Abstract
It is valuable to study the spatiotemporal pattern of Japanese encephalitis (JE) and its association with the contextual risk factors in southwest China, which is the most endemic area in China. Using data from 2004 to 2009, we applied GISmapping and spatial autocorrelation analysis to analyze reported incidence data of JE in 438 counties in southwest China, finding that JE cases were not randomly distributed, and a Bayesian hierarchical spatiotemporal model identified the east part of southwest China as a high risk area. Meanwhile, the Bayesian hierarchical spatial model in 2006 demonstrated a statistically significant association between JE and the agricultural and climatic variables, including the proportion of rural population, the pig-to-human ratio, the monthly precipitation and the monthly mean minimum and maximum temperatures. Particular emphasis was placed on the time-lagged effect for climatic factors. The regression method and the Spearman correlation analysis both identified a two-month lag for the precipitation, while the regression method found a one-month lag for temperature. The results show that the high risk area in the east part of southwest China may be connected to the agricultural and climatic factors. The routine surveillance and the allocation of health resources should be given more attention in this area. Moreover, the meteorological variables might be considered as possible predictors of JE in southwest China.
Highlights
Japanese encephalitis (JE) is a mosquito-borne viral disease, which is widely distributed in SouthAsia, Southeast Asia, East Asia and the Pacific [1]
Our aim was to assess the association between JE cases and contextual risk factors in southwest China and to identify the high risk area
A total of 17,007 JE cases were reported in southwest China from 2004 to 2009
Summary
Japanese encephalitis (JE) is a mosquito-borne viral disease, which is widely distributed in South. It is estimated that about three billion people live in countries where the JE virus is endemic [2]. JE causes death, and induces permanent and psychiatric sequelae [3]. The number of JE cases has declined substantially after the long-term nationwide immunization program starting in the 1970s. JE still remains a significant public health issue in China, with approximately a half of the global cases annually [4], and JE virus is one of the four principal arboviruses of public health importance in
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