title: Patterns of Bacillary Dysentery in China, 2005-2010.
abstract: Although the incidence of bacillary dysentery in China has been declining progressively, a considerable disease burden still exists. Few studies have analyzed bacillary dysentery across China and knowledge gaps still exist in the aspects of geographic distribution and ecological drivers, seasonality and its association with meteorological factors, urban-rural disparity, prevalence and distribution of Shigella species. Here, we performed nationwide analyses to fill the above gaps. Geographically, we found that incidence increased along an east-west gradient which was inversely related to the economic conditions of China. Two large endemically high-risk regions in western China and their ecological drivers were identified for the first time. We characterized seasonality of bacillary dysentery incidence and assessed its association with meteorological factors, and saw that it exhibits north-south differences in peak duration, relative amplitude and key meteorological factors. Urban and rural incidences among China's cities were compared, and disparity associated with urbanization level was invariant in most cities. Balanced decrease of urban and rural incidence was observed for all provinces except Hunan. S. flexneri and S. sonnei were identified as major causative species. Increasing prevalence of S. sonnei and geographic distribution of Shigella species were associated with economic status. Findings and inferences from this study draw broader pictures of bacillary dysentery in mainland China and could provide useful information for better interventions and public health planning.
authors.affiliation: Ministry of Education Key Laboratory for Earth System Modeling, Center for Earth System Science, Institute for Global Change Studies, Tsinghua University, Beijing 100084, China. zhanghan11@mails.tsinghua.edu.cn.
authors.forename: Han
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Ministry of Education Key Laboratory for Earth System Modeling, Center for Earth System Science, Institute for Global Change Studies, Tsinghua University, Beijing 100084, China. yalisi@mail.tsinghua.edu.cn.|Joint Center for Global Change Studies, Beijing 100875, China. yalisi@mail.tsinghua.edu.cn.
authors.forename: Yali
authors.initials: Y
authors.lastname: Si
authors.affiliation: Center for Disease Surveillance and Information Services, Chinese Center for Disease Control and Prevention, Beijing 102206, China. wangxf2002abc@163.com.
authors.forename: Xiaofeng
authors.initials: X
authors.lastname: Wang
authors.affiliation: Ministry of Education Key Laboratory for Earth System Modeling, Center for Earth System Science, Institute for Global Change Studies, Tsinghua University, Beijing 100084, China. penggong@tsinghua.edu.cn.|Joint Center for Global Change Studies, Beijing 100875, China. penggong@tsinghua.edu.cn.
authors.forename: Peng
authors.initials: P
authors.lastname: Gong
mesh_terms: D002681:China / Q000453:epidemiology; D004405:Dysentery, Bacillary / Q000453:epidemiology* / Q000382:microbiology*; D006801:Humans; D015994:Incidence; D008685:Meteorological Concepts; D015995:Prevalence; D011634:Public Health; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data; D012621:Seasons; D012703:Serotyping; D012760:Shigella / Q000472:pathogenicity*; D012763:Shigella flexneri / Q000472:pathogenicity; D012764:Shigella sonnei / Q000472:pathogenicity; D012959:Socioeconomic Factors; D014505:Urban Population / Q000706:statistics & numerical data
keywords: Shigella species; bacillary dysentery; ecological drivers; geographic and temporal patterns; high-risk regions; meteorological factors; seasonality; urban and rural disparities
references.citation: Environ Health Perspect. 2001 Feb;109(2):155-9
references.pmid: 11266326
references.citation: PLoS One. 2014;9(8):e104329
references.pmid: 25093593
references.citation: BMC Public Health. 2014;14:998
references.pmid: 25257255
references.citation: Epidemiol Infect. 2002 Aug;129(1):9-17
references.pmid: 12211601
references.citation: Med J Aust. 2002 Dec 2-16;177(11-12):614-8
references.pmid: 12463979
references.citation: Epidemiology. 2004 Jan;15(1):86-92
references.pmid: 14712151
references.citation: Clin Infect Dis. 2004 May 15;38(10):1372-7
references.pmid: 15156473
references.citation: Epidemiol Infect. 2004 Jun;132(3):443-53
references.pmid: 15188714
references.citation: Control Clin Trials. 1986 Sep;7(3):177-88
references.pmid: 3802833
references.citation: J Infect Dis. 1989 Jun;159(6):1126-8
references.pmid: 2656880
references.citation: Biomed Environ Sci. 1997 Mar;10(1):1-13
references.pmid: 9099422
references.citation: Emerg Infect Dis. 1999 Sep-Oct;5(5):607-25
references.pmid: 10511517
references.citation: Bull World Health Organ. 1999;77(8):651-66
references.pmid: 10516787
references.citation: Appl Environ Microbiol. 2004 Dec;70(12):7474-80
references.pmid: 15574950
references.citation: Bull World Health Organ. 2005 Oct;83(10):739-46
references.pmid: 16283050
references.citation: Epidemiol Infect. 2006 Feb;134(1):111-8
references.pmid: 16409657
references.citation: J Med Microbiol. 2006 Jul;55(Pt 7):871-7
references.pmid: 16772414
references.citation: Bull World Health Organ. 2006 Jul;84(7):561-8
references.pmid: 16878230
references.citation: Int J Infect Dis. 2006 Nov;10(6):425-33
references.pmid: 16997593
references.citation: PLoS Med. 2006 Sep;3(9):e353
references.pmid: 16968124
references.citation: Am J Trop Med Hyg. 2007 Apr;76(4):706-12
references.pmid: 17426175
references.citation: Zhonghua Yu Fang Yi Xue Za Zhi. 2007 Jan;41(1):54-7
references.pmid: 17484213
references.citation: J Infect. 2007 Aug;55(2):194-200
references.pmid: 17258812
references.citation: Diagn Microbiol Infect Dis. 2007 Aug;58(4):469-75
references.pmid: 17509797
references.citation: Zhonghua Liu Xing Bing Xue Za Zhi. 2007 Apr;28(4):370-3
references.pmid: 17850709
references.citation: Public Health Rep. 2008 Jan-Feb;123(1):61-6
references.pmid: 18348481
references.citation: Epidemiology. 2008 Mar;19(2):282-90
references.pmid: 18300694
references.citation: Epidemiol Infect. 2008 May;136(5):577-603
references.pmid: 17686195
references.citation: Health Place. 2008 Dec;14(4):755-67
references.pmid: 18296100
references.citation: BMC Infect Dis. 2008;8:130
references.pmid: 18816415
references.citation: Lancet. 2008 Nov 15;372(9651):1717-9
references.pmid: 18930533
references.citation: BMC Infect Dis. 2009;9:204
references.pmid: 20003464
references.citation: Lancet. 2010 Mar 27;375(9720):1110-9
references.pmid: 20346817
references.citation: Emerg Infect Dis. 2011 Jan;17(1):7-15
references.pmid: 21192848
references.citation: J Antimicrob Chemother. 2011 Nov;66(11):2527-35
references.pmid: 21859815
references.citation: Lancet. 2012 Mar 3;379(9818):843-52
references.pmid: 22386037
references.citation: J Infect. 2012 Sep;65(3):214-22
references.pmid: 22546618
references.citation: Bull World Health Organ. 2012 Aug 1;90(8):578-87
references.pmid: 22893741
references.citation: PLoS One. 2012;7(12):e52515
references.pmid: 23285073
references.citation: PLoS One. 2013;8(4):e62029
references.pmid: 23658619
references.citation: Sci Rep. 2013;3:3239
references.pmid: 24257434
references.citation: PLoS One. 2014;9(1):e83487
references.pmid: 24416167
references.citation: PLoS One. 2014;9(7):e102020
references.pmid: 25036182
references.citation: Lancet. 2000 Feb 5;355(9202):442-50
references.pmid: 10841124