Analysis of the geographic distribution of HFRS in Liaoning Province between 2000 and 2005.
BACKGROUND
Hemorrhagic fever with renal syndrome (HFRS) is endemic in Liaoning Province, China, and this province was the most serious area affected by HFRS during 2004 to 2005. In this study, we conducted a spatial analysis of HFRS cases with the objective to determine the distribution of HFRS cases and to identify key areas for future public health planning and resource allocation in Liaoning Province.


METHODS
The annual average incidence at the county level was calculated using HFRS cases reported between 2000 and 2005 in Liaoning Province. GIS-based spatial analyses were conducted to detect spatial distribution and clustering of HFRS incidence at the county level, and the difference of relative humidity and forestation between the cluster areas and non-cluster areas was analyzed.


RESULTS
Spatial distribution of HFRS cases in Liaoning Province from 2000 to 2005 was mapped at the county level to show crude incidence, excess hazard, and spatial smoothed incidence. Spatial cluster analysis suggested 16 and 41 counties were at increased risk for HFRS (p < 0.01) with the maximum spatial cluster sizes at < or = 50% and < or = 30% of the total population, respectively, and the analysis showed relative humidity and forestation in the cluster areas were significantly higher than in other areas.


CONCLUSIONS
Some clustering of HFRS cases in Liaoning Province may be etiologically linked. There was strong evidence some HFRS cases in Liaoning Province formed clusters, but the mechanism underlying it remains unknown. In this study we found the clustering was consistent with the relative humidity and amount of forestation, and showed data indicating there may be some significant relationships.
Lin
Hualiang
H
National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China. linhualiang2002@163.com
Liu
Qiyong
Q
Guo
Junqiao
J
Zhang
Jibo
J
Wang
Jinfeng
J
Chen
Huaxin
H
D002681:China / Q000453:epidemiology; D016000:Cluster Analysis; D040362:Geographic Information Systems; D006480:Hemorrhagic Fever with Renal Syndrome / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D011159:Population Surveillance / Q000379:methods*; D011634:Public Health
Int J Epidemiol. 2002 Feb;31(1):189-93
11914320
Emerg Infect Dis. 2002 Sep;8(9):943-8
12194771
Am J Epidemiol. 1997 Jul 15;146(2):161-70
9230778
Soc Sci Med. 2003 Aug;57(3):551-60
12791496
BMC Public Health. 2004 Jun 18;4:23
15202947
Emerg Infect Dis. 2002 Apr;8(4):427-9
11971779
Int J Health Geogr. 2004 Oct 27;3(1):25
15509301
Int J Health Geogr. 2005 Jan 13;4(1):1
15649329
Int J Epidemiol. 1997 Oct;26(5):1121-9
9363536
BMC Infect Dis. 2006;6:77
16638156
Int J Health Geogr. 2005 Jun 14;4:16
15953394
Chin Med J (Engl). 1994 Feb;107(2):107-12
7910790
Stat Med. 1995 Apr 30;14(8):799-810
7644860
Int J Health Geogr. 2004 Jun 4;3(1):11
15176979
Am J Prev Med. 2006 Feb;30(2 Suppl):S88-100
16458795