US Department of Health and Human Services, 5600 Fishers Lane, Rockville, MD 20857, USA.
Int Health. 2011 Mar;3(1):15-21. doi: 10.1016/j.inhe.2011.01.001.
Many neglected tropical and vector-borne diseases continue to emerge and reemerge in Africa where a significant number of governments have limited state capacity. The reasons these diseases resurface are numerous and this problem remains unsolved. This study contributes to existing research by examining how economic and sociopolitical attributes of state capacity influence the transmission of disease in a population. This ecological study examined relationships between state capacity and the epidemiology of five neglected tropical and vector-borne diseases in a sample of 33 African countries. Regression analyses were used to examine the relationships between state capacity, i.e., economic and sociopolitical attributes, and disease burden, incidence, prevention/control and mortality. Results revealed statistically significant relationships between state capacity and the following dependent variables: all disease-burden variables; insecticide-treated-nets prevention and control; and all age-related and human African trypanosomiasis mortalities. A broad range of effect sizes (R(2) = 0.02-0.59) were observed and the economic and sociopolitical attributes of state capacity made different contributions to these effects. Future studies should explore the economic and sociopolitical attributes of state capacity that influence disease transmission by examining different populations or diseases, and by using different research methods.
许多被忽视的热带病和媒介传播疾病继续在非洲出现和再现，而在这些国家中，相当数量的政府的国家能力有限。这些疾病再次出现的原因很多，而且这个问题仍然没有得到解决。本研究通过考察国家能力的经济和社会政治属性如何影响人口中疾病的传播，为现有研究做出了贡献。这项生态研究调查了 33 个非洲国家样本中，国家能力（即经济和社会政治属性）与五种被忽视的热带病和媒介传播疾病的流行病学之间的关系。回归分析用于检验国家能力与疾病负担、发病率、预防/控制和死亡率之间的关系。结果表明，国家能力与以下因变量之间存在统计学上显著的关系：所有疾病负担变量；经杀虫剂处理的蚊帐预防和控制；以及所有与年龄相关的和人类非洲锥虫病死亡率。观察到广泛的效应大小（R²=0.02-0.59），国家能力的经济和社会政治属性对这些影响有不同的贡献。未来的研究应该通过研究不同的人群或疾病，以及使用不同的研究方法，探讨影响疾病传播的国家能力的经济和社会政治属性。
