The Spatial–Temporal Trend Analysis of Schistosomiasis from 1997 to 2010 in Anhui Province, Eastern China

Si Li Department of Epidemiology and Biostatistics, School of Public Health, Fudan University, Shanghai, China;
Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China;
Laboratory for Spatial Analysis and Modelling, School of Public Health, Fudan University, Shanghai, China;
Collaborative Innovation Center of Social Risks Governance in Health, School of Public Health, Fudan University, Shanghai, China;

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Yue Chen School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada;

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Congcong Xia Department of Epidemiology and Biostatistics, School of Public Health, Fudan University, Shanghai, China;
Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China;
Laboratory for Spatial Analysis and Modelling, School of Public Health, Fudan University, Shanghai, China;
Collaborative Innovation Center of Social Risks Governance in Health, School of Public Health, Fudan University, Shanghai, China;

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Henry Lynn Department of Epidemiology and Biostatistics, School of Public Health, Fudan University, Shanghai, China;
Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China;

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Fenghua Gao Anhui Institute of Parasitic Diseases, Hefei, Anhui Province, China

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Qizhi Wang Anhui Institute of Parasitic Diseases, Hefei, Anhui Province, China

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Shiqing Zhang Anhui Institute of Parasitic Diseases, Hefei, Anhui Province, China

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Yi Hu Department of Epidemiology and Biostatistics, School of Public Health, Fudan University, Shanghai, China;
Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China;
Laboratory for Spatial Analysis and Modelling, School of Public Health, Fudan University, Shanghai, China;
Collaborative Innovation Center of Social Risks Governance in Health, School of Public Health, Fudan University, Shanghai, China;

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Zhijie Zhang Department of Epidemiology and Biostatistics, School of Public Health, Fudan University, Shanghai, China;
Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China;
Laboratory for Spatial Analysis and Modelling, School of Public Health, Fudan University, Shanghai, China;
Collaborative Innovation Center of Social Risks Governance in Health, School of Public Health, Fudan University, Shanghai, China;

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Schistosomiasis is still prevalent in some parts of China. A shift in strategy from morbidity control to elimination has led to great strides in the past several decades. The objective of this study was to explore the spatial and temporal characteristics of schistosomiasis in Anhui, an eastern province of China. In this study, township-based parasitological data were collected from annual cross-sectional surveys during 1997–2010. The kernel k-means method was used to identify spatial clusters of schistosomiasis, and an empirical mode decomposition technique was used to analyze the temporal trend for Schistosoma japonicum in each clustered region. Overall, the prevalence of schistosomiasis remained at a low level except for the resurgence in 2005. According to the Caliński–Harabas index, all the townships were classified into three different clusters (median prevalence: 3.6 per 10,100, 1.8 per 10,000 and 1.7 per 10,000), respectively representing high-, median-, and low-risk clusters. There was an increasing tendency observed for the disease over time. The prevalence increased rapidly from 2003 to 2005, peaked in 2006, and then decreased afterward in the high-risk cluster. A moderate increase was observed in the median-risk cluster from 1998 to 2006, but there was an obvious decreasing tendency in the low-risk cluster after the year 2000. The spatial and temporal patterns of schistosomiasis were nonsynchronous across the three clusters. Disease interventions may be adjusted according to the risk levels of the clusters.

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Author Notes

Address correspondence to Yi Hu or Zhijie Zhang, Department of Epidemiology and Biostatistics, School of Public Health, Fudan University, Shanghai 200032, People’s Republic of China. E-mail: huyi@fudan.edu.cn and epistat@gmail.com

Financial support: This research was supported by the National Natural Science Foundation of China (81673239), the National Science Fund for Distinguished Young Scholars (no. 81325017), Chang Jiang Scholars Program (no. T2014089), and the Fourth Round of Three-Year Public Health Action Plan of Shanghai, China (15GWZK0202 and 15GWZK0101).

Authors’ addresses: Si Li, Congcong Xia, Yi Hu, and Zhijie Zhang, Department of Epidemiology and Biostatistics, School of Public Health, Fudan University, Shanghai, China, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China, Laboratory for Spatial Analysis and Modelling, School of Public Health, Fudan University, Shanghai, China, and Collaborative Innovation Center of Social Risks Governance in Health, School of Public Health, Fudan University, Shanghai, China, E-mails: claudializ@126.com, 14211020071@fudan.edu.cn, huyi@fudan.edu.cn, and epistat@gmail.com. Yue Chen, School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada, E-mail: ychen@uottawa.ca. Henry Lynn, Department of Epidemiology and Biostatistics, School of Public Health, Fudan University, Shanghai, China, and Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China, E-mail: hslynn@shmu.edu.cn. Fenghua Gao, Qizhi Wang, and Shiqing Zhang, Anhui Institute of Parasitic Diseases, Hefei, Anhui Province, China, E-mails: ahxbb@126.com, qzhung@163.com, and zhangsq2820@163.com.

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