# Influence of natural and anthropogenic drivers on plague risk in Southwest China: A multicenter cross-sectional study

## TL;DR

This study explores how natural and human-related factors affect plague risk in Southwest China, finding that improved living conditions reduce disease risk.

## Contribution

The study introduces composite anthropogenic indices to assess how human factors influence zoonotic disease risks.

## Key findings

- Improved living environment is significantly linked to lower plague risk.
- Household sanitation and protective behaviors show no significant association with plague risk.
- Ethnic disparities in anthropogenic indices suggest a need for culturally tailored interventions.

## Abstract

The natural and anthropogenic environment have contributed to the dynamic risk of plague and their threats to human health. Although evidence has indicated the environmental suitability for disease dynamics, the alteration of the risk by anthropogenic factors have not been fully investigated. We conducted a multicenter cross-sectional survey among 2998 residences across 54 villages in 13 counties in Southwest China. With the survey data, we developed composite anthropogenic indices to make systematic assessment of people's living environment, household sanitation levels, and risk perception regarding plague. We identified disparities of these anthropogenic indices among ethnic groups. By featuring plague, we further established statistical model to assess how environmental and anthropogenic factors associate with the occurrence of the typical zoonotic disease. Our results show that the improved living environment is significantly linked to the lower risk of plague occurrence. In contrast, we have no evidence for the significant association between household sanitation, protective behaviors, environmental conditions and plague risk. These findings pointed at the improved living environment as the most likely anthropogenic driver that is associated with the reduced risk of plague. Integrating anthropogenic modulators of disease dynamics in public health strategies would be the key for the effective management of disease risks.

•We developed composite indices and assess anthropogenic impacts on zoonotic risks.•Improved living conditions is critical for the management of zoonotic disease risks.•Ethnic disparities highlight the need for the culturally tailored interventions.

We developed composite indices and assess anthropogenic impacts on zoonotic risks.

Improved living conditions is critical for the management of zoonotic disease risks.

Ethnic disparities highlight the need for the culturally tailored interventions.