The driver of dengue fever incidence in two high-risk areas of China: A comparative study
The driver of dengue fever incidence in two high-risk areas of China: A comparative study
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中国两个高风险地区登革热发病的驱动因素：一项比较研究。
DOI：
10.1038/s41598-019-56112-8
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发表时间：
2019-12-20
影响因子：
4.6
通讯作者：
Liu, Qiyong
中科院分区：
文献类型：
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作者：
Liu, Keke;Hou, Xiang;Liu, Qiyong
在中国看来，对不同高危地区登革热异质性分布格局的深层原因了解有限。比较研究将有助于我们了解不同高危地区登革热的影响因素。在这项研究中，我们使用广义加法模型(GAM)、随机森林模型和结构方程模型(SEM)比较了气候、蚊子密度和输入病例对两个高危地区登革热的影响。GAM分析发现，在广东和云南省的登革热高危地区，输入病例、伊蚊幼虫密度、气候变量与登革热发生之间存在类似的正相关关系。随机林显示，影响登革热发生的最重要因素是广东省的输入性病例数、BI和月平均最低气温，而输入性病例、云南省的月平均气温和月相对湿度是影响登革热发病的最重要因素。通过扫描电子显微镜观察发现，降雨量对两地登革热的发生均有间接影响，但直接作用在广东高发区以温度为主，而在云南省影响不明显。总体而言，气候因素和蚊子密度是中国不同高危地区登革热发病率的关键驱动因素。这些发现可以为登革热高危地区的早期预警和科学控制提供科学证据。
In China, the knowledge of the underlying causes of heterogeneous distribution pattern of dengue fever in different high-risk areas is limited. A comparative study will help us understand the influencing factors of dengue in different high-risk areas. In the study, we compared the effects of climate, mosquito density and imported cases on dengue fever in two high-risk areas using Generalized Additive Model (GAM), random forests and Structural Equation Model (SEM). GAM analysis identified a similar positive correlation between imported cases, density of Aedes larvae, climate variables and dengue fever occurrence in the studied high-risk areas of both Guangdong and Yunnan provinces. Random forests showed that the most important factors affecting dengue fever occurrence were the number of imported cases, BI and the monthly average minimum temperature in Guangdong province; whereas the imported cases, the monthly average temperature and monthly relative humidity in Yunnan province. We found the rainfall had the indirect effect on dengue fever occurrence in both areas mediated by mosquito density; while the direct effect in high-risk areas of Guangdong was dominated by temperature and no obvious effect in Yunnan province by SEM. In total, climate factors and mosquito density are the key drivers on dengue fever incidence in different high-risk areas of China. These findings could provide scientific evidence for early warning and the scientific control of dengue fever in high-risk areas.