Keat-Chuan Ng Casey, Linus-Lojikip Sharon, Mohamed Khairunnisa, Hss Amar-Singh
School of Biological Sciences, Universiti Sains Malaysia, 11800 Penang, Malaysia.
Clinical Research Centre, Hospital Raja Permaisuri Bainun, Ministry of Health, Jalan Raja Ashman Shah, 30450 Ipoh, Perak, Malaysia.
Int J Med Inform. 2023 Sep;177:105162. doi: 10.1016/j.ijmedinf.2023.105162. Epub 2023 Jul 25.
Dengue is widespread globally, but it is more severe in hyperendemic regions where the virus, its vectors, and its human hosts naturally occur. The problem is particularly acute in cities, where outbreaks affect a large human population living in a wide array of socio-environmental conditions. Controlling outbreaks will rely largely on systematic data collection and analysis approaches to uncover nuances on a city-by-city basis due to the diversity of factors.
The main objective of this study is to consolidate and analyse the dengue case dataset amassed by the e-Dengue web-based information system, developed by the Ministry of Health Malaysia, to improve our epidemiological understanding.
We retrieved data from the e-Dengue system and integrated a total of 18,812 cases from 2012 to 2019 (8 years) with meteorological data, geoinformatics techniques, and socio-environmental observations to identify plausible factors that could have caused dengue outbreaks in Ipoh, a hyperendemic city in Malaysia.
The rainfall trend characterised by a linearity of R > 0.99, termed the "wet-dry steps", may be the unifying factor for triggering dengue outbreaks, though it is still a hypothesis that needs further validation. Successful mapping of the dengue "reservoir" contact zones and spill-over diffusion revealed socio-environmental factors that may be controlled through preventive measures. Age is another factor to consider, as the platelet and white blood cell counts in the "below 5" age group are much greater than in other age groups.
Our work demonstrates the novelty of the e-Dengue system, which can identify outbreak factors at high resolution when integrated with non-medical fields. Besides dengue, the techniques and insights laid out in this paper are valuable, at large, for advancing control strategies for other mosquito-borne diseases such as malaria, chikungunya, and zika in other hyperendemic cities elsewhere globally.
登革热在全球广泛传播，但在病毒、其传播媒介及其人类宿主自然存在的高度流行地区更为严重。这个问题在城市中尤为突出，在城市中，疫情爆发影响着生活在各种社会环境条件下的大量人群。由于影响因素的多样性，控制疫情将在很大程度上依赖于系统的数据收集和分析方法，以便逐个城市地发现细微差别。
本研究的主要目的是整合和分析由马来西亚卫生部开发的基于网络的电子登革热信息系统收集的登革热病例数据集，以增进我们对流行病学的理解。
我们从电子登革热系统中检索数据，并将2012年至2019年（8年）的总共１８８１２个病例与气象数据、地理信息学技术和社会环境观测数据相结合，以确定可能导致马来西亚高度流行城市怡保登革热疫情爆发的合理因素。
以R>0.99的线性为特征的降雨趋势，称为“干湿步”，可能是引发登革热疫情的统一因素，尽管这仍然是一个需要进一步验证的假设。登革热“储存库”接触区和溢出扩散的成功映射揭示了可以通过预防措施加以控制的社会环境因素。年龄是另一个需要考虑的因素，因为“5岁以下”年龄组的血小板和白细胞计数远高于其他年龄组。
我们的工作展示了电子登革热系统的新颖性，该系统与非医学领域整合时能够高分辨率地识别疫情爆发因素。除登革热外，本文阐述的技术和见解总体上对于推进全球其他高度流行城市中疟疾、基孔肯雅热和寨卡等其他蚊媒疾病的控制策略具有重要价值。
