目的掌握地理景观因素对长沙市。肾综合征出血热(HFRS)传播的影响。方法收集2005-2009年长沙市各乡镇HFRS发病数据,共327例;收集整理2005-2009年长沙市人口数据、第二次全国土地调查数据及长沙市气象数据,建立长沙市乡镇尺度HFRS疫情景观因素空间数据库。采用时空聚类分析与泊松回归分析方法,探索长沙市2005-2009年HFRS传播的时空分布与地理景观影响因素。结果2005-2009年长沙市HFRS发病率分别为1.16/10万(70例)、0.95/10万(58例)、1.40/10万(87例)、0.75/10万(47例)、1.02/10万(65例)。主成分泊松回归分析显示,HFRS发病与耕地[中位数(肘)=29.00km^2]、城乡用地面积(M=6.12km^2)呈正相关[发病率比(IRR)=1.34,95%CI:1.27-1.41];与林地(M=39.00km^2)(IRR=0.67,95%CI:0.55-0.81)及园地面积(M=0.99km。)(IRR=0.74,95%CI:0.63-0.86)呈负相关。HFRS病例在时空传播上呈现集聚性,一级聚类区出现在2006-2007年以地理位置(28.9N,113.37E)为中心,半径为22.22km的区域,发病67例,发病率为4.4/10万,RR=5.23,对数似然比(脚):51.61。二级聚类在2008-2009年集中于(28.2N,113.6E)位置,发病11例,发病率为10.6/10万,RR=10.77,LLR=16.01。结论地理景观变化与HFRS在长沙市的流行与传播存在重要联系。
Objective To explore the influence of landscape elements on the transmission of hemorrhagic fever with renal syndrome (HFRS) in Changsha. Methods A total of 327 cases of HFRS diagnosed between year 2005 - 2009 were recruited in the study. Based on the demographic data, meteorological data and the data of second national land survey during the same period, a GIS landscape elements database of HFRS at the township scale of Changsha was established. Spatial-temporal cluster analysis nlcthods were adopted to cxplm'e the influence of landscape elements on the spatlal-temporal distribution of HFRS in Changsha during the year of 2005 - 2009. Results The annual incidences of HFRS in Changsha between year 2005 - 2009 were 1.16/100 000 (70 cases) , 0. 95/100 000 (58 cases) , 1.40/100 000 ( 87 cases) ,0. 75/100 000 (47 cases) and 1.02/100 000 (65 cases) respectively. The results of poisson regression model analysis of principal component showed that the incidence of HFRS was positively cmTelated with farmland area (M= 29.00 km^2) and urban and rural area (M= 6. 12 km^2; incidence rate ratios (IRR) = 1.34,95% CI: 1.27 -1.41 ); but negatively correlated with forestland area ( M = 39. 00 km^2 ; IRR = 0. 67,95% CI: 0. 55 - 0. 81 ) and garden plot area ( M = 0. 99 km^2 ; IRR = 0. 74, 95% (71:0. 63 -0. 86). A significant cluster of the spatial-temporal distribution of HFRS cases was found in the study. The primary cluster (28.9 N, 113.37 E, radius at 22. 22 km, RR = 5.23, log likelihood ratio (LLR) =51.61 ,P 〈0. 01,67 cases of HFRS and incidence at 4.4/100 000) was found between year 2006 and 2007 ; and the secondary cluster (28.2 N, 113.6 E, RR = 10. 77, LLR = 16. 01, P 〈 0. 01,11 cases of HFRS and the incidence at 10. 6/100 000) was found between year 2008 and 2009. Conclusion The landscape elements were found to be closely related to the prevalence and transmission of HFRS.