title: Spatial, temporal, and spatiotemporal analysis of malaria in Hubei Province, China from 2004-2011.
abstract: BACKGROUND
  Malaria remains a public health concern in Hubei Province despite the significant decrease in malaria incidence over the past decades. Furthermore, history reveals that malaria transmission is unstable and prone to local outbreaks in Hubei Province. Thus, understanding spatial, temporal, and spatiotemporal distribution of malaria is needed for the effective control and elimination of this disease in Hubei Province.
  
  
  METHODS
  Annual malaria incidence at the county level was calculated using the malaria cases reported from 2004 to 2011 in Hubei Province. Geographical information system (GIS) and spatial scan statistic method were used to identify spatial clusters of malaria cases at the county level. Pure retrospective temporal analysis scanning was performed to detect the temporal clusters of malaria cases with high rates using the discrete Poisson model. The space-time cluster was detected with high rates through the retrospective space-time analysis scanning using the discrete Poisson model.
  
  
  RESULTS
  The overall malaria incidence decreased to a low level from 2004 to 2011. The purely spatial cluster of malaria cases from 2004 to 2011 showed that the disease was not randomly distributed in the study area. A total of 11 high-risk counties were determined through Local Moran's I analysis from 2004 to 2011. The method of spatial scan statistics identified different 11 significant spatial clusters between 2004 and 2011. The space-time clustering analysis determined that the most likely cluster included 13 counties, and the time frame was from April 2004 to November 2007.
  
  
  CONCLUSIONS
  The GIS application and scan statistical technique can provide means to detect spatial, temporal, and spatiotemporal distribution of malaria, as well as to identify malaria high-risk areas. This study could be helpful in prioritizing resource assignment in high-risk areas for future malaria control and elimination.
authors: Department of Epidemiology and Health Statistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 430079, Wuhan, China. xiaj0608@163.com.|Institute of parasitic disease Control, Hubei Provincial Center for Disease Control and Prevention, 430079, Wuhan, China. xiaj0608@163.com.
authors: Jing
authors: J
authors: Xia
authors: Institute of parasitic disease Control, Hubei Provincial Center for Disease Control and Prevention, 430079, Wuhan, China. 441711219@qq.com.
authors: Shunxiang
authors: S
authors: Cai
authors: Institute of parasitic disease Control, Hubei Provincial Center for Disease Control and Prevention, 430079, Wuhan, China. 530777955@qq.com.
authors: Huaxun
authors: H
authors: Zhang
authors: Institute of parasitic disease Control, Hubei Provincial Center for Disease Control and Prevention, 430079, Wuhan, China. 5078294@qq.com.
authors: Wen
authors: W
authors: Lin
authors: Department of Epidemiology and Health Statistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 430079, Wuhan, China. fyz88033@126.com.
authors: Yunzhou
authors: Y
authors: Fan
authors: Key Laboratory of Monitoring and Estimate for Environment and Disaster of Hubei Province, Institute of Geodesy and Geophysics, Chinese Academy of Sciences, 430077, Wuhan, China. qiujuan2011@gmail.com.|University of Chinese Academy of Sciences, 100049, Beijing, China. qiujuan2011@gmail.com.
authors: Juan
authors: J
authors: Qiu
authors: Department of Epidemiology and Biostatistics, School of Public Health, Fudan University, Shanghai, P R China. 1039021808@qq.com.|Laboratory for Spatial Analysis and Modelling, School of Public Health, Fudan University, 200032, Shanghai, China. 1039021808@qq.com.
authors: Liqian
authors: L
authors: Sun
authors: Key Laboratory of Monitoring and Estimate for Environment and Disaster of Hubei Province, Institute of Geodesy and Geophysics, Chinese Academy of Sciences, 430077, Wuhan, China. changbianrong1220@163.com.|University of Chinese Academy of Sciences, 100049, Beijing, China. changbianrong1220@163.com.
authors: Bianrong
authors: B
authors: Chang
authors: Department of Epidemiology and Biostatistics, School of Public Health, Fudan University, Shanghai, P R China. epistat@gmail.com.|Laboratory for Spatial Analysis and Modelling, School of Public Health, Fudan University, 200032, Shanghai, China. epistat@gmail.com.
authors: Zhijie
authors: Z
authors: Zhang
authors: Department of Epidemiology and Health Statistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 430079, Wuhan, China. shaofanie@163.com.
authors: Shaofa
authors: S
authors: Nie
mesh_terms: D002681:China / Q000453:epidemiology; D062306:Geography, Medical; D006801:Humans; D015994:Incidence; D008288:Malaria / Q000453:epidemiology*; D012189:Retrospective Studies; D062211:Spatio-Temporal Analysis