Fuller D O, Troyo A, Alimi T O, Beier J C
Department of Geography and Regional Studies, University of Miami, Coral Gables, FL USA.
Centro de Investigación en Enfermedades Tropicales, Facultad de Microbiología, Universidad de Costa Rica, SanJosé, Costa Rica.
Appl Geogr. 2014 Mar 1;48:1-7. doi: 10.1016/j.apgeog.2014.01.002.
Malaria elimination remains a major public health challenge in many tropical regions, including large areas of northern South America. In this study, we present a new high spatial resolution (90 × 90 m) risk map for Colombia and surrounding areas based on environmental and human population data. The map was created through a participatory multi-criteria decision analysis in which expert opinion was solicited to determine key environmental and population risk factors, different fuzzy functions to standardize risk factor inputs, and variable factor weights to combine risk factors in a geographic information system. The new risk map was compared to a map of malaria cases in which cases were aggregated to the municipio (municipality) level. The relationship between mean municipio risk scores and total cases by muncípio showed a weak correlation. However, the relationship between pixel-level risk scores and vector occurrence points for two dominant vector species, and , was significantly different (p < 0.05) from a random point distribution, as was a pooled point distribution for these two vector species and . Thus, we conclude that the new risk map derived based on expert opinion provides an accurate spatial representation of risk of potential vector exposure rather than malaria transmission as shown by the pattern of malaria cases, and therefore it may be used to inform public health authorities as to where vector control measures should be prioritized to limit human-vector contact in future malaria outbreaks.
疟疾消除在包括南美洲北部大片地区在内的许多热带地区仍然是一项重大的公共卫生挑战。在本研究中,我们基于环境和人口数据,为哥伦比亚及周边地区绘制了一幅新的高空间分辨率(90×90米)风险地图。该地图是通过参与式多标准决策分析创建的,在分析过程中征求了专家意见以确定关键的环境和人口风险因素、用于标准化风险因素输入的不同模糊函数以及用于在地理信息系统中组合风险因素的可变因素权重。将新的风险地图与疟疾病例地图进行了比较,在疟疾病例地图中,病例被汇总到市一级。市平均风险得分与各市总病例数之间的关系显示出较弱的相关性。然而,两种主要病媒物种(按蚊属和伊蚊属)的像素级风险得分与病媒出现点之间的关系与随机点分布存在显著差异(p<0.05),这两种病媒物种的合并点分布情况也是如此。因此,我们得出结论,基于专家意见得出的新风险地图提供了潜在病媒暴露风险的准确空间表示,而不是如疟疾病例模式所示的疟疾传播风险,因此它可用于告知公共卫生当局在未来疟疾疫情中应优先在何处采取病媒控制措施以限制人与病媒的接触。