Abstract
BackgroundLittle comprehensive information on overall epidemic trend of notifiable respiratory infectious diseases is available in Shandong Province, China. This study aimed to determine the spatiotemporal distribution and epidemic characteristics of notifiable respiratory infectious diseases.MethodsTime series was firstly performed to describe the temporal distribution feature of notifiable respiratory infectious diseases during 2005–2014 in Shandong Province. GIS Natural Breaks (Jenks) was applied to divide the average annual incidence of notifiable respiratory infectious diseases into five grades. Spatial empirical Bayesian smoothed risk maps and excess risk maps were further used to investigate spatial patterns of notifiable respiratory infectious diseases. Global and local Moran’s I statistics were used to measure the spatial autocorrelation. Spatial-temporal scanning was used to detect spatiotemporal clusters and identify high-risk locations.ResultsA total of 537,506 cases of notifiable respiratory infectious diseases were reported in Shandong Province during 2005–2014. The morbidity of notifiable respiratory infectious diseases had obvious seasonality with high morbidity in winter and spring. Local Moran’s I analysis showed that there were 5, 23, 24, 4, 20, 8, 14, 10 and 7 high-risk counties determined for influenza A (H1N1), measles, tuberculosis, meningococcal meningitis, pertussis, scarlet fever, influenza, mumps and rubella, respectively. The spatial-temporal clustering analysis determined that the most likely cluster of influenza A (H1N1), measles, tuberculosis, meningococcal meningitis, pertussis, scarlet fever, influenza, mumps and rubella included 74, 66, 58, 56, 22, 64, 2, 75 and 56 counties, and the time frame was November 2009, March 2008, January 2007, February 2005, July 2007, December 2011, November 2009, June 2012 and May 2005, respectively.ConclusionsThere were obvious spatiotemporal clusters of notifiable respiratory infectious diseases in Shandong during 2005–2014. More attention should be paid to the epidemiological and spatiotemporal characteristics of notifiable respiratory infectious diseases to establish new strategies for its control.
Highlights
Little comprehensive information on overall epidemic trend of notifiable respiratory infectious diseases is available in Shandong Province, China
The monthly incidence rate of tuberculosis was between 4 per 100,000 and 5 per 100,000, which peaked in late winter and early spring, mainly from January to April
The incidence of scarlet fever showed a bimodal seasonal pattern with a peak occurring in summer and a peak occurring in winter (See Fig. 1F)
Summary
Little comprehensive information on overall epidemic trend of notifiable respiratory infectious diseases is available in Shandong Province, China. The incidence of infectious diseases has been effectively controlled, infectious diseases are still a major global public health problem. Infectious diseases still represent a significant public health problem in China, with over 10 million cases (incidence rate was 733.57 per 100,000) reported in 2019 [2]. Notifiable respiratory infectious diseases resulting from bacterial or viral pathogens such as mycobacterium tuberculosis, streptococcus pneumoniae, respiratory syncytial virus (RSV) or influenza virus are major global public health concerns. Being one of the provinces with high incidence rates of notifiable respiratory infections diseases in China, the annual incidence rate of notifiable respiratory infections diseases in Shandong Province ranged from 0.003 to 30.148 per 100,000 in the total population in 2017, with highest incidence of tuberculosis (30.148 per 100,000) and lowest incidence of meningococcal meningitis (0.003 per 100,000) [4]
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