Xianyan Tang and Qiuyun Deng contributed equally to this work.
Outbreaks of measles re-emerged in Guangxi province during 2013–2014, where measles again became a major public health concern. A better understanding of the patterns of measles cases would help in identifying high-risk areas and periods for optimizing preventive strategies, yet these patterns remain largely unknown. Thus, this study aimed to determine the patterns of measles clusters in space, time and space-time at the county level over the period 2004–2014 in Guangxi.
Annual data on measles cases and population sizes for each county were obtained from Guangxi CDC and Guangxi Bureau of Statistics, respectively. Epidemic curves and Kulldorff’s temporal scan statistics were used to identify seasonal peaks and high-risk periods. Tango’s flexible scan statistics were implemented to determine irregular spatial clusters. Spatio-temporal clusters in elliptical cylinder shapes were detected by Kulldorff’s scan statistics. Population attributable risk percent (PAR%) of children aged ≤24 months was used to identify regions with a heavy burden of measles.
Seasonal peaks occurred between April and June, and a temporal measles cluster was detected in 2014. Spatial clusters were identified in West, Southwest and North Central Guangxi. Three phases of spatio-temporal clusters with high relative risk were detected: Central Guangxi during 2004–2005, Midwest Guangxi in 2007, and West and Southwest Guangxi during 2013–2014. Regions with high PAR% were mainly clustered in West, Southwest, North and Central Guangxi.
A temporal uptrend of measles incidence existed in Guangxi between 2010 and 2014, while downtrend during 2004–2009. The hotspots shifted from Central to West and Southwest Guangxi, regions overburdened with measles. Thus, intensifying surveillance of timeliness and completeness of routine vaccination and implementing supplementary immunization activities for measles should prioritized in these regions.
Tang X, Geater A, McNeil E, Zhou H, Deng Q, Dong A, et al. Parental migration and children's timely measles vaccination in rural China: a cross-sectional study. Tropical Med Int Health. 2016;21(7):886–94. CrossRef
Kulldorff M. SaTScan user guide for version 9.4. Boston: Department of Ambulatory Care and Prevention, Harvard Medical School; 2015.
Carrel M, Emch M, Streatfield PK, Yunus M. Spatio-temporal clustering of cholera: the impact of flood control in Matlab, Bangladesh, 1983–2003. Health Place. 2009;15(3):771–82. CrossRef
Iftimi A, Martínez-Ruiz F, Santiyán AM, Montes F. Spatio-temporal cluster detection of chickenpox in Valencia, Spain in the period 2008-2012. Geospat Health. 2015;10(1):54–62. CrossRef
Jones SG, Conner W, Song B, Gordon D, Jayakaran A. Comparing spatio-temporal clusters of arthropod-borne infections using administrative medical claims and state reported surveillance data. Spat Spatio Temporal Epidemiol. 2012;3(3):205–13. CrossRef
Dept. of Immunization, Vaccines and Biologicals, World Health Organization. Manual for the laboratory diagnosis of measles and rubella virus infection. Geneva, 2007.
Mueller TG, Pusuluri NB, Mathias KK, Cornelius P, Barnhisel R, Shearer S. Map quality for ordinary kriging and inverse distance weighted interpolation. Soil Sci Soc Am J. 2004;68(6):2042–7. CrossRef
Takahashi K, Yokoyama T, Tango T. FleXScan User Guide for version 3.1, 2010. http://www.niph.go.jp/soshiki/gijutsu/index_e.html.
E Delaporte, E Jeannot, P Sudre, Wyler Lazarevic C, JL Richard and P Chastonay. Measles in Geneva between 2003 and 2010: persistence of measles outbreaks despite high immunisation coverage. Euro Surveill. 2011;16(39).
M Kulldorff. Spatial scan statistics: models, calculations, and applications. Scan statistics and applications. Springer, Birkhäuser Boston; 1999, p. 303–322.
Duczmal L, Kulldorff M, Huang L. Evaluation of spatial scan statistics for irregularly shaped clusters. J Comput Graph Stat. 2012;15(2):428–42. CrossRef
Read S, Bath P, Willett P, Maheswaran R. Measuring the spatial accuracy of the spatial scan statistic. Spat Spatio-Temporal Epidemiol. 2011;2(2):69–78. CrossRef
- Spatial, temporal and spatio-temporal clusters of measles incidence at the county level in Guangxi, China during 2004–2014: flexibly shaped scan statistics
- BioMed Central
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