Assessing the risk of malaria re-transmission in Anhui Province, China: an integration of spatiotemporal scan statistics and ecological niche modeling

BMC Infect Dis. 2026 Feb 6;26(1):520. doi: 10.1186/s12879-026-12783-z.

Abstract

Objective: This study aims to identify hotspots of imported malaria cases and areas suitable for malaria vector distribution in Anhui Province. By visualizing the province-wide risk of malaria re-transmission, the research provides a scientific basis for implementing stratified and targeted strategies to prevent malaria reintroduction.

Methods: Epidemiological data on imported malaria cases and demographic information from Anhui Province, spanning 2017 to 2023, were collected alongside vector surveillance data from 2023. ArcGIS10.8 and SaTScan10.1.2 were used to analyze the spatial-temporal characteristics of the imported cases, and R4.4.0 was used to construct a niche model based on vector surveillance data.

Results: The spatial-temporal scan analysis revealed that the spatial distribution of malaria hotspots remained largely consistent from 2017 to 2023, with the exception of 2021(P<0.05). Persistent clusters were primarily located in Yaohai District, Luyang District, Baohe District, Feidong County, Changfeng County, Feixi County, and Shushan District. The ensemble model based on the probability committee average method demonstrated strong predictive performance, with an AUC of 0.943 and a TSS of 0.759. The results of the ensemble model showed that the potential suitable areas of An. sinensis were mainly distributed in the central and part of the southern regions. The distribution of An. sinensis was mainly affected by the annual vegetation index, the brightness of night lights, and the precipitation in the wetest month.

Conclusions: The central region of Anhui Province is at the highest risk for malaria re-transmission. It is recommended to strengthen the surveillance of epidemic situations in the region, timely detection and standardized management of cases. Vector control measures should be taken in the epidemic spots during the mosquito vector activity season to interrupt the risk of re-transmission.

Clinical trial number: Not applicable.

Keywords: Anhui Province; Biomod2; China; Imported malaria; Prevention of re-transmission of malaria; Spatial epidemiology.