Duke Global Health Institute, Duke University, Durham, NC 27710, USA.
Nicholas School of the Environment, Duke University, Durham, NC 27710, USA.
Int J Environ Res Public Health. 2020 Oct 13;17(20):7434. doi: 10.3390/ijerph17207434.
Border regions have been implicated as important hot spots of malaria transmission, particularly in Latin America, where free movement rights mean that residents can cross borders using just a national ID. Additionally, rural livelihoods largely depend on short-term migrants traveling across borders via the Amazon's river networks to work in extractive industries, such as logging. As a result, there is likely considerable spillover across country borders, particularly along the border between Peru and Ecuador. This border region exhibits a steep gradient of transmission intensity, with Peru having a much higher incidence of malaria than Ecuador. In this paper, we integrate 13 years of weekly malaria surveillance data collected at the district level in Peru and the canton level in Ecuador, and leverage hierarchical Bayesian spatiotemporal regression models to identify the degree to which malaria transmission in Ecuador is influenced by transmission in Peru. We find that increased case incidence in Peruvian districts that border the Ecuadorian Amazon is associated with increased incidence in Ecuador. Our results highlight the importance of coordinated malaria control across borders.
边境地区被认为是疟疾传播的重要热点地区，特别是在拉丁美洲，那里的居民只需使用国民身份证就可以跨境自由流动。此外，农村生计在很大程度上依赖于短期移民通过亚马逊河网跨境流动，到采矿业等行业工作，如伐木。因此，跨境的疾病传播很可能相当严重，特别是在秘鲁和厄瓜多尔之间的边境地区。该边境地区的传播强度呈陡峭梯度分布，秘鲁的疟疾发病率远高于厄瓜多尔。在本文中，我们整合了秘鲁地区和厄瓜多尔的省级疟疾监测数据，利用分层贝叶斯时空回归模型来确定厄瓜多尔的疟疾传播在多大程度上受到秘鲁传播的影响。我们发现，与厄瓜多尔接壤的秘鲁地区的病例发病率增加与厄瓜多尔的发病率增加有关。我们的研究结果强调了跨境协调疟疾控制的重要性。
