How Socio-Environmental Factors Are Associated with Japanese Encephalitis in Shaanxi, China-A Bayesian Spatial Analysis.

Evidence indicated that socio-environmental factors were associated with occurrence of Japanese encephalitis (JE). This study explored the association of climate and socioeconomic factors with JE (2006-2014) in Shaanxi, China. JE data at the county level in Shaanxi were supplied by Shaanxi Center for Disease Control and Prevention. Population and socioeconomic data were obtained from the China Population Census in 2010 and statistical yearbooks. Meteorological data were acquired from the China Meteorological Administration. A Bayesian conditional autoregressive model was used to examine the association of meteorological and socioeconomic factors with JE. A total of 1197 JE cases were included in this study. Urbanization rate was inversely associated with JE incidence during the whole study period. Meteorological variables were significantly associated with JE incidence between 2012 and 2014. The excessive precipitation at lag of 1-2 months in the north of Shaanxi in June 2013 had an impact on the increase of local JE incidence. The spatial residual variations indicated that the whole study area had more stable risk (0.80-1.19 across all the counties) between 2012 and 2014 than earlier years. Public health interventions need to be implemented to reduce JE incidence, especially in rural areas and after extreme weather.