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The disease\u2019s rapid spread and high mortality have led to heavy casualties, along with disruptions to production, rising healthcare burdens and impaired economic exchanges.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Based on cholera historical and environmental data, Mann-Kendall test, wavelet analysis, hotspot analysis, epidemics center of gravity, and structural equation modeling were employed to investigate the spatial and temporal distribution pattern and formation mechanism of cholera epidemics in Hubei Province during the period of 1949\u20132020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Based on existing historical monitoring records. Temporally, high incidence occurred in the 1980s and 1990s, with summer and autumn being the dominant seasons. Three fluctuation cycles were identified: 29 years, 19 years, and 8 years. Spatially, 71 counties and districts were cumulatively affected, with Wuhan and Xianning serving as the primary hotspots. Cholera epidemics were distributed along rivers and lakes, and their centers of gravity shifted southward and westward over time. Mechanistically, cholera epidemics were the result of the combined effects of natural, disaster, and human factors. Population density and summer temperatures were the direct factors driving the spread of cholera epidemics, while river networks formed the basic environmental background that facilitated transmission. Natural environmental factors such as drought and flood disasters, elevation, and precipitation, as well as human environmental factors including road networks and economic conditions, could not only directly drive the spread of epidemics but also regulate epidemics development through indirect pathways. The coupling effects of various factors across different spatiotemporal scales jointly shaped the unique spatiotemporal distribution and evolutionary characteristics of cholera epidemics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion\/Significance<\/jats:title>\n                    <jats:p>This study helped to reveal the spatiotemporal patterns and formation mechanisms of regional cholera epidemics, filled the gap in cholera research in Hubei Province, and provided a reference for cholera prevention and control in areas with dense rivers and lakes.<\/jats:p>\n                  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Carrel","year":"2009","journal-title":"Health & Place"},{"issue":"3","key":"pntd.0014125.ref018","article-title":"Spatial distribution and natural environment mechanism of the cholera epidemic in ancient Jiangnan area, China","volume":"16","author":"X Wang","year":"2021","journal-title":"PLoS One"},{"issue":"05","key":"pntd.0014125.ref019","first-page":"649","article-title":"Spatiotemporal patterns and driving factors of cholera epidemics in Sichuan Province during the Republic of China period","volume":"57","author":"Y Jinbo","year":"2023","journal-title":"Journal of Central China Normal University (Natural Sciences Edition)"},{"issue":"1","key":"pntd.0014125.ref020","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0003440","article-title":"Epidemiology of cholera in the Philippines","volume":"9","author":"AL Lopez","year":"2015","journal-title":"PLoS Negl Trop 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Xie","year":"1987"},{"issue":"2","key":"pntd.0014125.ref025","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1016\/S1286-4579(01)01533-7","article-title":"Cholera and climate: revisiting the quantitative evidence","volume":"4","author":"M Pascual","year":"2002","journal-title":"Microbes Infect"},{"issue":"6","key":"pntd.0014125.ref026","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1002\/rra.3278","article-title":"Effects of air temperature and discharge on Upper Mississippi River summer water temperatures","volume":"34","author":"BR Gray","year":"2018","journal-title":"River Research & Apps"},{"issue":"7","key":"pntd.0014125.ref027","first-page":"1661","article-title":"Spatio-temporal patterns and influencing mechanisms of cholera epidemics in Hubei province from 1850 to 1949","volume":"79","author":"T Zhang","year":"2024","journal-title":"Acta Geographica Sinica"},{"key":"pntd.0014125.ref028","unstructured":"Peng SZ. Monthly precipitation dataset of China at 1km resolution (1901-2022). National Tibetan Plateau Data Center, 2020. https:\/\/www.tpdc.ac.cn\/zh-hans\/data\/faae7605-a0f2-4d18-b28f-5cee413766a2"},{"key":"pntd.0014125.ref029","unstructured":"Peng SZ. Monthly Mean Temperature Dataset of China (1901-2022) at 1km Resolution. National Tibetan Plateau Data Center, 2020. https:\/\/www.tpdc.ac.cn\/zh-hans\/data\/71ab4677-b66c-4fd1-a004-b2a541c4d5bf\/"},{"key":"pntd.0014125.ref030","unstructured":"Feng F. Wang Kaicun. High-resolution (10km) surface solar radiation dataset of regional fused sunshine hours in China (1983-2017). National Tibetan Plateau Data Center, 2020. https:\/\/www.tpdc.ac.cn\/zh-hans\/data\/a82849b0-9af5-457d-8968-4471dd845f2e"},{"key":"pntd.0014125.ref031","volume-title":"China Meteorological Hazards Dictionary, Hubei Volume","author":"Editorial Committee of China Meteorological Disaster Dictionary","year":"2007"},{"key":"pntd.0014125.ref032","first-page":"1","volume-title":"Hubei Provincial Population Survey Statistics (Internal Materials)","author":"Hubei Provincial Population Survey and Registration Office","year":"1954"},{"key":"pntd.0014125.ref033","first-page":"13","volume-title":"Hubei Province, Second National Population Census Compilation of Population Age (Internal)","author":"Hubei Provincial Population Census Office","year":"1964"},{"key":"pntd.0014125.ref034","first-page":"3","volume-title":"Hubei Province third population census data (internal data)","author":"Hubei Provincial Population Census Office","year":"1984"},{"key":"pntd.0014125.ref035","first-page":"2","volume-title":"Hubei Province 1990 Population Census Data (Computerized Summary","author":"Hubei Provincial Population Census Office","year":"1992"},{"key":"pntd.0014125.ref036","first-page":"12","volume-title":"Hubei fifth population census machine summary data","author":"Hubei Provincial Bureau of Statistics","year":"2002"},{"key":"pntd.0014125.ref037","first-page":"2","volume-title":"Hubei Provincial Bureau of Statistics. Hubei Province 2010 Population Census","author":"Hubei Provincial Population Census Office","year":"2012"},{"key":"pntd.0014125.ref038","volume-title":"Hubei Provincial Population Census Yearbook 2020","author":"Hubei Provincial People\u2019s Government Seventh National Population Census Leading Group Office., Hubei Provincial Bureau of Statistics","year":"2022"},{"key":"pntd.0014125.ref039","volume-title":"Replication data for: \u201cRoads, railroads and decentralization of Chinese cities\u201d","author":"N Baum-Snow","year":"2016"},{"key":"pntd.0014125.ref040","first-page":"1","article-title":"Developing Improved Time-Series DMSP-OLS-Like Data (1992\u20132019) in China by Integrating DMSP-OLS and SNPP-VIIRS","volume":"60","author":"Y Wu","year":"2022","journal-title":"IEEE Trans Geosci Remote Sensing"},{"key":"pntd.0014125.ref041","volume-title":"Hubei Statistical Yearbook 1991","author":"Hubei Provincial Bureau of Statistics","year":"1991"},{"issue":"9","key":"pntd.0014125.ref042","first-page":"869","article-title":"Cholera Prevention and Control in New China","volume":"36","author":"B Pang","year":"2021","journal-title":"Disease Surveillance"},{"issue":"6","key":"pntd.0014125.ref043","article-title":"Applicability of prewhitening to eliminate the influence of serial correlation on the Mann\u2010Kendall test","volume":"38","author":"S Yue","year":"2002","journal-title":"Water Resources Research"},{"issue":"5","key":"pntd.0014125.ref044","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0317108","article-title":"Geographical characteristics and formation mechanisms of smallpox epidemics in Hubei Province, China, 1488-1949","volume":"20","author":"Y Zeng","year":"2025","journal-title":"PLoS One"},{"issue":"05","key":"pntd.0014125.ref045","first-page":"661","article-title":"Spatiotemporal patterns and driving mechanisms of malaria prevalence in Hubei Province before 1949","volume":"57","author":"T Zhang","year":"2023","journal-title":"Journal of Central China Normal University (Natural Science Edition)"},{"issue":"1","key":"pntd.0014125.ref046","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1175\/1520-0477(1998)079<0061:APGTWA>2.0.CO;2","article-title":"A Practical Guide to Wavelet Analysis","volume":"79","author":"C Torrence","year":"1998","journal-title":"Bull Amer Meteor Soc"},{"issue":"3","key":"pntd.0014125.ref047","first-page":"352","article-title":"Characteristics and causes of spatio-temporal differentiation of population aging in Jilin Province","volume":"37","author":"L Mei","year":"2018","journal-title":"Advances in Geographic Science"},{"key":"pntd.0014125.ref048","first-page":"2","volume-title":"Structural equation modeling. 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