各縣區(qū)梅毒疫情地理信息系統(tǒng)數(shù)據(jù)庫(kù)；在此基礎(chǔ)上,利用GeoDa1.46和ArcGIS軟件,運(yùn)用探索性空間分析方法,包括頻數(shù)分布、全局趨勢(shì)分析、全局和局部空間自相關(guān)分析,探索我國(guó)梅毒疫情空間分布特征；然后運(yùn)用確認(rèn)性空間分析方法構(gòu)建我國(guó)梅毒疫情空間回歸模型,分析其空間分布模式的成因。 結(jié)果：頻數(shù)分布分析顯示,2011年全國(guó)2925個(gè)縣區(qū)梅毒發(fā)病率中位數(shù)為21.17/10萬(wàn)(25%分位數(shù)9.28/10萬(wàn),75%分位數(shù)43.00/10萬(wàn)),最小為0.00,最大為515.34/10萬(wàn),呈明顯的正偏態(tài)分布(偏度為3.11),有126個(gè)縣區(qū)梅毒發(fā)病率超過101/10萬(wàn),為極端異常值。全局趨勢(shì)分析表明,我國(guó)梅毒疫情分布從西北到東南方向呈現(xiàn)為“U”形變化趨勢(shì),顯示西北和東南沿海地區(qū)高發(fā)。全局空間自相關(guān)分析顯示,我國(guó)縣區(qū)級(jí)梅毒疫情呈正空間自相關(guān)(全局Moran指數(shù)為0.5762,P0.001),空間分布模式為“高—高”聚集(全局G系數(shù)為0.0331,P0.001)。通過局部自相關(guān)分析輸出了我國(guó)縣區(qū)級(jí)梅毒疫情分布的熱點(diǎn)地圖,期和二期梅毒有5個(gè)核心區(qū)和117個(gè)熱點(diǎn)縣區(qū)(其發(fā)病率均超過50/10萬(wàn)),主要分布在新疆西南部、青海中東部、廣西、東南沿海、東北(包括內(nèi)蒙錫林郭勒盟)等地區(qū)。同時(shí),對(duì)福建、廣東和新疆3個(gè)梅毒高發(fā)省份進(jìn)行探索性空間數(shù)據(jù)分析,找出了熱點(diǎn)縣區(qū)。我國(guó)地市級(jí)梅毒疫情空間滯后回歸分析結(jié)果顯示,空間回歸模型具有顯著的統(tǒng)計(jì)學(xué)意義(決定系數(shù)R2=0.48,空間自回歸系數(shù)=0.55,P0.0001),人均GDP、性病醫(yī)療機(jī)構(gòu)數(shù)量、流動(dòng)人口、FSW和MSM人群的梅毒感染率是影響梅毒疫情空間分布的顯著性因素,其空間回歸系數(shù)分別為3.47、0.12、4.46、1.85、和0.71(P值均0.05)。 結(jié)論：我國(guó)梅毒疫情熱點(diǎn)地區(qū)主要分布于新疆西南部、青海中東部、廣西、東南沿海、東北(包括內(nèi)蒙錫林郭勒盟)等地區(qū),應(yīng)突出重點(diǎn),集中有限資源,采取有效措施加強(qiáng)對(duì)這些地區(qū)尤其是少數(shù)民族地區(qū)的梅毒防治工作,做到精確防治和科學(xué)防治。經(jīng)濟(jì)發(fā)達(dá)、流動(dòng)人口和高危人群梅毒感染率高的地區(qū),其梅毒報(bào)告發(fā)病率高；流動(dòng)人口和FSW人群梅毒感染率較MSM和男性性病就診者人群對(duì)梅毒發(fā)病率的影響更大,值得進(jìn)一步研究。地理信息系統(tǒng)及空間分析方法具有可視化和精確定位等優(yōu)點(diǎn),應(yīng)作為一種新的重要工具用于梅毒監(jiān)測(cè)和防治。
[Abstract]:Background: syphilis is a classic venereal disease which is caused by the infection of the pallidum pallidum pallidum to human body. It is one of the most dangerous infectious diseases in human society. Syphilis has become one of the important public health problems in China. It is ranked third in the order of class A and B infectious disease. It is difficult to find the geographical distribution characteristics and influencing factors of syphilis in China. The geographic information system and spatial analysis method developed in recent years can make up for its shortcomings and open up a new way for the monitoring of syphilis epidemic situation. The analysis of epidemic situation of syphilis is a problem that needs to be studied in this topic.
Objective: to establish the geographic information system database of syphilis epidemic in China, to explore and reveal the spatial distribution characteristics of syphilis epidemic in China, to find out the hot areas of the syphilis epidemic in China, to establish the spatial regression model of the syphilis epidemic in China, to explore the factors affecting the spatial distribution of syphilis, and to achieve the accurate prevention and control of syphilis. Provide the basis.
Methods: the geographic information system database of syphilis epidemic in various counties of China in 2011 was set up using MapInfo10.0 software of geographic information system. On this basis, using GeoDa1.46 and ArcGIS software, exploratory spatial analysis was used, including frequency distribution, global trend analysis, global and local spatial autocorrelation analysis, to explore the syphilis epidemic in China. Secondly, the spatial distribution characteristics of syphilis epidemic in China were analyzed by using confirmatory spatial analysis method to construct the spatial regression model of syphilis epidemic in China.
Results: the frequency distribution analysis showed that the median of the incidence of syphilis in 2925 counties of the country in 2011 was 21.17/10 million (25% digits 9.28/10 million, 75% digits 43.00/10 million), the smallest was 0, and the maximum was 515.34/10 million, showing a significant positive partial distribution (3.11), and the incidence of syphilis in 126 counties was more than 101/10 million, the extreme anomaly value. The trend analysis shows that the distribution of syphilis in China shows a "U" change trend from northwest to Southeast, showing high incidence in Northwest and southeast coastal areas. Global spatial autocorrelation analysis shows that the epidemic situation of syphilis in the county level of China is positively spatial autocorrelation (global Moran index is 0.5762, P0.001), and the spatial distribution pattern is "high to high" aggregation. (global G coefficient is 0.0331, P0.001). Through local autocorrelation analysis, a hot map of the county level syphilis distribution in China is exported. There are 5 core regions and 117 hot spot counties (all over 50/10 million), mainly in southwestern Xinjiang, Middle East Qinghai, Guangxi, southeast coast, and Northeast (including Inner Mongolia tin Lin Guo). At the same time, 3 provinces with high incidence of syphilis in Fujian, Guangdong and Xinjiang were analyzed by exploratory spatial data analysis, and the hot spot counties were found. The spatial regression analysis results showed that the spatial regression model had significant statistical significance (determination coefficient R2=0.48, spatial autoregressive coefficient =0.55, P0.0001). GDP, the number of STD medical institutions, the flow population, the rate of syphilis infection in the population of FSW and MSM was a significant factor affecting the spatial distribution of syphilis, and the spatial regression coefficient was 3.47,0.12,4.46,1.85 and 0.71 (P value was 0.05).
Conclusion: the hot spots of syphilis in China are mainly distributed in the southwest of Xinjiang, in the Middle East of Qinghai, in Guangxi, in the southeast coast, in the Northeast (including Inner Mongolia and Xilinguole Meng). We should focus on the focus, concentrate the limited resources and take effective measures to strengthen the prevention and control of syphilis in these areas, especially in minority areas. The incidence of syphilis is higher in areas with high economic development and high rate of syphilis infection among the floating population and high risk population. The incidence of syphilis infection in the floating population and the FSW population is greater than that of the MSM and male STD patients. It is worth further study. The geographic information system and the spatial analysis method have the visualization and precision. The advantages of location and so on should be used as a new important tool for syphilis surveillance and control.
【學(xué)位授予單位】：北京協(xié)和醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R759.1
本文編號(hào)：2167166
[Abstract]:Background: syphilis is a classic venereal disease which is caused by the infection of the pallidum pallidum pallidum to human body. It is one of the most dangerous infectious diseases in human society. Syphilis has become one of the important public health problems in China. It is ranked third in the order of class A and B infectious disease. It is difficult to find the geographical distribution characteristics and influencing factors of syphilis in China. The geographic information system and spatial analysis method developed in recent years can make up for its shortcomings and open up a new way for the monitoring of syphilis epidemic situation. The analysis of epidemic situation of syphilis is a problem that needs to be studied in this topic.
Objective: to establish the geographic information system database of syphilis epidemic in China, to explore and reveal the spatial distribution characteristics of syphilis epidemic in China, to find out the hot areas of the syphilis epidemic in China, to establish the spatial regression model of the syphilis epidemic in China, to explore the factors affecting the spatial distribution of syphilis, and to achieve the accurate prevention and control of syphilis. Provide the basis.
Methods: the geographic information system database of syphilis epidemic in various counties of China in 2011 was set up using MapInfo10.0 software of geographic information system. On this basis, using GeoDa1.46 and ArcGIS software, exploratory spatial analysis was used, including frequency distribution, global trend analysis, global and local spatial autocorrelation analysis, to explore the syphilis epidemic in China. Secondly, the spatial distribution characteristics of syphilis epidemic in China were analyzed by using confirmatory spatial analysis method to construct the spatial regression model of syphilis epidemic in China.
Results: the frequency distribution analysis showed that the median of the incidence of syphilis in 2925 counties of the country in 2011 was 21.17/10 million (25% digits 9.28/10 million, 75% digits 43.00/10 million), the smallest was 0, and the maximum was 515.34/10 million, showing a significant positive partial distribution (3.11), and the incidence of syphilis in 126 counties was more than 101/10 million, the extreme anomaly value. The trend analysis shows that the distribution of syphilis in China shows a "U" change trend from northwest to Southeast, showing high incidence in Northwest and southeast coastal areas. Global spatial autocorrelation analysis shows that the epidemic situation of syphilis in the county level of China is positively spatial autocorrelation (global Moran index is 0.5762, P0.001), and the spatial distribution pattern is "high to high" aggregation. (global G coefficient is 0.0331, P0.001). Through local autocorrelation analysis, a hot map of the county level syphilis distribution in China is exported. There are 5 core regions and 117 hot spot counties (all over 50/10 million), mainly in southwestern Xinjiang, Middle East Qinghai, Guangxi, southeast coast, and Northeast (including Inner Mongolia tin Lin Guo). At the same time, 3 provinces with high incidence of syphilis in Fujian, Guangdong and Xinjiang were analyzed by exploratory spatial data analysis, and the hot spot counties were found. The spatial regression analysis results showed that the spatial regression model had significant statistical significance (determination coefficient R2=0.48, spatial autoregressive coefficient =0.55, P0.0001). GDP, the number of STD medical institutions, the flow population, the rate of syphilis infection in the population of FSW and MSM was a significant factor affecting the spatial distribution of syphilis, and the spatial regression coefficient was 3.47,0.12,4.46,1.85 and 0.71 (P value was 0.05).
Conclusion: the hot spots of syphilis in China are mainly distributed in the southwest of Xinjiang, in the Middle East of Qinghai, in Guangxi, in the southeast coast, in the Northeast (including Inner Mongolia and Xilinguole Meng). We should focus on the focus, concentrate the limited resources and take effective measures to strengthen the prevention and control of syphilis in these areas, especially in minority areas. The incidence of syphilis is higher in areas with high economic development and high rate of syphilis infection among the floating population and high risk population. The incidence of syphilis infection in the floating population and the FSW population is greater than that of the MSM and male STD patients. It is worth further study. The geographic information system and the spatial analysis method have the visualization and precision. The advantages of location and so on should be used as a new important tool for syphilis surveillance and control.
【學(xué)位授予單位】：北京協(xié)和醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R759.1
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