title: Analysis of the geographic distribution of HFRS in Liaoning Province between 2000 and 2005.
abstract: 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.
authors: National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China. linhualiang2002@163.com
authors: Hualiang
authors: H
authors: Lin
authors: Qiyong
authors: Q
authors: Liu
authors: Junqiao
authors: J
authors: Guo
authors: Jibo
authors: J
authors: Zhang
authors: Jinfeng
authors: J
authors: Wang
authors: Huaxin
authors: H
authors: Chen
mesh_terms: 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
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