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.