title: Spatial analysis of Schistosomiasis in Hubei Province, China: a GIS-based analysis of Schistosomiasis from 2009 to 2013.
abstract: BACKGROUND
  Schistosomiasis remains a major public health problem in China. The major endemic areas are located in the lake and marshland regions of southern China, particularly in areas along the middle and low reach of the Yangtze River. Spatial analytical techniques are often used in epidemiology to identify spatial clusters in disease regions. This study assesses the spatial distribution of schistosomiasis and explores high-risk regions in Hubei Province, China to provide guidance on schistosomiasis control in marshland regions.
  
  
  METHODS
  In this study, spatial autocorrelation methodologies, including global Moran's I and local Getis-Ord statistics, were utilized to describe and map spatial clusters and areas where human Schistosoma japonicum infection is prevalent at the county level in Hubei province. In addition, linear logistic regression model was used to determine the characteristics of spatial autocorrelation with time.
  
  
  RESULTS
  The infection rates of S. japonicum decreased from 2009 to 2013. The global autocorrelation analysis results on the infection rate of S. japonicum for five years showed statistical significance (Moran's I > 0, P < 0.01), which suggested that spatial clusters were present in the distribution of S. japonicum infection from 2009 to 2013. Local autocorrelation analysis results showed that the number of highly aggregated areas ranged from eight to eleven within the five-year analysis period. The highly aggregated areas were mainly distributed in eight counties.
  
  
  CONCLUSIONS
  The spatial distribution of human S. japonicum infections did not exhibit a temporal change at the county level in Hubei Province. The risk factors that influence human S. japonicum transmission may not have changed after achieving the national criterion of infection control. The findings indicated that spatial-temporal surveillance of S. japonicum transmission plays a significant role on schistosomiasis control. Timely and integrated prevention should be continued, especially in the Yangtze River Basin of Jianghan Plain area.
authors: Hubei Center for Disease Control and Prevention, Wuhan, China.
authors: Yan-Yan
authors: YY
authors: Chen
authors: Hubei Center for Disease Control and Prevention, Wuhan, China.
authors: Xi-Bao
authors: XB
authors: Huang
authors: Hubei Center for Disease Control and Prevention, Wuhan, China.
authors: Ying
authors: Y
authors: Xiao
authors: Hubei Center for Disease Control and Prevention, Wuhan, China.
authors: Yong
authors: Y
authors: Jiang
authors: Hubei Center for Disease Control and Prevention, Wuhan, China.
authors: Xiao-Wei
authors: XW
authors: Shan
authors: Hubei Center for Disease Control and Prevention, Wuhan, China.
authors: Juan
authors: J
authors: Zhang
authors: Hubei Center for Disease Control and Prevention, Wuhan, China.
authors: Shun-Xiang
authors: SX
authors: Cai
authors: Hubei Center for Disease Control and Prevention, Wuhan, China.
authors: Jian-Bing
authors: JB
authors: Liu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D002648:Child; D002681:China / Q000453:epidemiology; D040362:Geographic Information Systems; D006801:Humans; D060106:Lakes; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D045483:Rivers; D012549:Schistosoma japonicum / Q000472:pathogenicity*; D012552:Schistosomiasis / Q000453:epidemiology* / Q000469:parasitology*; D062206:Spatial Analysis; D013997:Time Factors; D055815:Young Adult