关键词: 肾综合征出血热, 空间自相关分析, 时空扫描, 流行病学特征, 楚雄彝族自治州, 云南省

Abstract: Objective To explore the temporal and spatial distribution characteristics of reported hemorrhagic fever with renal syndrome (HFRS) cases in Chuxiong Yi Autonomous Prefecture (Chuxiong Prefecture), Yunnan Province, China, 2014-2023, so as to provide scientific evidence for precise prevention and control. Methods The HFRS data, including both clinically diagnosed and laboratory-confirmed cases, were collected from the China Disease Prevention and Control Information System. Global and local spatial autocorrelation analyses were conducted using Geoda 1.22 software, spatiotemporal scan statistics was performed using SaTScan 10.12 software, and a seasonal autorgressive integrated moving average (SARIMA) model was established using R 4.3.2 software for incidence prediction. The reported incidence rates were calculated and the spatiotemporal distribution characteristics were analyzed at the township level. Results A total of 1 106 HFRS cases and 2 deaths were reported in Chuxiong Prefecture during 2014-2023, with an average annual reported incidence rate of 4.19/100 000. The reported incidence showed a significant increase (Z=2.683, τ=0.689, P=0.007) and marked seasonality, with the primary peak in April and secondary peak in June. Males (male-to-female ratio 2.31:1) and farmers (74.05%) accounted for the majority of cases, with the proportion of cases in the ≥60 age group showing a yearly increase (Z=3.041, τ=0.778, P<0.002). Spatial autocorrelation analysis revealed significant spatial clustering during 2014-2023, with hotspots shifting from the central area (2014-2016) to the northwestern area (post-2020) of Chuxiong Prefecture. Spatiotemporal scan statistics identified a pattern of narrowing spatial range and increasing clustering intensity. Three clusters involving 31 townships were identified during 2014-2018, while two clusters involving 13 townships were identified during 2019-2023, centered in the Dongchuan Township of Yao'an County (log-likelihood ratio=476.245, P<0.001, relative risk=19.51) and the Ziwu Township of Chuxiong City (log-likelihood ratio=19.739, P<0.001, relative risk=3.25), respectively. The SARIMA(1,0,0)(0,1,2)₁₂ model predicted that the HFRS epidemic would remain at a relatively high level in 2024. Conclusions The HFRS epidemic in Chuxiong Prefecture shows an increasing trend with significant spatiotemporal clustering. Comprehensive prevention and control measures should be implemented in key areas.

Key words: Hemorrhagic fever with renal syndrome, Spatial autocorrelation analysis, Spatiotemporal scan, Epidemiological characteristic, Chuxiong Yi Autonomous Prefecture, Yunnan Province