title: Spatial analysis of visceral leishmaniasis in the oases of the plains of Kashi Prefecture, Xinjiang Uygur Autonomous Region, China.
abstract: BACKGROUND
  Kashi Prefecture of Xinjiang is one of the most seriously affected areas with anthroponotic visceral leishmaniasis in China. A better understanding of space distribution features in this area was needed to guide strategies to eliminate visceral leishmaniasis from highly endemic areas. We performed a spatial analysis using the data collected in Bosh Klum Township in Xinjiang China.
  
  
  METHODS
  Based on the report of endemic diseases between 1990 and 2005, three villages with a high number of visceral leishmaniasis cases in Bosh Klum Township were selected. We conducted a household survey to collect the baseline data of kala-azar patients using standard case definitions. The geographical information was recorded with GIS equipment. A binomial distribution fitting test, runs test, and Scan statistical analysis were used to assess the space distribution of the study area.
  
  
  RESULTS
  The result of the binomial distribution fitting test showed that the distribution of visceral leishmaniasis cases in local families was inconsistent (χ(2) = 53.23, P < 0.01). The results of runs test showed that the distribution of leishmaniasis infected families along the channel was not random in the group of more than five infected families. The proportion of this kind of group in all infected families was 63.84 % (113 of 177). In the Scan statistical analysis, spatial aggregation was analyzed by poisson model, which found 3 spatial distribution areas 1) Zone A was located in a center point of 76.153447°E, 39.528477°N within its 1.11 mile radius, where the cumulative life-incidence of leishmaniasis was 1.95 times as high as that in surrounding areas (P < 0.05); 2) Zone B was located in a center point of 76.111968°E, 39.531895°N within its 0.54 mile radius, where the cumulative life-incidence of leishmaniasis was 1.82 times as high as that in surrounding areas (P < 0.01); and 3) Zone C was located in a center point of 76.195427°E, 39.563835°N within its 0.68 mile radius, where the cumulative life-incidence of leishmaniasis was 1.31 times as high as that in surrounding areas (P < 0.05).
  
  
  CONCLUSIONS
  The spatial distribution of visceral leishmaniasis-infected families was clustered. Thus, the proper use of this finding would be an improvement in highly endemic areas, which could help identify the types of endemic areas and population at high risk and carry out appropriate measures to prevent and control VL in this area as well.
authors.affiliation: National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, WHO Collaborating Center for Tropical Diseases; Key Laboratory of Parasite and Vector Biology, MOH, Shanghai, 200025, China.
authors.forename: Li-Ying
authors.initials: LY
authors.lastname: Wang
authors.affiliation: National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, WHO Collaborating Center for Tropical Diseases; Key Laboratory of Parasite and Vector Biology, MOH, Shanghai, 200025, China. wu_wpipd@163.com.
authors.forename: Wei-Ping
authors.initials: WP
authors.lastname: Wu
authors.affiliation: National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, WHO Collaborating Center for Tropical Diseases; Key Laboratory of Parasite and Vector Biology, MOH, Shanghai, 200025, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Fu
authors.affiliation: National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, WHO Collaborating Center for Tropical Diseases; Key Laboratory of Parasite and Vector Biology, MOH, Shanghai, 200025, China.
authors.forename: Ya-Yi
authors.initials: YY
authors.lastname: Guan
authors.affiliation: National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, WHO Collaborating Center for Tropical Diseases; Key Laboratory of Parasite and Vector Biology, MOH, Shanghai, 200025, China.
authors.forename: Shuai
authors.initials: S
authors.lastname: Han
authors.affiliation: National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, WHO Collaborating Center for Tropical Diseases; Key Laboratory of Parasite and Vector Biology, MOH, Shanghai, 200025, China.
authors.forename: Yan-Lin
authors.initials: YL
authors.lastname: Niu
authors.affiliation: Center for Disease Control and Prevention of Xinjiang Uygur Autonomous Region, Urumqi, 830002, China.
authors.forename: Su-Xiang
authors.initials: SX
authors.lastname: Tong
authors.affiliation: Center for Disease Control and Prevention of Xinjiang Uygur Autonomous Region, Urumqi, 830002, China.
authors.forename: Israyil
authors.initials: I
authors.lastname: Osman
authors.affiliation: Center for Disease Control and Prevention of Xinjiang Uygur Autonomous Region, Urumqi, 830002, China.
authors.forename: Song
authors.initials: S
authors.lastname: Zhang
authors.affiliation: Center for Disease Control and Prevention of Kashi Prefecture, Kashi, 844000, China.
authors.forename: Kaisar
authors.initials: K
authors.lastname: Kaisar
mesh_terms: D002681:China / Q000453:epidemiology; D003889:Desert Climate; D006801:Humans; D007898:Leishmaniasis, Visceral / Q000453:epidemiology*; D062206:Spatial Analysis
keywords: Familial aggregation; Spatial aggregation; Visceral leishmaniasis; Xinjiang, China