Analysis of spatial-temporal distribution of notifiable respiratory infectious diseases in Shandong Province, China during 2005-2014

Background Little 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. Methods Time 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. Results A 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. Conclusions There 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.

Automated summary

This study found that the morbidity of notifiable respiratory infectious diseases in Shandong Province during 2005-2014 exhibited clear seasonality, with higher morbidity in winter and spring. Spatial clustering analysis revealed different diseases had spatial clustering in the province, highlighting the need for more attention and new strategies for disease control.