Epidemiological characteristics and spatial-temporal clustering of scarlet fever in Hangzhou from 2010 to 2023
Objective This study aims to explore the epidemiology and spatial-temporal clustering characteristics of scarlet fever in Hangzhou from 2010 to 2023,providing a scientific basis for the formulation of prevention and control strategies for scarlet fever as well as the rational allocation of health resources in Hangzhou.Methods The incidence data of scarlet fever in Hangzhou from 2010 to 2023 came from China Disease Prevention and Control Information System.Joinpoint 5.1.0 software was used to analyze the trend of scarlet fever incidence data,and ArcGIS 10.8 software was used to carry out spatial autocorrelation analysis.SaTScan 10.1.2 was used to perform spatio-temporal scan analysis.Results The average annual incidence of scarlet fever in Hangzhou from 2010 to 2023 was 5.06 per 100 000 population.Joinpoint regression analysis revealed a decreasing trend in the incidence of scarlet fever in Hangzhou from 2015 to 2023.The distribution of cases exhibited distinct seasonal patterns,peaking in late spring to early summer(April to June)and late autumn to early winter(November to January of the following year).The majority of cases were among children aged 3～＜9 years(85.79％),males(61.00％),and preschool children(47.09％).Gongshu District and Shangcheng District were identified as high-incidence areas,accounting for 35.73％(2 459/6 882)of all reported cases.The global autocorrelation analysis showed that the incidence of scarlet fever was spatially correlated in all years except 2011,2013 and 2014(P＜0.05).Local spatial autocorrelation analysis indicated the presence of hotspots("high-high"clusters)of scarlet fever incidence in Hangzhou from 2010 to 2023,relatively concentrated in the northeastern and central regions.Spatiotemporal scan analysis detected three clusters,of which the primary cluster encompassed 13 neighborhoods in Shangcheng and Gongshu Districts,spanning from March 2014 to June 2016.Conclusions From 2010 to 2023,the epidemic of scarlet fever in Hangzhou initially shows a fluctuating upward trend,followed by a fluctuating downward trend after 2015.There is a significant spatial-temporal clustering in the city,primarily concentrated in the northeastern and central regions of Hangzhou.Enhanced health education and disease surveillance efforts should be implemented in high-incidence areas and populations.
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