Objective To analyze the incidence and spatial clustering of anthrax in Gansu province from 2014 to 2023,and to provide evidence for anthrax prevention and control.Methods Data on 883 reported anthrax cases in Gansu province from January 1,2014 to December 31,2023 were collected through the"Surveillance and Reporting Management"module of the China Disease Prevention and Control Information System.The Joinpoint regression model was employed to analyze the trend of anthrax incidence.ArcGIS 10.8.2 and FleXScan 3.1.2 were used for global spatial autocorrelation and spatial scanning,respectively.Results From 2014 to 2023,a total of 883 skin anthrax cases were reported in Gansu province.The number of cases in 2014,2015,2016,2017,2018,2019,2020,2021,2022,and 2023 was 93,104,128,117,66,41,37,84,93,and 120,respectively.The incidences of anthrax were 0.36/100 000,0.40/100 000,0.49/100 000,0.45/100 000,0.25/100 000,0.16/100 000,0.14/100 000,0.34/100 000,0.35/100 000,and 0.48/100 000,respectively.The incidence increased first,subsequently decreased,and then increased,but the difference was not statistically significant(P＞0.05).Anthrax cases in Gansu province occurred throughout the year,and the peak of incidence occurred from July to October each year,when 501 cases were reported,accounting for 56.74％of the total number of anthrax cases.The ratio of male-to-female cases was 1.46∶1.The disease predominantly affected young adults aged 20-49(68.74％).The majority(82.33％)of cases occurred among herdsmen.The number of cases in Gannan prefecture ranked the first in the province(92.19％).The results of global spatial autocorrelation analysis showed that there was certain spatial clustering of anthrax incidence in Gansu province from 2014 to 2023.The global Moran's I indices in 2014,2015,2016,2017,2018,2019,2020,2021,2022,and 2023,were 0.438,0.592,0.590,0.639,0.577,0.511,0.530,0.091,0.565,and 0.357,respectively(all P＜0.05).FleXScan 3.1.2 software scanned 3 clusters,mainly located in some counties and districts of Gannan prefecture in the southwest of Gansu province and Dingxi city.The first-level cluster area included Maqu county,Luqu county,and Xiahe county in Gannan prefecture,mainly pastoral areas,accounting for 80.63％of the reported cases.Two secondary cluster areas were Hezuo city,Zhuoni county,and Diebu county in Gannan prefecture as well as Minxian county in Dingxi city and Lintan county in Gannan prefecture,accounting for 9.51％and 4.98％of cases,respectively.Conclusions The incidence of anthrax in Gansu province from 2014 to 2023 was high and has increased in the past three years.Males,young adults,and herdsmen were the key populations for anthrax prevention and control.The primary cluster areas concentrated in Maqu county,Luqu county,and Xiahe county of Gannan prefecture in the southwest of Gansu province.It is necessary to conduct comprehensive monitoring in the aforementioned counties.

Objective To assess meteorological drivers of the second seasonal peaks in the incidence of hand,foot,mouth disease(HFMD)among children and adolescents in Gansu province.Methods Totally 83 462 records of 0-18 years old HFMD cases registered during 2010-2018 were collected from Gansu Provincial Center for Disease Control and Prevention and the data of same period on ambient temperature,relative humidity,rainfall,and wind speed were extracted from the Big Earth Data Platform for Three Poles.Weekly time series were established for the HFMD incidence and meteorological data.Local maximum filter and locally weighted scatter plot smoothing method were used in the identification of bimodal seasonal peaks of HFMD incidence.Logistic regression model analyses were performed to estimate the association of meteorological factors with the occurrence of second seasonal peaks of HFMD incidence,in which,the years with bimodal seasonal incidence peak were considered as the cases and those in years with monomodal incidence peak as the controls and the mean ambient temperature,relative humidity,rainfall and wind speed for 8 weeks before the identified second seasonal peak were considered as the exposure factors.Results Of the 83 190 HFMD cases finally included in the study,50 663(60.9％)were male and 77 346(93.0％)were aged less than 6 years,and more cases were reported in municipality/prefecture of Lanzhou(22 553,27.1％),Tianshui(9 756,11.7％),and Dingxi(7 917,9.5％).Of the 117 observation years for the 13 municipalities/prefecture during the 9 years,111(94.9％)of observation years had seasonal peaks of HFMD incidence,of which 92(78.6％)were with bimodal peak and only 19(16.2％)were with monomodal peak.The results of logistic regression analysis revealed a strong association between relative humidity of previous one week and the occurrence of second seasonal peak of HFMD,with a 4.2％increase(95％confidence interval[95％CI]:1.5％-7.3％)in the risk of second seasonal peak occurrence for every 1％increase in weekly average relative humidity;the results also indicated a 193.0％([95％CI]:21.9％-730.1％)increase in the risk of second seasonal peak occurrence of HFMD incidence for every 1m/s increased average weekly wind during 1-7 weeks before the second peak.Conclusion Weekly average relative humidity and wind speed are key meteorological factors correlated with the occurrence of the second seasonal peak of HFMD incidence.

Abstract Background Little research has been conducted on the spatio-temporal relationship between the severe cases and the enteroviruses infections of hand, foot and mouth disease (HFMD). This study aimed to investigate epidemic features and spatial clusters of HFMD incidence rates and assess the relationship between Enterovirus 71 (EV71) and Coxsackievirus A16 (CoxA16) and severe cases of HMFD in Gansu province, China. Methods Weekly county-specific data on HFMD between 1st January and 31st December 2018 were collected from the China Infectious Disease Information System (CIDIS), including enterovirus type (EV71 and CoxA16), severe and non-severe cases in Gansu province, China. Temporal risk [frequency index (α), duration index (β) and intensity index (γ)] and spatial cluster analysis were used to assess epidemic features and identify high-risk areas for HFMD. Time-series cross-correlation function and regression model were used to explore the relationship between the ratios of two types of viruses (i.e. EV71/Cox16) (EC) and severe cases index (i.e. severe cases/non-severe cases) (SI) of HFMD. Results Some counties in Dingxi City, Gansu were identified as a hot spot for the temporal risk indices. Time-series cross-correlation analysis showed that SI was significantly associated with EC (r = 0.417, P < 0.05) over a 4-week time lag. The regression analysis showed that SI was positively associated with EC (β = 0.04, 95% confidence interval (CI) 0.02–0.06). Conclusion The spatial patterns of HFMD incidence were associated with enteroviruses in Gansu. The research suggested that the EC could be considered a potential early warning sign for predicting severe cases of HFMD in Gansu province.

目的 了解2016-2020年甘肃省流行性感冒(流感)的时空分布特征,评估防控措施实施效果.方法 收集甘肃省87个县(区)每周流感数据进行空间扫描分析,采用空间自相关方法对流感的时间风险特征指数(频率指数、持续时间指数和强度指数)进行空间统计分析.结果 共报告病例46043例,年均发病率35.09/10万.2016-2020年甘肃省流感高发病率的可能聚集区域集中在定西市和天水市.流感的频率指数为0.58,持续时间指数为5.73,强度指数为10.49.全局自相关显示,流感的频率指数和强度指数呈正向空间自相关,局部自相关显示,频率指数和强度指数的热点区域主要集中在定西市.结论 甘肃省流感发病存在时空聚集性,定西市是流感的发病高风险区域,不同发病风险区防控措施效果不同.

目的 探讨甘肃省手足口病的时空分布特征和发病风险区域,评估防控措施实施效果.方法 收集2018年甘肃省87个县每周手足口病数据,分析手足口病的时间风险特征指数,采用空间聚类分析方法对时间风险特征指数的发病风险区进行可视化探测和分析.结果 2018年甘肃省手足口病共报告病例13571例,报告发病率为51.73/10万,全年有两个发病高峰.手足口病的时间风险特征指数(频率指数为0.430,持续时间指数为4.657,强度指数为11.106)存在空间聚集性,3个时间风险特征指数在定西市安定区和兰州市七里河区均呈现高值聚集状态,是手足口病发病的热点区域.结论 甘肃省手足口病发病存在时空聚集性,安定区和七里河区是手足口病的发病高风险区域,不同发病风险区防控措施效果不同.

Backgrounds: Seasonal influenza remains epidemic globally with a substantial health burden. Understanding the transmission patterns and epidemic features of influenza may facilitate the improvement of preventive and control measures. This study aims to assess the epidemic features of influenza among different climate zones and identify high-risk zones across Gansu province, China. Methods: We collected weekly influenza cases at county-level between 1st January 2012 and 31st December 2016, as well as climate zones classification shapefile data from Koppen-Geiger climate map. We compared the epidemic features (Frequency index (alpha), Duration index (beta) and Intensity index (gamma)) of influenza among different climate zones. Spatial cluster analysis was used to examine the high-risk areas of transmission of influenza. Results: The distribution of cases existed significant differences among eight climate zones (F-test: 267.02, p < 0.05). The highest mean weekly incidence rate (per 100,000 population) was 0.59 in snow climate with dry winter and warm summer (Dwb). The primary (relative risk (RR): 3.61, p < 0.001) and secondary (RR: 2.45, p < 0.001) clusters were located in Dwb. The highest values of alpha, beta and gamma were 1.00, 261 and 154.38 in Dwb. The hot spots (high-high clusters) of the epidemic indices were detected in Dwb. Conclusions: This study found the variability of epidemic features of influenza among eight climate zones. We highlight that Dwb was the high-risk zone where influenza clustered with the highest incidence rate and epidemic temporal indices. This provide further insight into potential improvement of preventive measures by climate zones to minimize the impact of epidemics.

目的 描述并探讨甘肃省新型冠状病毒肺炎(COVID-19)疫情的时间风险特征.方法 收集截至2020年2月16日甘肃省各县(区)报告的COVID-19的发病数、相应县(区)人口数等数据,运用空间统计学的方法计算各县(区)的时间风险指数频率指数(α)、持续时间频率(β)和强度指数(y).结果 全局自相关分析发现,α的Moran's I系数为0.115,提示未来COV1D-19发病频率增加概率较小.y的Moran's I系数为0.070,说明COVID-19确诊病例不会集中出现,疫情的发病强度较低.甘肃省COVID-19疫情的α、β存在全局空间自相关性(P＜0.05),y不存在全局空间自相关性(P＞0.05).α局部空间自相关分析发现区域(主要分布于兰州市城关区、七里河区、安宁区、红古区、皋兰县和榆中县)内存在高-高聚集性(P＜0.05).β局部空间自相关分析发现区域(主要分布于兰州市城关区、七里河区、西固区、安宁区、皋兰县和榆中县)内存在高-高聚集性(P＜0.05).结论 结果提示兰州市大部分县(区)呈现高风险聚集性,但发病强度较低;全省在疫情期间采取的各项防控措施及时、有效.

Objective: To analyze the epidemiological and spatial-temporal distribution of Brucellosis, epidemic encephalitis B and hemorrhagic fever with renal syndrome (HFRS) in Gansu province during 2014-2018 so as to provide evidence for the prevention and control of those diseases. Methods: A database was established in Gansu province from 2014 to 2018, using the geographical information system. A spatial distribution map was drawn, with trend analysis and space-time clustering used to study the 3-dimention of the diseases, by using both ArcGIS 10.5 and SaTScan 9.6 softwares. Results: Results from the trend surface analysis showed that the incidence of Brucellosis decreased gradually from north to south parts while the U type curve could reflect the distribution from the east to the west areas. Incidence of epidemic encephalitis B decreased significantly from south to north areas in the province, with incidence higher in the eastern than in the mid-west region. Difference on the incidence of HFRS was not significantly visible in the eastern and western regions, while the incidence was slightly higher in the southern than the northern parts of the province. Spatial and space-time clustering did exist among the 3 diseases in Gansu from 2014 to 2018. The areas with clusters of Brucellosis appeared in the eastern parts during 2014-2015, including 19 counties. The areas with secondary clusters of Brucellosis were seen in the Hexi district, including 4 counties, during 2017-2018. The areas with high incidence of epidemic encephalitis B were clustered in the middle and southeast areas, including 32 counties, during 2017-2018. Areas with most clusters of HFRS appeared in Min county of Dingxi city in 2018, with the areas of secondary clusters in 8 counties of the eastern areas in 2018. Conclusions: The overall incidence rates of the 3 natural focus diseases were in a upward trend and showing obvious characteristics on spatial clustering. According to the distributive characteristics, effective measures should be developed accordingly.

目的 探索气象因素对甘肃省流行性感冒(流感)流行强度的影响,为流感防控关口前移提供科学依据.方法 本研究选择2010-2016甘肃省白银、天水、酒泉3个地区监测点的病原学监测数据及气象资料,通过交互相关分析确定各气象因素对流感发病效应的滞后时间,运用分类回归树模型遴选出对流感流行强度影响最大的气象因素.结果 气象因素相关性研究显示,温度、湿度与流感流行强度呈负相关.天水市最高温度的3周移动平均低于19.11℃时流感流行强度升高1.89倍;酒泉市平均温度的3周移动平均低于8.03℃时流行强度升高2.01倍;白银市平均温度的3周移动平均低于8.68℃且相对湿度的14周移动平均低于61.04％时流行强度升高2.24倍.结论 甘肃省流感的流行受气象因素影响,寒冷干燥的气象条件有利于流感在人群中传播.

Objective To analyze the epidemic dynamics and distribution characteristics of influenza in Gansu province, so as to provide scientific basis for formulating prevention and control strategy. Methods Etiological surveillance data of influenza in Gansu province from 2010 to 2016 were collected through the Chinese Influenza Surveillance Information System. The difference in the positive rates of viral nucleic acid and type constitution of influenza in different years, seasons, populations and regions were compared by Chi-square test. The geographic distribution maps were drawn by ArcGIS 10.2. Results A total of 54 795 samples of influenza-like illness were collected in Gansu province from 2010 to 2016, the positive detection rate of influenza virus nucleic acid was 14.77% (8 091/ 54 795). The main types of influenza virus were A(H1N1)pdm09, A(H3N2) and B, accounting for 98.89% (8 001/ 8 091) of all positive specimens. The statistical difference of positve rates existed among each surveillance year (x2=289.68, P<0.01), and the highest was in 2015-2016 (19.00%, 2 529/13 309). The influenza epidemic intensity showed a typical annual single-peak distribution in December to the next January. For positive detection rate of influenza virus and pathogen type composition, there were statistically significant differences among age groups (the Chi-square values were 589.06 and 173.53, respectively, and both P values were less than 0.01). The positive rate was the highest in the 5~14 years old group (21.36%, 2 765/12 942), and influenza B virus was predominant in this group (51.02%, 1 401/2 746). Both influenza positive rate and pathogen type composition had statistically significant differences in different regions (the Chi-square values were 430.82 and 233.47, respectively, and both P values were less than 0.01). The positive rate was the highest in Dingxi city (20.25%, 559/2 761). Conclusions Annual influenza vaccination campaigns should start in October to provide effective protection during the epidemic period. School was the key sites of influenza epidemic prevention and control. Influenza vaccination for 5~14 years old group would be helpful to the prevention and control of influenza.

Objective: To optimize the warning threshold values of common communicable diseases in Gansu province, and improve the early warning effect. Method: An early warning model was set up for influenza, scarlet fever, other infectious diarrheal diseases, dysentery, typhoid and paratyphoid, viral hepatitis type E and hand foot and mouth disease (HFMD) respectively in Gansu by using the moving percentile method and cumulative sum method. By calculating the sensitivity, specificity, predictive value of positive test, predictive value of negative test, Youden' index and receiver-operating characteristic curve, the optimum early warning threshold values for communicable diseases in Gansu were selected. Results: The optimum early warning boundary values of influenza, scarlet fever, other infectious diarrheal diseases, dysentery, typhoid and paratyphoid, and viral hepatitis type E were P(90), P(80), P(95), P(90), P(80) and P(90) respectively. The optimum early warning parameters of HFMD were k=1.2, H=5σ. Under the optimum early warning boundary values/parameters, the early warning sensitivities of influenza, scarlet fever, other infectious diarrheal diseases, dysentery, typhoid and paratyphoid, viral hepatitis type E and HFMD were 86.67%, 100.00%, 91.67%, 100.00%, 100.00%, 100.00% and 100.00%, the specificities were 86.49%, 62.22%, 75.00%, 100.00%, 97.92%, 89.13% and 74.47%. The predictive values of positive test were 72.22%, 29.17%, 52.38%, 100.00%, 80.00%, 54.55% and 29.41%, and the predictive values of negative test were 94.12%, 100.00%, 96.77%, 100.00%, 100.00%, 100.00% and 100.00%, and the Youden' indexes were 0.73, 0.62, 0.67, 1.00, 0.98,0.89 and 0.74. Receiver-operating characteristic curve showed that the values/parameters of this warning boundary were the points closest to the upper left of the coordinate diagram. Conclusion: The early warning thresholds of influenza, other infectious diarrheal diseases, dysentery and hepatitis E in Gansu may be raised appropriately and the early warning parameters of HFMD need to be adjusted to improve the effectiveness of early warning.

To determine the linear and non-linear interacting relationships between weather factors and hand, foot and mouth disease (HFMD) in children in Gansu, China, and gain further traction as an early warning signal based on weather variability for HFMD transmission.

Three main surveillance systems (laboratory-confirmed, influenza-like illness (ILI) and nationwide Notifiable Infectious Diseases Reporting Information System (NIDRIS)) have been used for influenza surveillance in China. However, it is unclear which surveillance system is more reliable in developing influenza early warning system based on surveillance data. This study aims to evaluate the similarity and difference of the three surveillance systems and provide practical knowledge for improving the effectiveness of influenza surveillance. Weekly influenza data for the three systems were obtained from March 2010 to February 2015. Spearman correlation and time series seasonal decomposition were used to assess the relationship between the three surveillance systems and to explore seasonal patterns and characteristics of influenza epidemics in Gansu, China. Our results showed influenza epidemics appeared a single-peak around January in all three surveillance systems. Time series seasonal decomposition analysis demonstrated a similar seasonal pattern in the three systems, while long-term trends were observed to be different. Our research suggested that a combination of the NIDRIS together with ILI and laboratory-confirmed surveillance is an informative, comprehensive way to monitor influenza transmission in Gansu, China. These results will provide a useful information for developing influenza early warning systems based on influenza surveillance data.

Objective To analyze the performance efficiency of temporal model in China Infectious Diseases Automated-Alert and Response System(CIDARS) in Gansu province from 2008 to 2013 and to evaluate the sensitivity and practicability of CIDARS.Methods Data on infectious disease automated alert signals form CIDARS in Gansu province from January 2008 through December 2013 were collected and analyzed with descriptive methods and the effect of alert threshold adjustment in temporal model in CIDARS was assessed for different areas and diseases.Results Totally 39 940 early-warning signals were issued by CIDARS;the ratio between the number of reported infectious disease cases and the number of early-warning signals was 9.01:1;the suspected incident signals accounted for 1.57％ of all the early warning signals;the positive rate of early-warning signals was 0.64％.The majority of the warning signals were the incidents of dysentery,other infectious diarrhea,and mumps,accounting for 63.17％ of all the warning signals.The earlywarning signals involved 86 counties or districts of 14 prefectures in the province and the median response time for the signals was 0.84 hour.After the adjustment of early-warning threshold in December 2010,the sensitivity of CIDARS dropped from 70.59％ to 39.62％ and the positive rate dropped from 0.88％ to 0.34％.The positive rate declined for the early-warning signals of influenza,mumps,rubella,hand foot and mouth disease,other infectious diarrhea,dysentery,hepatitis A,and acute hemorrhagic conjunctivitis;whereas the positive rate increased for the signals for the incidents in Lanzhou and Jiayuguan municipality.The median response time shortened for all the early-warning signals.Conclusion The performance of CIDARS in Gansu province was stable between 2008 and 2013,but the adjustment of early-warning threshold in CIDARS showed no good results,suggesting that the threshold still needs to be optimized for the improve ment of sensitivity and specificity of CIDARS.

OBJECTIVE:To explore the appropriate early warning method for influenza epidemic in Gansu province.METHODS:By using simple control chart, moving percentile method, exponential smoothing method and cumulative sum control chart method, the annual incidence data of influenza-like illness in Gansu province during 2014-2015 were analyzed, and the sensitivities, specificities, positive predictive values, Jorden indexes and Kappa values of the 4 methods were evaluated and compared.RESULTS:The 2014-2015 seasonal influenza epidemic occurred in the fiftieth week of 2014 in Gansu, and the epidemic peak lasted for 6 weeks. Cumulative sum control chart method had the best early warning effect with the sensitivity of 66.67% and specificity of 93.48%.CONCLUSION:It is feasible to use cumulative sum control chart method to give early warning of influenza epidemic in Gansu.

OBJECTIVE:To understand the hot/cold spots and the spatial-temporal clustering of hepatitis B in Gansu province during 2009-2014 by using spatial statistics, and provide scientific evidence for the prevention and control of hepatitis B.METHODS:The spatial hot/cold spots and its trend, and the time frame and areas of its spatial-temporal clustering of hepatitis B in Gansu were analyzed by using the county specific incidence of hepatitis B from 2009 to 2014 and spatial statistical software GeoDa and SatScan.RESULTS:The incidences of hepatitis B from 2009 to 2014 in Gansu were spatial autocorrelated respectively. Local G scan statistics indicated that the number of hot spots was in decline in Hexi area, while the hot spots was in increase in Linxia Hui autonomous prefecture and Gannan Tibetan autonomous prefecture. There was no obvious pattern in cold spots. Temporal-spatial scan statistics showed that the areas with high hepatitis B incidence most likely clustered in Hexi area during 2009-2011, and the areas with low hepatitis B incidence most likely clustered in eastern Gansu during 2012-2014.CONCLUSIONS:The spatial and temporal clustering of hepatitis B was observed in Gansu from 2009 to 2014. The number of hot spots in Hexi area was in decline, while the numbers of hot spots in Linxia and Gannan were in increase, suggesting that the hepatitis B control and prevention in these areas should be strengthened.

The influence of socio-ecological factors on hand, foot and mouth disease (HFMD) were explored in this study using Bayesian spatial modeling and spatial patterns identified in dry regions of Gansu, China. Notified HFMD cases and socio-ecological data were obtained from the China Information System for Disease Control and Prevention, Gansu Yearbook and Gansu Meteorological Bureau. A Bayesian spatial conditional autoregressive model was used to quantify the effects of socio-ecological factors on the HFMD and explore spatial patterns, with the consideration of its socio-ecological effects. Our non-spatial model suggests temperature (relative risk (RR) 1.15, 95 % CI 1.01–1.31), GDP per capita (RR 1.19, 95 % CI 1.01–1.39) and population density (RR 1.98, 95 % CI 1.19–3.17) to have a significant effect on HFMD transmission. However, after controlling for spatial random effects, only temperature (RR 1.25, 95 % CI 1.04–1.53) showed significant association with HFMD. The spatial model demonstrates temperature to play a major role in the transmission of HFMD in dry regions. Estimated residual variation after taking into account the socio-ecological variables indicated that high incidences of HFMD were mainly clustered in the northwest of Gansu. And, spatial structure showed a unique distribution after taking account of socio-ecological effects.

目的 运用空间统计学的方法描述并分析2013年甘肃省肺结核发病的空间分布模式,为肺结核的防控提供理论依据.方法 利用"全国传染病疫情信息网络直报系统"导出甘肃省2013年各区(县)肺结核发病数据、相应区(县)人口数等数据,运用空间统计软件分析甘肃省肺结核发病的空间相关性、空间聚集性特征.结果 甘肃省2013年肺结核报告发病率存在空间自相关性(Moran's I=0.314,Z(I)=4.673,P＜0.001);局部空间自相关分析发现区域内存在高-高(或热点区域,主要分布于金昌市以西的河西地区)、低-低(或冷点区域,分布于兰州市部分地区、定西市安定区、平凉市与庆阳市相连地区)等关联模式的县(区)(P＜0.05);不规则空间扫描结果显示肺结核发病最大可能聚集区为河西地区(LLR=364.83,RR=1.888,P=0.001),且与局部空间自相关高-高关联模式区域相似.结论 甘肃省2013年肺结核报告发病率呈非随机分布,河西及陇南部分地区为甘肃省肺结核发病聚集区域,是肺结核的重点防控地区.

目的 运用空间统计学的方法描述并探讨2013年甘肃省甲型病毒型肝炎(甲肝)发病的空间分布特征.方法 利用“全国传染病疫情信息网络直报系统”导出2013年甘肃省各区(县)甲肝发病数据、相应区(县)人口数等数据,运用空间统计软件分析甘肃省甲肝发病的空间相关性、空间聚集性特征.结果 2013年甘肃省甲肝报告发病率存在空间自相关性(P＜0.00l);局部空间自相关分析发现区域内存在“高-高”(或热点区域,主要分布于酒泉市、武威市、甘南州和临夏州部分县区)、“低-低”(或冷点区域,分布于嘉峪关市、张掖市、甘肃东部和南部部分县区)等关联模式的县(区),P＜0.05;规则空间扫描结果显示甲肝发病最大可能聚集区为凉州区以及凉州区周边县区(RR=2.580,P=0.001).结论 2013年甘肃省甲肝报告发病率呈非随机分布,武威市、临夏州和甘南州为甘肃省甲肝发病聚集区域,是甲肝的重点防控地区.

OBJECTIVE:To detect the spatial temporal distribution of mumps in Gansu by means of spatial statistics.METHODS:The county-based incidence of mumps from 2009 to 2013 was used to calculate the global Moran's I and local G statistics, and analyze its spatial temporal distribution characteristics.RESULTS:The incidence of mumps in Gansu were spatial auto-correlated from 2009 to 2013 respectively (P<0.001), and the hot spots were mainly distributed in Hexi area, while the cold spots were distributed in Tianshui, Longnan and Qingyang. Spatial temporal analysis showed that the high incidence of mumps was most likely to be detect in Hexi area (RR=3.05, LLR=4 670.995, P<0.001), and the low incidence was most likely to be detect in Longdong area (RR=0.36, LLR=1 980.686, P<0.001).CONCLUSION:The spatial and spatial temporal clustering of mumps existed in Gansu from 2009 to 2013, the results can be used in the development of mumps prevention and control measure in Gansu.