Spatiotemporal Clustering Analysis and Risk Assessments of Human Cutaneous Anthrax in China, 2005–2012
Identifieur interne : 000013 ( Pmc/Curation ); précédent : 000012; suivant : 000014Spatiotemporal Clustering Analysis and Risk Assessments of Human Cutaneous Anthrax in China, 2005–2012
Auteurs : Wen-Yi Zhang [République populaire de Chine] ; Li-Ya Wang [République populaire de Chine] ; Xiu-Shan Zhang [République populaire de Chine] ; Zhi-Hai Han [République populaire de Chine] ; Wen-Biao Hu [Australie] ; Quan Qian [République populaire de Chine] ; Ubydul Haque [États-Unis] ; Ricardo J. Soares Magalhaes [Australie] ; Shen-Long Li [République populaire de Chine] ; Shi-Lu Tong [Australie] ; Cheng-Yi Li [République populaire de Chine] ; Hai-Long Sun [République populaire de Chine] ; Yan-Song Sun [République populaire de Chine]Source :
- PLoS ONE [ 1932-6203 ] ; 2015.
Abstract
To investigate the epidemic characteristics of human cutaneous anthrax (CA) in China, detect the spatiotemporal clusters at the county level for preemptive public health interventions, and evaluate the differences in the epidemiological characteristics within and outside clusters.
CA cases reported during 2005–2012 from the national surveillance system were evaluated at the county level using space-time scan statistic. Comparative analysis of the epidemic characteristics within and outside identified clusters was performed using using the χ2 test or Kruskal-Wallis test.
The group of 30–39 years had the highest incidence of CA, and the fatality rate increased with age, with persons ≥70 years showing a fatality rate of 4.04%. Seasonality analysis showed that most of CA cases occurred between May/June and September/October of each year. The primary spatiotemporal cluster contained 19 counties from June 2006 to May 2010, and it was mainly located straddling the borders of Sichuan, Gansu, and Qinghai provinces. In these high-risk areas, CA cases were predominantly found among younger, local, males, shepherds, who were living on agriculture and stockbreeding and characterized with high morbidity, low mortality and a shorter period from illness onset to diagnosis.
CA was geographically and persistently clustered in the Southwestern China during 2005–2012, with notable differences in the epidemic characteristics within and outside spatiotemporal clusters; this demonstrates the necessity for CA interventions such as enhanced surveillance, health education, mandatory and standard decontamination or disinfection procedures to be geographically targeted to the areas identified in this study.
Url:
DOI: 10.1371/journal.pone.0133736
PubMed: 26208355
PubMed Central: 4514625
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<author><name sortKey="Soares Magalhaes, Ricardo J" sort="Soares Magalhaes, Ricardo J" uniqKey="Soares Magalhaes R" first="Ricardo J." last="Soares Magalhaes">Ricardo J. Soares Magalhaes</name>
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<author><name sortKey="Li, Shen Long" sort="Li, Shen Long" uniqKey="Li S" first="Shen-Long" last="Li">Shen-Long Li</name>
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<author><name sortKey="Tong, Shi Lu" sort="Tong, Shi Lu" uniqKey="Tong S" first="Shi-Lu" last="Tong">Shi-Lu Tong</name>
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</nlm:aff>
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<author><name sortKey="Li, Cheng Yi" sort="Li, Cheng Yi" uniqKey="Li C" first="Cheng-Yi" last="Li">Cheng-Yi Li</name>
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</nlm:aff>
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<author><name sortKey="Sun, Hai Long" sort="Sun, Hai Long" uniqKey="Sun H" first="Hai-Long" last="Sun">Hai-Long Sun</name>
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</nlm:aff>
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<wicri:regionArea>Institute of Disease Control and Prevention, Academy of Military Medical Science, Beijing</wicri:regionArea>
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<author><name sortKey="Sun, Yan Song" sort="Sun, Yan Song" uniqKey="Sun Y" first="Yan-Song" last="Sun">Yan-Song Sun</name>
<affiliation wicri:level="1"><nlm:aff id="aff008"><addr-line>Academy of Military Medical Science, Beijing, People’s Republic of China</addr-line>
</nlm:aff>
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<front><div type="abstract" xml:lang="en"><sec id="sec001"><title>Objective</title>
<p>To investigate the epidemic characteristics of human cutaneous anthrax (CA) in China, detect the spatiotemporal clusters at the county level for preemptive public health interventions, and evaluate the differences in the epidemiological characteristics within and outside clusters.</p>
</sec>
<sec id="sec002"><title>Methods</title>
<p>CA cases reported during 2005–2012 from the national surveillance system were evaluated at the county level using space-time scan statistic. Comparative analysis of the epidemic characteristics within and outside identified clusters was performed using using the χ<sup>2</sup>
test or Kruskal-Wallis test.</p>
</sec>
<sec id="sec003"><title>Results</title>
<p>The group of 30–39 years had the highest incidence of CA, and the fatality rate increased with age, with persons ≥70 years showing a fatality rate of 4.04%. Seasonality analysis showed that most of CA cases occurred between May/June and September/October of each year. The primary spatiotemporal cluster contained 19 counties from June 2006 to May 2010, and it was mainly located straddling the borders of Sichuan, Gansu, and Qinghai provinces. In these high-risk areas, CA cases were predominantly found among younger, local, males, shepherds, who were living on agriculture and stockbreeding and characterized with high morbidity, low mortality and a shorter period from illness onset to diagnosis.</p>
</sec>
<sec id="sec004"><title>Conclusion</title>
<p>CA was geographically and persistently clustered in the Southwestern China during 2005–2012, with notable differences in the epidemic characteristics within and outside spatiotemporal clusters; this demonstrates the necessity for CA interventions such as enhanced surveillance, health education, mandatory and standard decontamination or disinfection procedures to be geographically targeted to the areas identified in this study.</p>
</sec>
</div>
</front>
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<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">PLoS One</journal-id>
<journal-id journal-id-type="iso-abbrev">PLoS ONE</journal-id>
<journal-id journal-id-type="publisher-id">plos</journal-id>
<journal-id journal-id-type="pmc">plosone</journal-id>
<journal-title-group><journal-title>PLoS ONE</journal-title>
</journal-title-group>
<issn pub-type="epub">1932-6203</issn>
<publisher><publisher-name>Public Library of Science</publisher-name>
<publisher-loc>San Francisco, CA USA</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">26208355</article-id>
<article-id pub-id-type="pmc">4514625</article-id>
<article-id pub-id-type="doi">10.1371/journal.pone.0133736</article-id>
<article-id pub-id-type="publisher-id">PONE-D-14-56431</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Spatiotemporal Clustering Analysis and Risk Assessments of Human Cutaneous Anthrax in China, 2005–2012</article-title>
<alt-title alt-title-type="running-head">Spatiotemporal Analysis of Human Cutaneous Anthrax in China</alt-title>
</title-group>
<contrib-group><contrib contrib-type="author" equal-contrib="yes"><name><surname>Zhang</surname>
<given-names>Wen-Yi</given-names>
</name>
<xref ref-type="aff" rid="aff001"><sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author" equal-contrib="yes"><name><surname>Wang</surname>
<given-names>Li-Ya</given-names>
</name>
<xref ref-type="aff" rid="aff001"><sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author" equal-contrib="yes"><name><surname>Zhang</surname>
<given-names>Xiu-Shan</given-names>
</name>
<xref ref-type="aff" rid="aff001"><sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author" equal-contrib="yes"><name><surname>Han</surname>
<given-names>Zhi-Hai</given-names>
</name>
<xref ref-type="aff" rid="aff002"><sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author" equal-contrib="yes"><name><surname>Hu</surname>
<given-names>Wen-Biao</given-names>
</name>
<xref ref-type="aff" rid="aff003"><sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Qian</surname>
<given-names>Quan</given-names>
</name>
<xref ref-type="aff" rid="aff001"><sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Haque</surname>
<given-names>Ubydul</given-names>
</name>
<xref ref-type="aff" rid="aff004"><sup>4</sup>
</xref>
<xref ref-type="aff" rid="aff005"><sup>5</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Soares Magalhaes</surname>
<given-names>Ricardo J.</given-names>
</name>
<xref ref-type="aff" rid="aff006"><sup>6</sup>
</xref>
<xref ref-type="aff" rid="aff007"><sup>7</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Li</surname>
<given-names>Shen-Long</given-names>
</name>
<xref ref-type="aff" rid="aff001"><sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Tong</surname>
<given-names>Shi-Lu</given-names>
</name>
<xref ref-type="aff" rid="aff003"><sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Li</surname>
<given-names>Cheng-Yi</given-names>
</name>
<xref ref-type="aff" rid="aff001"><sup>1</sup>
</xref>
<xref rid="cor001" ref-type="corresp">*</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Sun</surname>
<given-names>Hai-Long</given-names>
</name>
<xref ref-type="aff" rid="aff001"><sup>1</sup>
</xref>
<xref rid="cor001" ref-type="corresp">*</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Sun</surname>
<given-names>Yan-Song</given-names>
</name>
<xref ref-type="aff" rid="aff008"><sup>8</sup>
</xref>
<xref rid="cor001" ref-type="corresp">*</xref>
</contrib>
</contrib-group>
<aff id="aff001"><label>1</label>
<addr-line>Institute of Disease Control and Prevention, Academy of Military Medical Science, Beijing, People’s Republic of China</addr-line>
</aff>
<aff id="aff002"><label>2</label>
<addr-line>Navy General Hospital of PLA, Beijing, People’s Republic of China</addr-line>
</aff>
<aff id="aff003"><label>3</label>
<addr-line>School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia</addr-line>
</aff>
<aff id="aff004"><label>4</label>
<addr-line>Emerging Pathogens Institute, University of Florida, Gainesville, Florida, United States of America</addr-line>
</aff>
<aff id="aff005"><label>5</label>
<addr-line>Department of Geography, University of Florida, Gainesville, Florida, United States of America</addr-line>
</aff>
<aff id="aff006"><label>6</label>
<addr-line>School of Veterinary Science, The University of Queensland, Brisbane, Australia</addr-line>
</aff>
<aff id="aff007"><label>7</label>
<addr-line>Children’s Health and Environment Program, Queensland Children’s Medical Research Institute, The University of Queensland, Brisbane, Australia</addr-line>
</aff>
<aff id="aff008"><label>8</label>
<addr-line>Academy of Military Medical Science, Beijing, People’s Republic of China</addr-line>
</aff>
<contrib-group><contrib contrib-type="editor"><name><surname>Yu</surname>
<given-names>Xue-jie</given-names>
</name>
<role>Editor</role>
<xref ref-type="aff" rid="edit1"></xref>
</contrib>
</contrib-group>
<aff id="edit1"><addr-line>University of Texas Medical Branch, UNITED STATES</addr-line>
</aff>
<author-notes><fn fn-type="conflict" id="coi001"><p><bold>Competing Interests: </bold>
The authors have declared that no competing interests exist.</p>
</fn>
<fn fn-type="con" id="contrib001"><p>Conceived and designed the experiments: WYZ XSZ WBH CYL HLS YSS. Performed the experiments: WYZ LYW SLL. Analyzed the data: WYZ LYW XSZ ZHH CYL HLS YSS. Contributed reagents/materials/analysis tools: CYL HLS YSS. Wrote the paper: WYZ LYW XSZ ZHH WBH QQ UH RJSM SLT CYL HLS YSS.</p>
</fn>
<corresp id="cor001">* E-mail: <email>licy_60@163.com</email>
(C-YL); <email>xxsunhl@163.com</email>
(H-LS); <email>sunys1964@hotmail.com</email>
(Y-SS)</corresp>
</author-notes>
<pub-date pub-type="epub"><day>24</day>
<month>7</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="collection"><year>2015</year>
</pub-date>
<volume>10</volume>
<issue>7</issue>
<elocation-id>e0133736</elocation-id>
<history><date date-type="received"><day>16</day>
<month>12</month>
<year>2014</year>
</date>
<date date-type="accepted"><day>1</day>
<month>7</month>
<year>2015</year>
</date>
</history>
<permissions><copyright-year>2015</copyright-year>
<copyright-holder>Zhang et al</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/"><license-p>This is an open access article distributed under the terms of the <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">Creative Commons Attribution License</ext-link>
, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited</license-p>
</license>
</permissions>
<self-uri content-type="pdf" xlink:type="simple" xlink:href="pone.0133736.pdf"></self-uri>
<abstract><sec id="sec001"><title>Objective</title>
<p>To investigate the epidemic characteristics of human cutaneous anthrax (CA) in China, detect the spatiotemporal clusters at the county level for preemptive public health interventions, and evaluate the differences in the epidemiological characteristics within and outside clusters.</p>
</sec>
<sec id="sec002"><title>Methods</title>
<p>CA cases reported during 2005–2012 from the national surveillance system were evaluated at the county level using space-time scan statistic. Comparative analysis of the epidemic characteristics within and outside identified clusters was performed using using the χ<sup>2</sup>
test or Kruskal-Wallis test.</p>
</sec>
<sec id="sec003"><title>Results</title>
<p>The group of 30–39 years had the highest incidence of CA, and the fatality rate increased with age, with persons ≥70 years showing a fatality rate of 4.04%. Seasonality analysis showed that most of CA cases occurred between May/June and September/October of each year. The primary spatiotemporal cluster contained 19 counties from June 2006 to May 2010, and it was mainly located straddling the borders of Sichuan, Gansu, and Qinghai provinces. In these high-risk areas, CA cases were predominantly found among younger, local, males, shepherds, who were living on agriculture and stockbreeding and characterized with high morbidity, low mortality and a shorter period from illness onset to diagnosis.</p>
</sec>
<sec id="sec004"><title>Conclusion</title>
<p>CA was geographically and persistently clustered in the Southwestern China during 2005–2012, with notable differences in the epidemic characteristics within and outside spatiotemporal clusters; this demonstrates the necessity for CA interventions such as enhanced surveillance, health education, mandatory and standard decontamination or disinfection procedures to be geographically targeted to the areas identified in this study.</p>
</sec>
</abstract>
<funding-group><funding-statement>This study was funded in part by the grants from National Basic Research Program of China (2012CB955500-955504) and National Natural Science Foundation of China (81102169). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.</funding-statement>
</funding-group>
<counts><fig-count count="3"></fig-count>
<table-count count="3"></table-count>
<page-count count="11"></page-count>
</counts>
<custom-meta-group><custom-meta id="data-availability"><meta-name>Data Availability</meta-name>
<meta-value>Patient data are protected by the China CDC and are unsuitable for public sharing. Interested parties can apply for the data by contacting the data-center of China public health science (<ext-link ext-link-type="uri" xlink:href="http://www.phsciencedata.cn/Share/en/data.jsp?id=5ce33621-a178-4676-b688-d355ed9317cd&show=0">http://www.phsciencedata.cn/Share/en/data.jsp?id=5ce33621-a178-4676-b688-d355ed9317cd&show=0</ext-link>
) or email <email>data@chinacic.cn</email>
.</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
<notes><title>Data Availability</title>
<p>Patient data are protected by the China CDC and are unsuitable for public sharing. Interested parties can apply for the data by contacting the data-center of China public health science (<ext-link ext-link-type="uri" xlink:href="http://www.phsciencedata.cn/Share/en/data.jsp?id=5ce33621-a178-4676-b688-d355ed9317cd&show=0">http://www.phsciencedata.cn/Share/en/data.jsp?id=5ce33621-a178-4676-b688-d355ed9317cd&show=0</ext-link>
) or email <email>data@chinacic.cn</email>
.</p>
</notes>
</front>
</pmc>
</record>
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