Lee Jung-Seok, Carabali Mabel, Lim Jacqueline K, Herrera Victor M, Park Il-Yeon, Villar Luis, Farlow Andrew
Department of Zoology, The University of Oxford, The Tinbergen Building, South Parks Road, Oxford, OX1 3PS, UK.
Department of Epidemiology, McGill University, Biostatistics and Occupational Health, Purvis Hall, 1020 Pine Avenue West, Quebec, Montreal, H3A1A2, Canada.
BMC Infect Dis. 2017 Jul 10;17(1):480. doi: 10.1186/s12879-017-2577-4.
Dengue has been prevalent in Colombia with high risk of outbreaks in various locations. While the prediction of dengue epidemics will bring significant benefits to the society, accurate forecasts have been a challenge. Given competing health demands in Colombia, it is critical to consider the effective use of the limited healthcare resources by identifying high risk areas for dengue fever.
The Climate Risk Factor (CRF) index was constructed based upon temperature, precipitation, and humidity. Considering the conditions necessary for vector survival and transmission behavior, elevation and population density were taken into account. An Early Warning Signal (EWS) model was developed by estimating the elasticity of the climate risk factor function to detect dengue epidemics. The climate risk factor index was further estimated at the smaller geographical unit (5 km by 5 km resolution) to identify populations at high risk.
From January 2007 to December 2015, the Early Warning Signal model successfully detected 75% of the total number of outbreaks 1 ~ 5 months ahead of time, 12.5% in the same month, and missed 12.5% of all outbreaks. The climate risk factors showed that populations at high risk are concentrated in the Western part of Colombia where more suitable climate conditions for vector mosquitoes and the high population level were observed compared to the East.
This study concludes that it is possible to detect dengue outbreaks ahead of time and identify populations at high risk for various disease prevention activities based upon observed climate and non-climate information. The study outcomes can be used to minimize potential societal losses by prioritizing limited healthcare services and resources, as well as by conducting vector control activities prior to experiencing epidemics.
登革热在哥伦比亚一直很流行,各地爆发疫情的风险很高。虽然登革热疫情预测将给社会带来巨大益处,但准确预测一直是一项挑战。鉴于哥伦比亚存在相互竞争的卫生需求,通过识别登革热高热风险地区来有效利用有限的医疗资源至关重要。
基于温度、降水和湿度构建气候风险因素(CRF)指数。考虑到病媒生存和传播行为所需的条件,还纳入了海拔和人口密度因素。通过估计气候风险因素函数的弹性来开发早期预警信号(EWS)模型,以检测登革热疫情。进一步在较小的地理单元(5公里×5公里分辨率)估计气候风险因素指数,以识别高风险人群。
2007年1月至2015年12月,早期预警信号模型成功提前1至5个月检测到75%的疫情,同月检测到12.5%的疫情,未检测到12.5%的疫情。气候风险因素显示,高风险人群集中在哥伦比亚西部,与东部相比,那里观察到更适合病媒蚊子生存的气候条件和更高的人口水平。
本研究得出结论,根据观测到的气候和非气候信息,可以提前检测登革热疫情并识别高风险人群,以开展各种疾病预防活动。研究结果可用于通过优先安排有限的医疗服务和资源,以及在疫情发生前开展病媒控制活动,将潜在的社会损失降至最低。