Spatial, temporal and spatio-temporal clusters of measles incidence at the county level in Guangxi, China during 2004–2014: flexibly shaped scan statistics

BMC Infectious Diseases

Research Article

Xianyan Tang¹  Alan Geater²  Edward McNeil²  Qiuyun Deng³  Ge Zhong³  Aihu Dong³ 

[1] Department of Epidemiology and Biostatistics, School of Public Health, Guangxi Medical University, Guangxi Zhuang Autonomous Region, China;Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand;Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand;Guangxi Center for Disease Control and Prevention, Institute of Vaccination, Guangxi Zhuang Autonomous Region, China;

关键词: Spatial;    Temporal;    Spatio-temporal;    Irregular cluster;    Measles;    Scan statistics;   

DOI  :  10.1186/s12879-017-2357-1

 received in 2016-11-11, accepted in 2017-03-28,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundOutbreaks of measles re-emerged in Guangxi province during 2013–2014, where measles again became a major public health concern. A better understanding of the patterns of measles cases would help in identifying high-risk areas and periods for optimizing preventive strategies, yet these patterns remain largely unknown. Thus, this study aimed to determine the patterns of measles clusters in space, time and space-time at the county level over the period 2004–2014 in Guangxi.MethodsAnnual data on measles cases and population sizes for each county were obtained from Guangxi CDC and Guangxi Bureau of Statistics, respectively. Epidemic curves and Kulldorff’s temporal scan statistics were used to identify seasonal peaks and high-risk periods. Tango’s flexible scan statistics were implemented to determine irregular spatial clusters. Spatio-temporal clusters in elliptical cylinder shapes were detected by Kulldorff’s scan statistics. Population attributable risk percent (PAR%) of children aged ≤24 months was used to identify regions with a heavy burden of measles.ResultsSeasonal peaks occurred between April and June, and a temporal measles cluster was detected in 2014. Spatial clusters were identified in West, Southwest and North Central Guangxi. Three phases of spatio-temporal clusters with high relative risk were detected: Central Guangxi during 2004–2005, Midwest Guangxi in 2007, and West and Southwest Guangxi during 2013–2014. Regions with high PAR% were mainly clustered in West, Southwest, North and Central Guangxi.ConclusionsA temporal uptrend of measles incidence existed in Guangxi between 2010 and 2014, while downtrend during 2004–2009. The hotspots shifted from Central to West and Southwest Guangxi, regions overburdened with measles. Thus, intensifying surveillance of timeliness and completeness of routine vaccination and implementing supplementary immunization activities for measles should prioritized in these regions.

【 授权许可】

CC BY   
© The Author(s). 2017