Identifying Infectious Diarrhea Hot spots and Associated Socioeconomic Factors in Anhui Province, China

Abstract

Infectious diarrhea cases have increased during the past years in the Anhui Province of China, but little is known about its spatial cluster pattern and associated socioeconomic factors. We obtained county-level total cases of infectious diarrhea in 105 counties of Anhui in 2016 and computed age-adjusted rates. Socioeconomic factors were collected from the Statistical Yearbook. Hot spot analysis was used to identify hot and cold spot counties for infectious diarrhea incidence. We then applied binary logistic regression models to determine the association between socioeconomic factors and hot spot or cold spot clustering risk. Hot spot analysis indicated there were both significant hot spot (29 counties) and cold spot (18 counties) clustering areas for infectious diarrhea in Anhui (P < 0.10). Multivariate binary logistic regression results showed that infectious diarrhea hot spots were positively associated with per capita gross domestic product (GDP), with an adjusted odds ratio (AOR): 3.51, 95% CI: 2.09-5.91, whereas cold spots clustering were positively associated with the number of medical staffs (AOR: 1.18, 95% CI: 1.08-1.29) and negatively associated with the number of public health physicians (AOR: 0.27, 95% CI: 0.09-0.86). We identified locations for hot and cold spot clusters of infectious diarrhea incidence in Anhui, and the clustering risks were significantly associated with health workforce resources and the regional economic development. Targeted interventions should be carried out with considerations of regional socioeconomic conditions.

Epidemiological Trends and Hotspots of Other Infectious Diarrhea (OID) in Mainland China: A Population-Based Surveillance Study From 2004 to 2017

“…In previous studies, diarrhea was found presenting a specific temporal and spatial distribution which usually clustered spatially in different geographical locations (25)(26)(27). Several factors including sociodemographic variables, personal hygiene, and environmental and climatic changing were considered to be associated with the incidence of diarrhea (28,29).…”

Spatiotemporal Patterns of Diarrhea Incidence in Ghana and the Impact of Meteorological and Socio-Demographic Factors

“…For example, Bandyopadhyay et al (5) found a decrease in monthly rainfall and increase in temperature during the dry season was able to delineate hotspots of diarrhea prevalence in children under the age of 3 years in sub-Saharan Africa. In Anhui Province of China, Hao et al (17) found a strong association between socio-economic status and spatial clustering of diarrhea incidence. These studies demonstrate that the combination of meteorological and socio-demographic factors create different suitable pathways for diarrhea transmission, which are likely to be setting-specific.…”

Diarrhea Incidence in Tanah Bumbu, South Kalimantan, Under A Spatial Approach

“…The densely populated areas, like urban areas, with lots of waterlogging and the flow of urbanization continuing to increase annually, have made the problem of population density the main scourge for various diseases as well as diarrhea (Jarquin et al, 2016). Research in Anhui China illustrates that densely populated areas have a higher burden of infectious diseases, including diarrhea, than less densely populated areas (Hao et al, 2019).…”

“…However, there are still people who still do not have easy access to healthcare facilities. It is affected by economic conditions related to geographical location Hao et al, 2019). The people having access to healthcare facilities are constrained by long distances and significant costs so that they cannot take advantage of these health facilities (Arvelo et al, 2019;Woldeamanuel, 2020).…”