Association of rBS-WC cholera vaccination with decreased infectious diarrhea incidence in Guangzhou city:spatial autocorrelation and BSTS model-based analysis on report data of 2015-2022
Objective To explore incidence characteristics of infectious diarrhea and the association of recombinant B-subunit/inactivated whole cell(rBS/WC)cholera vaccination with infectious diarrhea incidence in Guangzou city,Guangdong province.Methods The data on reported infectious diarrhea cases and on rBS/WC cholera vaccination in Guangzhou city were extracted from Infectious Disease Monitoring and Reporting System and Immunization Planning Information Management System of Guangzhou Municipal Center for Disease Control and Prevention;the collected data were assigned into two datasets of different year period before(2015-2019)and after(2020-2022)the large-scale promotion on rBS/WC cholera vaccination.Relevant demographic data were obtained from municipal statistical yearbooks and the Seventh National Population Census.Community-and population group-specific annual and year period incidence of infectious diarrhea were calculated.ArcGIS10.8 was used to explore the spatial aggregation of infectious diarrhea incidence Guangzhou,and the effect of rBS/WC cholera vaccination on the incidence of infectious diarrhea was evaluated by using synthetic control method combined with Bayesian time series model(BSTS)-based counterfactual prediction method with R4.2.1 software.Results During 2015-2022,the cumulative number of infectious diarrhea cases was 123 582 in the city.The average annual reported incidence(1/100 000)of infectious diarrhea decreased significantly from 91.84 during 2015-2019 to 77.48 during 2020-2022(x2=13 891.686,P＜0.05).In terms of subgroup populations,there was no significant gender difference in year period-specific incidence before and after rBS/WC cholera vaccination,but the incidence changed significantly after the vaccine promotion among 0-2 years old children(x2=1 263.733)and community-dwelling children(x2=1 266.090)(both P＜0.05).The results of spatial autocorrelation analysis showed that there were spatial clusters in annual and year period infectious diarrhea incidence,with Moran's I values of greater than 0(all |Z|＞1.96,P＜0.05);the spatial clustering patterns of the incidence were basically consistent with the spatial configuration of BS/WC cholera vaccination level.The BSTS model analysis revealed a deficit ratio of 37.18％(95％confidence interval:13.81％-60.07％)between the predicted and observed number of infectious diarrhea incidence for the period of 2020-2022 with large-scale promotion of rBS/WC cholera vaccination and the deficit differed by age and daily activities of subgroup populations,suggesting a possible protective effect of rBS/WC cholera vaccination against infectious diarrhea caused by other pathogens.Conclusion The decrease and the variation in spatial and population clustering of infectious diarrhea incidence may associate with large-scale promotion of rBS/WC cholera vaccination in Guangzhou city.
Guangzhou cityinfectious diarrheacholera vaccinespatial epidemiologytime series
NETL
NSTL
万方数据
