| ObjectivesTo investigate the incidence and change trend of viral hepatitis B among residents of a county in western Liaoning from 2011 to 2021,and to analyze the spatial and temporal accumulation of hepatitis B in the county in the past 11 years through spatial epidemiology,so as to provide basic data and theoretical basis for the prevention and control of hepatitis B in this area.MethodsData of confirmed cases,clinically diagnosed cases,suspected cases and laboratory tests of residents of a county in western Liaoning from 2011 to 2021 were obtained from the county Center for Disease Control and Prevention.Demographic data of the county were obtained from the service population of the village clinic project subsidy distribution table.The fourth-level coordinate boundary data of the county were obtained from the municipal government.After obtaining the above materials,the following methods were used to carry out the research:1.The crude incidence rate and standardized incidence rate of viral hepatitis B from2011 to 2021 were calculated by case data and demographic data,and descriptive analysis was carried out;2.Joinpoint 4.4.0 was used to analyze the trend of viral hepatitis B in the county from 2011 to 2021;3.Arc GIS 10.7 software was used to establish a global autocorrelation model to study the global spatial-temporal clustering of hepatitis B in the county from 2011 to2021;4.Arc GIS 10.7 software was used to establish a local autocorrelation model to study the local spatial-temporal clustering of hepatitis B in the county from 2011 to 2021;5.Satscan 9.1 was used to conduct spatio-temporal scanning of the incidence of viral hepatitis B in the county from 2011 to 2021 to understand the prevalence areas and analyze the relative risk.Results1.From 2011 to 2021,there were 2978 cases of viral hepatitis B in a county of western Liaoning.The crude incidence of hepatitis B was 69.25/100 000,and the standard incidence was 70.13/ 100 000.The crude incidence was 73.60/100 000 for males and 64.82/ 100 000 for females,and was higher in males than in females,with a sex ratio of 1.16.The incidence of hepatitis B in 0-59 years old population increases with the increase of age,and the incidence of male is higher than female in all age groups.The proportion of hepatitis B by occupation was the highest in farmers(78.97%),followed by housework,unemployed and retired people.The average annual incidence of hepatitis B was highest in Manchu town of Toutai,followed by Gaotaizi Town and Chengguan Subdistrict;2.From 2011 to 2021,the standardized incidence rate of hepatitis B among residents in a county in western Liaoning showed an increasing trend(APC=3.89%,P < 0.05).Among all age groups,the annual percent change of age-standardized incidence rate in the 15-59 age group was 3.26%,and the increase of incidence rate in the elderly aged 60 years and above was the largest(APC=11.58%,P < 0.05).In the trend of gender incidence,the increase of female incidence was the largest(APC=6.35%,P < 0.05);3.Global autocorrelation analysis showed that the Moran’s I index in 2014,2016,2019 and 2021 were statistically significant and all were greater than 0,indicating a positive spatial correlation,and the hepatitis B cases showed clustering distribution in the above four years separately;4.Through local autocorrelation analysis,the local hot spots of viral hepatitis B in a county of western Liaoning were mainly concentrated in central and western China during 2011–2021.From 2011 to 2013,the L–L concentration areas were Toutai Manchu Town and Qilihe Town,the H–L concentration area was Liulongtai Town,and the L–H concentration areas were Yizhou Street and Jiudaoling Town.From 2014 to 2016,the HH gathering area included Toutai Manchu Town and Jiudaoling Town,the L–H gathering area included Yizhou Street,and the L–L gathering area was Liulonggou Manchu Town.From 2017 to 2019,the H-H gathering areas included Toudaohe Manchu Township,Yizhou Subdistrict and Chengguan Subdistrict;L–H gathering areas included Jiudaoling Town;L–L gathering areas included Dizangsi Manchu Township,Dadingpu Manchu Township and Liulonggou Manchu Township;From 2020 to 2021,both areas were H–H cluster areas,they were Qianyang Town and Toudaohe Manchu Township;5.According to the spatio-temporal scanning analysis,there were four clusters of hepatitis B in residents of a county in western Liaoning from 2011 to 2021.The firstlevel area was Zhangjiafu Township in 2017,the second-level cluster included Qianyang Town and Chengguan Sub-district during 2011—2015,and the third-level cluster included Gaotaizi Town during 2013—2016.The level 4 region was Toutai Manchu Town from 2014 to 2017.Conclusions1.The standardized incidence of hepatitis B in a county in western Liaoning increased year by year from 2011 to 2021.The incidence of hepatitis B in males was higher than that in females,and the incidence of hepatitis B in the whole age group was high in the middle and low at both ends.The proportion of occupational hepatitis B in farmers was the highest,and the annual incidence rate was the highest in Toutai Manchu town;2.From 2011 to 2021,the incidence rate of hepatitis B among residents in a county in western Liaoning showed an upward trend,and the increase rate was higher in women than in men,with the largest increase in the age group of 60 years old and above;3.From 2011 to 2021,the incidence of hepatitis B among residents in a county in western Liaoning Province was mainly concentrated in the central and northwest regions.The clustering of hepatitis B cases in the central and western areas of the county was high,and there was a trend of gradually spreading to the northern areas over time.After2019,a cluster distribution was observed among many townships,with four high-value clusters. |
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