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Spatiotemporal Clustering Analysis and Risk Assessments of Human Cutaneous Anthrax in China, 2005-2012.

Zhang WY, Wang LY, Zhang XS, Han ZH, Hu WB, Qian Q, Haque U, Soares Magalhaes RJ, Li SL, Tong SL, Li CY, Sun HL, Sun YS - PLoS ONE (2015)

Bottom Line: The primary spatiotemporal cluster contained 19 counties from June 2006 to May 2010, and it was mainly located straddling the borders of Sichuan, Gansu, and Qinghai provinces.In these high-risk areas, CA cases were predominantly found among younger, local, males, shepherds, who were living on agriculture and stockbreeding and characterized with high morbidity, low mortality and a shorter period from illness onset to diagnosis.CA was geographically and persistently clustered in the Southwestern China during 2005-2012, with notable differences in the epidemic characteristics within and outside spatiotemporal clusters; this demonstrates the necessity for CA interventions such as enhanced surveillance, health education, mandatory and standard decontamination or disinfection procedures to be geographically targeted to the areas identified in this study.

View Article: PubMed Central - PubMed

Affiliation: Institute of Disease Control and Prevention, Academy of Military Medical Science, Beijing, People's Republic of China.

ABSTRACT

Objective: To investigate the epidemic characteristics of human cutaneous anthrax (CA) in China, detect the spatiotemporal clusters at the county level for preemptive public health interventions, and evaluate the differences in the epidemiological characteristics within and outside clusters.

Methods: CA cases reported during 2005-2012 from the national surveillance system were evaluated at the county level using space-time scan statistic. Comparative analysis of the epidemic characteristics within and outside identified clusters was performed using using the χ2 test or Kruskal-Wallis test.

Results: The group of 30-39 years had the highest incidence of CA, and the fatality rate increased with age, with persons ≥70 years showing a fatality rate of 4.04%. Seasonality analysis showed that most of CA cases occurred between May/June and September/October of each year. The primary spatiotemporal cluster contained 19 counties from June 2006 to May 2010, and it was mainly located straddling the borders of Sichuan, Gansu, and Qinghai provinces. In these high-risk areas, CA cases were predominantly found among younger, local, males, shepherds, who were living on agriculture and stockbreeding and characterized with high morbidity, low mortality and a shorter period from illness onset to diagnosis.

Conclusion: CA was geographically and persistently clustered in the Southwestern China during 2005-2012, with notable differences in the epidemic characteristics within and outside spatiotemporal clusters; this demonstrates the necessity for CA interventions such as enhanced surveillance, health education, mandatory and standard decontamination or disinfection procedures to be geographically targeted to the areas identified in this study.

No MeSH data available.


Related in: MedlinePlus

Annual incidence of human cutaneous anthrax in mainland China, 2005–2012.
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pone.0133736.g002: Annual incidence of human cutaneous anthrax in mainland China, 2005–2012.

Mentions: Fig 1 depicts the temporal variation in monthly CA cases and the seasonal pattern of CA cases. CA cases occurred throughout the year, and the number of CA cases showed an initial increase from April followed by a peak in July–August and a decrease thereafter. The seasonal difference in CA occurrence was statistically significant (χ2 = 323.19, p < 0.001), with the highest occurrence noted in summer. Fig 2 shows yearly distributions of CA in mainland China from 2005 to 2012. Although there were different distributions of CA each year, the counties with the highest incidence were persistently located in the border areas of Sichuan, Gansu and Qinghai provinces (Fig 2).


Spatiotemporal Clustering Analysis and Risk Assessments of Human Cutaneous Anthrax in China, 2005-2012.

Zhang WY, Wang LY, Zhang XS, Han ZH, Hu WB, Qian Q, Haque U, Soares Magalhaes RJ, Li SL, Tong SL, Li CY, Sun HL, Sun YS - PLoS ONE (2015)

Annual incidence of human cutaneous anthrax in mainland China, 2005–2012.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4514625&req=5

pone.0133736.g002: Annual incidence of human cutaneous anthrax in mainland China, 2005–2012.
Mentions: Fig 1 depicts the temporal variation in monthly CA cases and the seasonal pattern of CA cases. CA cases occurred throughout the year, and the number of CA cases showed an initial increase from April followed by a peak in July–August and a decrease thereafter. The seasonal difference in CA occurrence was statistically significant (χ2 = 323.19, p < 0.001), with the highest occurrence noted in summer. Fig 2 shows yearly distributions of CA in mainland China from 2005 to 2012. Although there were different distributions of CA each year, the counties with the highest incidence were persistently located in the border areas of Sichuan, Gansu and Qinghai provinces (Fig 2).

Bottom Line: The primary spatiotemporal cluster contained 19 counties from June 2006 to May 2010, and it was mainly located straddling the borders of Sichuan, Gansu, and Qinghai provinces.In these high-risk areas, CA cases were predominantly found among younger, local, males, shepherds, who were living on agriculture and stockbreeding and characterized with high morbidity, low mortality and a shorter period from illness onset to diagnosis.CA was geographically and persistently clustered in the Southwestern China during 2005-2012, with notable differences in the epidemic characteristics within and outside spatiotemporal clusters; this demonstrates the necessity for CA interventions such as enhanced surveillance, health education, mandatory and standard decontamination or disinfection procedures to be geographically targeted to the areas identified in this study.

View Article: PubMed Central - PubMed

Affiliation: Institute of Disease Control and Prevention, Academy of Military Medical Science, Beijing, People's Republic of China.

ABSTRACT

Objective: To investigate the epidemic characteristics of human cutaneous anthrax (CA) in China, detect the spatiotemporal clusters at the county level for preemptive public health interventions, and evaluate the differences in the epidemiological characteristics within and outside clusters.

Methods: CA cases reported during 2005-2012 from the national surveillance system were evaluated at the county level using space-time scan statistic. Comparative analysis of the epidemic characteristics within and outside identified clusters was performed using using the χ2 test or Kruskal-Wallis test.

Results: The group of 30-39 years had the highest incidence of CA, and the fatality rate increased with age, with persons ≥70 years showing a fatality rate of 4.04%. Seasonality analysis showed that most of CA cases occurred between May/June and September/October of each year. The primary spatiotemporal cluster contained 19 counties from June 2006 to May 2010, and it was mainly located straddling the borders of Sichuan, Gansu, and Qinghai provinces. In these high-risk areas, CA cases were predominantly found among younger, local, males, shepherds, who were living on agriculture and stockbreeding and characterized with high morbidity, low mortality and a shorter period from illness onset to diagnosis.

Conclusion: CA was geographically and persistently clustered in the Southwestern China during 2005-2012, with notable differences in the epidemic characteristics within and outside spatiotemporal clusters; this demonstrates the necessity for CA interventions such as enhanced surveillance, health education, mandatory and standard decontamination or disinfection procedures to be geographically targeted to the areas identified in this study.

No MeSH data available.


Related in: MedlinePlus