Vanke School of Public Health, Tsinghua University, Beijing, China.
Institute for Healthy China, Tsinghua University, Beijing, China.
Front Public Health. 2023 Jan 24;11:1052946. doi: 10.3389/fpubh.2023.1052946. eCollection 2023.
BACKGROUND: Ninety-eight percent of documented cases of the zoonotic disease human monkeypox (MPX) were reported after 2001, with especially dramatic global spread in 2022. This longitudinal study aimed to assess spatiotemporal risk factors of MPX infection and predict global epidemiological trends. METHOD: Twenty-one potential risk factors were evaluated by correlation-based network analysis and multivariate regression. Country-level risk was assessed using a modified Susceptible-Exposed-Infectious-Removed (SEIR) model and a risk-factor-driven k-means clustering analysis. RESULTS: Between historical cases and the 2022 outbreak, MPX infection risk factors changed from relatively simple [human immunodeficiency virus (HIV) infection and population density] to multiple [human mobility, population of men who have sex with men, coronavirus disease 2019 (COVID-19) infection, and socioeconomic factors], with human mobility in the context of COVID-19 being especially key. The 141 included countries classified into three risk clusters: 24 high-risk countries mainly in West Europe and Northern America, 70 medium-risk countries mainly in Latin America and Asia, and 47 low-risk countries mainly in Africa and South Asia. The modified SEIR model predicted declining transmission rates, with basic reproduction numbers ranging 1.61-7.84 in the early stage and 0.70-4.13 in the current stage. The estimated cumulative cases in Northern and Latin America may overtake the number in Europe in autumn 2022. CONCLUSIONS: In the current outbreak, risk factors for MPX infection have changed and expanded. Forecasts of epidemiological trends from our modified SEIR models suggest that Northern America and Latin America are at greater risk of MPX infection in the future.
背景:有记录的 98%的人畜共患疾病人类猴痘(MPX)病例是在 2001 年后报告的,2022 年全球尤其出现了戏剧性的广泛传播。这项纵向研究旨在评估 MPX 感染的时空风险因素,并预测全球流行病学趋势。
方法:通过基于相关性的网络分析和多元回归评估了 21 个潜在的风险因素。使用改进的易感-暴露-感染-消除(SEIR)模型和风险因素驱动的 K 均值聚类分析评估国家层面的风险。
结果:在历史病例和 2022 年疫情之间,MPX 感染的风险因素从相对简单的(人类免疫缺陷病毒(HIV)感染和人口密度)转变为多种(人类流动性、男男性行为人群、2019 年冠状病毒病(COVID-19)感染和社会经济因素),特别是在 COVID-19 背景下的人类流动性尤为关键。所包括的 141 个国家分为三个风险集群:24 个高风险国家主要在西欧和北美,70 个中风险国家主要在拉丁美洲和亚洲,47 个低风险国家主要在非洲和南亚。改进的 SEIR 模型预测传播率下降,基本繁殖数在早期范围为 1.61-7.84,在当前阶段为 0.70-4.13。预计 2022 年秋季,北美和拉丁美洲的累积病例可能超过欧洲的病例数。
结论:在当前疫情中,MPX 感染的风险因素已经发生变化和扩大。我们的改进 SEIR 模型对流行病学趋势的预测表明,未来北美和拉丁美洲感染 MPX 的风险更大。
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