2018 12 22 12 1211 2007-2017 HIV /AIDS 2007-2017 human immunodeficiency virushiv acquired immunodeficiency syndromeaids 2007-2017 HIV /AIDS OpenGeoDa 1. 8 SaTScan 9. 4 Arcgis 10. 4 2007-2017 HIV /AIDS 76 476 Moran s I 0. 25 ~ 0. 43 P < 0. 05 2007-2017 6 6 19 P < 0. 05 R181. 22 A 1674-3679201812-1211-05 DOI10. 16462 /j. cnki. zhjbkz. 2018. 12. 003 Spatiotemporal characteristics of HIV /AIDS in Guangdong province2007-2017 ZHANG Ke-chunFU XiaobingLIU JunLIN Qi-huiXU Yu-chengLI Yan. AIDS prevention and Control DepartmentLong hua District Center for Disease Control and PreventionShenzhen 518000China Abstract Objective To understand the epidemiological characteristics and spatial and temporal distribution of HIV / AIDS in Guangdong province so as to provide scientific evidence for the prevention and control of AIDS. Methods Newly reported HIV / AIDS data from 2007 to 2017 in Guangdong were collected from HIV / AIDS Comprehensive Information Management System. OpenGeoDa 1. 8 software was used for autocorrelation analysissatscan 9. 4 software was used for statistical analysis of spatial scanningand finally geographic information system was used for visualization with Arcgis 10. 4 software. Results 76 476 HIV /AIDS cases were totally reported in Guangdong from 2007 to 2017the scope of spatial distribution on HIV / AIDS expanded annually and concentrated in certain areas. Global Moran's I index was between 0. 25 and 0. 34 annuallyp < 0. 05. Spatial and temporal scan analysis revealed that three categories including Shenzhen city six counties Yangjiang city and Luoding citysix counties Guangzhou cityfoshan citydongguan cityjiangmen city and Zhongshan citynineteen countieswere the main spatial and temporal cluster in area in 2007-2017P < 0. 05. Conclusions The high-high clustering areas gradually covered most counties in Pearl River Delta PRD and Yangjiang and its surrounding areas gradually withdrew from the high-high clustering areassuggesting that the PRD region was the key area for prevention and control of AIDS in Guangdong province in recent years. Key words HIV /AIDSSpatial autocorrelationspace-time scanspace-time cluster Chin J Dis Control Prev 2018 2212 1211-1215 2017 2017 human im- HIV /AIDS munodeficiency virushiv acquired immunodeficiency syndromeaids3. 45 2016 3 8. 03% 1-2 HIV /AIDS 518000 1977 - E-mail13580581074@ 126. com HIV /AIDS
1212 Chin J Dis Control Prev 2018 Dec2212 HIV AIDS 76 476 2007 10 2007-2017 HIV / 40 20 7 AIDS HIV / 100 AIDS 1 1. 1 2007-2017 300 ~ 400 1 HIV /AIDS 400 ~ 500 4 HIV /AIDS 926 1 2 1. 2 Arcgis 10. 4 2007-2017 HIV /AIDS 129 1. 3 1 Open- GeoDa 1. 8 Moran s I Z P 1 2007-2017 HIV /AIDS local Figure 1 Newly cases of HIV / AIDS in Guangdong province indicators of spatial associationlisa from 2007 to 2017 - - - 2. 2 2007-2017 - - - HIV /AIDS HIV /AIDS - - P 0. 010 1 HIV /AIDS 2 Poisson Kulldorff SaTScan 9. 4 Table 1 Global spatial autocorrelation analysis of HIV /AIDS in Guangdong province from 2007 to 2017 Moran's I Z P 2007 0. 34 6. 19 0. 01 log likelihood ratiollr RR 2008 0. 31 5. 96 0. 01 P < 0. 05 2009 0. 25 4. 78 0. 01 2010 0. 37 7. 00 0. 01 2011 0. 38 6. 49 0. 01 30% HIV /AIDS 1. 4 Excel 2010 2016 0. 38 6. 70 0. 01 Arcgis 10. 4 2017 0. 43 7. 24 0. 01 OpenGeoDa 1. 8 SaTScan 9. 4 2. 3 LISA α = 0. 05 2007-2011 4 2 291 2017 2. 1 2007-2017 6 2012 1 2007-2017 HIV /AIDS 2012 0. 41 8. 25 0. 01 2013 0. 43 7. 63 0. 01 2014 0. 45 8. 55 0. 01 2015 0. 41 8. 10 0. 01 2012
1213 中华疾病控制杂志 2018 年 12 月第 22 卷第 12 期 图2 Figure 2 广东省 2007 2017 年 129 个县 区 HIV / AIDS 空间分布 Spatial distribution map of HIV / AIDS in 129 counties districts of Guangdong province from 2007 to 2017 深圳市多数县 区 则变为热点区域 邻近深圳市 东莞市的广州番禺区 顺德区 禅城区及花都区也成 区 南海区 顺德区 花都区 南沙区 三水区 增城 区 蓬江区 东莞市 江海区 中山市市区见表 2 和 为热点区域 广东省北部的河源市 梅州市 韶关 市 清远市的县 区 则为历年的冷点区域见图 3 图 4 时空聚集性分析 2007 2017 年分别探测到 3 个聚集区 一类聚集区域为福田区 龙华区 南山 2 4 区 罗湖区 宝安区 龙岗区 二类聚集区域为 2007 2011 年的阳春市 阳东区 罗定市 阳西县 江城 区 恩平市三类聚集区域为海珠区 越秀区 天河 区 荔湾区 黄埔区 番禺区 白云区 萝岗区 禅城 表2 Table 2 聚集时间 年份 2013 2017 3 讨论 结合地理信息系统分析常见传染病如细菌性痢 疾 恙虫病 出血热 艾滋病 流感等的时空分布是近 1 4-8 本研究也利用该新技术新 方法对广东省艾滋病开展深入研究 本研究结果表 年研究的热点领域 明 广东省艾滋病疫情呈现逐年严重的趋势 截止 2007 2017 年广东省 HIV / AIDS 时空扫描分析 Spatial and temporal scanning analysis of HIV / AIDS in Guangdong province from 2007 to 2017 聚集类型 一级 聚集中心 聚集半径 公里 22 10 龙华区 位置 南部 涉及县 区 数 6 ＲＲ 值 3 61 LLＲ 值 4 707 17 P值 2007 2011 二级 阳春市 61 04 西南 6 3 60 2 516 38 2013 2017 三级 越秀区 63 04 中南部 19 1 86 2 381 89
1214 Chin J Dis Control Prev 2018 图3 Figure 3 Dec 22 12 广东省 2007 2017 年 129 个县 区 HIV / AIDS 的 LISA 聚集分布情况 Distribution of LISA aggregation of HIV / AIDS in 129 districts in Guangdong Province from 2007 to 2017 流动及经济 医疗卫生水平 艾滋病防治策略相似有 关局部空间自相关分析结果显示珠三角地区的热 点区域逐年扩大 而阳江市逐步退出艾滋病热点区 域粤北地区大部分县 区 则是历年的冷点区域 时空扫描分析结果显示一类聚集区为深圳市 6 个县 区 基本覆盖深圳大部分地区 二类聚集区为阳 江市及周边地区 聚集时间为 2007 2011 年 聚集 范围较广三类聚集区为以广州市为中心 向周边 东莞 佛山及中山辐射 与一类聚集地区融合 覆盖 珠三角的大部分县 区 图4 2007 2017 年广东省 HIV / AIDS 报告病例数的时空扫描分析 Figure 4 Spatial and temporal scanning analysis of HIV / AIDS 根据疾病的时空扫描监测结果 可以更好地指 导宏观防控方针的制定一是可以针对空间探测结 reported cases in Guangdong province from 2007 to 2017 果 针对艾滋病热点区域 如一类聚集区 深圳市的 6 个区 采取更加严格的防控手段 阻止艾滋病的传 2017 年 100% 的县 区 都有病例报告 报告病例 整体上存在空间自相关性 可能与相邻地区的人口 播二是仔细分析 高高 聚集区形成的因素 政府 多部门合作逐个消除高危因素 降低艾滋病流行强
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