Article(id=1241036329614627652, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241036327177744706, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202504261, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1744646400000, receivedDateStr=2025-04-15, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773815718319, onlineDateStr=2026-03-18, pubDate=1757433600000, pubDateStr=2025-09-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773815718319, onlineIssueDateStr=2026-03-18, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773815718319, creator=13701087609, updateTime=1773815718319, updator=13701087609, issue=Issue{id=1241036327177744706, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='17', pageStart='3073', pageEnd='3264', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773815717738, creator=13701087609, updateTime=1773840080282, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241138511152206262, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241036327177744706, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241138511152206263, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241036327177744706, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=3111, endPage=3115, ext={EN=ArticleExt(id=1241036330453488453, articleId=1241036329614627652, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Spatial-temporal clustering of mumps during periods with different immunization strategies in Tai’an, columnId=1240413921954295836, journalTitle=Modern Preventive Medicine, columnName=Epidemiology and Statistical Methods, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the spatial-temporal clustering of mumps during periods with different immunization strategies in Tai’an.

Methods

The immunization strategy for MuCV from 2009 to 2024 was divided into 1-dose period (2009-2013), 2-dose early period (2014-May 2020), and 2-dose later period (June 2020-2024). Mumps incidence data from 2009 to 2024 were obtained from the China Disease Control and Prevention Information System for descriptive epidemiological, trend analysis and spatial-temporal clustering analysis during different immunization strategy periods.

Results

The annual average incidence rate of mumps in Tai’an from 2009 to 2024 showed a general downward trend during the three immunization periods (χ2trend=4 273.971, P<0.001), and there were statistically significant differences (χ2=4 977.100, P<0.001). The trend surface analysis showed that it increased first and then decreased from west to east during three immunization periods. From north to south, the rate decreased and then increased during the 1-dose period, whereas a generally downward trend was observed during the 2-dose period. The global spatial autocorrelation analysis showed that mumps exhibited significant spatial clustering (P<0.001) during three immunization periods. The local autocorrelation analysis showed that the "High-High" clusters were predominantly concentrated in the townships/subdistricts covered by Taishan District, Daiyue District, Mount Tai Scenic Area, and Ningyang County, while the "Low-Low" clusters were mainly distributed in those under Feicheng City and Xintai City during the three immunization periods. The spatiotemporal scanning analysis showed that the main clusters were predominantly located in townships/subdistricts covered by Ningyang County, Taishan District, Daiyue District, and the Mount Tai Scenic Area during the three immunization periods, and this was basically consistent with the "high-high" clusters identified by the local spatial autocorrelation analysis.

Conclusion

The incidence of mumps during different immunization strategy periods exhibited spatial-temporal clustering in Tai’an City. It is necessary to strengthen the surveillance and early warning for mumps in high-priority regions.

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目的

分析不同免疫策略时期泰安市流行性腮腺炎(简称流腮)时空分布特征。

方法

2009—2024年含流腮成分疫苗(mumps containing vaccine, MuCV)免疫策略分为1剂次免疫时期(2009—2013年)、2剂次免疫前期(2014年—2020年5月)、2剂次免疫后期(2020年6月—2024年)。通过“中国疾病预防控制信息系统”收集2009—2024年泰安市流腮发病数据,对不同免疫策略时期流腮发病情况进行描述性流行病学、趋势面分析和时空聚集性分析。

结果

2009—2024年泰安市3个免疫时期流腮年均发病率总体呈下降趋势(χ2趋势=4 273.971,P<0.001),不同免疫时期流腮年均发病率差异具有统计学意义(χ2=4 977.100,P<0.001)。趋势面分析显示,3个免疫时期流腮年均发病率自西向东先上升后下降;自北向南方向上,1剂次免疫时期年均发病率先下降后上升,2剂次免疫时期年均发病率整体呈下降趋势。全局空间自相关分析显示,3个免疫时期流腮发病均存在空间聚集性(P<0.001)。局部空间自相关分析显示,3个免疫时期“高-高”聚集区主要集中在泰山区、岱岳区、泰山景区、宁阳县覆盖的乡镇/街道,“低-低”聚集区主要集中在肥城市、新泰市覆盖的乡镇/街道。时空扫描分析显示,3个免疫时期主要聚集区为宁阳县、泰山区、岱岳区、泰山景区覆盖的乡镇/街道,与局部空间自相关分析结果中“高-高”聚集区所在区域范围基本一致。

结论

泰安市在不同免疫策略时期流行性腮腺炎发病均存在时空聚集性,应加强重点地区流行性腮腺炎的监测和预警。

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傅连臣,E-mail:
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李楠(1989—),女,硕士,主管医师,研究方向:疾病预防与控制

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Chinese Journal of Vaccines and Immunization, 2011, 17(5): 426-430, 450.(In Chinese), articleTitle=Systematic review on immunology effect and protective efficacy of mumps attenuated live vaccine, refAbstract=null), Reference(id=1241139382472724569, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036329614627652, doi=null, pmid=null, pmcid=null, year=2023, volume=29, issue=3, pageStart=311, pageEnd=314, url=null, language=null, rfNumber=[17], rfOrder=29, authorNames=汪聪智, 杨敬源, 高岚, journalName=中国疫苗和免疫, refType=null, unstructuredReference=汪聪智,杨敬源,高岚,等.不同免疫策略对贵阳市流行性腮腺炎发病影响的中断时间序列分析[J].中国疫苗和免疫202329(3):311-314., articleTitle=不同免疫策略对贵阳市流行性腮腺炎发病影响的中断时间序列分析, refAbstract=null), Reference(id=1241139382585970784, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036329614627652, doi=null, pmid=null, pmcid=null, year=2023, volume=29, issue=3, pageStart=311, pageEnd=314, url=null, language=null, rfNumber=[17], rfOrder=30, authorNames=Wang CZ, Yang JY, Gao L, journalName=Chinese Journal of Vaccines and Immunization, refType=null, unstructuredReference=Wang CZ, Yang JY, Gao L, et al. 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Chinese Journal of Vaccines and Immunization, 2024, 30(6): 647-651.(In Chinese), articleTitle=Descriptive epidemiology and interrupted time series analyses of mumps in Ningxia Hui Autonomous Region,2004-2023, refAbstract=null)], funds=[Fund(id=1241139377154347810, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036329614627652, awardId=202412050054, language=CN, fundingSource=山东省医药卫生科技项目(202412050054), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1241139369638154717, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036329614627652, xref=null, ext=[AuthorCompanyExt(id=1241139369646543327, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036329614627652, companyId=1241139369638154717, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Tai’an Center for Disease Control and Prevention, Tai’an, Shandong 271000, China), AuthorCompanyExt(id=1241139369663320544, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036329614627652, companyId=1241139369638154717, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=泰安市疾病预防控制中心,山东 泰安 271000)])], figs=[ArticleFig(id=1241139374339969715, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036329614627652, language=EN, label=Figure 1, caption=Annual average incidence rate of townships/subdistricts during different immunization periods in Tai’an from 2009 to 2024, figureFileSmall=me6imYtsemwFQhXI8VNsRQ==, figureFileBig=loihV1LG8NnY+LhyzHPpkw==, tableContent=null), ArticleFig(id=1241139374449021627, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036329614627652, language=CN, label=图1, caption=泰安市2009—2024年不同免疫策略时期各乡镇/街道年均发病率, figureFileSmall=me6imYtsemwFQhXI8VNsRQ==, figureFileBig=loihV1LG8NnY+LhyzHPpkw==, tableContent=null), ArticleFig(id=1241139374553879240, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036329614627652, language=EN, label=Figure 2, caption=Trend surface analysis of annual average incidence rate during different immunization periods in Tai’an from 2009 to 2024, figureFileSmall=JUyVo0OmwOpo+qpc3WgeyQ==, figureFileBig=iPqAZMyzO3B9wf2K1T1mrA==, tableContent=null), ArticleFig(id=1241139374641959633, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036329614627652, language=CN, label=图2, caption=泰安市2009—2024年不同免疫时期流腮年均发病率趋势面分析

注:红色曲线表示流腮年均发病率在东西方向上的变化趋势;蓝色曲线表示流腮年均发病率在南北方向上的变化趋势。

, figureFileSmall=JUyVo0OmwOpo+qpc3WgeyQ==, figureFileBig=iPqAZMyzO3B9wf2K1T1mrA==, tableContent=null), ArticleFig(id=1241139374717457109, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036329614627652, language=EN, label=Table 1, caption=

Analysis of mumps incidence during different immunization periods in Tai’an from 2009 to 2024

, figureFileSmall=null, figureFileBig=null, tableContent=
免疫分期发病数年均发病率(/10万)
1剂次免疫时期5 34318.995
2剂次免疫前期2 2895.739
2剂次免疫后期7732.728
), ArticleFig(id=1241139374860063450, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036329614627652, language=CN, label=表1, caption=

泰安市2009—2024年不同免疫时期流腮发病情况分析

, figureFileSmall=null, figureFileBig=null, tableContent=
免疫分期发病数年均发病率(/10万)
1剂次免疫时期5 34318.995
2剂次免疫前期2 2895.739
2剂次免疫后期7732.728
), ArticleFig(id=1241139375006864105, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036329614627652, language=EN, label=Table 2, caption=

Spatial autocorrelation analysis of mumps incidence during different immunization periods in Tai’an from 2009 to 2024

, figureFileSmall=null, figureFileBig=null, tableContent=
免疫分期全局空间自相关分析局部空间自相关分析
Moran IZP聚集性“高-高”聚集区“高-高”聚集区所属县区“低-低”聚集区“低-低”聚集区所属县区
1剂次免疫时期0.2864.521<0.001岱庙街道、财源街道、上高街道泰前街道、徐家楼街道、粥店街道大津口乡、文庙街道、八仙桥街道葛石镇、泗店镇泰山区(5个)岱岳区(1个)泰山景区(1个)宁阳县(4个)新汶街道、仪阳街道桃园镇、安临站镇安驾庄镇、边院镇新泰市(1个)肥城市(5个)
2剂次免疫前期0.4276.737<0.001岱庙街道、财源街道、上高街道泰前街道、徐家楼街道、省庄镇粥店街道、北集坡街道、大津口乡老城街道泰山区(6个)岱岳区(1个)高新区(1个)泰山景区(1个)肥城市(1个)马庄镇、新汶街道安临站镇、安驾庄镇边院镇、新湖镇戴庙镇岱岳区(1个)新泰市(1个)肥城市(3个)东平县(2个)
2剂次免疫后期0.3916.416<0.001岱庙街道、财源街道、上高街道泰前街道、徐家楼街道、粥店街道天平街道、北集坡街道、大津口乡泰山区(5个)岱岳区(2个)高新区(1个)泰山景区(1个)新汶街道、岳家庄乡谷里镇、石莱镇放城镇、王庄镇孙伯镇、安驾庄镇边院镇、沙河站镇新泰市(5个)肥城市(4个)东平县(1个)
), ArticleFig(id=1241139375220773624, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036329614627652, language=CN, label=表2, caption=

泰安市2009—2024年不同免疫时期流腮发病空间自相关分析

, figureFileSmall=null, figureFileBig=null, tableContent=
免疫分期全局空间自相关分析局部空间自相关分析
Moran IZP聚集性“高-高”聚集区“高-高”聚集区所属县区“低-低”聚集区“低-低”聚集区所属县区
1剂次免疫时期0.2864.521<0.001岱庙街道、财源街道、上高街道泰前街道、徐家楼街道、粥店街道大津口乡、文庙街道、八仙桥街道葛石镇、泗店镇泰山区(5个)岱岳区(1个)泰山景区(1个)宁阳县(4个)新汶街道、仪阳街道桃园镇、安临站镇安驾庄镇、边院镇新泰市(1个)肥城市(5个)
2剂次免疫前期0.4276.737<0.001岱庙街道、财源街道、上高街道泰前街道、徐家楼街道、省庄镇粥店街道、北集坡街道、大津口乡老城街道泰山区(6个)岱岳区(1个)高新区(1个)泰山景区(1个)肥城市(1个)马庄镇、新汶街道安临站镇、安驾庄镇边院镇、新湖镇戴庙镇岱岳区(1个)新泰市(1个)肥城市(3个)东平县(2个)
2剂次免疫后期0.3916.416<0.001岱庙街道、财源街道、上高街道泰前街道、徐家楼街道、粥店街道天平街道、北集坡街道、大津口乡泰山区(5个)岱岳区(2个)高新区(1个)泰山景区(1个)新汶街道、岳家庄乡谷里镇、石莱镇放城镇、王庄镇孙伯镇、安驾庄镇边院镇、沙河站镇新泰市(5个)肥城市(4个)东平县(1个)
), ArticleFig(id=1241139375371768579, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036329614627652, language=EN, label=Table 3, caption=

Spatiotemporal scanning analysis of mumps incidence during different immunization periods in Tai’an from 2009 to 2024

, figureFileSmall=null, figureFileBig=null, tableContent=
免疫分期聚集类型聚集时间(年/月)覆盖乡镇/街道个数覆盖乡镇/街道所属县区发病数期望发病数RR值LLR值P
1剂次免疫时期主要2012/4—2013/711宁阳县924166.006.52886.65<0.001
主要2011/12—2013/77泰山区、岱岳区泰山景区947186.445.96837.55<0.001
次要2013/2—2013/71肥城市9613.357.30107.39<0.001
次要2012/4—2013/614泰山区、岱岳区新泰市、宁阳县411191.602.2499.00<0.001
次要2011/5—2011/61东平县391.6823.4285.53<0.001
次要2010/11—2011/32新泰市10320.765.0483.36<0.001
次要2012/12—2013/31东平县252.1511.7038.58<0.001
2剂次免疫前期主要2014/1—2015/1210泰山区、岱岳区泰山景区340104.313.65179.23<0.001
次要2019/3—2019/51新泰市561.6933.96142.41<0.001
次要2017/4—2019/122肥城市14338.893.8684.54<0.001
次要2014/8—2015/31东平县181.1615.6232.57<0.001
次要2014/1—2016/105宁阳县10756.681.9318.24<0.001
2剂次免疫后期主要2020/11—2022/106泰山区、岱岳区14536.134.71101.08<0.001
次要2020/6—2022/43肥城市9117.235.8581.42<0.001
次要2020/10—2022/91东平县298.953.3314.31<0.05
), ArticleFig(id=1241139375472431884, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036329614627652, language=CN, label=表3, caption=

泰安市2009—2024年不同免疫时期流腮发病时空扫描分析

, figureFileSmall=null, figureFileBig=null, tableContent=
免疫分期聚集类型聚集时间(年/月)覆盖乡镇/街道个数覆盖乡镇/街道所属县区发病数期望发病数RR值LLR值P
1剂次免疫时期主要2012/4—2013/711宁阳县924166.006.52886.65<0.001
主要2011/12—2013/77泰山区、岱岳区泰山景区947186.445.96837.55<0.001
次要2013/2—2013/71肥城市9613.357.30107.39<0.001
次要2012/4—2013/614泰山区、岱岳区新泰市、宁阳县411191.602.2499.00<0.001
次要2011/5—2011/61东平县391.6823.4285.53<0.001
次要2010/11—2011/32新泰市10320.765.0483.36<0.001
次要2012/12—2013/31东平县252.1511.7038.58<0.001
2剂次免疫前期主要2014/1—2015/1210泰山区、岱岳区泰山景区340104.313.65179.23<0.001
次要2019/3—2019/51新泰市561.6933.96142.41<0.001
次要2017/4—2019/122肥城市14338.893.8684.54<0.001
次要2014/8—2015/31东平县181.1615.6232.57<0.001
次要2014/1—2016/105宁阳县10756.681.9318.24<0.001
2剂次免疫后期主要2020/11—2022/106泰山区、岱岳区14536.134.71101.08<0.001
次要2020/6—2022/43肥城市9117.235.8581.42<0.001
次要2020/10—2022/91东平县298.953.3314.31<0.05
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不同免疫策略时期泰安市流行性腮腺炎时空聚集性分析
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李楠 , 徐丽莎 , 崔亚楠 , 石艳艳 , 国青 , 傅连臣
现代预防医学 | 流行病与统计方法 2025,52(17): 3111-3115
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现代预防医学 | 流行病与统计方法 2025, 52(17): 3111-3115
不同免疫策略时期泰安市流行性腮腺炎时空聚集性分析
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李楠, 徐丽莎, 崔亚楠, 石艳艳, 国青, 傅连臣
作者信息
  • 泰安市疾病预防控制中心,山东 泰安 271000
  • 李楠(1989—),女,硕士,主管医师,研究方向:疾病预防与控制

通讯作者:

傅连臣,E-mail:
Spatial-temporal clustering of mumps during periods with different immunization strategies in Tai’an
Nan LI, Li-sha XU, Ya-nan CUI, Yan-yan SHI, Qing GUO, Lian-chen FU
Affiliations
  • Tai’an Center for Disease Control and Prevention, Tai’an, Shandong 271000, China
出版时间: 2025-09-10 doi: 10.20043/j.cnki.MPM.202504261
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目的

分析不同免疫策略时期泰安市流行性腮腺炎(简称流腮)时空分布特征。

方法

2009—2024年含流腮成分疫苗(mumps containing vaccine, MuCV)免疫策略分为1剂次免疫时期(2009—2013年)、2剂次免疫前期(2014年—2020年5月)、2剂次免疫后期(2020年6月—2024年)。通过“中国疾病预防控制信息系统”收集2009—2024年泰安市流腮发病数据,对不同免疫策略时期流腮发病情况进行描述性流行病学、趋势面分析和时空聚集性分析。

结果

2009—2024年泰安市3个免疫时期流腮年均发病率总体呈下降趋势(χ2趋势=4 273.971,P<0.001),不同免疫时期流腮年均发病率差异具有统计学意义(χ2=4 977.100,P<0.001)。趋势面分析显示,3个免疫时期流腮年均发病率自西向东先上升后下降;自北向南方向上,1剂次免疫时期年均发病率先下降后上升,2剂次免疫时期年均发病率整体呈下降趋势。全局空间自相关分析显示,3个免疫时期流腮发病均存在空间聚集性(P<0.001)。局部空间自相关分析显示,3个免疫时期“高-高”聚集区主要集中在泰山区、岱岳区、泰山景区、宁阳县覆盖的乡镇/街道,“低-低”聚集区主要集中在肥城市、新泰市覆盖的乡镇/街道。时空扫描分析显示,3个免疫时期主要聚集区为宁阳县、泰山区、岱岳区、泰山景区覆盖的乡镇/街道,与局部空间自相关分析结果中“高-高”聚集区所在区域范围基本一致。

结论

泰安市在不同免疫策略时期流行性腮腺炎发病均存在时空聚集性,应加强重点地区流行性腮腺炎的监测和预警。

流行性腮腺炎  /  免疫策略  /  时空聚集性  /  趋势面分析
Objective

To analyze the spatial-temporal clustering of mumps during periods with different immunization strategies in Tai’an.

Methods

The immunization strategy for MuCV from 2009 to 2024 was divided into 1-dose period (2009-2013), 2-dose early period (2014-May 2020), and 2-dose later period (June 2020-2024). Mumps incidence data from 2009 to 2024 were obtained from the China Disease Control and Prevention Information System for descriptive epidemiological, trend analysis and spatial-temporal clustering analysis during different immunization strategy periods.

Results

The annual average incidence rate of mumps in Tai’an from 2009 to 2024 showed a general downward trend during the three immunization periods (χ2trend=4 273.971, P<0.001), and there were statistically significant differences (χ2=4 977.100, P<0.001). The trend surface analysis showed that it increased first and then decreased from west to east during three immunization periods. From north to south, the rate decreased and then increased during the 1-dose period, whereas a generally downward trend was observed during the 2-dose period. The global spatial autocorrelation analysis showed that mumps exhibited significant spatial clustering (P<0.001) during three immunization periods. The local autocorrelation analysis showed that the "High-High" clusters were predominantly concentrated in the townships/subdistricts covered by Taishan District, Daiyue District, Mount Tai Scenic Area, and Ningyang County, while the "Low-Low" clusters were mainly distributed in those under Feicheng City and Xintai City during the three immunization periods. The spatiotemporal scanning analysis showed that the main clusters were predominantly located in townships/subdistricts covered by Ningyang County, Taishan District, Daiyue District, and the Mount Tai Scenic Area during the three immunization periods, and this was basically consistent with the "high-high" clusters identified by the local spatial autocorrelation analysis.

Conclusion

The incidence of mumps during different immunization strategy periods exhibited spatial-temporal clustering in Tai’an City. It is necessary to strengthen the surveillance and early warning for mumps in high-priority regions.

Mumps  /  Immunization strategy  /  Spatial-temporal clustering  /  Trend surface analysis
李楠, 徐丽莎, 崔亚楠, 石艳艳, 国青, 傅连臣. 不同免疫策略时期泰安市流行性腮腺炎时空聚集性分析. 现代预防医学, 2025 , 52 (17) : 3111 -3115 . DOI: 10.20043/j.cnki.MPM.202504261
Nan LI, Li-sha XU, Ya-nan CUI, Yan-yan SHI, Qing GUO, Lian-chen FU. Spatial-temporal clustering of mumps during periods with different immunization strategies in Tai’an[J]. Modern Preventive Medicine, 2025 , 52 (17) : 3111 -3115 . DOI: 10.20043/j.cnki.MPM.202504261
流行性腮腺炎(简称流腮)是由腮腺炎病毒引起的急性呼吸道传染病,可引起单侧或双侧腮腺肿胀和疼痛,严重可导致脑膜炎、睾丸炎等并发症,危害儿童健康[1-2]。流腮是疫苗针对传染病,2009年山东省按照国家扩大免疫规划(Expanded Program on Immunization,EPI)要求全面实施1剂次含流腮成分疫苗(mumps containing vaccine, MuCV)免疫策略,即满18月龄儿童接种1剂次MuCV[3]。1剂次MuCV接种后流腮发病得到一定控制,但仍呈高发态势,2012—2013年发病达到高峰。2014年起免疫策略调整为2剂次,即18月龄、6岁儿童各接种1剂次麻腮风联合减毒活疫苗(measles, mumps and rubella combined attenuated live vaccine, MMR)[3]。2020年6月起,实施国家统一的2剂次MMR免疫程序,即对8月龄和18月龄儿童各接种1剂次MMR[4]。为探讨不同免疫策略时期泰安市流行性腮腺炎时空分布特征,本研究基于2009—2024年泰安市流腮监测数据并结合地理信息系统(Geographic Information System, GIS)对不同免疫策略时期流腮时空聚集性进行分析。
本研究流腮资料来源于“中国疾病预防控制信息系统”,按照“现住地址、发病日期”收集2009—2024年泰安市报告流腮病例个案,个案中乡镇/街道是居住地所在的乡镇/街道,乡镇/街道不详的采用报告该病例的医疗机构所在的乡镇/街道。乡镇/街道人口数据资料来源于泰安市统计年鉴,个别年份人口数据不详通过人口自然增长率推算。
根据泰安市MuCV免疫策略实施情况,2009—2024年MuCV免疫策略分为1剂次免疫时期(2009—2013年)、2剂次免疫前期(2014年—2020年5月)、2剂次免疫后期(2020年6月—2024年)。
运用Excel 2023软件对流腮个案数据整理汇总并建立数据库,SPSS 21.0软件进行描述性统计分析,对2009—2024年不同免疫策略时期流腮年均发病率进行χ2检验及χ2趋势分析。应用ArcMap10.8软件对不同免疫策略时期流腮发病率进行趋势面分析、空间自相关分析。趋势面分析将各乡镇/街道的经纬度绘制在X、Y平面,Z轴杆的高度由不同免疫时期流腮年均发病率值来确定;全局空间自相关分析以Moran I>0表示空间正相关,空间相邻区域的流腮发病趋势相似,反之流腮发病趋势相反。运用SaTScan 9.5软件对流腮发病率进行时空扫描分析,选择Poisson分布模型,根据既往研究[5-6]和本研究实际情况,空间窗口最大空间聚类大小设定为总人口数的20%,时间窗口最大时间聚类大小设定为总研究期限的45%,时间单位为“月”,地区单位为“乡镇/街道”。通过对数似然比(log likelihood ratio,LLR)来判断时空聚集的可能性,LLR越大,存在时空聚集的可能性越大,将具有统计学意义的区域划分为主要和次要聚集区[7-8]。检验水准α=0.05。
泰安市88个乡镇/街道在2009—2024年报告流腮病例8 405例,年均发病率为9.277/10万,粥店街道年均发病率最高,为28.127/10万,新甫街道年均发病率最低,为0.138/10万。全市28个乡镇、街道年均发病率高于全市年均发病率水平,粥店街道、文庙街道、财源街道、泗店镇、八仙桥街道、徐家楼街道、泰前街道居前七位,分别为28.127/10万、27.888/10万、25.320/10万、22.606/10万、22.456/10万、21.253/10万、20.918/10万,年均发病率均大于20/10万。
以乡镇/街道为单位,1剂次免疫时期共报告流腮病例5 343例,年均发病率为18.995/10万,文庙街道年均发病率最高,为64.155/10万;2剂次免疫前期报告流腮病例2 289例,年均发病率为5.739/10万,财源街道年均发病率最高,为19.858/10万;2剂次免疫后期报告流腮病例773例,年均发病率为2.728/10万,粥店街道年均发病率最高,为18.376/10万。见图1。2009—2024年泰安市3个免疫时期流腮年均发病率总体呈下降趋势(χ2趋势=4 273.971,P<0.001),不同免疫时期年均发病率差异具有统计学意义(χ2=4 977.100,P<0.001)。见表1
泰安市2009—2024年不同免疫时期流腮年均发病率趋势面分析显示,3个免疫时期年均发病率自西向东先上升后下降,呈倒“U”型变化趋势,曲线的高峰位于中部区域(中部区域年均发病率较高)。自北向南方向上,1剂次免疫时期年均发病率先下降后上升,呈“U”型变化趋势,曲线的低谷位于中部区域(自北向南方向上中部区域年均发病率较低),2剂次免疫时期(前期、后期)年均发病率整体呈下降趋势,南部区域年均发病率较低。见图2
2009—2024年不同免疫时期流腮年均发病率全局空间自相关分析显示,3个免疫时期流腮年均发病率呈空间正相关,存在空间聚集性,Moran I分别为0.286(P<0.001)、0.427(P<0.001)、0.391(P<0.001)。局部空间自相关分析提示,1剂次免疫时期“高-高”聚集区主要集中在北部地区泰山区、岱岳区、泰山景区7个乡镇/街道和南部地区宁阳县4个乡镇/街道,“低-低”聚集区主要集中在中部偏西地区肥城市5个乡镇/街道、东部新泰市1个乡镇/街道。2剂次免疫前期“高-高”聚集区集中在北部地区泰山区、岱岳区、泰山景区、高新区、肥城市10个乡镇/街道,“低-低”聚集区分布在西部东平县2个乡镇/街道、中部偏西地区岱岳区、肥城市4个乡镇/街道、东部新泰市1个乡镇/街道。2剂次免疫后期“高-高”聚集区集中在北部地区泰山区、岱岳区、泰山景区、高新区9个乡镇/街道,“低-低”聚集区分布在偏西南部东平县1个乡镇/街道、中部偏西肥城市4个乡镇/街道、偏东南部新泰市5个乡镇/街道。见表2
2009—2024年不同免疫时期流腮发病时空扫描分析显示,1剂次免疫时期存在7个聚集区、2个主要聚集区、5个次要聚集区,2个主要聚集区LLR分别为886.65、837.55,分别覆盖11、7个乡镇/街道,涉及宁阳县、泰山区、岱岳区、泰山景区,聚集时间分别为2012年4月—2013年7月、2011年12月—2013年7月。2剂次免疫前期存在5个聚集区、1个主要聚集区、4个次要聚集区,主要聚集区LLR为179.23,覆盖10个乡镇/街道,涉及泰山区、岱岳区、泰山景区,聚集时间为2014年1月—2015年12月。2剂次免疫后期存在3个聚集区、1个主要聚集区、2个次要聚集区,主要聚集区LLR为101.08,分别覆盖6个乡镇/街道,涉及泰山区、岱岳区,聚集时间分别为2020年11月—2022年10月。不同免疫时期主要聚集区相互比较,1剂次免疫时期流腮发病时空聚集的可能性大于2剂次免疫时期,2剂次免疫前期大于2剂次免疫后期,泰山区、岱岳区、泰山景区是主要的聚集县区。见表3
本研究结果显示,2009—2024年泰安市88个乡镇/街道流腮年均发病率为9.277/10万,低于全国[9]、省内济南市、滨州市[10-11],高于省内日照市、滕州市年均发病率水平[12-13]。以乡镇/街道为单位,1剂次免疫时期流腮年均发病率为18.995/10万,2剂次免疫前期年均发病率为5.739/10万,2剂次免疫后期年均发病率为2.728/10万。2009—2024年泰安市3个免疫时期流腮年均发病率总体呈下降趋势,与山东省既往研究结果相一致[14]。分析原因可能为1剂次免疫时期免疫覆盖率不高,免疫保护效果有限,抗体水平逐渐下降[15-16]。适龄儿童家长健康素养水平逐步提升,疫苗接种意愿增强,MuCV接种率逐步提高[3],且2014年起实施2剂次免疫程序,免疫保护效果加强,流腮发病下降,与国内外研究结果[17-18]相一致;其次,学校、托幼机构等防控措施的加强、查漏补种等工作的开展对降低流腮发病也有一定影响;最后,新冠疫情期间一系列针对性防护措施也有效阻断了流腮的传播[19]
趋势面分析发现,自西向东方向上,3个免疫时期年均发病率均呈倒“U”型变化趋势,中部区域年均发病率较高。出现此种现象的原因可能为不同区县流腮监测敏感性不同,而中部地区监测敏感性较高,导致流腮年均发病率较高。自北向南方向上,1剂次免疫时期年均发病率呈“U”型变化趋势,中部区域年均发病率较低,2剂次免疫时期(前期、后期)年均发病率整体呈下降趋势,南部区域年均发病率较低,可能与北部区域覆盖泰安市主城区,人口密度高、人口流动性大、经济发展水平高、医疗机构报告流腮敏感性较高等有关;南部区域1剂次免疫时期年均发病率较高与2012—2013年暴发疫情报告病例数较多、监测敏感性高等有关,且与1剂次接种相比,2剂次免疫能更好的降低流腮发病[20]
全局空间自相关分析显示,3个免疫时期流腮年均发病率均存在空间聚集性。局部空间自相关分析进一步显示,3个免疫时期“高-高”聚集区主要集中在泰山区、岱岳区等主城区覆盖的乡镇/街道,“低-低”聚集区主要集中在肥城市、新泰市覆盖的乡镇/街道,与趋势面分析结果基本一致,且从1剂次免疫时期到2剂次免疫后期,“高-高”聚集区数量逐渐减少,“低-低”聚集区数量逐渐增加,表明MuCV接种作为主要的防控措施降低流腮发病效果显著,2剂次接种效果更好[9,20]
时空扫描分析显示,3个免疫时期流腮年均发病率主要聚集区集中在泰山区、岱岳区等主城区覆盖的乡镇/街道,且从1剂次免疫时期到2剂次免疫后期,主要聚集区LLR值逐渐减小,流腮发病时空聚集的可能性逐渐降低,覆盖的乡镇/街道数量也逐渐减少,这与趋势面分析和局部空间自相关分析结果基本一致,原因可能也与之相类似。
本研究存在一定局限性,流腮个案资料来源于中国疾病预防控制信息系统,属于被动监测,存在报告偏倚;流腮个案中乡镇/街道不详的采用报告该病例的医疗机构所在的乡镇/街道,与真实的信息可能存在差异;乡镇/街道人口数不详的通过人口自然增长率推算,与真实的人口数据可能存在差异。
综上所述,泰安市3个免疫时期流腮年均发病率总体呈下降趋势,不同免疫时期流腮发病均存在时空聚集性,应加强重点地区流腮的监测和预警。
  • 山东省医药卫生科技项目(202412050054)
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2025年第52卷第17期
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doi: 10.20043/j.cnki.MPM.202504261
  • 接收时间:2025-04-15
  • 首发时间:2026-03-18
  • 出版时间:2025-09-10
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  • 收稿日期:2025-04-15
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山东省医药卫生科技项目(202412050054)
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    泰安市疾病预防控制中心,山东 泰安 271000

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2种不同金属材料的力学参数

Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)

Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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