Spatiotemporal distribution of schistosomiasis transmission risk in Jiangling County, Hubei Province, P.R. China.

Objective: This study aims to explore the spatiotemporal distribution of schistosomiasis in Jiangling County, and provide insights into the precise schistosomiasis control. Methods: The descriptive epidemiological method and Joinpoint regression model were used to analyze the changes in infection rates of humans, livestock, snails, average density of living snails and occurrence rate of frames with snails in Jiangling County from 2005 to 2021. Spatial epidemiology methods were used to detect the spatiotemporal clustering of schistosomiasis transmission risk in Jiangling county. Results: The infection rates in humans, livestock, snails, average density of living snails and occurrence rate of frames with snails in Jiangling County decreased from 2005 to 2021 with statistically significant. The average density of living snails in Jiangling County was spatially clustered in each year, and the Moran's I varied from 0.10 to 0.26. The hot spots were mainly concentrated in some villages of Xionghe Town, Baimasi Town and Shagang Town. The mean center of the distribution of average density of living snails in Jiangling County first moved from northwest to southeast, and then returned from southeast to northwest after 2014. SDE azimuth fluctuated in the range of 111.68°-124.42°. Kernal density analysis showed that the high and medium-high risk areas of Jiangling County from 2005 to 2021 were mainly concentrated in the central and eastern of Jiangling County, and the medium-low and low risk areas were mainly distributed in the periphery of Jiangling County. Conclusions: The epidemic situation of schistosomiasis decreased significantly in Jiangling County from 2005 to 2021, but the schistosomiasis transmission risk still had spatial clustering in some areas. After transmission interruption, targeted transmission risk intervention strategies can be adopted according to different types of schistosomiasis risk areas. Author summary: Schistosoma (S.) japonicum was once hyper-endemic in southern China. Jiangling County is one of the key endemic areas of schistosomiasis in Hubei Province, P.R. China. Although the prevalence of schistosomiasis in Jiangling County has decreased significantly, the geographical location of Jiangling County is suitable for snails breeding due to the crisscrossed ditches, so the risk of schistosomiasis transmission is still widespread. This study analyzed the schistosomiasis transmission risk in different regions in Jiangling County from 2005 to 2021, and targeted transmission risk intervention strategies can be adopted in different endemic areas after schistosomiasis transmission interruption. The areas with high risk of schistosomiasis transmission in Jiangling County were mainly distributed in the central part of Jiangling County near the west main ditch and the eastern part of Jiangling County. It is suggested strengthen schistosomiasis risk monitoring in Jiangling County, especially snails monitoring and snails elimination. In addition, health education intervention should be strengthened in key areas to prevent the spread of transmission risk to surrounding areas, in order to achieve the goal of eliminating schistosomiasis as soon as possible. [ABSTRACT FROM AUTHOR]