School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong, China.
School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.
PLoS Negl Trop Dis. 2018 Mar 21;12(3):e0006318. doi: 10.1371/journal.pntd.0006318. eCollection 2018 Mar.
This study aimed to investigate the spatiotemporal clustering and socio-environmental factors associated with dengue fever (DF) incidence rates at street level in Guangzhou city, China.
Spatiotemporal scan technique was applied to identify the high risk region of DF. Multiple regression model was used to identify the socio-environmental factors associated with DF infection. A Poisson regression model was employed to examine the spatiotemporal patterns in the spread of DF.
Spatial clusters of DF were primarily concentrated at the southwest part of Guangzhou city. Age group (65+ years) (Odd Ratio (OR) = 1.49, 95% Confidence Interval (CI) = 1.13 to 2.03), floating population (OR = 1.09, 95% CI = 1.05 to 1.15), low-education (OR = 1.08, 95% CI = 1.01 to 1.16) and non-agriculture (OR = 1.07, 95% CI = 1.03 to 1.11) were associated with DF transmission. Poisson regression results indicated that changes in DF incidence rates were significantly associated with longitude (β = -5.08, P<0.01) and latitude (β = -1.99, P<0.01).
The study demonstrated that social-environmental factors may play an important role in DF transmission in Guangzhou. As geographic range of notified DF has significantly expanded over recent years, an early warning systems based on spatiotemporal model with socio-environmental is urgently needed to improve the effectiveness and efficiency of dengue control and prevention.
本研究旨在调查中国广州市街级登革热(DF)发病率的时空聚集性及其与社会环境因素的关系。
应用时空扫描技术确定 DF 的高风险区域。采用多元回归模型确定与 DF 感染相关的社会环境因素。采用泊松回归模型检验 DF 传播的时空模式。
DF 的空间聚集主要集中在广州市的西南部。年龄组(65 岁以上)(优势比(OR)= 1.49,95%置信区间(CI)= 1.13 至 2.03)、流动人口(OR = 1.09,95% CI = 1.05 至 1.15)、低教育程度(OR = 1.08,95% CI = 1.01 至 1.16)和非农业(OR = 1.07,95% CI = 1.03 至 1.11)与 DF 传播有关。泊松回归结果表明,DF 发病率的变化与经度(β=-5.08,P<0.01)和纬度(β=-1.99,P<0.01)显著相关。
本研究表明,社会环境因素可能在广州的 DF 传播中发挥重要作用。由于近年来通报的 DF 地理范围显著扩大,因此迫切需要基于时空模型和社会环境因素的预警系统,以提高登革热控制和预防的效果和效率。