Objective: To explore the spatial-temporal distribution and epidemic characteristics of hemorrhagic fever with renal syndrome (HFRS) in Hebei province from 2005 to 2016. Methods: Records of HFRS cases reported from each county in Hebei during January 2005 to December 2016 were collected from National Notifiable Disease Surveillance System (NNDSS). Global and local spatial association statistics were used to measure the spatial autocorrelation and software GeoDa 1.2.0. Software SaTScan 9.4.1 was used to analyze spatiotemporal clusters. Software ArcGIS 10.2 was used to visualize the yearly scan results. Results: In Hebei province, a total of 8 437 human HFRS cases reported from 170 counties with an annual incidence rate of 0.99/100 000 population during 2005-2016. The peak incidence season was spring. Global spatial autocorrelation analysis on the incidence of HFRS at county-level showed that the value of Moran's I were all above 0 (P<0.05), indicating that the significant spatial cluster. The result of local indicators on spatial association (LISA) analysis revealed that identified hot spots were mainly in northeastern area, while cold spots were found in some counties of central and southern areas. Spatial-temporal scan detected that the primary cluster of HFRS incidence was mainly distributed in Qinhuangdao city and Tangshan city, including 11 counties (city/district): Beidaihe district, Haigang district, Funing district, Shanhaiguan district, Changli county, Lulong county and Qinglong Manchu autonomous county in Qinhuangdao city, and Qian'an city, Laoting county, Luanzhou city and Luannan county in Tangshan city (RR=39.64, P<0.001), during January-July in 2005. Conclusions: There were significant spatial-temporal cluster of HFRS in Hebei from 2005 to 2016. The cluster areas of HFRS were mainly in northeastern Hebei, it is necessary to strengthen the prevention and control programs of HFRS in these areas.
目的： 通过时空扫描聚集性分析方法，探讨2005－2016年河北省肾综合征出血热（HFRS）发病情况的时空聚集性分布特征。 方法： 收集中国疾病控制信息系统中河北省2005－2016年HFRS监测数据，应用GeoDa 1.2.0软件进行全局和局部空间自相关分析，SaTScan 9.4.1软件进行时空聚集性分析，使用ArcGIS 10.2软件绘制地图并进行可视化展示。 结果： 2005－2016年河北省累计报告HFRS病例8 437例，年均报告发病率为0.99/10万，发病季节性呈现明显的春季高峰。全局空间自相关分析显示，在县（市、区）级水平，河北省各年HFRS发病整体呈现空间自相关性（Moran’s I值均>0，P<0.05），提示HFRS发病存在聚集性。局部自相关分析显示，热点县（市、区）主要分布于河北省东北部地区，冷点区域主要集中在河北省中部和南部的部分地区。时空扫描分析探测到聚集时间为2005年1－7月，一级高发聚集区主要分布在秦皇岛市和唐山市，覆盖11个县（市、区），包括秦皇岛市北戴河区、海港区、抚宁区、山海关区、昌黎县、卢龙县、青龙满族自治县、唐山市迁安市、乐亭县、滦州市、滦南县（RR=39.64，P<0.001），聚集区位置相对固定。 结论： 2005－2016年河北省HFRS发病存在明显的时空分布特征，发病热点地区主要集中在东北部地区，是HFRS的重点防控地区。.
Keywords: Hemorrhagic fever with renal syndrome; Spatial autocorrelation; Spatial-temporal cluster.