Effect of Rapid Urbanization in Mainland China on the Seasonal Influenza Epidemic: Spatiotemporal Analysis of Surveillance Data From 2010 to 2017.

Effect of Rapid Urbanization in Mainland China on the Seasonal Influenza Epidemic: Spatiotemporal Analysis of Surveillance Data From 2010 to 2017.
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DOI:
10.2196/41435
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发表时间:
2023-07-07
影响因子:
8.5
通讯作者:
Shu, Yuelong
Shu, Yuelong
中科院分区:
医学3区
文献类型:
--
作者:
Lei, Hao;Zhang, Nan;Niu, Beidi;Wang, Xiao;Xiao, Shenglan;Du, Xiangjun;Chen, Tao;Yang, Lei;Wang, Dayan;Cowling, Benjamin;Li, Yuguo;Shu, Yuelong

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世界正在经历前所未有的城市化浪潮。然而,城市化早期或中期的快速城市化对季节性流感传播的影响仍不清楚。由于世界约70%的人口生活在低收入国家,探索城市化对城市化国家流感传播的影响对于全球感染预测和预防具有重要意义。本研究的目的是探讨快速城市化对中国流感传播的影响。我们对2010年4月1日至2017年3月31日在中国大陆收集的省级流感监测数据进行了时空分析。建立了基于每小时人类接触相关行为的基于代理的模型来模拟流感传播动态,并探讨城市化对流感传播影响的潜在机制。我们观察到,在7年的研究期间,中国大陆各省之间流感疫情发病率持续存在差异,冬季流感发病率与城市化率呈U型关系,拐点出现在中国大陆城市化率50%-60%之间。中国快速的城市化导致城市人口密度和劳动力比例增加,但家庭规模和学生人口比例下降。社区和工作场所流感传播增加但家庭和学校传播减少的净效应产生了观察到的 U 形关系。我们的结果凸显了城市化对中国季节性流感疫情的复杂影响。由于中国目前的城市化率约为59%,在没有相关干预措施的情况下进一步城市化表明未来流感疫情发病率上升的趋势令人担忧。
The world is undergoing an unprecedented wave of urbanization. However, the effect of rapid urbanization during the early or middle stages of urbanization on seasonal influenza transmission remains unknown. Since about 70% of the world population live in low-income countries, exploring the impact of urbanization on influenza transmission in urbanized countries is significant for global infection prediction and prevention. The aim of this study was to explore the effect of rapid urbanization on influenza transmission in China. We performed spatiotemporal analyses of province-level influenza surveillance data collected in Mainland China from April 1, 2010, to March 31, 2017. An agent-based model based on hourly human contact–related behaviors was built to simulate the influenza transmission dynamics and to explore the potential mechanism of the impact of urbanization on influenza transmission. We observed persistent differences in the influenza epidemic attack rates among the provinces of Mainland China across the 7-year study period, and the attack rate in the winter waves exhibited a U-shaped relationship with the urbanization rates, with a turning point at 50%-60% urbanization across Mainland China. Rapid Chinese urbanization has led to increases in the urban population density and percentage of the workforce but decreases in household size and the percentage of student population. The net effect of increased influenza transmission in the community and workplaces but decreased transmission in households and schools yielded the observed U-shaped relationship. Our results highlight the complicated effects of urbanization on the seasonal influenza epidemic in China. As the current urbanization rate in China is approximately 59%, further urbanization with no relevant interventions suggests a worrisome increasing future trend in the influenza epidemic attack rate.
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