Spatiotemporal Clustering of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) Incidence in Saudi Arabia, 2012–2019
Identifieur interne : 000D42 ( Pmc/Curation ); précédent : 000D41; suivant : 000D43Spatiotemporal Clustering of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) Incidence in Saudi Arabia, 2012–2019
Auteurs : Khalid Al-Ahmadi [Arabie saoudite] ; Sabah Alahmadi [Arabie saoudite] ; Ali Al-Zahrani [Arabie saoudite]Source :
- International Journal of Environmental Research and Public Health [ 1661-7827 ] ; 2019.
Abstract
Middle East respiratory syndrome coronavirus (MERS-CoV) is a great public health concern globally. Although 83% of the globally confirmed cases have emerged in Saudi Arabia, the spatiotemporal clustering of MERS-CoV incidence has not been investigated. This study analysed the spatiotemporal patterns and clusters of laboratory-confirmed MERS-CoV cases reported in Saudi Arabia between June 2012 and March 2019. Temporal, seasonal, spatial and spatiotemporal cluster analyses were performed using Kulldorff’s spatial scan statistics to determine the time period and geographical areas with the highest MERS-CoV infection risk. A strongly significant temporal cluster for MERS-CoV infection risk was identified between April 5 and May 24, 2014. Most MERS-CoV infections occurred during the spring season (41.88%), with April and May showing significant seasonal clusters. Wadi Addawasir showed a high-risk spatial cluster for MERS-CoV infection. The most likely high-risk MERS-CoV annual spatiotemporal clusters were identified for a group of cities (
Url:
DOI: 10.3390/ijerph16142520
PubMed: 31311073
PubMed Central: 6678379
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Spatiotemporal Clustering of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) Incidence in Saudi Arabia, 2012–2019</title><author><name sortKey="Al Ahmadi, Khalid" sort="Al Ahmadi, Khalid" uniqKey="Al Ahmadi K" first="Khalid" last="Al-Ahmadi">Khalid Al-Ahmadi</name><affiliation wicri:level="1"><nlm:aff id="af1-ijerph-16-02520">King Abdulaziz City for Science and Technology, P.O. Box 6086, Riyadh 11442, Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>King Abdulaziz City for Science and Technology, P.O. Box 6086, Riyadh 11442</wicri:regionArea></affiliation></author><author><name sortKey="Alahmadi, Sabah" sort="Alahmadi, Sabah" uniqKey="Alahmadi S" first="Sabah" last="Alahmadi">Sabah Alahmadi</name><affiliation wicri:level="1"><nlm:aff id="af1-ijerph-16-02520">King Abdulaziz City for Science and Technology, P.O. Box 6086, Riyadh 11442, Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>King Abdulaziz City for Science and Technology, P.O. Box 6086, Riyadh 11442</wicri:regionArea></affiliation></author><author><name sortKey="Al Zahrani, Ali" sort="Al Zahrani, Ali" uniqKey="Al Zahrani A" first="Ali" last="Al-Zahrani">Ali Al-Zahrani</name><affiliation wicri:level="1"><nlm:aff id="af2-ijerph-16-02520">King Faisal Specialist Hospital and Research Centre, P.O. Box 3354, Riyadh 11211, Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>King Faisal Specialist Hospital and Research Centre, P.O. Box 3354, Riyadh 11211</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">31311073</idno><idno type="pmc">6678379</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6678379</idno><idno type="RBID">PMC:6678379</idno><idno type="doi">10.3390/ijerph16142520</idno><date when="2019">2019</date><idno type="wicri:Area/Pmc/Corpus">000D42</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000D42</idno><idno type="wicri:Area/Pmc/Curation">000D42</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000D42</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Spatiotemporal Clustering of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) Incidence in Saudi Arabia, 2012–2019</title><author><name sortKey="Al Ahmadi, Khalid" sort="Al Ahmadi, Khalid" uniqKey="Al Ahmadi K" first="Khalid" last="Al-Ahmadi">Khalid Al-Ahmadi</name><affiliation wicri:level="1"><nlm:aff id="af1-ijerph-16-02520">King Abdulaziz City for Science and Technology, P.O. Box 6086, Riyadh 11442, Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>King Abdulaziz City for Science and Technology, P.O. Box 6086, Riyadh 11442</wicri:regionArea></affiliation></author><author><name sortKey="Alahmadi, Sabah" sort="Alahmadi, Sabah" uniqKey="Alahmadi S" first="Sabah" last="Alahmadi">Sabah Alahmadi</name><affiliation wicri:level="1"><nlm:aff id="af1-ijerph-16-02520">King Abdulaziz City for Science and Technology, P.O. Box 6086, Riyadh 11442, Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>King Abdulaziz City for Science and Technology, P.O. Box 6086, Riyadh 11442</wicri:regionArea></affiliation></author><author><name sortKey="Al Zahrani, Ali" sort="Al Zahrani, Ali" uniqKey="Al Zahrani A" first="Ali" last="Al-Zahrani">Ali Al-Zahrani</name><affiliation wicri:level="1"><nlm:aff id="af2-ijerph-16-02520">King Faisal Specialist Hospital and Research Centre, P.O. Box 3354, Riyadh 11211, Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>King Faisal Specialist Hospital and Research Centre, P.O. Box 3354, Riyadh 11211</wicri:regionArea></affiliation></author></analytic><series><title level="j">International Journal of Environmental Research and Public Health</title><idno type="ISSN">1661-7827</idno><idno type="eISSN">1660-4601</idno><imprint><date when="2019">2019</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Middle East respiratory syndrome coronavirus (MERS-CoV) is a great public health concern globally. Although 83% of the globally confirmed cases have emerged in Saudi Arabia, the spatiotemporal clustering of MERS-CoV incidence has not been investigated. This study analysed the spatiotemporal patterns and clusters of laboratory-confirmed MERS-CoV cases reported in Saudi Arabia between June 2012 and March 2019. Temporal, seasonal, spatial and spatiotemporal cluster analyses were performed using Kulldorff’s spatial scan statistics to determine the time period and geographical areas with the highest MERS-CoV infection risk. A strongly significant temporal cluster for MERS-CoV infection risk was identified between April 5 and May 24, 2014. Most MERS-CoV infections occurred during the spring season (41.88%), with April and May showing significant seasonal clusters. Wadi Addawasir showed a high-risk spatial cluster for MERS-CoV infection. The most likely high-risk MERS-CoV annual spatiotemporal clusters were identified for a group of cities (<italic>n</italic> = 10) in Riyadh province between 2014 and 2016. A monthly spatiotemporal cluster included Jeddah, Makkah and Taif cities, with the most likely high-risk MERS-CoV infection cluster occurring between April and May 2014. Significant spatiotemporal clusters of MERS-CoV incidence were identified in Saudi Arabia. The findings are relevant to control the spread of the disease. This study provides preliminary risk assessments for the further investigation of the environmental risk factors associated with MERS-CoV clusters.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Zaki, A M" uniqKey="Zaki A">A.M. Zaki</name></author><author><name sortKey="Van Boheemen, S" uniqKey="Van Boheemen S">S. van Boheemen</name></author><author><name sortKey="Bestebroer, T M" uniqKey="Bestebroer T">T.M. Bestebroer</name></author><author><name sortKey="Osterhaus, A D" uniqKey="Osterhaus A">A.D. Osterhaus</name></author><author><name sortKey="Fouchier, R A" uniqKey="Fouchier R">R.A. 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Int J Environ Res Public Health</journal-id><journal-id journal-id-type="iso-abbrev">Int J Environ Res Public Health</journal-id><journal-id journal-id-type="publisher-id">ijerph</journal-id><journal-title-group><journal-title>International Journal of Environmental Research and Public Health</journal-title></journal-title-group><issn pub-type="ppub">1661-7827</issn><issn pub-type="epub">1660-4601</issn><publisher><publisher-name>MDPI</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">31311073</article-id><article-id pub-id-type="pmc">6678379</article-id><article-id pub-id-type="doi">10.3390/ijerph16142520</article-id><article-id pub-id-type="publisher-id">ijerph-16-02520</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Spatiotemporal Clustering of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) Incidence in Saudi Arabia, 2012–2019</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Al-Ahmadi</surname><given-names>Khalid</given-names></name><xref ref-type="aff" rid="af1-ijerph-16-02520">1</xref></contrib><contrib contrib-type="author"><name><surname>Alahmadi</surname><given-names>Sabah</given-names></name><xref ref-type="aff" rid="af1-ijerph-16-02520">1</xref><xref rid="c1-ijerph-16-02520" ref-type="corresp">*</xref></contrib><contrib contrib-type="author"><name><surname>Al-Zahrani</surname><given-names>Ali</given-names></name><xref ref-type="aff" rid="af2-ijerph-16-02520">2</xref></contrib></contrib-group><aff id="af1-ijerph-16-02520"><label>1</label>King Abdulaziz City for Science and Technology, P.O. Box 6086, Riyadh 11442, Saudi Arabia</aff><aff id="af2-ijerph-16-02520"><label>2</label>King Faisal Specialist Hospital and Research Centre, P.O. Box 3354, Riyadh 11211, Saudi Arabia</aff><author-notes><corresp id="c1-ijerph-16-02520"><label>*</label>Correspondence: <email>salahmdi@kacst.edu.sa</email>; Tel.: +966114814542</corresp></author-notes><pub-date pub-type="epub"><day>15</day><month>7</month><year>2019</year></pub-date><pub-date pub-type="ppub"><month>7</month><year>2019</year></pub-date><volume>16</volume><issue>14</issue><elocation-id>2520</elocation-id><history><date date-type="received"><day>31</day><month>5</month><year>2019</year></date><date date-type="accepted"><day>29</day><month>6</month><year>2019</year></date></history><permissions><copyright-statement>© 2019 by the authors.</copyright-statement><copyright-year>2019</copyright-year><license license-type="open-access"><license-p>Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">http://creativecommons.org/licenses/by/4.0/</ext-link>).</license-p></license></permissions><abstract><p>Middle East respiratory syndrome coronavirus (MERS-CoV) is a great public health concern globally. Although 83% of the globally confirmed cases have emerged in Saudi Arabia, the spatiotemporal clustering of MERS-CoV incidence has not been investigated. This study analysed the spatiotemporal patterns and clusters of laboratory-confirmed MERS-CoV cases reported in Saudi Arabia between June 2012 and March 2019. Temporal, seasonal, spatial and spatiotemporal cluster analyses were performed using Kulldorff’s spatial scan statistics to determine the time period and geographical areas with the highest MERS-CoV infection risk. A strongly significant temporal cluster for MERS-CoV infection risk was identified between April 5 and May 24, 2014. Most MERS-CoV infections occurred during the spring season (41.88%), with April and May showing significant seasonal clusters. Wadi Addawasir showed a high-risk spatial cluster for MERS-CoV infection. The most likely high-risk MERS-CoV annual spatiotemporal clusters were identified for a group of cities (<italic>n</italic> = 10) in Riyadh province between 2014 and 2016. A monthly spatiotemporal cluster included Jeddah, Makkah and Taif cities, with the most likely high-risk MERS-CoV infection cluster occurring between April and May 2014. Significant spatiotemporal clusters of MERS-CoV incidence were identified in Saudi Arabia. The findings are relevant to control the spread of the disease. This study provides preliminary risk assessments for the further investigation of the environmental risk factors associated with MERS-CoV clusters.</p></abstract><kwd-group><kwd>Middle East respiratory syndrome</kwd><kwd>coronavirus</kwd><kwd>spatiotemporal cluster</kwd><kwd>GIS</kwd><kwd>epidemiology</kwd><kwd>outbreak</kwd><kwd>Saudi Arabia</kwd></kwd-group></article-meta></front><floats-group><fig id="ijerph-16-02520-f001" orientation="portrait" position="float"><label>Figure 1</label><caption><p>Epidemic curve of Middle East respiratory syndrome coronavirus (MERS-CoV) incidence in Saudi Arabia between 2012 and 2019.</p></caption><graphic xlink:href="ijerph-16-02520-g001"></graphic></fig><fig id="ijerph-16-02520-f002" orientation="portrait" position="float"><label>Figure 2</label><caption><p>Spatial distribution of the number of MERS-CoV cases in Saudi Arabia between 2012 and 2019. The presented data are for the governorate level, with the provincial boundaries overlaid.</p></caption><graphic xlink:href="ijerph-16-02520-g002"></graphic></fig><fig id="ijerph-16-02520-f003" orientation="portrait" position="float"><label>Figure 3</label><caption><p>Empirical Bayes smoothed incidence rate of MERS-CoV in Saudi Arabia between 2012 and 2019. The presented data are for the governorate level, with the provincial boundaries overlaid.</p></caption><graphic xlink:href="ijerph-16-02520-g003"></graphic></fig><fig id="ijerph-16-02520-f004" orientation="portrait" position="float"><label>Figure 4</label><caption><p>Locations of the spatial clusters of MERS-CoV incidence in Saudi Arabia between 2012 and 2019.</p></caption><graphic xlink:href="ijerph-16-02520-g004"></graphic></fig><fig id="ijerph-16-02520-f005" orientation="portrait" position="float"><label>Figure 5</label><caption><p>Locations of the annual spatiotemporal clusters of MERS-CoV incidence in Saudi Arabia between 2012 and 2019.</p></caption><graphic xlink:href="ijerph-16-02520-g005"></graphic></fig><fig id="ijerph-16-02520-f006" orientation="portrait" position="float"><label>Figure 6</label><caption><p>Locations of the monthly spatiotemporal clusters of MERS-CoV incidence in Saudi Arabia between 2012 and 2019.</p></caption><graphic xlink:href="ijerph-16-02520-g006"></graphic></fig><table-wrap id="ijerph-16-02520-t001" orientation="portrait" position="float"><object-id pub-id-type="pii">ijerph-16-02520-t001_Table 1</object-id><label>Table 1</label><caption><p>Temporal and seasonal clusters of MERS-CoV incidence in Saudi Arabia between 2012 and 2019. LLR: log likelihood ratio.</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1">Timeframe</th><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1">Observed Cases</th><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1">Expected Cases</th><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1">LLR</th><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1">Relative Risk</th><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1"><italic>p</italic>-Value</th></tr></thead><tbody><tr><td align="left" valign="middle" rowspan="1" colspan="1">2014 to 2016</td><td align="center" valign="middle" rowspan="1" colspan="1">1364</td><td align="center" valign="middle" rowspan="1" colspan="1">592</td><td align="center" valign="middle" rowspan="1" colspan="1">320</td><td align="center" valign="middle" rowspan="1" colspan="1">3.12</td><td align="center" valign="middle" rowspan="1" colspan="1">0.001</td></tr><tr><td align="left" valign="middle" rowspan="1" colspan="1">April 2014 to May 2014</td><td align="center" valign="middle" rowspan="1" colspan="1">466</td><td align="center" valign="middle" rowspan="1" colspan="1">49</td><td align="center" valign="middle" rowspan="1" colspan="1">677</td><td align="center" valign="middle" rowspan="1" colspan="1">11.98</td><td align="center" valign="middle" rowspan="1" colspan="1">0.001</td></tr><tr><td align="left" valign="middle" rowspan="1" colspan="1">April 5, 2014 to May 24, 2014</td><td align="center" valign="middle" rowspan="1" colspan="1">446</td><td align="center" valign="middle" rowspan="1" colspan="1">41</td><td align="center" valign="middle" rowspan="1" colspan="1">709</td><td align="center" valign="middle" rowspan="1" colspan="1">13.87</td><td align="center" valign="middle" rowspan="1" colspan="1">0.001</td></tr><tr><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">April to May</td><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">629</td><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">296</td><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">161</td><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">2.54</td><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">0.001</td></tr></tbody></table></table-wrap><table-wrap id="ijerph-16-02520-t002" orientation="portrait" position="float"><object-id pub-id-type="pii">ijerph-16-02520-t002_Table 2</object-id><label>Table 2</label><caption><p>Spatial clusters of MERS-CoV incidence in Saudi Arabia between 2012 and 2019.</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1">Cluster Type</th><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1">No. of Cities in the Cluster </th><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1">Observed Cases</th><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1">Expected Cases</th><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1">LLR</th><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1">Relative Risk</th><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1"><italic>p</italic>-Value </th></tr></thead><tbody><tr><td align="center" valign="middle" rowspan="1" colspan="1">Most likely </td><td align="center" valign="middle" rowspan="1" colspan="1">1</td><td align="center" valign="middle" rowspan="1" colspan="1">81</td><td align="center" valign="middle" rowspan="1" colspan="1">9</td><td align="center" valign="middle" rowspan="1" colspan="1">104</td><td align="center" valign="middle" rowspan="1" colspan="1">8.92</td><td align="center" valign="middle" rowspan="1" colspan="1"><0.001</td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1">Secondary </td><td align="center" valign="middle" rowspan="1" colspan="1">2</td><td align="center" valign="middle" rowspan="1" colspan="1">70</td><td align="center" valign="middle" rowspan="1" colspan="1">15</td><td align="center" valign="middle" rowspan="1" colspan="1">55</td><td align="center" valign="middle" rowspan="1" colspan="1">4.92</td><td align="center" valign="middle" rowspan="1" colspan="1"><0.001</td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1">Second secondary </td><td align="center" valign="middle" rowspan="1" colspan="1">1</td><td align="center" valign="middle" rowspan="1" colspan="1">128</td><td align="center" valign="middle" rowspan="1" colspan="1">67</td><td align="center" valign="middle" rowspan="1" colspan="1">23</td><td align="center" valign="middle" rowspan="1" colspan="1">1.97</td><td align="center" valign="middle" rowspan="1" colspan="1"><0.001</td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1">Third secondary </td><td align="center" valign="middle" rowspan="1" colspan="1">1</td><td align="center" valign="middle" rowspan="1" colspan="1">21</td><td align="center" valign="middle" rowspan="1" colspan="1">3</td><td align="center" valign="middle" rowspan="1" colspan="1">21</td><td align="center" valign="middle" rowspan="1" colspan="1">6.42</td><td align="center" valign="middle" rowspan="1" colspan="1"><0.001</td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1">Fourth secondary </td><td align="center" valign="middle" rowspan="1" colspan="1">1</td><td align="center" valign="middle" rowspan="1" colspan="1">68</td><td align="center" valign="middle" rowspan="1" colspan="1">30</td><td align="center" valign="middle" rowspan="1" colspan="1">18</td><td align="center" valign="middle" rowspan="1" colspan="1">2.30</td><td align="center" valign="middle" rowspan="1" colspan="1"><0.001</td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1">Fifth secondary</td><td align="center" valign="middle" rowspan="1" colspan="1">1</td><td align="center" valign="middle" rowspan="1" colspan="1">14</td><td align="center" valign="middle" rowspan="1" colspan="1">2</td><td align="center" valign="middle" rowspan="1" colspan="1">13</td><td align="center" valign="middle" rowspan="1" colspan="1">5.67</td><td align="center" valign="middle" rowspan="1" colspan="1"><0.001</td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1">Sixth secondary </td><td align="center" valign="middle" rowspan="1" colspan="1">1</td><td align="center" valign="middle" rowspan="1" colspan="1">11</td><td align="center" valign="middle" rowspan="1" colspan="1">2</td><td align="center" valign="middle" rowspan="1" colspan="1">11</td><td align="center" valign="middle" rowspan="1" colspan="1">6.52</td><td align="center" valign="middle" rowspan="1" colspan="1"><0.001</td></tr><tr><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Seventh secondary</td><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">2</td><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">85</td><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">50</td><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">10</td><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">1.73</td><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"><0.001</td></tr></tbody></table></table-wrap><table-wrap id="ijerph-16-02520-t003" orientation="portrait" position="float"><object-id pub-id-type="pii">ijerph-16-02520-t003_Table 3</object-id><label>Table 3</label><caption><p>Annual spatiotemporal clusters of MERS-CoV in Saudi Arabia between 2012 and 2019.</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1">Cluster Type</th><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1">Timeframe (year) </th><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1">No. of Cities in the Cluster </th><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1">Observed Cases</th><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1">Expected Cases</th><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1">LLR</th><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1">Relative Risk</th><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1"><italic>p</italic>-Value</th></tr></thead><tbody><tr><td align="center" valign="middle" rowspan="1" colspan="1">Most likely </td><td align="center" valign="middle" rowspan="1" colspan="1">2014 to 2016</td><td align="center" valign="middle" rowspan="1" colspan="1">10</td><td align="center" valign="middle" rowspan="1" colspan="1">491</td><td align="center" valign="middle" rowspan="1" colspan="1">163</td><td align="center" valign="middle" rowspan="1" colspan="1">245</td><td align="center" valign="middle" rowspan="1" colspan="1">3.67</td><td align="center" valign="middle" rowspan="1" colspan="1"><0.001</td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1">Secondary </td><td align="center" valign="middle" rowspan="1" colspan="1">2014 to 2015</td><td align="center" valign="middle" rowspan="1" colspan="1">3</td><td align="center" valign="middle" rowspan="1" colspan="1">315</td><td align="center" valign="middle" rowspan="1" colspan="1">84</td><td align="center" valign="middle" rowspan="1" colspan="1">201</td><td align="center" valign="middle" rowspan="1" colspan="1">4.28</td><td align="center" valign="middle" rowspan="1" colspan="1"><0.001</td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1">Second secondary </td><td align="center" valign="middle" rowspan="1" colspan="1">2018 to 2019</td><td align="center" valign="middle" rowspan="1" colspan="1">1</td><td align="center" valign="middle" rowspan="1" colspan="1">56</td><td align="center" valign="middle" rowspan="1" colspan="1">1</td><td align="center" valign="middle" rowspan="1" colspan="1">153</td><td align="center" valign="middle" rowspan="1" colspan="1">41.57</td><td align="center" valign="middle" rowspan="1" colspan="1"><0.001</td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1">Third secondary </td><td align="center" valign="middle" rowspan="1" colspan="1">2017 to 2018</td><td align="center" valign="middle" rowspan="1" colspan="1">1</td><td align="center" valign="middle" rowspan="1" colspan="1">21</td><td align="center" valign="middle" rowspan="1" colspan="1">0</td><td align="center" valign="middle" rowspan="1" colspan="1">59</td><td align="center" valign="middle" rowspan="1" colspan="1">43.70</td><td align="center" valign="middle" rowspan="1" colspan="1"><0.001</td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1">Fourth secondary </td><td align="center" valign="middle" rowspan="1" colspan="1">2015 to 2016</td><td align="center" valign="middle" rowspan="1" colspan="1">1</td><td align="center" valign="middle" rowspan="1" colspan="1">50</td><td align="center" valign="middle" rowspan="1" colspan="1">10</td><td align="center" valign="middle" rowspan="1" colspan="1">41</td><td align="center" valign="middle" rowspan="1" colspan="1">5.17</td><td align="center" valign="middle" rowspan="1" colspan="1"><0.001</td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1">Fifth secondary</td><td align="center" valign="middle" rowspan="1" colspan="1">2015 to 2016</td><td align="center" valign="middle" rowspan="1" colspan="1">1</td><td align="center" valign="middle" rowspan="1" colspan="1">33</td><td align="center" valign="middle" rowspan="1" colspan="1">7</td><td align="center" valign="middle" rowspan="1" colspan="1">25</td><td align="center" valign="middle" rowspan="1" colspan="1">4.79</td><td align="center" valign="middle" rowspan="1" colspan="1"><0.001</td></tr><tr><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Sixth secondary </td><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">2014 to 2015</td><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">1</td><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">9</td><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">0</td><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">23</td><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">36.28</td><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"><0.001</td></tr></tbody></table></table-wrap><table-wrap id="ijerph-16-02520-t004" orientation="portrait" position="float"><object-id pub-id-type="pii">ijerph-16-02520-t004_Table 4</object-id><label>Table 4</label><caption><p>Monthly spatiotemporal clusters of MERS-CoV in Saudi Arabia between 2012 and 2019.</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1">Cluster Type</th><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1">Timeframe (month/year) </th><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1">No. of Cities in the Cluster</th><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1">Observed Cases</th><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1">Expected Cases</th><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1">LLR</th><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1">Relative Risk</th><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1"><italic>p</italic>-Value</th></tr></thead><tbody><tr><td align="center" valign="middle" rowspan="1" colspan="1">Most likely </td><td align="center" valign="middle" rowspan="1" colspan="1">04/2014 to 05/2015</td><td align="center" valign="middle" rowspan="1" colspan="1">2</td><td align="center" valign="middle" rowspan="1" colspan="1">252</td><td align="center" valign="middle" rowspan="1" colspan="1">13</td><td align="center" valign="middle" rowspan="1" colspan="1">532</td><td align="center" valign="middle" rowspan="1" colspan="1">22.83</td><td align="center" valign="middle" rowspan="1" colspan="1"><0.001</td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1">Secondary </td><td align="center" valign="middle" rowspan="1" colspan="1">03/2014 to 10/2015</td><td align="center" valign="middle" rowspan="1" colspan="1">8</td><td align="center" valign="middle" rowspan="1" colspan="1">500</td><td align="center" valign="middle" rowspan="1" colspan="1">135</td><td align="center" valign="middle" rowspan="1" colspan="1">326</td><td align="center" valign="middle" rowspan="1" colspan="1">4.58</td><td align="center" valign="middle" rowspan="1" colspan="1"><0.001</td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1">Second secondary </td><td align="center" valign="middle" rowspan="1" colspan="1">02/2019 </td><td align="center" valign="middle" rowspan="1" colspan="1">1</td><td align="center" valign="middle" rowspan="1" colspan="1">47</td><td align="center" valign="middle" rowspan="1" colspan="1">0</td><td align="center" valign="middle" rowspan="1" colspan="1">240</td><td align="center" valign="middle" rowspan="1" colspan="1">452.96</td><td align="center" valign="middle" rowspan="1" colspan="1"><0.001</td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1">Third secondary </td><td align="center" valign="middle" rowspan="1" colspan="1">03/2016 </td><td align="center" valign="middle" rowspan="1" colspan="1">8</td><td align="center" valign="middle" rowspan="1" colspan="1">39</td><td align="center" valign="middle" rowspan="1" colspan="1">1</td><td align="center" valign="middle" rowspan="1" colspan="1">98</td><td align="center" valign="middle" rowspan="1" colspan="1">32.90</td><td align="center" valign="middle" rowspan="1" colspan="1"><0.001</td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1">Fourth secondary </td><td align="center" valign="middle" rowspan="1" colspan="1">08/2017 </td><td align="center" valign="middle" rowspan="1" colspan="1">1</td><td align="center" valign="middle" rowspan="1" colspan="1">19</td><td align="center" valign="middle" rowspan="1" colspan="1">0</td><td align="center" valign="middle" rowspan="1" colspan="1">98</td><td align="center" valign="middle" rowspan="1" colspan="1">465.20</td><td align="center" valign="middle" rowspan="1" colspan="1"><0.001</td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1">Fifth secondary</td><td align="center" valign="middle" rowspan="1" colspan="1">05/2015 to 06/2015</td><td align="center" valign="middle" rowspan="1" colspan="1">1</td><td align="center" valign="middle" rowspan="1" colspan="1">38</td><td align="center" valign="middle" rowspan="1" colspan="1">2</td><td align="center" valign="middle" rowspan="1" colspan="1">83</td><td align="center" valign="middle" rowspan="1" colspan="1">23.54</td><td align="center" valign="middle" rowspan="1" colspan="1"><0.001</td></tr><tr><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Sixth secondary </td><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">04/2014 to 06/2014</td><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">4</td><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">38</td><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">4</td><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">49</td><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">8.94</td><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"><0.001</td></tr></tbody></table></table-wrap></floats-group></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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