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登革热感染时空决定因素的多层次分析。

Multi-level analyses of spatial and temporal determinants for dengue infection.

作者信息

Vanwambeke Sophie O, van Benthem Birgit H B, Khantikul Nardlada, Burghoorn-Maas Chantal, Panart Kamolwan, Oskam Linda, Lambin Eric F, Somboon Pradya

机构信息

Department of Geography, Université Catholique de Louvain, Place Pasteur, 3, 1348 Louvain-la-Neuve, Belgium.

出版信息

Int J Health Geogr. 2006 Jan 18;5:5. doi: 10.1186/1476-072X-5-5.

DOI:10.1186/1476-072X-5-5
PMID:16420702
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1373612/
Abstract

BACKGROUND

Dengue is a mosquito-borne viral infection that is now endemic in most tropical countries. In Thailand, dengue fever/dengue hemorrhagic fever is a leading cause of hospitalization and death among children. A longitudinal study among 1750 people in two rural and one urban sites in northern Thailand from 2001 to 2003 studied spatial and temporal determinants for recent dengue infection at three levels (time, individual and household).

METHOD

Determinants for dengue infection were measured by questionnaire, land-cover maps and GIS. IgM antibodies against dengue were detected by ELISA. Three-level multi-level analysis was used to study the risk determinants of recent dengue infection.

RESULTS

Rates of recent dengue infection varied substantially in time from 4 to 30%, peaking in 2002. Determinants for recent dengue infection differed per site. Spatial clustering was observed, demonstrating variation in local infection patterns. Most of the variation in recent dengue infection was explained at the time-period level. Location of a person and the environment around the house (including irrigated fields and orchards) were important determinants for recent dengue infection.

CONCLUSION

We showed the focal nature of asymptomatic dengue infections. The great variation of determinants for recent dengue infection in space and time should be taken into account when designing local dengue control programs.

摘要

背景

登革热是一种由蚊子传播的病毒感染，目前在大多数热带国家呈地方性流行。在泰国，登革热/登革出血热是儿童住院和死亡的主要原因。2001年至2003年期间，在泰国北部两个农村地区和一个城市地区对1750人进行的一项纵向研究，在时间、个体和家庭三个层面研究了近期登革热感染的空间和时间决定因素。

方法

通过问卷调查、土地覆盖图和地理信息系统测量登革热感染的决定因素。采用酶联免疫吸附测定法检测抗登革热的IgM抗体。使用三级多层次分析来研究近期登革热感染的风险决定因素。

结果

近期登革热感染率在时间上差异很大，从4%到30%不等，在2002年达到峰值。不同地点近期登革热感染的决定因素有所不同。观察到空间聚集现象，表明局部感染模式存在差异。近期登革热感染的大部分变异在时间段层面得到了解释。个人所在位置和房屋周围环境（包括灌溉田地和果园）是近期登革热感染的重要决定因素。

结论

我们展示了无症状登革热感染的聚集性。在设计当地登革热控制项目时，应考虑近期登革热感染决定因素在空间和时间上的巨大差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c330/1373612/4eb0e080c2d1/1476-072X-5-5-7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c330/1373612/1d382c435306/1476-072X-5-5-1.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c330/1373612/1d382c435306/1476-072X-5-5-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c330/1373612/683cc32ca74c/1476-072X-5-5-2.jpg
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