Background: Malaria remains a public health concern in Hubei Province despite the significant decrease in malaria incidence over the past decades. Furthermore, history reveals that malaria transmission is unstable and prone to local outbreaks in Hubei Province. Thus, understanding spatial, temporal, and spatiotemporal distribution of malaria is needed for the effective control and elimination of this disease in Hubei Province. Methods: Annual malaria incidence at the county level was calculated using the malaria cases reported from 2004 to 2011 in Hubei Province. Geographical information system (GIS) and spatial scan statistic method were used to identify spatial clusters of malaria cases at the county level. Pure retrospective temporal analysis scanning was performed to detect the temporal clusters of malaria cases with high rates using the discrete Poisson model. The space-time cluster was detected with high rates through the retrospective space-time analysis scanning using the discrete Poisson model. Results: The overall malaria incidence decreased to a low level from 2004 to 2011. The purely spatial cluster of malaria cases from 2004 to 2011 showed that the disease was not randomly distributed in the study area. A total of 11 high-risk counties were determined through Local Moran's I analysis from 2004 to 2011. The method of spatial scan statistics identified different 11 significant spatial clusters between 2004 and 2011. The space-time clustering analysis determined that the most likely cluster included 13 counties, and the time frame was from April 2004 to November 2007. Conclusions: The GIS application and scan statistical technique can provide means to detect spatial, temporal, and spatiotemporal distribution of malaria, as well as to identify malaria high-risk areas. This study could be helpful in prioritizing resource assignment in high-risk areas for future malaria control and elimination.
[1]Huazhong Univ Sci & Technol, Tongji Med Coll, Sch Publ Hlth, Dept Epidemiol & Hlth Stat, Wuhan 430079, Peoples R China.
[2]Hubei Prov Ctr Dis Control & Prevent, Inst Parasit Dis Control, Wuhan 430079, Peoples R China.
[3]Chinese Acad Sci, Inst Geodesy & Geophys, Key Lab Monitoring & Estimate Environm & Disaster, Wuhan 430077, Peoples R China.
[4]Univ Chinese Acad Sci, Beijing 100049, Peoples R China.
[5]Fudan Univ, Sch Publ Hlth, Dept Epidemiol & Biostat, Shanghai 200433, Peoples R China.
[6]Fudan Univ, Sch Publ Hlth, Lab Spatial Anal & Modelling, Shanghai 200032, Peoples R China.
(8.0+极速模式)