Risk factors and predicted distribution of visceral leishmaniasis in the Xinjiang Uygur Autonomous Region, China, 2005-2015
Risk factors and predicted distribution of visceral leishmaniasis in the Xinjiang Uygur Autonomous Region, China, 2005-2015
复制标题
新疆内脏利什曼病危险因素及预测分布，中国，2005年-2015年
DOI：
10.1186/s13071-019-3778-z
复制
发表时间：
2019-11-08
影响因子：
3.2
通讯作者：
Jiang, Dong
中科院分区：
文献类型：
--
作者：
Ding, Fangyu;Wang, Qian;Jiang, Dong
背景内脏利什曼病(VL)是一种被忽视的疾病，通过感染的雌性沙蝇的叮咬传播给人类。虽然这种媒介传播的疾病在中国的大部分地区已经消除，但它仍然给新疆维吾尔自治区带来了重大的公共卫生负担。当地社区对这种疾病的空间流行病学的了解仍然不明确。在本研究中，我们调查了该地区VL的时空分布，以评估该疾病的潜在威胁。方法根据综合感染记录，分析2005~2015年该地区VL新发病例的时空分布特征。通过结合环境和社会经济相关图，采用增强回归树(BRT)模型来识别VL的环境生态位。结果用拟合的BRT模型绘制新疆维吾尔自治区VL潜在感染危险区，预测的高危区域主要集中在喀什地区中北部、喀什地区交界的阿图什市南部和巴音郭勒蒙古自治州北部地区。最终结果显示，约有1664万人居住在该地区预测的潜在感染风险地区。结论以1 km的空间分辨率对新疆维吾尔自治区VL的潜在疫源地有了更好的了解，从而提高了我们针对潜在危险地区、制定疾病控制策略和分配医疗用品的能力。
Background Visceral leishmaniasis (VL) is a neglected disease that is spread to humans by the bites of infected female phlebotomine sand flies. Although this vector-borne disease has been eliminated in most parts of China, it still poses a significant public health burden in the Xinjiang Uygur Autonomous Region. Understanding of the spatial epidemiology of the disease remains vague in the local community. In the present study, we investigated the spatiotemporal distribution of VL in the region in order to assess the potential threat of the disease. Methods Based on comprehensive infection records, the spatiotemporal patterns of new cases of VL in the region between 2005 and 2015 were analysed. By combining maps of environmental and socioeconomic correlates, the boosted regression tree (BRT) model was adopted to identify the environmental niche of VL. Results The fitted BRT models were used to map potential infection risk zones of VL in the Xinjiang Uygur Autonomous Region, revealing that the predicted high infection risk zones were mainly concentrated in central and northern Kashgar Prefecture, south of Atushi City bordering Kashgar Prefecture and regions of the northern Bayingolin Mongol Autonomous Prefecture. The final result revealed that approximately 16.64 million people inhabited the predicted potential infection risk areas in the region. Conclusions Our results provide a better understanding of the potential endemic foci of VL in the Xinjiang Uygur Autonomous Region with a 1 km spatial resolution, thereby enhancing our capacity to target the potential risk areas, to develop disease control strategies and to allocate medical supplies.