Environmental determinants of infectious disease: A framework for tracking causal links and guiding public health research
Environmental determinants of infectious disease: A framework for tracking causal links and guiding public health research
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DOI：
10.1289/ehp.9806
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发表时间：
2007-08-01
影响因子：
10.4
通讯作者：
Scott, James C.
中科院分区：
文献类型：
--
作者：
Eisenberg, Joseph N. S.;Desai, Manish A.;Scott, James C.
背景：新出现和再次出现的病原体起源于环境变化的发现，迫切需要了解这些环境变化如何影响疾病负担。在这篇文章中，我们提出了一个框架，它提供了一个研究环境变化与疾病传播之间关系的背景，以及一个将来自不同学科的不同信息整合在一起的结构。方法：该框架集成了环境-疾病关系的三个相互关联的特征：a)环境变化表现在可能最终影响疾病的生态和社会因素的复杂网络中；这些因素被表示为与疾病关系更远的因素和更接近疾病的因素。B)传染病原体的传播动力学中介了环境变化对疾病的影响。C)疾病负担是环境变化和病原体传播周期相互作用的结果。结果：为了将这一框架付诸实施，我们提出了一个矩阵公式，作为一种手段来定义这个系统的重要元素，并总结这些元素及其关系的已知和未知。该框架在系统层面上明确表达了问题，超越了公共卫生中使用的传统风险因素分析，该矩阵提供了一种明确表达不同系统组成部分之间耦合的方法。结论：环境和疾病传播过程的这种耦合为我们进一步理解环境变化和传染病之间的具体和一般关系提供了亟需的结构。
BACKGROUND: Discoveries that emerging and re-emerging pathogens have their origin in environmental change has created an urgent need to understand how these environmental changes impact disease burden. In this article we present a framework that provides a context from which to examine the relationship between environmental changes and disease transmission and a structure from which to unite disparate pieces of information from a variety of disciplines.METHODS: The framework integrates three interrelated characteristics of environment-disease relationships: a) Environmental change manifests in a complex web of ecologic and social factors that may ultimately impact disease; these factors are represented as those more distally related and those more proximally related to disease. b) Transmission dynamics of infectious pathogens mediate effects that environmental changes have on disease. c) Disease burden is the outcome of the inter play between environmental change and the transmission cycle of a pathogen.RESULTS: To put this framework into operation, we present a matrix formulation as a means to define important elements of this system and to summarize what is known and unknown about the these elements and their relationships. The framework explicitly expresses the problem at a systems level that goes beyond the traditional risk factor analysis used in public health, and the matrix provides a means to explicitly express the coupling of different system components.CONCLUSION: This coupling of environmental and disease transmission processes provides a much-needed construct for furthering our understanding of both specific and general relationships between environmental change and infectious disease.