Spatial-temporal analysis of malaria and the effect of environmental factors on its incidence in Yongcheng, China, 2006-2010.
Spatial-temporal analysis of malaria and the effect of environmental factors on its incidence in Yongcheng, China, 2006-2010.
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DOI：
10.1186/1471-2458-12-544
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发表时间：
2012-07-23
影响因子：
4.5
通讯作者：
Li ZF
中科院分区：
文献类型：
--
作者：
Zhang Y;Liu QY;Luan RS;Liu XB;Zhou GC;Jiang JY;Li HS;Li ZF
2003年，间日疟原虫疟疾在包括河南省永城市在内的中国中东部地区重新出现，该地区已经11年没有报告病例。目的：了解永城市2006 - 2010年疟疾的时空分布特征，确定影响疟疾发病的重要环境因素，为进一步优化疟疾监测和控制方案提供科学依据。本研究利用地理信息系统（GIS）和时间序列分析方法，探讨了疟疾发病风险的时空异质性和疟疾发病的影响因素。进行了单变量分析，以估计疟疾发病率与蚊子数量和气候因素等环境变量之间的粗略相关性。采用广义估计方程（GEE）方法，通过多变量分析构建预测模型，探讨疟疾流行的主要环境决定因素。镇级疟疾年发病率从北向南呈下降趋势，地级疟疾月发病率呈明显的季节性变化，高峰在7 ~ 11月。疟疾年发病率与年平均气温有明显的空间相关性。最佳拟合时间模型（模型2）（QIC = 16.934，P<0.001，R2 = 0.818）表明，影响疟疾发病率的主要因素是滞后1个月的最高气温、滞后1个月的平均湿度和前一个月的疟疾发病率。研究结果支持环境因素对疟疾发病的影响，并指出疟疾防治目标应根据疟疾发病强度而有所不同，应将更多的公共资源用于控制传染源，而不是大规模的疟疾防治。在疟疾发病率较低的情况下，对中华按蚊的控制效果进行评价，为我国及疟疾传播不稳定或低水平国家的疟疾监测方案的优化提供参考。
In 2003, Plasmodium vivax malaria has re-emerged in central eastern China including Yongcheng prefecture, Henan Province, where no case has been reported for eleven years. Our goals were to detect the space-time distribution pattern of malaria and to determine significant environmental variables contributing to malaria incidence in Yongcheng from 2006 to 2010, thus providing scientific basis for further optimizing current malaria surveillance and control programs. This study examined the spatial and temporal heterogeneities in the risk of malaria and the influencing factors on malaria incidence using geographical information system (GIS) and time series analysis. Univariate analysis was conducted to estimate the crude correlations between malaria incidence and environmental variables, such as mosquito abundance and climatic factors. Multivariate analysis was implemented to construct predictive models to explore the principal environmental determinants on malaria epidemic using a Generalized Estimating Equation (GEE) approach. Annual malaria incidence at town-level decreased from the north to south, and monthly incidence at prefecture-level demonstrated a strong seasonal pattern with a peak from July to November. Yearly malaria incidence had a visual spatial association with yearly average temperature. Moreover, the best-fit temporal model (model 2) (QIC = 16.934, P<0.001, R2 = 0.818) indicated that significant factors contributing to malaria incidence were maximum temperature at one month lag, average humidity at one month lag, and malaria incidence of the previous month. Findings supported the effects of environment factors on malaria incidence and indicated that malaria control targets should vary with intensity of malaria incidence, with more public resource allocated to control the source of infections instead of large scale An. sinensis control when malaria incidence was at a low level, which would benefit for optimizing the malaria surveillance project in China and some other countries with unstable or low malaria transmission.
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影响因子：
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作者：
Lee, Hee-Il;Lee, Jong-Soo;Lee, Kyung-Ro
通讯作者：
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影响因子：
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作者：
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通讯作者：
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Olson SH;Gangnon R;Elguero E;Durieux L;Guégan JF;Foley JA;Patz JA
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影响因子：
64.8
作者：
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通讯作者：
Snow, Robert W