Spatio-temporal Analysis And Prediction Of AIDS Morbidity And Mortality In China From 2004 To 2020

PurposeAcquired immune deficiency syndrome(AIDS)is a chronic infectious disease with high mortality caused by the Human immune deficiency virus(HIV).However,the effects of age and period on the risk of AIDS morbidity and mortality are not very clear at present,and the prediction model needs to be optimized.(1)This study analyzed the temporal and spatial distribution of HIV/AIDS morbidity and mortality in China from 2004 to 2020,and explored the role of age,period and cohort factors in the incidence of HIV/AIDS.(2)This study constructed the combined prediction model of AIDS morbidity and mortality,and predicted the prevalence of AIDS in a short period of time,in order to provide a theoretical basis for relevant departments to formulate AIDS prevention policies.MethodsBased on the AIDS incidence and mortality data released by The National Health Commission of China,the Joinpoint regression model was used to describe and analyze the prevalence trend of AIDS incidence and mortality in China from 2004 to 2020.Age,period and cohort effects in AIDS morbidity and mortality were analyzed using ageperiod-cohort model(APC Model).Using spatial autocorrelation and spatiotemporal scanning analysis,the spatiotemporal distribution characteristics and spatial aggregation of AIDS morbidity and mortality in China were analyzed.Seasonal autoregressive integrated moving average(SARIMA)model,Prophet model,and the combined model based on L1 norm was established based on monthly incidence and mortality data of AIDS in China from 2004 to 2020.It was validated using AIDS morbidity and mortality data for January-December 2021.Furthermore,the optimal model was selected to predict the morbidity and mortality of AIDS in China from 2022 to 2023.The software used in this study is Joinpoint 4.9.0.1,SPSS 22.0,Arc GIS 9.0,Sa TScan 9.5,Stata 16.0,R 4.0.2 and LINGO 15.0.The test level of the above methods was bilateral α=0.05.Results1.From 2004 to 2018,a total of 440,259 cases of AIDS were reported in China,with a male to female ratio of 3.03 to 1 and 132,163 deaths,with a male to female ratio of 3.35 to 1.The number of cases and deaths among 25-44 years old was the highest and decreasing at both ends.From 2004 to 2020,the number of AIDS cases and deaths in China are increasing year by year.2.The results of Joinpoint regression analysis show that in the total population,the incidence and mortality of AIDS in China experienced two turning points from2004 to 2020.For incidence,the the annual percentage change(APC)was the highest during 2009-2012(APC=48.68%),and for mortality,APC was the highest in the period2004-2008(APC=67.22%).Stratified by gender,the incidence and mortality of HIV/AIDS in both male and female China experienced two turning points from 2004 to 2018,and showed an upward trend in all observed periods.The joinpoints for most age-group changes in HIV incidence occurred in 2012.3.The results of cohort model analysis of AIDS incidence showed that the highest and lowest age effects were located in 25-29 years old group(APC=0.91,P<0.05)and10-14 years old group(APC=-2.01,P<0.05),respectively,and with the passage of time,the period effect gradually increased,but the cohort effect had little effect.The analysis results of APC model of AIDS mortality showed that the age effect of the mortality rate increased first,then decreased,and finally increased slightly,the temporal effect increases gradually over time,and no cohort effect on mortality was observed.4.The results of spatial correlation analysis showed that the provinces with high incidence and mortality of AIDS were mainly located in southwest China,such as Yunnan Province.There was a global positive correlation from 2010 to 2020,and Yunnan province,Sichuan Province,Guizhou Province,Chongqing municipality and Guangxi Zhuang Autonomous Region showed a "high-high" concentration of incidence and death in 2020.The results of hot spot analysis showed that the hot spots of AIDS incidence and death are both concentrated in southwest China such as Yunnan Province,while the cold spots are concentrated in eastern coastal areas such as Shandong Province.The results of spatio-temporal scanning analysis showed that the incidence and mortality of AIDS showed significant spatio-temporal aggregation at provincial level from 2013 to 2020,and the first type of aggregation was concentrated in Guangxi Zhuang Autonomous Region,Chongqing,Sichuan,Guizhou and Yunnan provinces.5.The SARIMA(1,0,3)(0,1,1)[12],Prophet model and the combination model based on L1 norm were established for the monthly AIDS incidence in China from2004 to 2020.It was verified that the combined model had the lowest effect value.Mean Squared Error,(MSE)=0.0046,Mean Absolute Error,(MAE)=0.0464,Mean Absolute Percentage Error,(MAPE)=14.9316%,Root Mean Squared Error,(RMSE)=0.2580.The SARIMA(1,0,2)(0,1,1)[12] model,Prophet model and combination model based on L1 norm were established for the monthly AIDS mortality in China from 2004 to 2020.It was verified that the combined model had the lowest effect value(MSE=0.0002,MAE=0.0135,MAPE=11.2644%,RMSE=0.1244).The combined model was used to predict the prevalence of AIDS in China from 2022 to2023,and the results showed that the incidence and mortality still have a slow increase trend.Conclusion1.In recent years,the overall prevalence of HIV/AIDS is low.With the passage of time,the period effect of the incidence and mortality of AIDS gradually increases,the age effect of the middle-aged and young and the elderly population has a greater impact.2.From 2013 to 2020,the incidence and mortality of HIV/AIDS in China showed obvious spatial and temporal aggregation in southwest China such as Yunnan Province.3.The combined model of SARIMA and Prophet model based on L1 norm is an appropriate method to predict the incidence and mortality of AIDS in China.