Abstract：Objective To understand the spatial distribution of multidrug resistant/rifampicin resistant pulmonary tuberculosis（MDR/RR PTB）in Wenzhou from 2014 to 2017,and to provide the scientific basis for MDR/RR TB control and prevention.Methods The data of MDR/RR PTB cases in Wenzhou from 2014 to 2017 were collected from the Tuberculosis Management Information System of the Chinese Disease Prevention and Control Information System,and was associated with the geographic information database of Wenzhou Survey and Mapping Research Institute. The global spatial autocorrelation analysis was carried out by ArcGIS 10.1 to determine if there was spatial clustering of MDR/RR PTB cases in Wenzhou. The specific clustering areas of the MDR/RR PTB in Wenzhou was analyzed by SaTScan 9.3 and presented by ArcGIS.Results There were 452 MDR/RR PTB cases reported in Wenzhou from 2014 to 2017,with a total registration rate of 4.74/100 000. The incidence rate of MDR/RR PTB in Wenzhou was unevenly distributed;the areas with registration rates of more than 7.45/100 000 were the north-central parts of Yongjia,the south-central parts of Yueqing and the east-central parts of Wencheng. The results of global spatial autocorrelation analysis showed that there were obvious clustering for MDR/RR PTB in Wenzhou（Moran's I=0.321,Z=7.352,P<0.001）. The spatial scanning found two clusters：20 towns/streets in the southeastern part of Yongjia and the south of Yueqing were the primary clustering areas（RR=2.213,LLR=22.353,P<0.001）;Yangyi Street and Shuangyu Street in Lucheng were the secondary clustering areas（RR=2.488,LLR=9.889,P=0.004）.Conclusion The MDR/RR PTB cases reported from 2014 to 2017 in Wenzhou had spatial clustering. The high-incidence areas were in the southeast of Yongjia,south of Yueqing,Yangyi Street and Shuangyu Street of Lucheng.
单志力, 李君, 逄颖鑫, 毛玲琼, 朱小梅. 温州市耐多药/耐利福平肺结核空间聚集性分析[J]. 预防医学, 2019, 31(3): 242-245.
SHAN Zhi-li, LI Jun, PANG Ying-xin, MAO Ling-qiong, ZHU Xiao-mei. Analysis on the spatial clustering of multidrug resistant or rifampicin resistant pulmonary tuberculosis in Wenzhou. Preventive Medicine, 2019, 31(3): 242-245.
World Health Organization. Global tuberculosis report2018 [R/OL].[2018-11-30]. http://www.who.int/tb/publications/global_report/en/.
[2]
LI L,XI Y L,REN F,et al.Spatio-temporal distribution characteristics and trajectory similarity analysis of tuberculosis in Beijing,China[J]. Int J Environ Res Public Health,2016,13(3):291.
[3]
MACIEL E L,PAN W,DIETZE R,et al.Spatial patterns of pulmonary tuberculosis incidence and their relationship to socio-economic status in Vitoria,Brazil[J]. Int J Tuberc Lung Dis,2010,14(11):1395-1402.
[4]
AGARWAL S,NGUYEN D T,TEETER L D,et al.Spatial- temporal distribution of genotyped tuberculosis cases in a county with active transmission[J]. BMC Infect Dis,2017,17(1):378.
[5]
SERAPHIN M N,LAUZARDO M,DOGGERR R T,et al.Spatio-temporal clustering of Mycobacterium tuberculosis complex genotypes in Florida:genetic diversity segregated by country of birth[J]. PLoS One,2016,11(4):e0153575.
[6]
CURTIS A,CURTIS J W,SHOOK E,et al.Spatial video geonarratives and health:case studies in post-disaster recovery,crime,mosquito control and tuberculosis in the homeless[J]. Int J Health Geogr,2015,14:22.
[7]
LUIZ RDOS S,SUFFYS P,BARROSO E C,et al.Genotyping and drug resistance patterns of Mycobacterium tuberculosis strains observed in a tuberculosis high-burden municipality in Northeast,Brazil[J]. Braz J Infect Dis,2013 17(3):338-345.
[8]
KULLDORFF M.SaTScan User Guide for version 9.3[EB/OL].[2018-11-30]. http://www.satscan.org.
STELLING J,YIH W K,GALAS M,et al.Automated use of WHONET and SaTScan to detect outbreaks of Shigella spp. using antimicrobial resistance phenotypes[J]. Epidemiol Infect,2010, 138(6):873-883.
[11]
YANG C,LUO T,SHEN X,et al.Transmission of multidrug-resistant Mycobacterium tuberculosis in Shanghai,China:a retrospective observational study using whole-genome sequencing and epidemiological investigation[J]. Lancet Infect Dis,2017,17(3):275-284.
[12]
CASALI N,NIKOLAYEVSKYY B,BALABANOVA Y,et al.Evolution and transmission of drug-resistant tuberculosis in a Russian population[J]. Nat Genet,2014,46(3):279-286.
[13]
CASALI N,BRODA A,HARRIS S R,et al.Whole genome sequence analysis of a large isoniazid-resistant tuberculosis outbreak in London:a retrospective observational study[J]. PLoS Med,2016,13:e1002137-32.
[14]
WUBULI A,XUE F,JIANG D B,et al.Socio-demographic predictors and distribution of pulmonary tuberculosis(TB)in Xinjiang,China:a spatial analysis[J]. PLoS One,2015,10(12):e0144010.
[15]
LI X X,WANG L X,ZHANG H,et al.Spatial variations of pulmonary tuberculosis prevalenceco-impacted by socio-economic and geographic factors in People's Republic of China,2010[J]. BMC Public Health,2014,14:257.
