Tahmo Nancy B, Wirsiy Frankline Sevidzem, Brett-Major David M
University of Nebraska Medical Center, Omaha, NE, United States of America.
Africa Centres for Disease Control and Prevention (Africa CDC), Addis Ababa, Ethiopia.
PLOS Glob Public Health. 2023 May 16;3(5):e0001814. doi: 10.1371/journal.pgph.0001814. eCollection 2023.
Nigeria struggles with seasonal outbreaks of Lassa fever (LF), with 70 to 100% of its states affected annually. Since 2018, the seasonal dynamics have changed with a stark increase in infections, though the pattern in 2021 differed from the other years. Nigeria had three outbreaks of Lassa Fever in 2021. In that year, Nigeria also experienced substantial burdens from COVID-19 and Cholera. There is potential that these three outbreak events interacted with each other. This may have been from community disruption and so changes in how people access the health system, how the health system responds, or overlapping biological interactions, misclassification, social factors, misinformation, and pre-existing disparities and vulnerabilities. We assessed the syndemic potential of Lassa Fever, COVID-19, and Cholera through modeling their interactions across the 2021 calendar year employing a Poisson regression model. We included the number of states affected and the month of the year. We used these predictors to forecast the progression of the outbreak using a Seasonal Autoregressive Integrated Moving Average (SARIMA) model. The Poisson model prediction for the confirmed number of Lassa fever cases was significantly dependent on the number of confirmed COVID-19 cases, the number of states affected, and the month of the year (p-value < 0.001), and the SARIMA model was a good fit, accounting for 48% of the change in the number of cases of Lassa fever (p-value < 0.001) with parameters ARIMA (6, 1, 3) (5, 0, 3). Lassa Fever, COVID-19, and Cholera 2021 case curves have mirrored dynamics and likely interact. Further research into common, intervenable aspects of those interactions should be performed.
尼日利亚饱受拉沙热季节性疫情之苦，每年有70%至100%的州受到影响。自2018年以来，季节性动态发生了变化，感染人数大幅增加，不过2021年的模式与其他年份不同。2021年尼日利亚发生了三次拉沙热疫情。同年，尼日利亚还承受了来自新冠疫情和霍乱的沉重负担。这三次疫情有可能相互影响。这可能是由于社区混乱，以及人们获取医疗系统的方式、医疗系统的应对方式发生了变化，或者是由于生物相互作用重叠、错误分类、社会因素、错误信息以及先前存在的差异和脆弱性。我们通过使用泊松回归模型对2021年全年这三种疾病的相互作用进行建模，评估了拉沙热、新冠疫情和霍乱的共病潜力。我们纳入了受影响的州数量和年份月份。我们使用这些预测变量，通过季节性自回归积分滑动平均（SARIMA）模型预测疫情的发展。泊松模型对确诊拉沙热病例数的预测显著取决于确诊新冠病例数、受影响的州数量和年份月份（p值<0.001），并且SARIMA模型拟合良好，解释了拉沙热病例数变化的48%（p值<0.001），参数为ARIMA(6, 1, 3)(5, 0, 3)。2021年拉沙热、新冠疫情和霍乱的病例曲线呈现出相似的动态，很可能相互影响。应该对这些相互作用的共同、可干预方面进行进一步研究。
