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Epidemic characteristics, high-risk townships and space-time clusters of human brucellosis in Shanxi Province of China, 2005–2014

Epidemic characteristics, high-risk townships and space-time clusters of human brucellosis in Shanxi Province of China, 2005–2014
Epidemic characteristics, high-risk townships and space-time clusters of human brucellosis in Shanxi Province of China, 2005–2014
BACKGROUND: Brucellosis, one of the world's most important zoonosis, has been re-emerging in China. Shanxi Province, located in northern China, where husbandry development has been accelerated in recent years, has a rather high incidence of human brucellosis but drew little attention from the researchers. This study aimed to describe the changing epidemiology of human brucellosis in Shanxi Province from 2005 to 2014 and explore high-risk towns and space-time clusters for elucidating the necessity of decentralizing disease control resource to township level in epidemic regions, particularly in hotspot areas.

METHODS: We extracted data from the Chinese National Notifiable Infectious Disease Reporting System to describe the incidence and spatiotemporal distribution of human brucellosis in Shanxi Province. Geographic information system was used to identify townships at high risk for the disease. Space-Time Scan Statistic was applied to detect the space-time clusters of human brucellosis during the past decade.

RESULTS: From 2005 to 2014, a total of 50,002 cases of human brucellosis were recorded in Shanxi, with a male-to-female ratio of 3.9:1. The reported incidence rate increased dramatically from 7.0/100,000 in 2005 to 23.5/100,000 in 2014, with an average annual increase of 14.5%. There were still 33.8% cases delaying diagnosis in 2014. The proportion of the affected towns increased from 31.5% in 2005 to 82.5% in 2014. High-risk towns spread from the north to the center and then south of Shanxi Province, which were basins and adjacent highlands suitable for livestock cultivation. During the past decade, there were 55 space-time clusters of human brucellosis detected in high risk towns; the clusters could happen in any season. Some clusters' location maintained stable over time.

CONCLUSIONS: During the last decade, Shanxi province's human brucellosis epidemic had been aggravated and high-risk areas concentrated in some towns located in basins and adjacent highlands. Space-time clusters existed and some located steadily over time. Quite a few cases still missed timely diagnosis. Greater resources should be allocated and decentralized to mitigate the momentum of rise and improve the accessibility of prompt diagnosis treatment in the high-risk townships.
1471-2334
1-10
Chen, Qiulan
ba6f6420-7bdd-4650-b34d-b5e084baff96
Lai, Shengjie
b57a5fe8-cfb6-4fa7-b414-a98bb891b001
Yin, Wenwu
08baf5f0-df1b-4e67-b251-427ba3bce1b4
Zhou, Hang
e6311e21-1708-41e9-ac9b-bfdd834102b9
Li, Yu
23fe8f7d-b310-4a65-a9c0-1b76009de5d9
Mu, Di
e58d130e-3c45-4641-9b80-a8f0bf7e8c5e
Li, Zhongjie
f89a98f7-f6d3-4312-995a-bc658ae9a93f
Yu, Hongjie
f6a43c0c-0da8-4124-bd15-cd832d6fee7c
Yang, Weizhong
65d18fbc-d752-42a7-ac38-01534ceda15c
Chen, Qiulan
ba6f6420-7bdd-4650-b34d-b5e084baff96
Lai, Shengjie
b57a5fe8-cfb6-4fa7-b414-a98bb891b001
Yin, Wenwu
08baf5f0-df1b-4e67-b251-427ba3bce1b4
Zhou, Hang
e6311e21-1708-41e9-ac9b-bfdd834102b9
Li, Yu
23fe8f7d-b310-4a65-a9c0-1b76009de5d9
Mu, Di
e58d130e-3c45-4641-9b80-a8f0bf7e8c5e
Li, Zhongjie
f89a98f7-f6d3-4312-995a-bc658ae9a93f
Yu, Hongjie
f6a43c0c-0da8-4124-bd15-cd832d6fee7c
Yang, Weizhong
65d18fbc-d752-42a7-ac38-01534ceda15c

Chen, Qiulan, Lai, Shengjie, Yin, Wenwu, Zhou, Hang, Li, Yu, Mu, Di, Li, Zhongjie, Yu, Hongjie and Yang, Weizhong (2016) Epidemic characteristics, high-risk townships and space-time clusters of human brucellosis in Shanxi Province of China, 2005–2014. BMC Infectious Diseases, 16 (760), 1-10. (doi:10.1186/s12879-016-2086-x). (PMID:27993134)

Record type: Article

Abstract

BACKGROUND: Brucellosis, one of the world's most important zoonosis, has been re-emerging in China. Shanxi Province, located in northern China, where husbandry development has been accelerated in recent years, has a rather high incidence of human brucellosis but drew little attention from the researchers. This study aimed to describe the changing epidemiology of human brucellosis in Shanxi Province from 2005 to 2014 and explore high-risk towns and space-time clusters for elucidating the necessity of decentralizing disease control resource to township level in epidemic regions, particularly in hotspot areas.

METHODS: We extracted data from the Chinese National Notifiable Infectious Disease Reporting System to describe the incidence and spatiotemporal distribution of human brucellosis in Shanxi Province. Geographic information system was used to identify townships at high risk for the disease. Space-Time Scan Statistic was applied to detect the space-time clusters of human brucellosis during the past decade.

RESULTS: From 2005 to 2014, a total of 50,002 cases of human brucellosis were recorded in Shanxi, with a male-to-female ratio of 3.9:1. The reported incidence rate increased dramatically from 7.0/100,000 in 2005 to 23.5/100,000 in 2014, with an average annual increase of 14.5%. There were still 33.8% cases delaying diagnosis in 2014. The proportion of the affected towns increased from 31.5% in 2005 to 82.5% in 2014. High-risk towns spread from the north to the center and then south of Shanxi Province, which were basins and adjacent highlands suitable for livestock cultivation. During the past decade, there were 55 space-time clusters of human brucellosis detected in high risk towns; the clusters could happen in any season. Some clusters' location maintained stable over time.

CONCLUSIONS: During the last decade, Shanxi province's human brucellosis epidemic had been aggravated and high-risk areas concentrated in some towns located in basins and adjacent highlands. Space-time clusters existed and some located steadily over time. Quite a few cases still missed timely diagnosis. Greater resources should be allocated and decentralized to mitigate the momentum of rise and improve the accessibility of prompt diagnosis treatment in the high-risk townships.

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Accepted/In Press date: 2 December 2016
e-pub ahead of print date: 19 December 2016
Organisations: WorldPop, Population, Health & Wellbeing (PHeW)

Identifiers

Local EPrints ID: 405110
URI: https://eprints.soton.ac.uk/id/eprint/405110
ISSN: 1471-2334
PURE UUID: d39d45e6-2b3d-4e22-81d3-8a90e0dfa3f0
ORCID for Shengjie Lai: ORCID iD orcid.org/0000-0001-9781-8148

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Date deposited: 27 Jan 2017 10:03
Last modified: 10 Dec 2019 01:23

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Contributors

Author: Qiulan Chen
Author: Shengjie Lai ORCID iD
Author: Wenwu Yin
Author: Hang Zhou
Author: Yu Li
Author: Di Mu
Author: Zhongjie Li
Author: Hongjie Yu
Author: Weizhong Yang

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