2013-2016年浙江省人感染H7N9禽流感疫情的空间分析及回归模型构建
|
摘要
目的掌握浙江省H7N9禽流感疫情的空间分布特征及分布模式,构建疾病暴发与社会、环境因素之间关系的空间回归模型,为H7N9防控和预警提供方法学参考。方法以浙江省2013—2016年人感染H7N9禽流感病例以及病毒外环境监测数据为基础,结合相关的社会、环境数据,运用空间自相关分析(Global Moran's I)和热点分析(Getis-Ord Gi*)等方法分析疫情的空间分布模式,运用地理加权回归模型(GWR)分析禽流感病例数与人口密度、家禽密度以及外环境病毒分布的关系,并与传统的最小二乘法(OLS)模型进行比较。结果 2013—2016年浙江省共报告人感染H7N9禽流感252例,外环境监测发现阳性监测点846个,分布于11个地市的77个县(区)。省级层面疫情呈现以浙北地区为中心逐步向周边地区扩散的趋势,市级层面呈现以人口密集的城区为中心逐步向偏远县(区)扩散的趋势。空间回归分析显示县(区)的病例数与人口密度、外环境监测病毒阳性点数呈显著正相关(t=4.127、2.697,P=0.000、0.009)。地理加权回归模型(R2=0.504)预测效果优于OLS回归模型(R2=0.257)。结论浙江省人感染H7N9禽流感疫情起源于湖州地区,并以杭嘉湖一带为中心向周边逐步扩散,目前已广泛分部于全省各地,活禽贸易可能是疫情传播与扩散的主要途径。病例的分布存在显著的时空聚集性,人口、家禽密度大、病毒外环境监测阳性水平高的地区更容易出现疫情。GWR对人感染H7N9禽流感病例的分布具有较好的拟合效果,具有实际应用前景。
Objective To investigate the spatial distribution of the cases of human infection with influenza A(H7N9) virus in Zhejiang province during 2013-2016,establish mathematic models to identify the environmental and social factors associated with disease distribution and provide methodological support for the prevention and control of the disease.Methods Based on the incidence data of human infection with H7N9 virus,virus surveillance data of environmental samples as well as population and socioeconomic data in Zhejiang during this period,a spatial database was established.Global Moran's I and Getis-Ord Gi* were applied to explore the spatial distribution of H7N9 virus infection epidemic.Geographically Weighted Regression(GWR) model was constructed to analyze the spatial correlation between the epidemic and population density,poultry density and virus distribution in environment.The results were compared with those of Ordinary Least Squares(OLS) model.Results From 2013 to 2016,a total of 252 human cases of H7N9 virus infection were reported and the viruses were detected in 846 surveillance sites distributed in 77 counties and districts of 11 prefecture-level cities,.At provincial level,the epidemic spread from central-northern part of Zhejiang to surrounding areas;at city level,the epidemic spread from downtown area with high population density to surrounding counties or districts.Spatial regression analysis suggested that the number of human infection cases was correlated with population density and number of H7N9 virus positive surveillance sites(t=4.127 and 2.697 respectively,P=0.000 and 0.009 respectively).GWR model(R2=0.504) showed better fitness compared with OLS model(R2=0.257).Conclusion The H7N9 virus infection epidemic in Zhejiang originated in Huzhou and gradually spread to the surrounding areas of Hangjiahu plain.The virus is distributed wildly in the province now.Live poultry marketing might be the main route for the spread of the infection.The spatiotemporal clustering of human infection with H7N9 virus was very obvious,the epidemic was more likely to occur in area with high population and poultry densities and more virus positive surveillance sites.GWR model is suitable for practical application due to its good predicting effect for the distribution of human infections with H7N9 virus.
Objective To investigate the spatial distribution of the cases of human infection with influenza A(H7N9) virus in Zhejiang province during 2013-2016,establish mathematic models to identify the environmental and social factors associated with disease distribution and provide methodological support for the prevention and control of the disease.Methods Based on the incidence data of human infection with H7N9 virus,virus surveillance data of environmental samples as well as population and socioeconomic data in Zhejiang during this period,a spatial database was established.Global Moran's I and Getis-Ord Gi* were applied to explore the spatial distribution of H7N9 virus infection epidemic.Geographically Weighted Regression(GWR) model was constructed to analyze the spatial correlation between the epidemic and population density,poultry density and virus distribution in environment.The results were compared with those of Ordinary Least Squares(OLS) model.Results From 2013 to 2016,a total of 252 human cases of H7N9 virus infection were reported and the viruses were detected in 846 surveillance sites distributed in 77 counties and districts of 11 prefecture-level cities,.At provincial level,the epidemic spread from central-northern part of Zhejiang to surrounding areas;at city level,the epidemic spread from downtown area with high population density to surrounding counties or districts.Spatial regression analysis suggested that the number of human infection cases was correlated with population density and number of H7N9 virus positive surveillance sites(t=4.127 and 2.697 respectively,P=0.000 and 0.009 respectively).GWR model(R2=0.504) showed better fitness compared with OLS model(R2=0.257).Conclusion The H7N9 virus infection epidemic in Zhejiang originated in Huzhou and gradually spread to the surrounding areas of Hangjiahu plain.The virus is distributed wildly in the province now.Live poultry marketing might be the main route for the spread of the infection.The spatiotemporal clustering of human infection with H7N9 virus was very obvious,the epidemic was more likely to occur in area with high population and poultry densities and more virus positive surveillance sites.GWR model is suitable for practical application due to its good predicting effect for the distribution of human infections with H7N9 virus.
引文
[1]肖雄,杨长虹,谭柯,等.地理加权回归模型在传染病空间分析中的应用[J].中国卫生统计,2013,30(6):833-836,841.Xiao X,Yang CH,Tan K,et al.A study on the application of geographically weighted regression model in spatial analysis of infectious disease[J].Chin J Health Statist,2013,30(6):833-836,841.
[2]魏传华,胡晶,吴喜之.空间自相关地理加权回归模型的估计[J].数学的实践与认识,2010,40(22):126-134.Wei CH,Hu J,Wu XZ.Estimation in gegorapically weighted regression with spatial autocorrelation[J].Mathemat Pract Theory,2010,40(22):126-134.
[3]Fotheringham AS,Charlton ME,Brunsdon C.Geographically weighted regression:a natural evolution of the expansion method for spatial data analysis[J].Environ Plann A,1998,30(11):1905-1927.DOI:10.1068/a301905.
[4]黄秋兰,唐咸艳,周红霞,等.四种空间回归模型在疾病空间数据影响因素筛选中的比较研究[J].中国卫生统计,2013,30(3):334-338.Huang QL,Tang XY,Zhou HX,et al.Comparison of four spatial regression models for screening disease factors[J].Chin J Health Statist,2013,30(3):334-338.
[5]凌佳,张婧.江苏省艾滋病分布研究及影响因素分析[J].数理医药学杂志,2016,29(5):695-697.Ling J,Zhang J.Study of spatial distribution and impact factors of HIV/AIDS in Jiangsu province based on spatial statistics[J].JMath Med,2016,29(5):695-697.
[6]刘炜炜,胡跃华,于石成,等.中国大陆地区2008-2013年丙肝发病时空聚集性及社会经济影响因素[J].中国公共卫生,2016,32(4):482-487.DOI:10.11847/zgggws2016-32-04-19.Liu WW,Hu YH,Yu SC,et al.Temporal-spatial clustering and socio-economic influencing factors of hepatitis C in mainland China,2008-2013[J].Chin J Public Health,2016,32(4):482-487.DOI:10.11847/zgggws2016-32-04-19.
[7]吕华坤,龚震宇,孙继民,等.浙江省人感染H7N9禽流感疫情特征与活禽市场休市的影响分析[J].疾病监测,2014,29(9):700-703.DOI:10.3784/j.issn.1003-9961.2014.09.008.Lv HK,Gong ZY,Sun JM,et al.Epidemic characteristics of human infection with avian influenza A(H7N9)virus and influence of closure of live poultry markets on the epidemic in Zhejiang[J].Dis Surveill,2014,29(9):700-703.DOI:10.3784/j.issn.1003-9961.2014.09.008.
[8]王笑笑,程伟,余昭,等.浙江省冬春季涉禽场所禽流感病毒污染特征及影响因素研究[J].中华预防医学杂志,2016,50(3):250-254.DOI:10.3760/cma.j.issn.0253-9624.2016.03.012.Wang XX,Cheng W,Yu Z,et al.Avian influenza virus in various environments and risk factors for the contamination of live poultry markets during winter and spring season in Zhejiang province[J].Chin J Prev Med,2016,50(3):250-254.DOI:10.3760/cma.j.issn.0253-9624.2016.03.012.
[9]Cowling BJ,Jin LM,Lau EHY,et al.Comparative epidemiology of human infections with avian influenza A H7N9 and H5N1viruses in China:a population-based study of laboratory-confirmed cases[J].Lancet,2013,382(9887):129-137.DOI:10.1016/S0140-6736(13)61171-X.
[10]Zhang Y,Shen ZX,Ma CN,et al.Cluster of human infections with avian influenza A(H7N9)cases:a temporal and spatial analysis[J].Int J Environ Res Public Health,2015,12(1):816-828.DOI:10.3390/ijerph120100816.
[11]Prosser DJ,Wu JX,Ellis EC,et al.Modelling the distribution of chickens,ducks,and geese in China[J].Agric Ecosyst Environ,2011,141(3/4):381-389.DOI:10.1016/j.agee.2011.04.002.
[12]Han JK,Wang LL,Liu J,et al.Cocirculation of three hemagglutinin and two neuraminidase subtypes of avian influenza viruses in Huzhou,China,April 2013:implication for the origin of the novel H7N9 virus[J].J Virol,2014,88(11):6506-6511.DOI:10.1128/JVI.03319-13.
[13]方立群,曹春香,陈国胜,等.地理信息系统应用于中国大陆高致病性禽流感的空间分布及环境因素分析[J].中华流行病学杂志,2005,26(11):839-842.DOI:10.3760/j.issn:0254-6450.2005.11.002.Fang LQ,Cao CX,Chen GS,et al.Studies on the spatial distribution and environmental factors of highly pathogenic avian influenza in Mainland China,using geographic information system technology[J].Chin J Epidemiol,2005,26(11):839-842.DOI:10.3760/j.issn:0254-6450.2005.11.002.
[14]于伟文,杜鹏程,陈晨,等.利用网络数据分析我国活禽市场与人感染H7N9禽流感病例的地理关系[J].中华流行病学杂志,2014,35(3):266-270.DOI:10.3760/cma.j.issn.0254-6450.2014.03.011.Yu WW,Du PC,Chen C,et al.Investigation of geographic relationship between farmer's market with live birds and human infections with avian influenza A(H7N9)virus based on internet data analysis[J].Chin J Epidemiol,2014,35(3):266-270.DOI:10.3760/cma.j.issn.0254-6450.2014.03.011.
[15]Pantin-Jackwood MJ,Miller PJ,Spackman E,et al.Role of poultry in the spread of novel H7N9 influenza virus in China[J].J Virol,2014,88(10):5381-5390.DOI:10.1128/JVI.03689-13.
[16]Lee SS,Wong NS.The clustering and transmission dynamics of pandemic influenza A(H1N1)2009 cases in Hong Kong[J].JInfect,2011,63(4):274-280.DOI:10.1016/j.jinf.2011.03.011.
[17]张人杰,李娜,王臻,等.浙江省2013-2014年人感染H7N9禽流感病例空间自相关分析[J].中国公共卫生,2017,33(1):70-73.DOI:10.11847/zgggws2017-33-01-17.Zhang RJ,Li N,Wang Z,et al.Spatial autocorrelation of human H7N9 avian influenza incidents in Zhejiang province,2013-2014[J].Chin J Public Health,2017,33(1):70-73.DOI:10.11847/zgggws2017-33-01-17.
[2]魏传华,胡晶,吴喜之.空间自相关地理加权回归模型的估计[J].数学的实践与认识,2010,40(22):126-134.Wei CH,Hu J,Wu XZ.Estimation in gegorapically weighted regression with spatial autocorrelation[J].Mathemat Pract Theory,2010,40(22):126-134.
[3]Fotheringham AS,Charlton ME,Brunsdon C.Geographically weighted regression:a natural evolution of the expansion method for spatial data analysis[J].Environ Plann A,1998,30(11):1905-1927.DOI:10.1068/a301905.
[4]黄秋兰,唐咸艳,周红霞,等.四种空间回归模型在疾病空间数据影响因素筛选中的比较研究[J].中国卫生统计,2013,30(3):334-338.Huang QL,Tang XY,Zhou HX,et al.Comparison of four spatial regression models for screening disease factors[J].Chin J Health Statist,2013,30(3):334-338.
[5]凌佳,张婧.江苏省艾滋病分布研究及影响因素分析[J].数理医药学杂志,2016,29(5):695-697.Ling J,Zhang J.Study of spatial distribution and impact factors of HIV/AIDS in Jiangsu province based on spatial statistics[J].JMath Med,2016,29(5):695-697.
[6]刘炜炜,胡跃华,于石成,等.中国大陆地区2008-2013年丙肝发病时空聚集性及社会经济影响因素[J].中国公共卫生,2016,32(4):482-487.DOI:10.11847/zgggws2016-32-04-19.Liu WW,Hu YH,Yu SC,et al.Temporal-spatial clustering and socio-economic influencing factors of hepatitis C in mainland China,2008-2013[J].Chin J Public Health,2016,32(4):482-487.DOI:10.11847/zgggws2016-32-04-19.
[7]吕华坤,龚震宇,孙继民,等.浙江省人感染H7N9禽流感疫情特征与活禽市场休市的影响分析[J].疾病监测,2014,29(9):700-703.DOI:10.3784/j.issn.1003-9961.2014.09.008.Lv HK,Gong ZY,Sun JM,et al.Epidemic characteristics of human infection with avian influenza A(H7N9)virus and influence of closure of live poultry markets on the epidemic in Zhejiang[J].Dis Surveill,2014,29(9):700-703.DOI:10.3784/j.issn.1003-9961.2014.09.008.
[8]王笑笑,程伟,余昭,等.浙江省冬春季涉禽场所禽流感病毒污染特征及影响因素研究[J].中华预防医学杂志,2016,50(3):250-254.DOI:10.3760/cma.j.issn.0253-9624.2016.03.012.Wang XX,Cheng W,Yu Z,et al.Avian influenza virus in various environments and risk factors for the contamination of live poultry markets during winter and spring season in Zhejiang province[J].Chin J Prev Med,2016,50(3):250-254.DOI:10.3760/cma.j.issn.0253-9624.2016.03.012.
[9]Cowling BJ,Jin LM,Lau EHY,et al.Comparative epidemiology of human infections with avian influenza A H7N9 and H5N1viruses in China:a population-based study of laboratory-confirmed cases[J].Lancet,2013,382(9887):129-137.DOI:10.1016/S0140-6736(13)61171-X.
[10]Zhang Y,Shen ZX,Ma CN,et al.Cluster of human infections with avian influenza A(H7N9)cases:a temporal and spatial analysis[J].Int J Environ Res Public Health,2015,12(1):816-828.DOI:10.3390/ijerph120100816.
[11]Prosser DJ,Wu JX,Ellis EC,et al.Modelling the distribution of chickens,ducks,and geese in China[J].Agric Ecosyst Environ,2011,141(3/4):381-389.DOI:10.1016/j.agee.2011.04.002.
[12]Han JK,Wang LL,Liu J,et al.Cocirculation of three hemagglutinin and two neuraminidase subtypes of avian influenza viruses in Huzhou,China,April 2013:implication for the origin of the novel H7N9 virus[J].J Virol,2014,88(11):6506-6511.DOI:10.1128/JVI.03319-13.
[13]方立群,曹春香,陈国胜,等.地理信息系统应用于中国大陆高致病性禽流感的空间分布及环境因素分析[J].中华流行病学杂志,2005,26(11):839-842.DOI:10.3760/j.issn:0254-6450.2005.11.002.Fang LQ,Cao CX,Chen GS,et al.Studies on the spatial distribution and environmental factors of highly pathogenic avian influenza in Mainland China,using geographic information system technology[J].Chin J Epidemiol,2005,26(11):839-842.DOI:10.3760/j.issn:0254-6450.2005.11.002.
[14]于伟文,杜鹏程,陈晨,等.利用网络数据分析我国活禽市场与人感染H7N9禽流感病例的地理关系[J].中华流行病学杂志,2014,35(3):266-270.DOI:10.3760/cma.j.issn.0254-6450.2014.03.011.Yu WW,Du PC,Chen C,et al.Investigation of geographic relationship between farmer's market with live birds and human infections with avian influenza A(H7N9)virus based on internet data analysis[J].Chin J Epidemiol,2014,35(3):266-270.DOI:10.3760/cma.j.issn.0254-6450.2014.03.011.
[15]Pantin-Jackwood MJ,Miller PJ,Spackman E,et al.Role of poultry in the spread of novel H7N9 influenza virus in China[J].J Virol,2014,88(10):5381-5390.DOI:10.1128/JVI.03689-13.
[16]Lee SS,Wong NS.The clustering and transmission dynamics of pandemic influenza A(H1N1)2009 cases in Hong Kong[J].JInfect,2011,63(4):274-280.DOI:10.1016/j.jinf.2011.03.011.
[17]张人杰,李娜,王臻,等.浙江省2013-2014年人感染H7N9禽流感病例空间自相关分析[J].中国公共卫生,2017,33(1):70-73.DOI:10.11847/zgggws2017-33-01-17.Zhang RJ,Li N,Wang Z,et al.Spatial autocorrelation of human H7N9 avian influenza incidents in Zhejiang province,2013-2014[J].Chin J Public Health,2017,33(1):70-73.DOI:10.11847/zgggws2017-33-01-17.