气候适宜性、城市化和连通性对 21 世纪巴西登革热传播的影响。

The impact of climate suitability, urbanisation, and connectivity on the expansion of dengue in 21st century Brazil.

机构信息

Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom.

Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, United Kingdom.

出版信息

PLoS Negl Trop Dis. 2021 Dec 9;15(12):e0009773. doi: 10.1371/journal.pntd.0009773. eCollection 2021 Dec.

Abstract

Dengue is hyperendemic in Brazil, with outbreaks affecting all regions. Previous studies identified geographical barriers to dengue transmission in Brazil, beyond which certain areas, such as South Brazil and the Amazon rainforest, were relatively protected from outbreaks. Recent data shows these barriers are being eroded. In this study, we explore the drivers of this expansion and identify the current limits to the dengue transmission zone. We used a spatio-temporal additive model to explore the associations between dengue outbreaks and temperature suitability, urbanisation, and connectivity to the Brazilian urban network. The model was applied to a binary outbreak indicator, assuming the official threshold value of 300 cases per 100,000 residents, for Brazil's municipalities between 2001 and 2020. We found a nonlinear relationship between higher levels of connectivity to the Brazilian urban network and the odds of an outbreak, with lower odds in metropoles compared to regional capitals. The number of months per year with suitable temperature conditions for Aedes mosquitoes was positively associated with the dengue outbreak occurrence. Temperature suitability explained most interannual and spatial variation in South Brazil, confirming this geographical barrier is influenced by lower seasonal temperatures. Municipalities that had experienced an outbreak previously had double the odds of subsequent outbreaks. We identified geographical barriers to dengue transmission in South Brazil, western Amazon, and along the northern coast of Brazil. Although a southern barrier still exists, it has shifted south, and the Amazon no longer has a clear boundary. Few areas of Brazil remain protected from dengue outbreaks. Communities living on the edge of previous barriers are particularly susceptible to future outbreaks as they lack immunity. Control strategies should target regions at risk of future outbreaks as well as those currently within the dengue transmission zone.

摘要

登革热在巴西高度流行,疫情爆发影响所有地区。先前的研究确定了巴西登革热传播的地理障碍,在这些障碍之外,某些地区,如南里奥格兰德州和亚马逊雨林,相对免受疫情爆发的影响。最近的数据显示,这些障碍正在被侵蚀。在这项研究中,我们探讨了这种扩张的驱动因素,并确定了登革热传播区的当前限制。我们使用时空附加模型来探索登革热疫情与温度适宜性、城市化和与巴西城市网络的连通性之间的关联。该模型应用于巴西各城市 2001 年至 2020 年的二进制疫情指标,假设官方阈值为每 10 万居民 300 例。我们发现,与巴西城市网络的连通性较高与疫情爆发的几率呈非线性关系,与区域首府相比,大都市的几率较低。适宜白纹伊蚊生存的温度条件的月数与登革热疫情的发生呈正相关。温度适宜性解释了南里奥格兰德州大部分的年际和空间变化,证实了这种地理障碍受到季节性温度较低的影响。以前发生过疫情的城市,随后爆发疫情的几率是之前的两倍。我们确定了南里奥格兰德州、西部亚马逊地区和巴西北部沿海地区的登革热传播地理障碍。尽管南部仍存在障碍,但它已经向南转移,亚马逊地区不再有明确的边界。巴西很少有地区免受登革热疫情的影响。生活在以前的障碍边缘的社区特别容易受到未来疫情的影响,因为他们没有免疫力。控制策略应针对有未来疫情风险的地区以及目前处于登革热传播区的地区。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f03d/8691609/ed0f06cf30f4/pntd.0009773.g001.jpg

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