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. 2018 Feb;24(2):210–220. doi: 10.3201/eid2402.160122

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Classification of health zones according to environmental factors related to bubonic plague, Orientale Province, Democratic Republic of the Congo, 2004–2014. A) Classification and regression tree analysis of plague cases determined a significant (p = 0.015) high-risk class of 7 health zones (class 2). Health zones in class 2 have >72.7% of their territory in the mountain tropical climate. The increase in risk for class 2 compared with class 1 was not significant when analyzed with a generalized additive model (incidence rate 1.79; p = 0.14). B) Locations of class 2 zones within Orientale Province. Class 2 zones were grouped in the highlands of Ituri. The cluster determined by spatial scan statistics in the Ituri Highlands ("SaTScan cluster") was composed entirely of class 2 health zones.