Recurrence and Driving Factors of Visceral Leishmaniasis in Central China

Yingze Zhao,Qian Wang,Xiaolan Xie,Tian Ma,Fangyu Ding,Shuai Chen,Mengmeng Hao,Dong Jiang,Canjun Zheng

doi:10.3390/ijerph18189535

Abstract

Visceral leishmaniasis (VL) is an important vector-borne zoonosis caused by Leishmania spp. that has been spreading in China. It has been posing a significant risk to public health in central China due to its recurrence in recent decades. Yet, the spatiotemporal patterns and the driving factors of VL in central China remain unclear at present. The purpose of this study was to analyse spatiotemporal distribution, explore driving factors, and provide novel insight into prevention and control countermeasures of the VL spreading in central China. Based on data of human VL cases from 2006 to 2019 obtained from the Chinese Centres for Disease Control and Prevention (CDC), we depicted the map showing the spatiotemporal distribution of VL in central China. We further explored the driving factors contributing to the spread of VL through the general additive model (GAM) by combining maps of environmental, meteorological, and socioeconomic correlates. Most VL cases were reported in Shaanxi and Shanxi provinces, the number of which has been increasing every year in the last 14 years, from 3 new cases in 2006 to 101 new cases in 2019. The results of GAM revealed that environmental (i.e., changes in grasslands/forests), meteorological (i.e., temperature and relative humidity), and socioeconomic (i.e., population density) factors are significantly associated with the prevalence of VL in central China. Our results provide a better understanding regarding the current situation and the driving factors of VL in central China, assisting in developing the disease prevention and control strategies implemented by public health authorities.

Highlights

Visceral leishmaniasis (VL) is an important parasitic zoonotic disease caused by Leishmania spp. and transmitted by infected female phlebotomine sand flies (i.e., Phlebotomus chinensis and P. longiductus), the hosts of which include animals such as canids, rodents, marsupials, hyraxes, and human beings [1,2,3,4]
The red triangle symbols represent counties where VL was historically endemic with reported local VL cases in the past years [20,43]
Other scattered VL cases occurred in the northern part of Shanxi and Henan and central Hebei

Summary

Introduction

Visceral leishmaniasis (VL) is an important parasitic zoonotic disease caused by Leishmania spp. and transmitted by infected female phlebotomine sand flies (i.e., Phlebotomus chinensis and P. longiductus), the hosts of which include animals such as canids, rodents, marsupials, hyraxes, and human beings [1,2,3,4]. The main clinical manifestations of this disease are usually chronic irregular fever, splenomegaly, anaemia, emaciation, leukopenia, and increased serum globulin, which can be fatal without treatment [2,5]. As one of the deadliest parasitic diseases in the world, VL causes nearly 500,000 new cases globally each year, of which approximately. For receiving inadequate public attention and having high mortality.

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