确定与高发病率地区HIV感染病例的空间聚类相关的因素:定量地理空间研究
Qiyu Zhu1,2, Chunnong Jike3, Chengdong Xu4
1National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
JMIR public health and surveillance
|September 16, 2025
概括
中国梁山的艾滋病毒感染群是由城市化和交通驱动的,而不仅仅是艾滋病毒的流行. 更高的抗逆转录病毒治疗 (ART) 覆盖率矛盾地与传播增加相关,需要综合预防策略.
科学领域:
- 流行病学 流行病学
- 地理空间分析是什么
- 公共卫生 公共卫生
背景情况:
- 发生性艾滋病毒感染是一个关键的流行病指标,特别是在负担较高的地区,如中国的梁山义自治县,在四个关键县的流行率超过1%.
- 确定最近艾滋病毒感染的空间集群和驱动因素对于有针对性的干预至关重要,但对事件艾滋病毒集群驱动因素的研究是有限的,特别是在资源不足的环境中.
研究的目的:
- 确定最近艾滋病毒感染的空间集群在梁山义自治县的四个关键县.
- 调查导致这些最近的艾滋病毒感染集群的潜在驱动因素.
- 为该地区预防和控制艾滋病毒制定有针对性的干预策略提供信息.
主要方法:
- 在5555例新诊断病例 (2017年11月至2018年6月) 中,鉴定了246例最近的艾滋病毒感染病例 (4.42%),这些病例使用了限制抗原狂热度测试或记录的血清转化.
- 使用核密度估计分析了发生的艾滋病毒病例的空间分布.
- 使用空间滞后回归和Geodetector q-统计来识别和量化与聚类相关的因素,包括人口密度,艾滋病患患病率,海拔,城市附近和ART覆盖率.
主要成果:
- 观察到近期艾滋病毒病例的显著空间自相关性 (莫兰I=0.11;P<.01),在城市中心或主要道路附近确定了六个空间集群.
- 人口密度 (β=0.59),艾滋病毒流行率 (β=0.02),距离城市地区的距离 (β=-3.10),海拔的SD (β=-0.15) 和ART覆盖率 (β=183.80) 与集群有显著的相关性.
- 人口密度和艾滋病毒流行率在推动艾滋病毒聚类方面显示出最强的交互效应 (q=0.69).
结论:
- 梁山的艾滋病毒事件集群是由城市化因素 (人口密度,城市附近) 和交通便利性以及艾滋病毒流行率所驱动的.
- 矛盾的是,更高的抗逆转录病毒疗法 (ART) 覆盖率与传播的增加有关,突出了除了ART扩展之外需要综合预防策略的需要.
- 乡镇层面的地理空间方法对于识别传输热点和定制全球高负担地区的干预措施是有价值的.
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