| Objective:1.To explore the time,population and regional distribution of other infectious diarrhea and hepatitis A in Shanxi Province based on time-series data of four cities in Shanxi Province.2.Using GIS technology to describe the spatial distribution characteristics of other infectious diarrhea and hepatitis A in Shanxi Province.3.Construct negative binomial regression model to explore the relationship be tween other infectious diarrhea and hepatitis A and meteorological factors.Methods:1.Data collection: Collection of other infectious diarrhea,hepatitis A disease surveillance data,meteorological data(including precipitation,temperature,humidity,sunshine duration)from January 1,2008 to December 31,2013 to establish a database.Descriptive epidemiological methods were used to analyze the spatiotemporal distribution characteristics of other infectious diarrhea and hepatitis A in Shanxi Province.The seasonal distribution curve was drawn and the seasonal peak was analyzed.2.Spatial statistical methods: Draw epidemiological level of disease map: Count communicable disease data by region,then use Arc GIS 10.0 to render the number of incidents by different colors or patterns,and finally get the disease level distribution map to reveal the spatial distribution of disease trends for further study Provide clues.3.Correlation analysis: Analyze the correlation between meteorological factors and the incidence of disease.Spearman correlation analysis was performed by SAS 9.2.Analyze the correlation between meteorological factors and the incidence of disease.After adjusting for seasonal and long-term trends,SAS9.2 was used to construct negative binomial regression model to evaluate the impact of each variable on the risk of disease.Results:1.There were cases of other infectious diarrhea cases in Datong,Taiyuan,C hangzhi and Yuncheng between 2008 and 2013 with obvious seasonal changes.The incidence was highest in July-August and most of the reported cases were children under 5 years old.2.Spatial analysis of other infectious diarrhea: the incidence of other infectious diarrhea showed small difference in each year in Datong and C hangzhi.The number of cases showed the trend of decreasing first and then increasing in Yuncheng.The overall incidence of Datong gradually decreased from west to east.The number of cases from high to low was Xinghualing District,Wanbailin District,Xiaodian District,Jiancaoping District,Yingze District,Jinyuan District in Taiyuan.The urban area is the most affected area of other infectious diarrhea in Changzhi C ity.The incidence of higher counties in Yuncheng were Pinglu County,Hejin C ity,Linqu County,Wenxi County,Salt Lake District,Yuncheng City and other infectious diarrhea-prone areas relatively dispersed.3.The association of other infectious diarrhea and meteorological factors: the incidence of other infectious diarrhea was positively correlated with average temperature,mean vapor pressure,mean relative humidity,daily minimum temperature(r= 0.056,0.085,0.077,0.070,P <0.05)in Datong.The incidence of other infectious diarrhea in Taiyuan was negatively correlated with mean barometric pressure and mean wind speed(r=-0.446,-0.103,P <0.001)and the incidence was positively correlated with other meteorological factors studied.The incidence of other infectious diarrhea in Changzhi was positively correlated with mean temperature,mean vapor pressure,average relative humidity and daily minimum temperature(r= 0.188,0.222,0.099,0.192,P <0.05).The number of onset were positively correlated with mean temperature,average vapor pressure,average relative humidity,daily minimum temperature,maximum daily temperature,significantly(r= 0.178,0.189,0.120,0.180,0.163,P <0.05).After adjusting the long-term trend and other confounding factors,the meteorological factors were respectively introduced into the negative binomial regression model,on the basis of the single-factor correlation analysis.The best models were for lag 6,5,2,6 in Datong,Taiyuan,Changzhi,Yuncheng,respectively.4.2141 hepatitis A cases were collected in four cities in 2008-2013.Hepatitis A occurred throughout the year,especially in winter and spring.The people of 40-50 years old were with high risk.5.Spatial Analysis of Hepatitis A: The incidence of hepatitis A in Taiyuan showed an increasing trend.The other three cities showed the trend of decreasing first and then increasing.And the number of incidents in Yuncheng has increased by a large margin.The southern suburbs incidence of the most in Datong.Taiyuan urban disease number from high to low were: Xinghua Ridge District,Yingze District,Wanbailin District,Dian District,Jiancaoping District,Jinyuan District.There was the most incidence of diseases in urban area in C hangzi,while the counties in the northern regions of Ji County,Licheng County,and Wuxiang County all had a higher incidence.The eastern area of Yuncheng was a high-risk area of hepatitis A.6.Correlation analysis of Hepatitis A with meteorological factors: There was positive correlation between Hepatitis A and average temperature,sunshine duration,minimum temperature and precipitation in Datong(r = 0.794,0.219,0.465,0.134,P <0.05);Hepatitis A was positively correlated with mean temperature,mean vapor pressure,sunshine hours,maximum temperature and minimum temperature(r = 0.130,0.133,0.146,0.133,0.128,P <0.05)in Taiyuan.There was a significant positive correlation between temperature,mean vapor pressure and daily minimum pressure(r = 0.173,0.179,0.170,P <0.05)with the incidence of hepatitis A in Changzhi.The incidence showed significantly positive correlations(r=0.183,0.122,0.175,0.188,P < 0.05)with mean pressure,mean temperature,mean vapor pressure,minimum temperature and maximum temperature in Yuncheng.And it was negatively correlated with precipitation(r=-0.140,P=0.019).The incidence of hepatitis A in four cities had no association with average wind speed and average relative humidity.After adjusting for long-term trends and other confounding factors,on the basis of the single-factor correlation analysis,a negative binomial regression model was constructed.The lagged 6,3,5,4 weeks of the model were the best model in four cities.Conclusion:The incidence of other infectious diarrhea and hepatitis A are related to meteorological factors and it has a certain lag effect. |
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