MERS-Coronavirus across Kenya: a spatial examination of social and environmental drivers

Climate and agricultural land-use change have increased the likelihood of infectious disease emergence and transmissions, but these drivers are often examined separately as synergistic effects are ignored. Further, seldom are the influence of climate and agricultural land use on emerging infectious diseases examined in a spatially explicit way at regional scales. Our objective in this study was to spatially examine the climate, agriculture, and socio-demographic factors related to agro-pastoralism that can influence the prevalence of Middle East Respiratory Syndrome coronavirus (MERS-CoV) in dromedary camels across northern Kenya. Our research questions were: 1) how has MERS-CoV in dromedary camels varied across geographic regions of northern Kenya, and 2) what climate, agriculture, and socio-demographic factors of agro-pastoralism were spatially related to the geographic variation in MERS-CoV cases? To answer our questions, we analyzed the spatial distribution of historical cases of serological evidence of MERS-CoV at the county level and applied spatial statistical analysis to examine the spatial relationships of the MERS-CoV cases between 2016 and 2018 to climate, agriculture, and socio-demographic factors of agro-pastoralism. Regional differences in MERS-CoV cases were spatially correlated with both social and environmental factors and highlight the complexity in the distribution of MERS-CoV in dromedary camels across Kenya. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This work was supported in part by the Taylor Geospatial Institute and a seed research grant from the Living Earth Collaborative at Washington University in St. Louis. Furthermore, this research was also supported in part by the UK Biotechnology and Biological Sciences Research Council, the Department for International Development, the Economic & Social Research Council, the Medical Research Council, the Natural Environment Research Council, and the Defense Science & Technology Laboratory, under the Zoonoses and Emerging Livestock Systems (ZELS) programme, grant reference BB/L019019/1. This study also received support from the CGIAR One Health initiative Protecting Human Health Through a One Health Approach, which was supported by contributors to the CGIAR Trust Fund (https://www.cgiar.org/funders/). We thank the University of Liverpool Open Access team for support of the CC-BY open access license for this article. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors