CAJ | 학술논문

目的分析2009年长沙市甲型H1N1流感大流行期间时空传播过程及扩散过程中的影响因素.方法以长沙市甲型H1N1流感疫情数据,结合长沙市地理信息系统(GIS),利用热点分析、时空聚类分析、空间过程分析和Spearman相关性分析等数据分析方法,对疫情进行深入分析.结果疫情热点区域多出现在市辖区与县城等经济较发达的地区,疫情时空一级聚类区位于浏阳市中部(RR=22.70,P<0.01),二级聚类区位于市辖区岳麓区(RR=6.49,P<0.01)、雨花区(RR=81.63,P<0.01)、长沙县中部星沙镇周边(RR=2.90,P<0.01)、雨敞坪镇(RR=19.31,P<0.01)、城郊乡(RR=73.14,P<0.01)、宁乡县西部龙田镇周边(RR=14.43,P<0.01)以及望城县中部乌山镇周边(RR=13.84,P<0.01),随着时间推移在空间上呈现向东(经济发达地区)扩散的趋势;人口数量、学生数、空间相邻性和经济活动对疫情传播过程产生重要影响;甲型H1N1流感起始期人口密度是主要影响因素(r=0.477,P<0.05),疫情初期与快速发展期学生数量是重要的指标(r=0.831,P<0.01;r=0.518,P<0.01),在疫情顶峰期经济活动对疫情扩散起主要作用(r=-0.676,P<0.01).结论在流感不同的发展阶段,疫情的高危人群与高发区域均有明显的变化,因此应根据疫情的不同阶段对防控措施进行调整.
목적 분석2009년장사시갑형H1N1류감대류행기간시공전파과정급확산과정중적영향인소.방법 이장사시갑형H1N1류감역정수거,결합장사시지리신식계통(GIS),이용열점분석、시공취류분석、공간과정분석화Spearman상관성분석등수거분석방법,대역정진행심입분석.결과 역정열점구역다출현재시할구여현성등경제교발체적지구,역정시공일급취류구위우류양시중부(RR=22.70,P<0.01),이급취류구위우시할구악록구(RR=6.49,P<0.01)、우화구(RR=81.63,P<0.01)、장사현중부성사진주변(RR=2.90,P<0.01)、우창평진(RR=19.31,P<0.01)、성교향(RR=73.14,P<0.01)、저향현서부룡전진주변(RR=14.43,P<0.01)이급망성현중부오산진주변(RR=13.84,P<0.01),수착시간추이재공간상정현향동(경제발체지구)확산적추세;인구수량、학생수、공간상린성화경제활동대역정전파과정산생중요영향;갑형H1N1류감기시기인구밀도시주요영향인소(r=0.477,P<0.05),역정초기여쾌속발전기학생수량시중요적지표(r=0.831,P<0.01;r=0.518,P<0.01),재역정정봉기경제활동대역정확산기주요작용(r=-0.676,P<0.01).결론 재류감불동적발전계단,역정적고위인군여고발구역균유명현적변화,인차응근거역정적불동계단대방공조시진행조정.
Objective To analyze the spatio-temporal process on 2009 influenza A (HlNl) pandemic in Changsha and the influencing factors during the diffusion process. Methods Data were from the following 5 sources, influenza A (HlNl) pandemic gathered in 2009, Geographic Information System (GIS) of Changsha, the broad range of theorems and techniques of hot spot analysis, spatio-temporal process analysis and Spearman correlation analysis. Results Hot spot areas appeared to be more in the economically developed areas, such as cities and townships. The cluster of spatial-temporal distribution of influenza A (HlNl) pandemic was most likely appearing in Liuyang city (RR=22.70,P<0.01). The secondary cluster would include districts as Yuelu (RR=6A9,P< 0.01) , Yuhua (RR=81.63, P<0.01). Xingsha township appeared as the center in the Changsha county (RR=2.90, P<0.01) while townships as Yutangping (RR=19.31, P<0.01) , Chengjiao (RR=73.14,P<0.01) and Longtian appeared as the center in the west of Ningxiang county (RR= 14.43,P<0.01) and Wushan as the center in the Wangcheng county (RR= 13.84,P<0.01). As time went on, the epidemic moved towards the eastern and more developed regions. Regarding factor analysis, population, the amount of students, geographic relationship and business activities etc. appeared to be the key elements influencing the transmission of influenza A (H1N1) pandemic. At the beginning of the epidemic, population density served as the main factor (r=0.477, P<0.05) but during the initial and fast growing stages, it was replaced by the size of students to serve as the important indicator (r=0.831, P<0.01; r=0.518, P<0.01). However, during the peak of the epidemics, the business activities played an important role (r=-0.676, P<0.01). Conclusion Groups under high risk and districts with high incidence rates were shifting, along with the temporal process of influenza A(H1N1) pandemic, suggesting that the protection measures need to be adjusted, according to the significance of influencing factors at different stages.