Spatio-temporal Cluster Research Of Hepatitis C In Jilin Province From 2005 To 2021

Objective:Hepatitis C is a legally reported class B infectious disease in China,and the reported incidence rate ranks second among viral hepatitis.Jilin Province is one of the areas with high incidence of hepatitis C in China.At present,there is a lack of spatial analysis of hepatitis C in Jilin Province.Based on the reported incidence data of hepatitis C in Jilin Province from 2005 to 2021,this study aims to describe the epidemic characteristics of hepatitis C,and explore the spatial distribution characteristics and spatio-temporal clusters of hepatitis C.By identifying the epidemic trend and hot spots of hepatitis C in Jilin Province,and determining the key monitoring areas,we can provide a reference basis for the prevention and control of Hepatitis C.Methods:1.Using Excel 2016 and R 4.1.0 software to summarize,collate and analyze the reported incidence data of hepatitis C in Jilin Province from 2005 to 2021,and the epidemic characteristics of hepatitis C were described by the number of cases,incidence rate and other indicators.2.Using Arc GIS 10.2 software to draw a visual incidence map of hepatitis C in Jilin Province from 2005 to 2021 and carry out spatial autocorrelation analysis to study the spatial distribution characteristics of hepatitis C incidence.3.Using Sa TScan 10.0.2 software to analyze the incidence of hepatitis C in Jilin Province from 2005 to 2021 with year/month as time unit and county(district)as space unit,so as to study the cluster of hepatitis C in time,space and spatio-temporal scales.Results:1.A total of 94,842 cases of hepatitis C were reported in Jilin Province from2005 to 2021,and the average annual was 5,579 cases,with an average annual incidence rate of 20.49/100,000.The incidence of hepatitis C increased first and then decreased.2.From the perspective of time distribution,March has the highest number of reported cases.From the perspective of regional distribution,Fuyu City,Tumen City,Yanji City,Hunchun City and Hunjiang District were the five regions with the highest annual average incidence rate of hepatitis C in Jilin Province.From the perspective of population distribution,the number of cases and incidence rate of males were higher than females,but the difference was gradually decreasing.The age group with the largest number of patients was 50-59,and the average annual reported incidence rate decreases with age.The three categories of people with the highest occupation proportion were farmers,housework and job-seekers,and retirees.The proportion of farmers,housework and job-seekers was on the rise.3.Global spatial autocorrelation analysis showed that the incidence of hepatitis C in 2005-2018 and 2020-2021 showed spatial autocorrelation(P<0.05),Global Moran’s I was 0.5864,0.4669,0.4175,0.5034,0.4580,0.4919,0.4688,0.3204,0.1630,0.1814,0.2320,0.2998,0.4004,0.2487,0.2022 and 0.2626,respectively.4.The results of hot spot analysis in local spatial autocorrelation analysis showed that the hot spots of hepatitis C covered 21 regions,mostly concentrated in the eastern,southern and northern parts of Jilin Province.The cold spots covered 12 regions,mostly concentrated in the central and western parts of Jilin Province.The results of Anselin Local Moran’s I clustering and outlier analysis showed that there were 17 high-value clusters(HH),and their distribution locations were basically consistent with the hot spots.There were 7 low-value clusters(LL),and their distribution locations were basically consistent with the cold spots.There were 2 areas with low value and surrounded by high value(LH),namely Yushu City and Dehui City.There was one area with high value and surrounded by low value(HL),which was Da’an City.5.Time scan statistics analysis showed that there were statistically significant differences in the relative risk of hepatitis C reported from 2005 to 2021,but there was no specific clustering period.6.Spatial scan statistics analysis showed that the most likely cluster was mainly concentrated in Yanbian Prefecture before 2011,and in Fuyu City after 2011.The secondary clusters were scattered,mainly in the southern and central parts of Jilin Province at the beginning,and gradually spread to the northern and western parts over time.7.In the Spatio-temporal scan statistics analysis using years as the time unit,the most likely cluster was Fuyu City,and the secondary clusters were mainly distributed in the marginal counties(districts)of Jilin Province,except for Gongzhuling City and Jilin City.When using months as the time unit,the most likely clusters before 2011 was mainly distributed in Yanbian Prefecture,such as Hunchun City,Tumen City,Yanji City and Wangqing County,while after 2011,they were mainly distributed in Fuyu City.All districts of cities and prefectures have experienced cluster except for some districts of Changchun City and Siping City.Conclusion:1.In 2005-2021,the reported incidence of hepatitis C in Jilin Province increased first and then decreased,with the highest point in 2011.The incidence of hepatitis C in males was higher than that in females,and the annual average incidence rate increased with age.Farmers,housework and job-seekers,and retired people were the main population.2.In 2005-2021,the incidence of hepatitis C in Jilin Province has clustered in the local spatial autocorrelation analysis.The hot spots were located in Songyuan City,Yanbian Prefecture,and the southern region of Jilin Province,while the cold spots were in the central and western regions.3.In 2005-2021,the most likely cluster for hepatitis C in Jilin Province will mainly change from Yanbian Prefecture to Fuyu City.Secondary clusters appeared in most counties(districts),and there was a trend of spreading and expanding from the south and central to the surrounding areas in some years.