BMC Infect Dis. 2026 Apr 9. doi: 10.1186/s12879-026-13207-8. Online ahead of print.
ABSTRACT
BACKGROUND: Bacillary dysentery remains a common intestinal infectious disease in China. With economic development and improvements in sanitation, the incidence rate of bacillary dysentery has changed substantially across counties in Shaanxi Province. This study aims to elucidate its epidemiological characteristics and spatio-temporal dynamics to inform prevention and control strategies.
METHODS: Surveillance data of confirmed bacillary dysentery cases in Shaanxi Province from 2005 to 2024 were obtained from the China Information System for Disease Control and Prevention. We analyzed epidemiological features across temporal, regional, and population distributions. Long-term incidence trends were assessed using Joinpoint regression, while spatial autocorrelation and spatio-temporal scan statistics were employed to identify clustering patterns at the county level.
RESULTS: A total of 156,656 cases of bacillary dysentery were reported in Shaanxi Province from 2005 to 2024. The reported incidence decreased from 65.30 per 100,000 in 2005 to 3.33 per 100,000 in 2024. A unimodal seasonal pattern was observed, with 76.09% of cases occurring between May and October. Children under five years of age were the most susceptible group, particularly infants under one. The incidence was higher in males than in females. The majority of cases were farmers (27.08%), home-care children (22.35%), and students (17.71%). Joinpoint regression revealed a significant overall decreasing trend (Average Annual Percent Change, AAPC = -15.0%; 95% CI: -18.4%, -11.4%; p < 0.001). Geographically, high-incidence counties were primarily located in the northern and central-western regions before 2014. After 2015, the number of high-incidence counties markedly decreased. By 2024, the incidence in 84.07% (95/113) of counties had fallen below 5 per 100,000. Global spatial autocorrelation analysis indicated significant clustered distributions annually. Local spatial autocorrelation identified 174 “High-High” clusters. Spatio-temporal scan statistics showed that primary clusters were located in the northern and central-western regions before 2010, shifting to the central region thereafter.
CONCLUSIONS: Both the incidence and the spatial clustering of bacillary dysentery have decreased significantly in Shaanxi Province. However, targeted interventions during the summer and autumn seasons, focusing on children under five and populations in the central region, remain crucial for future control efforts.
PMID:41957594 | DOI:10.1186/s12879-026-13207-8
