Spatiotemporal expansion of human brucellosis in Shaanxi Province, Northwestern China and model for risk prediction.
Spatiotemporal expansion of human brucellosis in Shaanxi Province, Northwestern China and model for risk prediction.
复制标题
陕西省人类布鲁氏菌病时空扩展及风险预测模型
作者：
Yang Z;Pang M;Zhou Q;Song S;Liang W;Chen J;Guo T;Shao Z;Liu K
背景人类布鲁氏菌病给流行地区的健康和经济带来了沉重的负担。自2011年以来，中国每年至少报告35，000例人间布鲁氏菌病病例，其中90%以上报告在北方。鉴于人类布鲁氏菌病病例的高发病率和地理分布的变化令人震惊，迫切需要破译这种地理分布变化的原因。方法2005年1月1日至2018年12月31日在陕西省开展回顾性流行病学调查，首次根据西北地区人间布鲁氏菌病的地理分布差异和季节性波动，探讨气象因素与人间布鲁氏菌病传播的关系。结果2008年以前，人间布鲁氏菌病主要分布在陕北高地，之后逐渐向南部地区扩散，季节波动明显。GAMM模型结果表明，气温、日照时数、降雨量、相对湿度和蒸发量对人间布鲁氏菌病的传播起着决定性的作用，其最大滞后时间在7个月以内，且具有季节波动性。与陕北高地相比，关中盆地因气象因素的变化，人间布病的发生波动更为明显。此外，所建立的GAMM模型对基于气象因素的人间布鲁氏菌病发病预测具有较高的准确性。结论本研究结果可用于预测陕西省及类似环境条件地区人间布鲁氏菌病的季节性波动，并制定可靠、经济有效的防治策略。
Background Human brucellosis imposes a heavy burden on the health and economy of endemic regions. Since 2011, China has reported at least 35,000 human brucellosis cases annually, with more than 90% of these cases reported in the northern. Given the alarmingly high incidence and variation in the geographical distribution of human brucellosis cases, there is an urgent need to decipher the causes of such variation in geographical distribution. Method We conducted a retrospective epidemiological study in Shaanxi Province from January 1, 2005 to December 31, 2018 to investigate the association between meteorological factors and transmission of human brucellosis according to differences in geographical distribution and seasonal fluctuation in northwestern China for the first time. Results Human brucellosis cases were mainly distributed in the Shaanbei upland plateau before 2008 and then slowly extended towards the southern region with significant seasonal fluctuation. The results of quasi-Poisson generalized additive mixed model (GAMM) indicated that air temperature, sunshine duration, rainfall, relative humidity, and evaporation with maximum lag time within 7 months played crucial roles in the transmission of human brucellosis with seasonal fluctuation. Compared with the Shaanbei upland plateau, Guanzhong basin had more obvious fluctuations in the occurrence of human brucellosis due to changes in meteorological factors. Additionally, the established GAMM model showed high accuracy in predicting the occurrence of human brucellosis based on the meteorological factors. Conclusion These findings may be used to predict the seasonal fluctuations of human brucellosis and to develop reliable and cost-effective prevention strategies in Shaanxi Province and other areas with similar environmental conditions.