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. 2019 Jul 15;16(14):2520.
doi: 10.3390/ijerph16142520.

Spatiotemporal Clustering of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) Incidence in Saudi Arabia, 2012-2019

Khalid Al-Ahmadi  1 , Sabah Alahmadi  2 , Ali Al-Zahrani  3
Affiliations

Spatiotemporal Clustering of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) Incidence in Saudi Arabia, 2012-2019

Khalid Al-Ahmadi et al. Int J Environ Res Public Health. .

Abstract

Middle East respiratory syndrome coronavirus (MERS-CoV) is a great public health concern globally. Although 83% of the globally confirmed cases have emerged in Saudi Arabia, the spatiotemporal clustering of MERS-CoV incidence has not been investigated. This study analysed the spatiotemporal patterns and clusters of laboratory-confirmed MERS-CoV cases reported in Saudi Arabia between June 2012 and March 2019. Temporal, seasonal, spatial and spatiotemporal cluster analyses were performed using Kulldorff's spatial scan statistics to determine the time period and geographical areas with the highest MERS-CoV infection risk. A strongly significant temporal cluster for MERS-CoV infection risk was identified between April 5 and May 24, 2014. Most MERS-CoV infections occurred during the spring season (41.88%), with April and May showing significant seasonal clusters. Wadi Addawasir showed a high-risk spatial cluster for MERS-CoV infection. The most likely high-risk MERS-CoV annual spatiotemporal clusters were identified for a group of cities (n = 10) in Riyadh province between 2014 and 2016. A monthly spatiotemporal cluster included Jeddah, Makkah and Taif cities, with the most likely high-risk MERS-CoV infection cluster occurring between April and May 2014. Significant spatiotemporal clusters of MERS-CoV incidence were identified in Saudi Arabia. The findings are relevant to control the spread of the disease. This study provides preliminary risk assessments for the further investigation of the environmental risk factors associated with MERS-CoV clusters.

Keywords: GIS; Middle East respiratory syndrome; Saudi Arabia; coronavirus; epidemiology; outbreak; spatiotemporal cluster.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Epidemic curve of Middle East respiratory syndrome coronavirus (MERS-CoV) incidence in Saudi Arabia between 2012 and 2019.
Figure 2
Figure 2
Spatial distribution of the number of MERS-CoV cases in Saudi Arabia between 2012 and 2019. The presented data are for the governorate level, with the provincial boundaries overlaid.
Figure 3
Figure 3
Empirical Bayes smoothed incidence rate of MERS-CoV in Saudi Arabia between 2012 and 2019. The presented data are for the governorate level, with the provincial boundaries overlaid.
Figure 4
Figure 4
Locations of the spatial clusters of MERS-CoV incidence in Saudi Arabia between 2012 and 2019.
Figure 5
Figure 5
Locations of the annual spatiotemporal clusters of MERS-CoV incidence in Saudi Arabia between 2012 and 2019.
Figure 6
Figure 6
Locations of the monthly spatiotemporal clusters of MERS-CoV incidence in Saudi Arabia between 2012 and 2019.
See this image and copyright information in PMC

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