Abstract
BackgroundDespite the declining burden of malaria in China, the disease remains a significant public health problem with periodic outbreaks and spatial variation across the country. A better understanding of the spatial and temporal characteristics of malaria is essential for consolidating the disease control and elimination programme. This study aims to understand the spatial and spatiotemporal distribution of Plasmodium vivax and Plasmodium falciparum malaria in China during 2005–2009.MethodsGlobal Moran’s I statistics was used to detect a spatial distribution of local P. falciparum and P. vivax malaria at the county level. Spatial and space–time scan statistics were applied to detect spatial and spatiotemporal clusters, respectively.ResultsBoth P. vivax and P. falciparum malaria showed spatial autocorrelation. The most likely spatial cluster of P. vivax was detected in northern Anhui province between 2005 and 2009, and western Yunnan province between 2010 and 2014. For P. falciparum, the clusters included several counties of western Yunnan province from 2005 to 2011, Guangxi from 2012 to 2013, and Anhui in 2014. The most likely space–time clusters of P. vivax malaria and P. falciparum malaria were detected in northern Anhui province and western Yunnan province, respectively, during 2005–2009.ConclusionThe spatial and space–time cluster analysis identified high-risk areas and periods for both P. vivax and P. falciparum malaria. Both malaria types showed significant spatial and spatiotemporal variations. Contrary to P. vivax, the high-risk areas for P. falciparum malaria shifted from the west to the east of China. Further studies are required to examine the spatial changes in risk of malaria transmission and identify the underlying causes of elevated risk in the high-risk areas.Electronic supplementary materialThe online version of this article (doi:10.1186/s12936-016-1646-2) contains supplementary material, which is available to authorized users.
Highlights
Despite the declining burden of malaria in China, the disease remains a significant public health problem with periodic outbreaks and spatial variation across the country
Overall trend of malaria A total of 247,540 malaria cases were reported in China during 2005–2014
An annual variation in number of malaria cases was observed with most cases in 2006 (N = 73, 283), comprising 56,258 P. vivax and 3113 P. falciparum malaria
Summary
Despite the declining burden of malaria in China, the disease remains a significant public health problem with periodic outbreaks and spatial variation across the country. A better understanding of the spatial and temporal characteristics of malaria is essential for consolidating the disease control and elimination programme. This study aims to understand the spatial and spatiotemporal distribution of Plasmodium vivax and Plasmodium falciparum malaria in China during 2005–2009. Owing to its substantial public health importance, a Malaria Control. The malaria burden has greatly declined [8, 9], but it has remained a serious public health problem in China with periodic outbreaks [10]. P. falciparum greatly increased dominating the overall confirmed malaria cases since 2007. Areas affected by P. falciparum have consistently increased from 17 provinces in 2006 to 20 in 2010, 22 in 2011 [14], and to 30 provinces in 2013 [14,15,16], involving formerly non-endemic provinces [17]
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