Epidemiological characteristics and spatial-temporal cluster of visceral leishmaniosis in China,2017-2022
Objective To analyze the epidemiological characteristics and spatial-temporal trends of visceral leishmani-osis(VL)in China from 2017 to 2022 for scientific evidence to formulate targeted prevention and control strategies and measures.Methods Individual data of VL cases in China from 2017 to 2022 were collected from the China Informa-tion System for Disease Control and Prevention,and descriptively analyzed for the population characteristics and time trends.ArcGIS 10.7 software was used to map the case distribution,and Moran's I and local Moran's I were calculated to analyze the spatial autocorrelation and clustering type.SaTScan 10.1 software was used to scan the spatial-temporal characteristics and analyze the clustering.Results Between 2017 and 2022,a total of 1 251 VL cases were reported in 296 counties of 22 provinces in China.Among these cases,891(71.22%)were from canine-derived endemic areas,with increase trend year by year.Cases from anthropogenic and wildlife-derived endemic areas accounted for 47(3.76%)and 36(2.88%),respectively,which remained at a low level.The number of VL cases was highest in April(142 cases),and the case ratio of male-to-female was 2.18∶1.Farmers and herdsmen as well as preschool children dominated the cases(43.88%,549/1251;27.50%,344/1251,respectively).By the age group,0-4 years old were the most reported(325 cases,25.98%),followed by 50-64 years old(300 cases,23.98%).The cases were primarily distributed in Shanxi(449 cases),Gansu(257 cases),Shaanxi(188 cases),Xinjiang(88 cases),Sichuan(84 cases),Henan(70 cases)and Hebei(41 cases),which accounted for 94.08%(1 177/1 251)of the total cases.The canine-derived in Pingding County(112 cases),the an-thropogenic in Kashgar City(11 cases)and the wildlife-derived in Jiashi County(11 cases)were the highest cumulative number of cases.Spatial correlation analysis showed a spatial clustering(Moran's I>0,all Z>2.58,all P<0.01),and the number of counties in high-high clustering area increased from 38 in 2017 to 48 in 2022,displacing from west to east.High-high clustering occurred in Hebei,Henan and Beijing in 2022.Spatio-temporal scanning showed three-level aggre-gation areas from 2017 to 2022,and the highest incidence was found in the first-level aggregation area,covering 8 coun-ties and centering on the urban area of Yangquan City(RR=46.76,LLR=704.79,P<0.01).The aggregation occurred be-tween January 2020 to September 2022,during which 256 cases were reported.Conclusion The VL reported in Chi-na from 2017 to 2022 presented a rising trend.The key epidemic areas shifted from Xinjiang with wildlife-derived to Shanxi,Shaanxi,Henan and Hebei with canine-derived in the north-central of China.The findings suggest that it is nec-essary to intensify prevention and control efforts targeting key areas and populations to restrain the epidemic.
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