Spatial Patterns of Malaria Reported Deaths in Yunnan Province, China

Yan Bi School of Public Health and Social Work, Institution of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia; Yunnan Center for Disease Control and Prevention, Kunming, Yunnan, China; School of Population Health, University of Queensland, Brisbane, Australia; Yunnan Institute of Parasitic Diseases, Puer, Yunnan, China; National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, China

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Wenbiao Hu School of Public Health and Social Work, Institution of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia; Yunnan Center for Disease Control and Prevention, Kunming, Yunnan, China; School of Population Health, University of Queensland, Brisbane, Australia; Yunnan Institute of Parasitic Diseases, Puer, Yunnan, China; National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, China

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Henling Yang School of Public Health and Social Work, Institution of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia; Yunnan Center for Disease Control and Prevention, Kunming, Yunnan, China; School of Population Health, University of Queensland, Brisbane, Australia; Yunnan Institute of Parasitic Diseases, Puer, Yunnan, China; National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, China

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Xiao-Nong Zhou School of Public Health and Social Work, Institution of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia; Yunnan Center for Disease Control and Prevention, Kunming, Yunnan, China; School of Population Health, University of Queensland, Brisbane, Australia; Yunnan Institute of Parasitic Diseases, Puer, Yunnan, China; National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, China

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Weiwei Yu School of Public Health and Social Work, Institution of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia; Yunnan Center for Disease Control and Prevention, Kunming, Yunnan, China; School of Population Health, University of Queensland, Brisbane, Australia; Yunnan Institute of Parasitic Diseases, Puer, Yunnan, China; National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, China

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Yuming Guo School of Public Health and Social Work, Institution of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia; Yunnan Center for Disease Control and Prevention, Kunming, Yunnan, China; School of Population Health, University of Queensland, Brisbane, Australia; Yunnan Institute of Parasitic Diseases, Puer, Yunnan, China; National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, China

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Shilu Tong School of Public Health and Social Work, Institution of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia; Yunnan Center for Disease Control and Prevention, Kunming, Yunnan, China; School of Population Health, University of Queensland, Brisbane, Australia; Yunnan Institute of Parasitic Diseases, Puer, Yunnan, China; National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, China

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DOI:
https://doi.org/10.4269/ajtmh.2012.12-0217
Volume/Issue:
Volume 88: Issue 3
Page(s):
526–535
Restricted access
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Malaria has been a heavy social and health burden in the remote and poor areas in southern China. Analyses of malaria epidemic patterns can uncover important features of malaria transmission. This study identified spatial clusters, seasonal patterns, and geographic variations of malaria deaths at a county level in Yunnan, China, during 1991–2010. A discrete Poisson model was used to identify purely spatial clusters of malaria deaths. Logistic regression analysis was performed to detect changes in geographic patterns. The results show that malaria mortality had declined in Yunnan over the study period and the most likely spatial clusters (relative risk [RR] = 23.03–32.06, P < 0.001) of malaria deaths were identified in western Yunnan along the China–Myanmar border. The highest risk of malaria deaths occurred in autumn (RR = 58.91, P < 0.001) and summer (RR = 31.91, P < 0.001). The results suggested that the geographic distribution of malaria deaths was significantly changed with longitude, which indicated there was decreased mortality of malaria in eastern areas over the last two decades, although there was no significant change in latitude during the same period. Public health interventions should target populations in western Yunnan along border areas, especially focusing on floating populations crossing international borders.

Author Notes

* Address correspondence to Yan Bi or Shilu Tong, School of Public Health and Social Work, Institution of Health and Biomedical Innovation (IHBI), Queensland University of Technology, Victoria Park Road, 4059 Kelvin Grove, Brisbane, Australia. E-mails: y1.bi@qut.edu.au or s.tong@qut.edu.au

Financial support: S.T. is supported by a NHMRC Research Fellowship (no. 553043). Y.B. is supported by a Queensland University of Technology Postgraduate Research Award. X.N.Z. is partially supported by National Nature Science Foundation of China (no. 81273192).

Authors' addresses: Yan Bi, School of Public Health and Social Work, and IHBI, Queensland University of Technology (QUT), Brisbane, Australia, and Yunnan Center for Disease Control and Prevention, Kunming, China, E-mail: y1.bi@qut.edu.au. Wenbiao Hu, School of Population Health, University of Queensland, Brisbane, Australia, E-mail: w.hu@sph.uq.edu.au. Henglin Yang, Yunnan Institute of Parasitic Diseases, Puer, China, E-mail: yang_henglin@sohu.com. Xiao-Nong Zhou, National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, China, E-mail: ipdzhouxn@sh163.net. Weiwei Yu and Shilu Tong, School of Public Health and Social Work, and IHBI, QUT, Brisbane, Australia, E-mails: weiwei.yu@qut.edu.au and s.tong@qut.edu.au. Yuming Guo, School of Population Health, University of Queensland, Brisbane, Australia, E-mail: guoyuming@yahoo.cn.

Copyright:
© The American Society of Tropical Medicine and Hygiene 2013
Received:
03 Apr 2012
|
Accepted:
12 Nov 2012
|
Published Online:
06 Mar 2013
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
Online ISSN:
1476-1645
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