Epidemiological characteristics and spatiotemporal patterns of scrub typhus in Fujian province during 2012–2020

• Published in: PLoS neglected tropical diseases 2022-09, Vol.16 (9), p.e0010278-e0010278
• Main Authors: Qian, Li, Wang, Yong, Wei, Xianyu, Liu, Ping, Magalhaes, Ricardo J. Soares, Qian, Quan, Peng, Hong, Wen, Liang, Xu, Yuanyong, Sun, Hailong, Yin, Wenwu, Zhang, Wenyi
• Format: Article
• Language: English
• Subjects: Autocorrelation; Causes of; Computer and Information Sciences; Demographics; Demography; Disease control; Disease prevention; Distribution; Earth Sciences; Epidemiology; Health promotion; Heterogeneity; Infectious diseases; Laboratories; Medicine and Health Sciences; Orientia tsutsugamushi; People and Places; Provinces; Public health; Risk; Risk analysis; Risk factors; Scrub typhus; Seasons; Spatial analysis; Statistical methods; Statistics; Surveillance systems; Time series; Transmission; Trends; Tropical diseases; Typhus
• ISSN: 1935-2735; 1935-2727; 1935-2735
• DOI: 10.1371/journal.pntd.0010278

Background Scrub typhus has become a serious public health concern in the Asia-Pacific region including China. There were new natural foci continuously recognized and dramatically increased reported cases in mainland China. However, the epidemiological characteristics and spatiotemporal patterns of scrub typhus in Fujian province have yet to be investigated. Objective This study proposes to explore demographic characteristics and spatiotemporal dynamics of scrub typhus cases in Fujian province, and to detect high-risk regions between January 2012 and December 2020 at county/district scale and thereby help in devising public health strategies to improve scrub typhus prevention and control measures. Method Monthly cases of scrub typhus reported at the county level in Fujian province during 2012-2020 were collected from the National Notifiable Disease Surveillance System. Time-series analyses, spatial autocorrelation analyses and space-time scan statistics were applied to identify and visualize the spatiotemporal patterns of scrub typhus cases in Fujian province. The demographic differences of scrub typhus cases from high-risk and low-risk counties in Fujian province were also compared. Results A total of 11,859 scrub typhus cases reported in 87 counties from Fujian province were analyzed and the incidence showed an increasing trend from 2012 (2.31 per 100,000) to 2020 (3.20 per 100,000) with a peak in 2018 (4.59 per 100,000). There existed two seasonal peaks in June-July and September-October every year in Fujian province. A significant positive spatial autocorrelation of scrub typhus incidence in Fujian province was observed with Moran's I values ranging from 0.258 to 0.471 (P