Contextual risk factors for regional distribution of Japanese encephalitis in the People's Republic of China

OBJECTIVE To investigate the contextual risk factors for the regional distribution of Japanese encephalitis (JE) in the People's Republic of China to enhance the prevention and control of JE. METHODS A multilevel Poisson regression model was used to analyse the association between the epidemic of JE and its contextual risk factors with an emphasis on the proportion of rice-planting area, the extent of pig rearing and the proportion of rural population. RESULTS The highest risk of JE was observed in the southwestern and the central areas of P.R. China, characterized by high proportions of rice-planting area, rural population and extent of pig rearing. These contextual determinants seem to govern the risk of JE. CONCLUSION In P.R. China, an effective surveillance system should be established in the high-risk regions of JE; immunization coverage for the prevention of JE should be expanded in rural areas, and mosquito-control efforts should be made to enhance the prevention and control of JE.