Analysis On Spatial-temporal Clusters And Influencing Factors Of Chronic Obstructive Pulmonary Disease In Chongqing

Chronic obstructive pulmonary disease(COPD)is a chronic disease of the respiratory system that is not only the leading cause of morbidity and mortality in developed countries,but is becoming a major disease in developing countries,with 2019 World Health Organization data ranking COPD as the third leading cause of death worldwide,after ischaemic heart disease and stroke.When severe,the disease will affect the patient’s ability to perform daily activities and quality of life,placing a significant financial burden on the patient’s family and society.The high prevalence and mortality rates and the increasing trend have made it an international public health issue,a social problem and an important topic of research in related fields.The emergence of spatial epidemiology has expanded the study of epidemiology in the medical field.In recent years,with the rapid development of science and technology and the maturation of spatial analysis technologies such as geographic information systems,spatial epidemiology has become more and more prominent in the prevention and control of public health diseases,realising the combination of disease data with demographic,economic and environmental data and quantifying the risk factors of disease epidemics.However,spatial epidemiology studies on COPD are scarce,especially in cities located in the south-western region,which is a high prevalence area.Based on the above,this paper presents a comprehensive analysis of the prevalence of COPD in Chongqing from 2018 to 2020 based on spatial analysis methods such as geographic information systems(GIS)and selecting districts and counties as the study units.Firstly,using the descriptive disease analysis method,the disease patients were counted according to time series,and the prevalence of age,gender and occupation were summarised.In order to compare the magnitude of prevalence in each district and county,the prevalence and age-standardised prevalence of each district and county were calculated separately,and the overall situation of COPD prevalence in Chongqing was described in detail.Then,global spatial autocorrelation and local spatial autocorrelation analyses were applied to explore the spatial clustering and clustering cold hotspots of COPD in Chongqing,followed by spatio-temporal scan analysis to detect the most likely clustering areas and times of COPD prevalence in Chongqing.Finally,an OLS global regression model and a GWR local regression model were developed successively.By comparing the goodness of fit of the two models,the GWR local regression model with better model fit was finally selected to study the relevant influencing factors affecting the prevalence of COPD.The details are as follows.Chapter 1: Firstly,the background of the study is introduced,including the current prevalence of COPD and the current status of research on COPD at home and abroad,then the purpose,content and significance of the study are described,and finally the overall research technical route of this study is mapped.Chapter 2: Firstly,it introduces the overall overview of the study area,shows all the data sources and pre-processing methods of this study,including the pre-processing of disease data,the sources of map information,and the selection of influencing factors,and finally details the methods used in this study.The descriptive disease analysis introduces the calculation methods of prevalence and age standardisation,uses spatial autocorrelation analysis to explore the Chongqing COPD clustering status,the use of spatio-temporal scanning statistics to analyse the spatio-temporal distribution characteristics of COPD in Chongqing,and the exploration of the influencing factors of COPD in different regions of Chongqing through the establishment of ordinary least squares linear regression models and geographically weighted regression models.Chapter 3: The findings of the COPD prevalence characteristics are as follows.(1)Population distribution: the number of reported cases in Chongqing from 2018 to 2020 showed a rapid upward trend;men were more severely affected than women;the affected population was mainly concentrated in the elderly population aged 60 and above;the occupational group with the highest prevalence rate was those engaged in agricultural production.(2)Spatial distribution: There is a significant spatial autocorrelation of ASPR of COPD in Chongqing in 2018 and 2019,but the spatial autocorrelation is gradually weakening.2020,the spatial autocorrelation of ASPR of COPD in Chongqing is not statistically significant and has a discrete distribution.The local spatial autocorrelation clustering hotspots are gradually shrinking;the high prevalence counties(districts)of COPD in Chongqing are relatively concentrated,and the prevalence levels in the low and high prevalence areas are different,and the high prevalence areas are gradually shifting to the periphery of Chongqing city.(3)Temporal distribution: The distribution of COPD cases in Chongqing from 2018 to 2020 is not random in terms of spatial and temporal distribution,showing a more obvious clustering.The incidence of disease has obvious seasonal distribution characteristics,showing significant unimodal seasonality,with severe disease in winter.Chapter 4: By constructing an OLS linear regression model and a GWR geographically weighted regression model,the optimal model was selected from the four influencing factors of environment,economy,medical care and population into the model operation,and it was concluded that there were differences in the influencing factors of COPD prevalence level in different districts and counties of Chongqing.Chapter 5: Summarises the findings of this study and provides an in-depth discussion of the findings.Finally,the innovations and shortcomings of this study are described and an outlook is given.By systematically analysing the prevalence of COPD in Chongqing and the related influencing factors,the findings of this paper will provide a more scientific basis for the formulation of prevention and control strategies and measures and the rational allocation of health resources in Chongqing,and will help the relevant departments to identify and implement prevention and control measures in a targeted manner for different regions.