Abstract
In recent years, the incidence of human brucellosis (HB) in the Shanxi province has ranked to be the top five among the 31 China provinces. HB data in Shanxi province between 2011 and 2016 were collected from the Centers for Disease Control and Prevention. Spatial and temporal distribution of HB was evaluated using spatial autocorrelation analysis and space-time scan analysis. The global Moran’s I index ranged from 0.37 to 0.50 between 2011 and 2016 (all P < 0.05), and the “high-high” clusters of HB were located at the northern Shanxi, while the “low-low” clusters in the central and southeastern Shanxi. The high-incidence time interval was between March and July with a 2-fold higher risk of HB compared to the other months in the same year. One most likely cluster and three secondary clusters were identified. The radius of the most likely cluster region was 158.03 km containing 10,051 HB cases. Compared to the remaining regions, people dwelling in the most likely region were reported 4.50-fold ascended risk of incident HB. HB cases during the high-risk time interval of each year were more likely to be younger, to be males or to be farmers or herdsman than that during the low-risk time interval. The HB incidence had a significantly high correlation with the number of the cattle or sheep especially in the northern Shanxi. HB in Shanxi showed unique spatio-temporal clustering. Public health concern for HB in Shanxi should give priority to the northern region especially between the late spring and early summer.
Highlights
The worldwide geographical map of human brucellosis (HB) has sharply changed over several decades with the ameliorating sanitary conditions, the rapid developing of socioeconomic status, and the increased public health concern
The overall 3-dimensional trend for each year indicated an even distribution of HB in Shanxi every year (Fig. 1), HB incidences in the northern region were higher than the southern region
Our study investigated the spatial and temporal distribution of HB incidences in the Shanxi province, based on the population-based monitoring data between 2011 and 2016
Summary
The worldwide geographical map of HB has sharply changed over several decades with the ameliorating sanitary conditions, the rapid developing of socioeconomic status, and the increased public health concern. According to the worldwide epidemiology distribution of HB in 2013, low HB incidences were reported from the developed nations[5]. The highest incidence of HB was reported in Syria and Mongolia, with greater than 500 cases per million in the population, and only two to ten cases in China[2,5]. For the areas in northern China especially Inner Mongolia, Shanxi, Heilongjiang, Jilin and Xinjiang, the HB incidences are extremely high[13]. No recent spatial-temporal epidemic of HB has been systematically investigated in Shanxi. We combined spatial autocorrelation analysis and space-time scan analysis, and aimed to investigate the spatial and temporal clustering of HB in Shanxi province between 2011 and 2016, and to identify the HB high-risk regions and high-time[22]
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