Spatial - temporal clustering analysis of schistosomiasis transmission risk in Yunnan Province from 2004 to 2015 / 中国血吸虫病防治杂志

ABSTRACT

Objective To explore the spatial-temporal clustering distribution of schistosomiasis transmission risk in Yunnan Province from 2004 to 2015, so as to provide scientific evidence for the future schistosomiasis control and consolidation of the control achievements. Methods All data pertaining to endemic situation of human and bovine schistosomiasis and snail survey at a township level in Yunnan Province from 2004 to 2015 were collected. A descriptive epidemiological method and Joinpoint model were used to describe the changing trends of Schistosoma japonicum infections in humans, bovine and snails, and the hotspots and clusters of schistosomiasis transmission risk were identified using spatial autocorrelation analysis, hotspots analysis and retrospective space-time scan statistic in Yunnan Province from 2004 to 2015. Results The prevalence of S. japonicum infections appeared a continuous decline in humans, bovine and snails in Yunnan Province from 2004 to 2015, and the estimated number of schistosomiasis cases reduced from 43 056 in 2004 to 756 in 2015, with a decline rate of 98.24%. There were no acute cases since 2008 and no infected snails since 2014 in Yunnan Province. There were significant differences in the changing trends of human and bovine S. japonicum infections in Yunnan Province between 2012 and 2015 and between 2013 and 2015, respectively using the Joinpoint model (P < 0.05). In addition, there was a spatial autocorrelation in human S. japonicum infections in Yunnan Province from 2004 to 2013 (P < 0.01), and the hotspots areas for human S. japonicum infections were mainly distributed in some townships from Dali City, Weishan County and Eryuan County. Retrospective spatial-temporal scanning revealed that S. japonicum human, bovine and snail infections were clustered in 23, 15, 4 townships from Dali City, Weishan County, Eryuan County, Nanjian County and Heqing County, respectively, with relative risks of 6.25 to 28.75 (P < 0.01), which was almost consistent with the cluster areas detected by hotspots analysis. Conclusions The endemic situation of schistosomiasis significantly reduced in Yunnan Province from 2004 to 2015; however, there is still a risk of schistosomiasis transmission. The monitoring and control of schistosomiasis should be intensified in the future in Yunnan Province.