Environmental Conditions and Mite Vectors Shape the Spatiotemporal Patterns of Scrub Typhus in Guangdong Province, Mainland China.

Scrub typhus has emerged as a life-threatening and increasingly prevalent vector-borne disease. While the spatial and temporal distributions of scrub typhus have been studied by the research community, the main driving factors that influence the spatiotemporal patterns of the disease remain under investigation. Using Guangdong Province as a case study, we combined monthly scrub typhus case data from 2010 to 2019 and environmental and vector-related datasets with a Bayesian hierarchical mixed model to elucidate the spatiotemporal characteristics of the disease. This study revealed that the most highly endemic areas of scrub typhus are concentrated in the western and southern parts of Guangdong Province. A distinct bimodal pattern of scrub typhus was observed, with peaks typically occurring from May to July and October to November. The fitted model indicated that forest, cropland, and chigger mites were positively associated with scrub typhus transmission. Furthermore, climate and vectors were identified as key factors shaping the bimodal seasonal patterns of scrub typhus. Despite data-related limitations, including the treatment of population as a time-invariant variable and the binary simplification of vector suitability, sensitivity analyses confirmed the robustness of the model, offering valuable insights for scrub typhus prevention in Guangdong.