Abstract:

Objective To analyze the epidemiological characteristics and spatiotemporal clustering of hemorrhagic fever with renal syndrome (HFRS) in Changsha from 2011 to 2022 for evidences for prevention and control of this entity. Methods The case data on HFRS in Changsha area reported from 2011 to 2022 were retrieved from the Chinese Disease Prevention and Control Information System. Descriptive epidemiology was used to analyze the temporal, regional and population distribution of HFRS cases. Software ArcGIS 10.8 and SaTScan 10.1 were used to respectively analyze the spatial autocorrelation and spatiotemporal clustering of HFRS. Results A total of 1 519 cases of HFRS, including 9 deaths, were reported in Changsha area from 2011 to 2022. The mortality was 0.01/100 000 population. There were two epidemic peaks in terms of temporal distribution, which occurred from April to June and from November to January of the following year. The ages of the cases were in population aged between 40 and 59 years (50.89%; 773/1 519). Farmers constituted the main occupational group (71.43%; 1 085/1 519). By gender distribution, males were in the majority (71.49%; 1 086/1 519). Ningxiang and Liuyang were the higher prevalence areas of HFRS in Changsha, accounting for 68.47% (1 040/1 519) of all cases, with an average annual reported incidence rate of 4.41/100 000 and 2.42/100 000, respectively. The hotspot areas for HFRS in Changsha between 2011 and 2022 were primarily distributed in the central and eastern towns of Ningxiang City, as well as the Liuyang area surrounding the east of Dashanchong Forest Park, while the coldspot areas were mainly centered around Furong District in the city center and its surrounding regions. The kernel density estimation (KDE) showed that the high-intensity clustering areas were located in the Chengjiao Subdistrict of Ningxiang City and its surrounding regions, while the medium-intensity clustering areas were distributed around Beisheng Town of Liuyang City and the junction area of four districts (Furong, Tianxin, Kaifu, and Yuhua) in the central main urban area. The spatiotemporal scan detected a Type Ⅰ clustering area occurring from August 1, 2014, to June 30, 2020, covering 22 townships with Xiangzikou Town of Ningxiang as the center and a radius of 55.60 km. Conclusion The incidence of HFRS in Changsha City still remains at a relatively high level, with obvious spatiotemporal distribution, yet the scope of the source of the epidemic is basically stable. The key prevention and control areas shall be Ningxiang and Liuyang, the traditional epidemic areas where HFRS occurs, and at the same time, the old city center should be taken into account.

Key words: Hemorrhagic fever with renal syndrome, Epidemic characteristics, Spatiotemporal clustering, Changsha City