Study on clinical classification of Japanese encephalitis by Bayes discriminant analysis / 中华流行病学杂志

Objective@#To construct Bayes discriminant function for clinical classification of common and severe Japanese encephalitis (JE) cases, and to identify cases accurately with quantitative indicators.@*Methods@#Samples of confirmed common and severe JE cases reported by the epidemic surveillance system of Gansu Provincial Center for Disease Control and Prevention from 2005 to 2017 were collected. Non-conditional logistic regression analysis and Bayes stepwise discriminant analysis were used to screen meaningful clinical indicators, so as to construct and evaluate Bayes discriminant function.@*Results@#There were 256 common JE cases and 257 severe JE cases. There were no significant differences in sex, age and occupation distributions between the two groups (P>0.05) and there was significant difference in case fatality rate (P<0.05). Non-conditional logistic regression analysis and Bayes stepwise discriminant analysis, combined with using related literature, to screen 11 clinical indicators for the construction of Bayes discriminant function. Interactive validation showed that the sensitivity of discriminant function was 71.48% (95%CI: 65.53%-76.93%) and the specificity was 73.93% (95%CI: 68.11%-79.19%). The area under ROC curve was 0.761 (95%CI: 0.720-0.803) and the total accuracy rate was 72.71%.@*Conclusion@#Bayes discriminant function can be used to identify common and severe JE cases more accurately, which is helpful for the reasonable treatment and good prognosis of JE patients.

Incidence of chronic obstructive pulmonary disease and pneumoconiosis in different occupational positions among populations from jinchang cohort / 中华劳动卫生职业病杂志

Objective@#To investigate the incidence and rank of chronic obstructive pulmonary disease and pneumoconiosis to the workers in different occupational positions in Jinchang Cohort.@*Methods@#In January 2014, a cohort of follow-up population in jinchang city was taken as the research object, 17843 individuals among follow-up populations in Jinchang Cohort Study, removed the individuals with chronic obstructive pulmonary disease and pneumoconiosis before 2013, and counted the new incidence individuals diagnosed by the A-Class hospital in Grade III in Jinchang City, Gansu Province, as the investigation objects to investigate the incidence rate & rank of chronic obstructive pulmonary disease and pneumoconiosis. The statistical significance was tested by chi-square test.@*Results@#The 2-year incidence rate of Chronic Obstructive Pulmonary Disease and Pneumoconiosis in the population of Jinchang Cohort Study were 11.60‰, 13.51‰ for male and 8.46‰ for female. the ranks of 2-year incidence rates of chronic bronchitis, emphysema, pneumoconiosis and other phenotypes of chronic obstructive pulmonary disease were 7.06‰、3.42‰、0.84‰、0.34‰, respectively. Incidence rate of chronic bronchitis among administrators and executive staffs were 10.45‰; incidence rate of chronic bronchitis among service staffs were 10.45‰; incidence rate of pneumoconiosis among mining staffs were 3.44‰.@*Conclusion@#The first incidence rank of chronic obstructive pulmonary disease and pneumoconiosis in Jinchang cohort is chronic bronchitis, and the risk factors are smoking and occupational exposure.

Association between fatty liver and type 2 diabetes in the baseline population of Jinchang Cohort / 中华流行病学杂志

Objective To explore the association between fatty liver and type 2 diabetes mellitus (T2DM) in the baseline-population of Jinchang cohort study.Methods Data from all the participants involved in the baseline-population of Jinchang cohort study was used,to compare the risks of T2DM in fatty liver and non fatty liver groups and to explore the interaction between family history or fatty liver of diabetes and the prevalence of T2DM.Results Among all the 46 861 participants,10 574 were diagnosed as having fatty liver (22.56％),with the standardized rate as 20.66％.Another 3 818 participants were diagnosed as having T2DM (8.15％) with standardized rate as 6.90％.The prevalence of T2DM increased in parallel with the increase of age (trendx2 =2 833.671,trend P＜ 0.001).The prevalence of T2DM in the fatty liver group was significantly higher than that in the non-fatty liver group,both in men or women and in the overall population.Compared with the group of non-fatty liver,the risks of T2DM in fatty liver group were seen 1.78 times higher in males,2.33 times in women and 2.10 times in the overall population,after adjustment for factors as age,levels of education,smoking,drinking,physical exercise,BMI,family history of diabetes and some metabolic indicators (pressure,TC,TG,uric acid,ALT,AST,gamma-glutamyl transferase).Date from the interaction model showed that fatty liver and family history of diabetes present a positive additive interaction on T2DM (RERI=1.18,95％CI:0.59-1.78;AP=0.24,95％CI:0.14-0.34;S=1.43,95％CI:1.21-1.69).Conclusions Fatty liver could significantly increase the risk of T2DM and a positive additive interaction was also observed between fatty liver and family history of diabetes on T2DM.It was important to strengthen the prevention program on T2DM,in order to effectively control the development of fatty liver.

Association between fatty liver and type 2 diabetes in the baseline population of Jinchang Cohort / 中华流行病学杂志

Objective To explore the association between fatty liver and type 2 diabetes mellitus (T2DM) in the baseline-population of Jinchang cohort study.Methods Data from all the participants involved in the baseline-population of Jinchang cohort study was used,to compare the risks of T2DM in fatty liver and non fatty liver groups and to explore the interaction between family history or fatty liver of diabetes and the prevalence of T2DM.Results Among all the 46 861 participants,10 574 were diagnosed as having fatty liver (22.56％),with the standardized rate as 20.66％.Another 3 818 participants were diagnosed as having T2DM (8.15％) with standardized rate as 6.90％.The prevalence of T2DM increased in parallel with the increase of age (trendx2 =2 833.671,trend P＜ 0.001).The prevalence of T2DM in the fatty liver group was significantly higher than that in the non-fatty liver group,both in men or women and in the overall population.Compared with the group of non-fatty liver,the risks of T2DM in fatty liver group were seen 1.78 times higher in males,2.33 times in women and 2.10 times in the overall population,after adjustment for factors as age,levels of education,smoking,drinking,physical exercise,BMI,family history of diabetes and some metabolic indicators (pressure,TC,TG,uric acid,ALT,AST,gamma-glutamyl transferase).Date from the interaction model showed that fatty liver and family history of diabetes present a positive additive interaction on T2DM (RERI=1.18,95％CI:0.59-1.78;AP=0.24,95％CI:0.14-0.34;S=1.43,95％CI:1.21-1.69).Conclusions Fatty liver could significantly increase the risk of T2DM and a positive additive interaction was also observed between fatty liver and family history of diabetes on T2DM.It was important to strengthen the prevention program on T2DM,in order to effectively control the development of fatty liver.

A study on the etiology and epidemiological characteristics of fever and rash syndrome among children under the age of five years in Northwest China from 2009 to 2015 / 中华疾病控制杂志

Objective To explore the etiology and epidemiological characteristics of fever and rash syndrome a mong children under the age of five years in Northwest China from 2009 to 2015.Methods Descriptive epidemiological analysis was conducted based on the monitoring data in sentinel hospitals,which was from the information management system of national infectious disease monitoring from 2009 to 2015 in Gansu,Qinghai,Inner Mongolia and Xinjiang.Results The results showed that the major pathogens of fever and rash syndrome among children under the age of five years were enterovirus,measles virus,varicella-zoster virus (VZV) and rubella virus.The major pathogens among children in the age group of 0-years and in the age group of 1-5 years were measles virus and enteroviruses,respectively.Among the positive cases of enterovirus,the positive detectable rates of human enterovirus 71 (EV71) and coxsackie A16 (CA16) were 47.18％ and 45.59％,respectively.The incidences of enterovirus and measles virus infection were mainly concentrated on May to July and March to May,respectively.Conclusions The major pathogens of fever and rash syndrome among children under the age of five years in Northwest china were enterovirus and measles virus with seasonal epidemic characteristics.Therefore,the prevention and control of measles and hand-foot-mouth disease should be strengthened.

Study on the classification of dominant pathogens related to febrile respiratory syndrome, based on the method of Bayes discriminant analysis / 中华流行病学杂志

Objective To understand the dominant pathogens of febrile respiratory syndrome (FRS) patients in Gansu province and to establish the Bayes discriminant function in order to identify the patients infected with the dominant pathogens.Methods FRS patients were collected in various sentinel hospitals of Gansu province from 2009 to 2015 and the dominant pathogens were determined by describing the composition of pathogenic profile.Significant clinical variables were selected by stepwise discriminant analysis to establish the Bayes discriminant function.Results In the detection of pathogens for FRS,both influenza virus and rhinovirus showed higher positive rates than those caused by other viruses (13.79％,8.63％),that accounting for 54.38％,13.73％ of total viral positive patients.Most frequently detected bacteria would include Streptococcus pneumoniae,and haemophilus influenza (44.41％,18.07％) that accounting for 66.21％ and 24.55％ among the bacterial positive patients.The original-validated rate of discriminant function,established by 11 clinical variables,was 73.1％,with the cross-validated rate as 70.6％.Conclusion Influenza virus,Rhinovirus,Streptococcus pneumoniae and Haemophilus influenzae were the dominant pathogens of FRS in Gansu province.Results from the Bayes discriminant analysis showed both higher accuracy in the classification of dominant pathogens,and applicative value for FRS.

Risk factors of gout in Jinchang cohort: a Cox regression analysis / 中华流行病学杂志

Objective To explore the incidence and risk factors of gout in Jinchang cohort and provide scientific evidence for the prevention and control of gout.Methods People without gout detected by baseline survey in Jinchang cohort were selected as study subjects.All the subjects were followed up through questionnaire interview,physical examination as well as laboratory test from January 24,2013 to November 24,2015.Cox regression model was used to analyze the risk factors for gout in Jinchang cohort.In addition,log-linear model was used to analyze the interaction between risk factors.Results A total of 33 153 subjects were followed up,and there were 277 newly diagnosed gout cases in the cohort.The overall incidence of gout was 0.8％.The incidence of gout in males was higher than that in the females,but the incidence of gout in males and females was similar after the age of 60 years.Cox regression analysis showed that age ＞40 years (at age 40 to 59 years:HR=2.982,95％CI:1.503-5.981;at age 60 to 91 years:HR=2.588,95％CI:1.107-6.049),alcohol abuse (HR=2.234,95％CI:1.128-4.427),obesity (HR=2.204,95％CI:1.216-3.997),diabetes (HR=2.725,95％CI:1.500-4.950) and high uric acid (HR=5.963,95％CI:3.577-9.943) were risk factors for gout,while weekly beans intake ≥0.25 kg (HR=0.528,95％CI:0.345-0.808) and regular physical exercise (HR=0.499,95％ CI:0.286-0.869) were protective factors for gout.The analysis with log-linear model showed that there were two order effects between the risk factors.Conclusions Age,beans intake,alcohol abuse,physical exercises,obesity,diabetes and high uric acid were important factors influencing the incidence of gout.It is important to have healthy lifestyle and dietary habits,receive regular health examination to prevent and control the incidence of gout in this cohort.

Evaluation of estimation of prevalence ratio using bayesian log-binomial regression model / 中华流行病学杂志

To evaluate the estimation of prevalence ratio (PR) by using bayesian log-binomial regression model and its application,we estimated the PR of medical care-seeking prevalence to caregivers' recognition of risk signs of diarrhea in their infants by using bayesian log-binomial regression model in Openbugs software.The results showed that caregivers' recognition of infant's risk signs of diarrhea was associated significantly with a 13％ increase of medical care-seeking.Meanwhile,we compared the differences in PR's point estimation and its interval estimation of medical care-seeking prevalence to caregivers' recognition of risk signs of diarrhea and convergence of three models (model 1:not adjusting for the covariates;model 2:adjusting for duration of caregivers' education,model 3:adjusting for distance between village and township and child month-age based on model 2) between bayesian log-binomial regression model and conventional log-binomial regression model.The results showed that all three bayesian log-binomial regression models were convergence and the estimated PRs were 1.130(95％CI:1.005-1.265),1.128(95％CI:1.001-1.264)and 1.132(95％CI:1.004-1.267),respectively.Conventional log-binomial regression model 1 and model 2 were convergence and their PRs were 1.130(95％ CI:1.055-1.206) and 1.126(95％ CI:1.051-1.203),respectively,but the model 3 was misconvergence,so COPY method was used to estimate PR,which was 1.125 (95％CI:1.051-1.200).In addition,the point estimation and interval estimation of PRs from three bayesian log-binomial regression models differed slightly from those of PRs from conventional log-binomial regression model,but they had a good consistency in estimating PR.Therefore,bayesian log-binomial regression model can effectively estimate PR with less misconvergence and have more advantages in application compared with conventional log-binomial regression model.

Study on the classification of dominant pathogens related to febrile respiratory syndrome, based on the method of Bayes discriminant analysis / 中华流行病学杂志

Objective To understand the dominant pathogens of febrile respiratory syndrome (FRS) patients in Gansu province and to establish the Bayes discriminant function in order to identify the patients infected with the dominant pathogens.Methods FRS patients were collected in various sentinel hospitals of Gansu province from 2009 to 2015 and the dominant pathogens were determined by describing the composition of pathogenic profile.Significant clinical variables were selected by stepwise discriminant analysis to establish the Bayes discriminant function.Results In the detection of pathogens for FRS,both influenza virus and rhinovirus showed higher positive rates than those caused by other viruses (13.79％,8.63％),that accounting for 54.38％,13.73％ of total viral positive patients.Most frequently detected bacteria would include Streptococcus pneumoniae,and haemophilus influenza (44.41％,18.07％) that accounting for 66.21％ and 24.55％ among the bacterial positive patients.The original-validated rate of discriminant function,established by 11 clinical variables,was 73.1％,with the cross-validated rate as 70.6％.Conclusion Influenza virus,Rhinovirus,Streptococcus pneumoniae and Haemophilus influenzae were the dominant pathogens of FRS in Gansu province.Results from the Bayes discriminant analysis showed both higher accuracy in the classification of dominant pathogens,and applicative value for FRS.

Risk factors of gout in Jinchang cohort: a Cox regression analysis / 中华流行病学杂志

Objective To explore the incidence and risk factors of gout in Jinchang cohort and provide scientific evidence for the prevention and control of gout.Methods People without gout detected by baseline survey in Jinchang cohort were selected as study subjects.All the subjects were followed up through questionnaire interview,physical examination as well as laboratory test from January 24,2013 to November 24,2015.Cox regression model was used to analyze the risk factors for gout in Jinchang cohort.In addition,log-linear model was used to analyze the interaction between risk factors.Results A total of 33 153 subjects were followed up,and there were 277 newly diagnosed gout cases in the cohort.The overall incidence of gout was 0.8％.The incidence of gout in males was higher than that in the females,but the incidence of gout in males and females was similar after the age of 60 years.Cox regression analysis showed that age ＞40 years (at age 40 to 59 years:HR=2.982,95％CI:1.503-5.981;at age 60 to 91 years:HR=2.588,95％CI:1.107-6.049),alcohol abuse (HR=2.234,95％CI:1.128-4.427),obesity (HR=2.204,95％CI:1.216-3.997),diabetes (HR=2.725,95％CI:1.500-4.950) and high uric acid (HR=5.963,95％CI:3.577-9.943) were risk factors for gout,while weekly beans intake ≥0.25 kg (HR=0.528,95％CI:0.345-0.808) and regular physical exercise (HR=0.499,95％ CI:0.286-0.869) were protective factors for gout.The analysis with log-linear model showed that there were two order effects between the risk factors.Conclusions Age,beans intake,alcohol abuse,physical exercises,obesity,diabetes and high uric acid were important factors influencing the incidence of gout.It is important to have healthy lifestyle and dietary habits,receive regular health examination to prevent and control the incidence of gout in this cohort.

Evaluation of estimation of prevalence ratio using bayesian log-binomial regression model / 中华流行病学杂志

To evaluate the estimation of prevalence ratio (PR) by using bayesian log-binomial regression model and its application,we estimated the PR of medical care-seeking prevalence to caregivers' recognition of risk signs of diarrhea in their infants by using bayesian log-binomial regression model in Openbugs software.The results showed that caregivers' recognition of infant's risk signs of diarrhea was associated significantly with a 13％ increase of medical care-seeking.Meanwhile,we compared the differences in PR's point estimation and its interval estimation of medical care-seeking prevalence to caregivers' recognition of risk signs of diarrhea and convergence of three models (model 1:not adjusting for the covariates;model 2:adjusting for duration of caregivers' education,model 3:adjusting for distance between village and township and child month-age based on model 2) between bayesian log-binomial regression model and conventional log-binomial regression model.The results showed that all three bayesian log-binomial regression models were convergence and the estimated PRs were 1.130(95％CI:1.005-1.265),1.128(95％CI:1.001-1.264)and 1.132(95％CI:1.004-1.267),respectively.Conventional log-binomial regression model 1 and model 2 were convergence and their PRs were 1.130(95％ CI:1.055-1.206) and 1.126(95％ CI:1.051-1.203),respectively,but the model 3 was misconvergence,so COPY method was used to estimate PR,which was 1.125 (95％CI:1.051-1.200).In addition,the point estimation and interval estimation of PRs from three bayesian log-binomial regression models differed slightly from those of PRs from conventional log-binomial regression model,but they had a good consistency in estimating PR.Therefore,bayesian log-binomial regression model can effectively estimate PR with less misconvergence and have more advantages in application compared with conventional log-binomial regression model.

Cancer burden in the Jinchang cohort / 中华流行病学杂志

<p><b>OBJECTIVE</b>To understand the disease burden caused by cancers in Jinchang cohort, and develop effective strategies for cancer prevention and control in this population.</p><p><b>METHODS</b>The cancer mortality data from 2001 to 2013 and the medical records for cancer patients from 2001 to 2010 in Jinchang cohort were collected. The disease burden caused by cancer was analyzed by using mortality rate, potential years of life lost (PYLL), working PYLL (WPYLL), and direct economic burden.</p><p><b>RESULTS</b>During 2001-2013, in Jinchang cohort, the five leading cancers ranked by mortality rate were lung cancer (78.06/100,000), gastric cancer (38.03/100,000), liver cancer (37.23/100,000), esophageal cancer (19.06/100,000), and colorectal cancer (9.53/100,000). The five leading cancers in terms of PYLL (person-years) and WPYLL (person-years) were lung cancer (3480.33, 1161.00), liver cancer (2809.03, 1475.00), gastric cancer (2120.54, 844.00), esophageal cancer (949.61, 315.00), and colorectal cancer (539.90, 246.00). From 2001 to 2010, the five leading cancers in term of average daily cost of hospitalization were gastric cancer (8,102.23 Yuan), esophageal cancer (7135.79 Yuan), colorectal cancer (7064.38 Yuan), breast cancer (6723.53 Yuan), and lung cancer (6309.39 Yuan).</p><p><b>CONCLUSIONS</b>The cancers common causing higher disease burden in Jinchang cohort were lung cancer, gastric cancer, liver cancer, esophageal cancer and colorectal cancer. The lung cancer disease burden was the highest.</p>

Disease burden of lung cancer in Jinchang cohort / 中华流行病学杂志

<p><b>OBJECTIVE</b>To understand the current status of lung cancer disease burden in Jinchang cohort.</p><p><b>METHODS</b>In this historical cohort study, the mortality data of the lung cancer from 2001 to 2013 and medical records of the lung cancer cases from 2001 to 2010 in Jinchang cohort were used, analyze mortality, direct economic burden, potential years of life lost (PYLL) and working PYLL (WPYLL) associated with lung cancer.</p><p><b>RESULTS</b>A total of 434 lung cancer deaths occurred in Jinchang cohort from 2001 to 2013. The crude mortality rate of lung cancer was 78.06 per 100,000 from 2001 to 2013, with the increasing rate of 4.77%. The mortality rate of lung cancer in males and females were about 108.90 per 100,000 and 26.08 per 100,000 with the increasing rate of 4.24% and 6.91%, respectively. During the thirteen years, the PYLL and average PYLL (APYLL) of lung cancer were 3 721.71 person-years and 8.58 years. The APYLL of lung cancer in females (15.94 years) was higher than that in males (7.87 years). The WPYLL and the average WPYLL (AWPYLL) of lung cancer were 1161.00 person-years and 2.68 years, respectively. The AWPYLL of lung cancer was also higher in females than in males. The direct economic burden of lung cancer from 2001 to 2010 in Jinchang cohort was 6309.39 Yuan per case with no increased trend.</p><p><b>CONCLUSION</b>Lung cancer is the main health problem in Jinchang cohort, causing heavy disease burden.</p>

Disease burden of gastric cancer in Jinchang cohort / 中华流行病学杂志

<p><b>OBJECTIVE</b>To understand the current status of disease burden caused by gastric cancer in Jinchang cohort.</p><p><b>METHODS</b>In this historical cohort study, the data of gastric cancer deaths from 2001 to 2013 and the medical records of gastric cancer cases from 2001 to 2010 in Jinchang cohort were collected to analyze the mortality, potential years of life lost (PYLL), working PYLL (WPYLL) associated with gastric cancer, and the medical expenditure data were used to evaluate the direct economic burden. Spearman correlation analysis and the average growth rate were used to describe the change trend of disease burden of gastric cancer.</p><p><b>RESULTS</b>A total of 213 gastric cancer deaths occurred in Jinchang cohort from 2001 to 2013. The average annual crude mortality rate of gastric cancer was 38.30 per 100,000 in Jinchang cohort during 2001-2013 and no obvious change was observed. The crude mortality rate in males was 6.84 times higher than that in females. Gastric cancer death mainly occurred in age group 50-79 years (82.62%), while the mortality rates was increasing among the people under 50 years with an average annual increase rate of 0.77%. The annual average PYLL (APYLL) and average WPYLL (AWPYLL) caused by gastric cancer decreased by 8.43% and 10.46%, respectively. No obvious change in medical expenditure of gastric cancer cases was observed in Jinchang Cohort during 2001-2010, and the medical expenditure and average daily cost of hospitalization were 8102.23 Yuan, and 463.45 Yuan per capita, respectively.</p><p><b>CONCLUSIONS</b>The burden of disease for gastric cancer was heavy in Jinchang cohort. The PYLL and WPYLL had no change, while the APYLL and AWPYLL showed a increasing trend during the last ten years. Direct economic burden of inpatients with gastric cancer had no change.</p>

Spatial-temporal distribution of hepatitis B in Gansu province, 2009-2014 / 中华流行病学杂志

<p><b>OBJECTIVE</b>To understand the hot/cold spots and the spatial-temporal clustering of hepatitis B in Gansu province during 2009-2014 by using spatial statistics, and provide scientific evidence for the prevention and control of hepatitis B.</p><p><b>METHODS</b>The spatial hot/cold spots and its trend, and the time frame and areas of its spatial-temporal clustering of hepatitis B in Gansu were analyzed by using the county specific incidence of hepatitis B from 2009 to 2014 and spatial statistical software GeoDa and SatScan.</p><p><b>RESULTS</b>The incidences of hepatitis B from 2009 to 2014 in Gansu were spatial autocorrelated respectively. Local G scan statistics indicated that the number of hot spots was in decline in Hexi area, while the hot spots was in increase in Linxia Hui autonomous prefecture and Gannan Tibetan autonomous prefecture. There was no obvious pattern in cold spots. Temporal-spatial scan statistics showed that the areas with high hepatitis B incidence most likely clustered in Hexi area during 2009-2011, and the areas with low hepatitis B incidence most likely clustered in eastern Gansu during 2012-2014.</p><p><b>CONCLUSIONS</b>The spatial and temporal clustering of hepatitis B was observed in Gansu from 2009 to 2014. The number of hot spots in Hexi area was in decline, while the numbers of hot spots in Linxia and Gannan were in increase, suggesting that the hepatitis B control and prevention in these areas should be strengthened.</p>

Spatial-temporal specific incidence of pulmonary tuberculosis in Gansu, 2009-2013 / 中华流行病学杂志

<p><b>OBJECTIVE</b>To understand the spatial-temporal specific incidence of pulmonary tuberculosis (TB) in Gansu.</p><p><b>METHODS</b>The county-based incidence of pulmonary TB in Gansu from 2009 to 2013 was used to calculate Moran's I and G statistics, and analyze the spatial-temporal distribution of areas with different pulmonary TB incidences.</p><p><b>RESULTS</b>The spatial correlation in incidence of pulmonary TB was found in Gansu from 2009 to 2013 (P<0.001), and the hot spot areas were mainly in Hexi area, Linxia, part of Dingxi, while the cold spot areas were in Lanzhou, part of Dingxi, Tianshui, Pingliang and Qingyang. Spatial-temporal analysis showed that the clustering of high pulmonary TB incidence areas were most likely in the Hexi area during 2009-2010 (LLR=3,031.10, RR=2.27, P<0.001), and the clustering of low pulmonary TB incidence areas were most likely in Lanzhou during 2011-2013 (LLR=1,545.52, RR=0.37, P<0.001).</p><p><b>CONCLUSION</b>The analysis on spatial and spatial-temporal specific incidences of pulmonary TB in Gansu from 2009 to 2013 indicated that Hexi area is the key area in pulmonary TB prevention and control in Gansu.</p>

Spatial clustering of hand-foot-mouth disease in Gansu, 2012 / 中华流行病学杂志

<p><b>OBJECTIVE</b>The purpose of this study was to explore the spatial distribution and spatial clustering of hand-foot-mouth disease (HFMD) in Gansu, 2012.</p><p><b>METHODS</b>Spatial autocorrelation and Spatial scanning analysis were used to conduct spatial statistical analyses for the HFMD at the county/district level.</p><p><b>RESULTS</b>HFMD cases did not show a random distribution but with significant spatial aggregation. When Local Autocorrelation analysis was applied at the county/district level, with nine hot spot areas as Jiayuguan, Yumen, Dunhuang, Jinta, Suzhou, Chengguan, Anning, Xigu and Gaolan, were discovered. Four statistically significant HFMD clusters were identified by spatial scan statistics.</p><p><b>CONCLUSION</b>HFMD was noticed geographically clustered in Gansu in 2012. Results from this study indicated that the spatial autocorrelation and spatial scanning analysis could effectively detect the areas which presenting significant clusters. Cluster Detection System (CDS) could provide evidence for the development of an effective measure concerning the prevention and control of HFMD.</p>