Abstract
Viral hepatitis, as one of the most serious notifiable infectious diseases in China, takes heavy tolls from the infected and causes a severe economic burden to society, yet few studies have systematically explored the spatio-temporal epidemiology of viral hepatitis in China. This study aims to explore, visualize and compare the epidemiologic trends and spatial changing patterns of different types of viral hepatitis (A, B, C, E and unspecified, based on the classification of CDC) at the provincial level in China. The growth rates of incidence are used and converted to box plots to visualize the epidemiologic trends, with the linear trend being tested by chi-square linear by linear association test. Two complementary spatial cluster methods are used to explore the overall agglomeration level and identify spatial clusters: spatial autocorrelation analysis (measured by global and local Moran’s I) and space-time scan analysis. Based on the spatial autocorrelation analysis, the hotspots of hepatitis A remain relatively stable and gradually shrunk, with Yunnan and Sichuan successively moving out the high-high (HH) cluster area. The HH clustering feature of hepatitis B in China gradually disappeared with time. However, the HH cluster area of hepatitis C has gradually moved towards the west, while for hepatitis E, the provincial units around the Yangtze River Delta region have been revealing HH cluster features since 2005. The space-time scan analysis also indicates the distinct spatial changing patterns of different types of viral hepatitis in China. It is easy to conclude that there is no one-size-fits-all plan for the prevention and control of viral hepatitis in all the provincial units. An effective response requires a package of coordinated actions, which should vary across localities regarding the spatial-temporal epidemic dynamics of each type of virus and the specific conditions of each provincial unit.
Highlights
Mankind has been fighting for hundreds of years against infectious diseases, which has resulted in a significant burden on communities across the global [1]
We would like to discuss the spatial-temporal epidemiology for different types of viral hepatitis first and focus on the future prevention and control strategy
China is still facing the severe threats of all types of viral hepatitis, with the reported cases of each kind of viral hepatitis distributed in all the provincial units
Summary
Mankind has been fighting for hundreds of years against infectious diseases, which has resulted in a significant burden on communities across the global [1]. The United Nations set the 2030 agenda for Sustainable Development in 2015, defining an ambitious goal for infectious disease control and prevention. With a particular interest in a few kinds of diseases (Health Target 3.3), the UN proposed to fight against infectious diseases with specific actions across the economic and social dimension [2]. Res. Public Health 2018, 15, 661; doi:10.3390/ijerph15040661 www.mdpi.com/journal/ijerph
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