Mulligan Kate, Dixon Jenna, Sinn Chi-Ling Joanna, Elliott Susan J
Pathog Glob Health. 2015 Feb;109(1):10-8. doi: 10.1179/2047773214Y.0000000168. Epub 2014 Dec 29.
Policy prescriptions for combating dengue fever tend to focus on addressing environmental and social conditions of poverty. However, while poverty has long been considered a determinant of dengue, the research evidence for such a relationship is not well established. Results of a systematic review of the research literature designed to identify and assess the current state of the empirical evidence for the dengue-poverty link reveal a mixed story. Of 260 peer-reviewed articles referencing dengue-poverty relationships, only 12 English-language studies empirically assessed these relationships. Our analysis covering various social and economic conditions of poverty showed no clear associations with dengue rates. While nine of the 12 studies demonstrated some positive associations between measures of dengue and poverty (measured inconsistently through income, education, structural housing condition, overcrowding, and socioeconomic status), nine also presented null results and five with negative results. Of the five studies relating to access to water and sanitation, four reported null associations. Income and physical housing conditions were more consistently correlated with dengue outcomes than other poverty indicators. The small size of this sample, and the heterogeneity of measures and scales used to capture conditions of poverty, make it difficult to assess the strength and consistency of associations between various poverty indicators and dengue outcomes. At present, the global body of eligible English-language peer-reviewed literature investigating dengue-poverty relationships is too small to support a definitive relationship. We conclude that more research, particularly using standardized measures of both outcomes and indicators, is needed to support evidence-informed policies and approaches.
抗击登革热的政策处方往往侧重于解决贫困的环境和社会状况。然而，尽管长期以来贫困一直被视为登革热的一个决定因素，但这种关系的研究证据并不充分。一项旨在识别和评估登革热与贫困联系的实证证据现状的研究文献系统综述结果显示情况不一。在260篇引用登革热与贫困关系的同行评议文章中，只有12项英文研究对这些关系进行了实证评估。我们对各种贫困社会和经济状况的分析表明，与登革热发病率没有明显关联。虽然12项研究中的9项表明登革热指标与贫困之间存在一些正相关（通过收入、教育、结构性住房条件、过度拥挤和社会经济地位进行了不一致的衡量），但也有9项研究呈现出无关联结果，5项呈现出负相关结果。在与获得水和卫生设施相关的5项研究中，4项报告无关联。与其他贫困指标相比，收入和实际住房条件与登革热结果的相关性更为一致。由于该样本规模较小，以及用于衡量贫困状况的方法和尺度存在异质性，因此难以评估各种贫困指标与登革热结果之间关联的强度和一致性。目前，全球范围内研究登革热与贫困关系的符合条件的英文同行评议文献数量太少，无法支持确定的关系。我们得出结论，需要进行更多研究，特别是使用结果和指标的标准化衡量方法，以支持基于证据的政策和方法。
