ABSTRACT: Background:Rift Valley fever (RVF) is a zoonotic viral vector-borne disease that affects both animals and humans and leads to severe economic consequences. RVF outbreaks are triggered by a favorable environment and flooding, which enable mosquitoes to proliferate and spread the virus further. RVF is endemic to Africa and has spread to Saudi Arabia and Yemen. There is great concern that RVF may spread to previously unaffected geographic regions due to climate change. We aimed to better understand the spatiotemporal pattern of the 2007 RVF outbreak at the human-animal-environment interface and to determine environmental factors that may have effects on RVF occurrence in Gezira state, Sudan. Materials and methods:We compiled epidemiological, environmental, and spatiotemporal data across time and space using remote sensing and a geographical information system (GIS). The epidemiological data included 430 RVF human cases as well as human and animal population demographic data for each locality. The cases were collected from 41 locations in Gezira state. The environmental data represent classified land cover during 2007, the year of the RVF outbreak, and the average of the Normalized Difference Vegetation Index (NDVI) for 6 months of 2007 is compared with those of 2010 and 2014, when there was no RVF outbreak. To determine the effect of the environmental factors such as NDVI, soil type, and RVF case's location on the Blue Nile riverbank on RVF incidence in Gezira state, a multilevel logistic regression model was carried out. Results:We found that the outbreak in Gezira state occurred as a result of interaction among animals, humans, and the environment. The multilevel logistic regression model (F?=?43,858, df?=?3, p?=?0.000) explained 23% of the variance in RVF incidence due to the explanatory variables. Notably, soil type (??=?0.613, t?=?11.284, p?=?0.000) and NDVI (??=?-?0.165, t?=?-?3.254, p?=?0.001) were the explanatory environmental factors that had significant effects on RVF incidence in 2007 in Gezira state, Sudan. Conclusions:Precise remote sensing and the GIS technique, which rely on environmental indices such as NDVI and soil type that are satellite-derived, can contribute to establishing an early warning system for RVF in Sudan.Future preparedness and strengthening the capacity of regional laboratories are necessary for early notification of outbreaks in animals and humans.
