[Analysis of schistosomiasis prevalence in endemic areas using retrospective space-time permutation scan statistics].

Yu-wan Hao, Jing-bo Xue, Jun-fang Xu, Fei Hu, Yun Zhang, Chun-li Cao, Yao Ruan, Tian Tian, Li-juan Zhang, Jing Xu, Dan-dan Lin, Yi Dong, Shi-zhu Li
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Abstract

Objective: To analyze the characteristics of schistosomasis prevalence by using the spatial epidemiological method, and test the application of retrospective space-time permutation scan statistics in determining mountainous and lake-type endemic areas of schistosomiasis.

Methods: The data of schistosomasis in humans, cattle and snails in Jiangxi Province during 2009-2014 and in Yunnan Province during 2004-2013 were collected and analyzed. The temporal and spatial distribution of schistosomiasis endemic areas in the two provinces was analyzed with retrospective space-time permutation scan statistics.

Results: The prevalence of schistosomiasis in residents and Oncomelania snails showed a trend of decline in Jiangxi, from 0.21% and 0.03% in 2009 to 0.01% and zero in 2014. A similar trend was found in cattle, from 1.25% in 2012 to 0.12% in 2014. The average annual percentage change (APC) in residents was-47.36%(P < 0.05). The space-time permutation clustering analysis revealed a temporal and spatial clustering of schistosomiasis prevalence from 2009 to 2014 in residents, cattle, and snails, with 3,2 and 1 clustering areas, respectively, all distributed in Poyang Lake Region. A similar declining trend of schistosomiasis prevalence was found in residents, snails and cattle in Yunnan during 2004-2013, from 2.49%,0.70% and 3.76% in 2004 to no infection in residents and snails and 0.02% in cattle in 2013. The APC in residents was-49.17%(P < 0.05). There was a temporal and spatial clustering of schistosomiasis prevalence during 2004-2013 in residents, cattle, and snails, with 2,2 and 6 clustering areas, respectively.

Conclusion: A declining trend of schistosomiasis prevalence is shown in lake-type endemic areas in Jiangxi during 2009-2014 and in mountainous endemic areas in Yunnan during 2004-2013. The retrospective space-time permutation scan statistics reveal a clustering of schistosomiasis in humans, cattle, and snails, suggesting its applicability in analyzing the temporal and spatial distribution of schistosomiasis.

回顾性时空排列扫描统计分析流行地区血吸虫病流行情况。
目的:应用空间流行病学方法分析血吸虫病流行特征,并检验回顾性时空排列扫描统计在确定山区和湖区血吸虫病流行区的应用。方法:收集江西省2009-2014年和云南省2004-2013年人、牛、螺血吸虫病病例资料并进行分析。采用回顾性时空排列扫描统计分析两省血吸虫病流行区时空分布。结果:江西省居民血吸虫病患病率和钉螺患病率呈下降趋势,由2009年的0.21%和0.03%降至2014年的0.01%和零。在牛中也发现了类似的趋势,从2012年的1.25%到2014年的0.12%。居民平均年变化百分比(APC)为-47.36%(P < 0.05)。时空排列聚类分析显示,2009 - 2014年居民、牛、蜗牛血吸虫病流行呈时空聚类,聚类区分别为3个、2个和1个,均分布在鄱阳湖地区。2004-2013年云南省居民、钉螺和牛血吸虫病患病率呈下降趋势,从2004年的2.49%、0.70%和3.76%降至2013年居民和钉螺无感染、牛0.02%。居民APC为-49.17%(P < 0.05)。2004-2013年居民、牛和钉螺血吸虫病流行呈时空聚类,分别有2个、2个和6个聚类区。结论:2009-2014年江西湖泊型流行区和2004-2013年云南山地流行区血吸虫病患病率呈下降趋势。回顾性时空排列扫描统计结果显示,血吸虫病在人、牛、蜗牛中存在聚类现象,提示其在分析血吸虫病时空分布上的适用性。
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