{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T17:13:35Z","timestamp":1779297215060,"version":"3.51.4"},"update-to":[{"DOI":"10.1371\/journal.pntd.0009152","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2021,4,1]],"date-time":"2021-04-01T00:00:00Z","timestamp":1617235200000}}],"reference-count":32,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2021,3,22]],"date-time":"2021-03-22T00:00:00Z","timestamp":1616371200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Special Science and Technology Project for Major Infection Diseases of China","award":["2016ZX10004222-004"],"award-info":[{"award-number":["2016ZX10004222-004"]}]},{"name":"National Special Science and Technology Project for Major Infection Diseases of China","award":["2016ZX10004222-004"],"award-info":[{"award-number":["2016ZX10004222-004"]}]},{"name":"National Special Science and Technology Project for Major Infection Diseases of China","award":["2016ZX10004222-004"],"award-info":[{"award-number":["2016ZX10004222-004"]}]},{"name":"National Special Science and Technology Project for Major Infection Diseases of China","award":["2016ZX10004222-004"],"award-info":[{"award-number":["2016ZX10004222-004"]}]},{"name":"National Special Science and Technology Project for Major Infection Diseases of China","award":["2016ZX10004222-004"],"award-info":[{"award-number":["2016ZX10004222-004"]}]},{"name":"the scientific investigation on regional climate-sensitive diseases in China","award":["2017FY101203"],"award-info":[{"award-number":["2017FY101203"]}]},{"name":"the scientific investigation on regional climate-sensitive diseases in China","award":["2017FY101203"],"award-info":[{"award-number":["2017FY101203"]}]},{"name":"the scientific investigation on regional climate-sensitive diseases in China","award":["2017FY101203"],"award-info":[{"award-number":["2017FY101203"]}]},{"name":"the scientific investigation on regional climate-sensitive diseases in China","award":["2017FY101203"],"award-info":[{"award-number":["2017FY101203"]}]},{"name":"the Fifth Round of Three-Year Public Health Action Plan of Shanghai","award":["GWV-10.1-XK13"],"award-info":[{"award-number":["GWV-10.1-XK13"]}]},{"name":"the Fifth Round of Three-Year Public Health Action Plan of Shanghai","award":["GWV-10.1-XK13"],"award-info":[{"award-number":["GWV-10.1-XK13"]}]},{"name":"the Fifth Round of Three-Year Public Health Action Plan of Shanghai","award":["GWV-10.1-XK13"],"award-info":[{"award-number":["GWV-10.1-XK13"]}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:p>With several decades of concerted control efforts, visceral leishmaniasis(VL) eradication had almost been achieved in China. However, VL cases continue to be detected in parts of western China recent years. Using data of reported cases, this study aimed to investigate the epidemiology and spatio\u2043temporal distribution, of mountain-type zoonotic visceral leishmaniasis (MT-ZVL) in China between the years 2015 and 2019. Epidemiological data pertaining to patients with visceral leishmaniasis (VL) were collected in Gansu, Shaanxi, Sichuan, Shanxi, Henan and Hebei provinces between the years 2015 and 2019. Joinpoint regression analysis was performed to determine changes in the epidemic trend of MT-ZVL within the time period during which data was collected. Spatial autocorrelation of infection was examined using the Global Moran\u2019s <jats:italic>I<\/jats:italic> statistic wand hotspot analysis was carried out using the Getis-Ord <jats:italic>Gi*<\/jats:italic> statistic. Spatio-temporal clustering analysis was conducted using the retrospective space-time permutation flexible spatial scanning statistics. A total of 529 cases of MT-ZVL were detected in the six provinces from which data were collected during the study time period, predominantly in Gansu (55.0%), Shanxi (21.7%), Shaanxi (12.5%) and Sichuan (8.9%) provinces. A decline in VL incidence in China was observed during the study period, whereas an increase in MT-ZVL incidence was observed in the six provinces from which data was obtained (<jats:italic>t<\/jats:italic> = 4.87, <jats:italic>P<\/jats:italic> &lt; 0.05), with highest incidence in Shanxi province (<jats:italic>t<\/jats:italic> = 16.91, <jats:italic>P<\/jats:italic> &lt; 0.05). Significant differences in the Moran\u2019s <jats:italic>I<\/jats:italic> statistic were observed during study time period (<jats:italic>P<\/jats:italic> &lt; 0.05), indicating spatial autocorrelation in the spatial distribution of MT-ZVL. Hotspot and spatial autocorrelation analysis revealed clustering of infection cases in the Shaanxi-Shanxi border areas and in east of Shanxi province, where transmission increased rapidly over the study duration, as well as in well know high transmission areas in the south of Gansu province and the north of the Sichuan province. It indicates resurgence of MT-ZVL transmission over the latter three years of the study. Spatial clustering of infection was observed in localized areas, as well as sporadic outbreaks of infection.<\/jats:p>","DOI":"10.1371\/journal.pntd.0009152","type":"journal-article","created":{"date-parts":[[2021,3,22]],"date-time":"2021-03-22T17:33:53Z","timestamp":1616434433000},"page":"e0009152","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":15,"title":["Spatio-temporal clustering of Mountain-type Zoonotic Visceral Leishmaniasis in China between 2015 and 2019"],"prefix":"10.1371","volume":"15","author":[{"given":"Yuwan","family":"Hao","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaokang","family":"Hu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2540-6560","authenticated-orcid":true,"given":"Yanfeng","family":"Gong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingbo","family":"Xue","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9134-1318","authenticated-orcid":true,"given":"Zhengbin","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuanyuan","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiang","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3172-5218","authenticated-orcid":true,"given":"Shizhu","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2021,3,22]]},"reference":[{"issue":"12","key":"pntd.0009152.ref001","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1016\/j.pt.2006.09.004","article-title":"Leishmaniasis and poverty [J]","volume":"22","author":"J Alvar","year":"2006","journal-title":"Trends Parasitol"},{"issue":"1","key":"pntd.0009152.ref002","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/j.1365-2915.1990.tb00255.x","article-title":"Phlebotomine vectors of the leishmaniases: a review[J]","volume":"4","author":"R Killick-Kendrick","year":"1990","journal-title":"Med Vet Entomol"},{"key":"pntd.0009152.ref003","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1186\/s13071-016-1743-7","article-title":"A review of visceral leishmaniasis during the conflict in South Sudan and the consequences for East African countries [J]","volume":"9","author":"W Al-Salem","year":"2016","journal-title":"Parasit Vectors"},{"issue":"5","key":"pntd.0009152.ref004","doi-asserted-by":"crossref","first-page":"e35671","DOI":"10.1371\/journal.pone.0035671","article-title":"Leishmaniasis worldwide and global estimates of its incidence [J]","volume":"7","author":"J Alvar","year":"2012","journal-title":"PLoS One"},{"key":"pntd.0009152.ref005","first-page":"5","volume-title":"Control of the Leishmaniasis [R]","author":"World Health Organization","year":"2010"},{"issue":"1","key":"pntd.0009152.ref006","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1186\/s40249-020-0630-9","article-title":"Neglected tropical diseases: an effective global response to local poverty-related disease priorities[J]","volume":"9","author":"D. 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