title: Microgeographic Heterogeneity of Border Malaria During Elimination Phase, Yunnan Province, China, 2011-2013.
abstract: To identify township-level high-risk foci of malaria transmission in Yunnan Province, China, along the international border, we retrospectively reviewed data collected in hospitals and clinics of 58 townships in 4 counties during 2011-2013. We analyzed spatiotemporal distribution, especially hot spots of confirmed malaria, using geographic information systems and Getis-Ord Gi*(d) cluster analysis. Malaria incidence, transmission seasonality, and Plasmodium vivax:P. falciparum ratio remained almost unchanged from 2011 to 2013, but heterogeneity in distribution increased. The number of townships with confirmed malaria decreased significantly during the 3 years; incidence became increasingly concentrated within a few townships. High-/low-incidence clusters of P. falciparum shifted in location and size every year, whereas the locations of high-incidence P. vivax townships remained unchanged. All high-incidence clusters were located along the China-Myanmar border. Because of increasing heterogeneity in malaria distribution, microgeographic analysis of malaria transmission hot spots provided useful information for designing targeted malaria intervention during the elimination phase.
authors.forename: Xin
authors.initials: X
authors.lastname: Xu
authors.forename: Guofa
authors.initials: G
authors.lastname: Zhou
authors.forename: Ying
authors.initials: Y
authors.lastname: Wang
authors.forename: Yue
authors.initials: Y
authors.lastname: Hu
authors.forename: Yonghua
authors.initials: Y
authors.lastname: Ruan
authors.forename: Qi
authors.initials: Q
authors.lastname: Fan
authors.forename: Zhaoqing
authors.initials: Z
authors.lastname: Yang
authors.forename: Guiyun
authors.initials: G
authors.lastname: Yan
authors.forename: Liwang
authors.initials: L
authors.lastname: Cui
mesh_terms: D002681:China / Q000453:epidemiology; D060740:Disease Eradication / Q000266:history*; D005260:Female; D049674:History, 21st Century; D006801:Humans; D008288:Malaria / Q000453:epidemiology* / Q000469:parasitology* / Q000517:prevention & control; D008297:Male; D010961:Plasmodium / Q000145:classification*; D012307:Risk Factors; D012621:Seasons; D013997:Time Factors
keywords: China; Myanmar; Plasmodium falciparum; Plasmodium vivax; fine-scale; international border; malaria; mosquitoes; parasites; spatial clustering; spatial heterogeneity; vector-borne infections