{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T06:09:14Z","timestamp":1791266954770,"version":"4.1.0"},"reference-count":49,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,8,29]],"date-time":"2022-08-29T00:00:00Z","timestamp":1661731200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2021YFC2300800"],"award-info":[{"award-number":["2021YFC2300800"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2021YFC2300804"],"award-info":[{"award-number":["2021YFC2300804"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["No.32161143036"],"award-info":[{"award-number":["No.32161143036"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Microbiol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Visceral leishmaniasis (VL) is a serious vector-borne disease in central and western China. In recent years, the number of VL cases increased gradually, particularly the mountain-type zoonotic visceral leishmaniasis (MT-ZVL). This study clarified the epidemiological features and spatial-temporal clustering of VL in China between 2019 and 2021, identified the risk areas for VL transmission, and provided scientific evidence for the prevention and control of VL.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>The information on VL cases in 2019\u20132021 was collected from the Infectious Disease Reporting Information Management System of the Chinese Center for Disease Control and Prevention. The epidemiological characteristics of VL cases were analyzed. The global <jats:italic>Moran\u2019s I<\/jats:italic> and Getis-ORD Gi* statistical data were processed for spatial autocorrelation and hotspot analysis in ESRI ArcGIS software. Also, spatial-temporal clustering analysis was conducted with the retrospective space\u2013time permutation scan statistics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 608 VL cases were reported from 2019 to 2021, with 158, 213, and 237 cases reported each year, respectively. Of the 608 cases, there were 10 cases of anthroponotic visceral leishmaniasis (AVL), 20 cases of desert-type zoonotic visceral leishmaniasis (DT-ZVL), and 578 cases of MT-ZVL. The age of VL cases was mainly distributed in the group of subjects aged \u2265 15 years. Peasants and infants were the dominant high-risk population. The incidence peak season of VL occurred between March and May. The cases were mainly distributed in Shanxi (299 cases), Shaanxi (118 cases), and Gansu (106 cases) Provinces, accounting for 86.02% (523\/608) of the total reported cases in China. Spatial analysis revealed that clustering of infection is mainly located in eastern Shanxi Province and Shaanxi\u2013Shanxi border areas, as well as southern Gansu and northern Sichuan Province. In addition, new reemergence hotspots in Shanxi, Henan, and Hebei Provinces have been detected since 2020. Spatio-temporal clustering analysis revealed an increase in the degree of infection aggregation in eastern Shanxi Province and Shaanxi\u2013Shanxi border areas.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The AVL and DT-ZVL were endemic at a lower level in western China, whereas MT-ZVL rebounded rapidly and showed a resurgence in historically endemic counties. The spatial-temporal clustering analysis displayed that the high-incidence areas of VL have shifted to central China, particularly in Shanxi and Shaanxi Provinces. Integrated mitigation strategies targeting high-risk populations are needed to control VL transmission in high-risk areas.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmicb.2022.959901","type":"journal-article","created":{"date-parts":[[2022,8,29]],"date-time":"2022-08-29T06:16:46Z","timestamp":1661753806000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":22,"title":["Epidemiological features and spatial-temporal clustering of visceral leishmaniasis in mainland China from 2019 to 2021"],"prefix":"10.3389","volume":"13","author":[{"given":"Yuanyuan","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhuowei","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuwan","family":"Hao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Limin","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhongqiu","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhengbin","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shizhu","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,8,29]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1186\/s41182-017-0054-9","article-title":"Environmental factors associated with the distribution of visceral leishmaniasis in endemic areas of Bangladesh: Modeling the ecological niche.","volume":"45","author":"Abdullah","year":"2017","journal-title":"Trop. 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