Epidemiological Characteristics and Spatiotemporal Patterns of Visceral Leishmaniasis in Xinjiang, China, during 2004–2021

Author:

Zhao Jiangshan1,Zhang Yue2,Zhang Haiting1,Wang Shuo1,He Haibo1,Shi Guangzhong1,Maimaitijiang Wumaier1,Hou Yanyan1,Zhang Ling1,Yin Jianhai345ORCID,Wang Yi345,Cao Jianping3456ORCID

Affiliation:

1. Center for Disease Control and Prevention of Xinjiang Uygur Autonomous Region, Urumqi 830002, China

2. Department of Public Health, Xinjiang Medical University, Urumqi 830000, China

3. National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute of Parasitic Diseases at Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Diseases Research, Shanghai 200025, China

4. Key Laboratory of Parasite and Vector Biology, National Health Commission of the People’s Republic of China, Shanghai 200025, China

5. World Health Organization Centre for Tropical Diseases, Shanghai 200025, China

6. The School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China

Abstract

The spread of visceral leishmaniasis (VL), a serious global zoonotic parasitic disease, is mostly under control; however, several cases have been reported in recent decades in Xinjiang, China. This study aimed to analyze the epidemiological status and spatiotemporal clustering characteristics of VL in Xinjiang, China, between 2004 and 2021 to provide a basis for the development and implementation of surveillance and response measures. Data on VL incidence during 2004–2021 were collected from the National Diseases Reporting Information System of China. Global spatial autocorrelation analysis, identification of local indicators of spatial association, and spatial–temporal clustering analysis were conducted to identify the distribution and high-risk areas. A total of 2034 VL cases were reported, with a mean annual incidence of 0.50 per 100,000. There was a general decreasing trend in the incidence of VL during our study period. The majority of the cases were reported from October to February of the following year, and fewer cases were reported from April to July. Spatial autocorrelation analysis revealed that the incidence of VL was spatially clustered within a few counties. Significant differences were observed during the study period (Moran’s I = 0.74, Z = 4.900, p < 0.05). The male-to-female ratio was 1.37:1, and most patients were in the age group 0–3 years. Cases were primarily distributed in seven regions and two autonomous prefectures, and Kashgar reported the highest number of cases (1688, 82.98%). Spatial analysis revealed that the aggregation of VL was predominantly observed in southwest Xinjiang. This was in alignment with the high-risk areas identified by spatiotemporal clustering analysis. The H-H clustering region was primarily observed in Gashi, Atushi, Shufu, Injisha, Kashgar, Yepuhu, and Bachu. These findings indicate that integrated control measures must be taken in different endemic areas to strengthen the VL control program in Xinjiang, China.

Funder

Key Laboratory of Parasite and Vector Biology, National Health Commission of the People’s Republic of China

Three-Year Public Health Action Plan of Shanghai

Publisher

MDPI AG

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