[Design of schistosomiasis surveillance sites based on Spatial Kluster Analysis by Tree Edge Removal (SKATER) method:...

To develop a method for designing schistosomiasis surveillance sites, so as to improve the efficiency and quality of schitsosomiasis surveillance.

By using the minimum spanning tree-based Spatial Kluster Analysis by Tree Edge Removal (SKATER) method, spatially constrained clustering was performed upon 31 historical schistosomiasis-endemic counties (districts) in Anhui Province. A surveillance site was selected from each cluster to evaluate the representativeness and surveillance efficiency of these cluster-based surveillance sites for the endemic situation of schistosomiassi in Anhui Province, and to compare the surveillance efficiency with local national schistosomiasis surveillance sites.

There was no significant difference in the environmental factors between the cluster-based schistosomiasis surveillance sites and the whole region, showing a high homogeneity. If the same number of schistosomiasis surveillance sites was selected, there was no significant difference between the cluster-based surveillance sites and national schistosomiasis surveillance sites in the efficiency of the mean risk and long-term trend of schistosomiasis surveillance in Anhui Province; however, the cluster-based surveillance sites were superior to the national schistosomiasis surveillance sites for the prediction and estimation of the endemic situation of schistosomiasis in the unmonitored areas.

The SKATER-based selection of schistosomiasis surveillance sites may better represent the endemic situation of schistosomiasis in Anhui Province, which may serve as an effective supplement for the conventional method of selecting schistosomiasis surveillance sites.