Lin Chia-Hsien, Wen Tzai-Hung
Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei City, Taiwan.
Department of Geography, National Taiwan University, Taipei City, Taiwan.
Heliyon. 2024 Mar 10;10(6):e27931. doi: 10.1016/j.heliyon.2024.e27931. eCollection 2024 Mar 30.
The patterns of dengue are affected by many factors, including population density and climate factors. Densely populated areas could play a role in dengue transmission due to increased human-mosquito contacts, the presence of more diverse and suitable vector habitats and breeding sites, and changes in land use. In addition to population densities, climatic factors such as temperature, relative humidity, and precipitation have been demonstrated to predict dengue patterns. To control dengue, emergency measures should focus on vector management. Most approaches to assessing emergency responses to dengue risks involve applying simulation models or describing emergency activities and the results of implementing those responses. Research using real-world data with analytical methods to evaluate emergency responses to dengue has been limited. This study investigated emergency control measures associated with dengue risks in areas with high and low population densities, considering their different control capacities.
Data from the 2015 dengue outbreak in Kaohsiung City, Taiwan, were utilized. The government database provided information on confirmed dengue cases, emergency control measures, and climatic data. The study employed a distributed lag non-linear model (DLNM) to assess the effect of emergency control measures and their time lags on dengue risk.
The findings revealed that in areas with high population density, the absence of emergency measures significantly elevated the risks of dengue. However, implementing emergency measures, especially a higher number, was associated with lower risks. In contrast, in areas with low population density, the risks of dengue were only significantly elevated at the 1st week lag if no emergency control measures were implemented. When emergency activities were carried out, the risks of dengue significantly decreased only for the 1st week lag.
Our findings reveal distinct exposure-lag-response patterns in the associations between emergency control measures and dengue in areas with high and low population density. In regions with a high population density, implementing emergency activities during a significant dengue outbreak is crucial for reducing the risk. Conversely, in areas of low population density, the necessity of applying emergency activities may be less pronounced. The implications of this study on dengue management could provide valuable insights for health authorities dealing with limited resources.
登革热的流行模式受多种因素影响，包括人口密度和气候因素。人口密集地区可能因人类与蚊子接触增加、存在更多样化且适宜的病媒栖息地和繁殖场所以及土地利用变化而在登革热传播中发挥作用。除人口密度外，温度、相对湿度和降水等气候因素已被证明可预测登革热流行模式。为控制登革热，应急措施应侧重于病媒管理。大多数评估登革热风险应急响应的方法包括应用模拟模型或描述应急活动及实施这些响应的结果。利用实际数据和分析方法评估登革热应急响应的研究有限。本研究考虑了不同的控制能力，调查了高人口密度和低人口密度地区与登革热风险相关的应急控制措施。
利用台湾高雄市2015年登革热疫情的数据。政府数据库提供了确诊登革热病例、应急控制措施和气候数据的信息。该研究采用分布滞后非线性模型（DLNM）评估应急控制措施及其时间滞后对登革热风险的影响。
研究结果显示，在高人口密度地区，不采取应急措施会显著增加登革热风险。然而，实施应急措施，尤其是更多的应急措施，与较低风险相关。相比之下，在低人口密度地区，若不实施应急控制措施，仅在滞后第1周登革热风险会显著升高。当开展应急活动时，仅在滞后第1周登革热风险会显著降低。
我们的研究结果揭示了高人口密度和低人口密度地区应急控制措施与登革热之间关联的不同暴露-滞后-反应模式。在人口密度高的地区，在重大登革热疫情期间实施应急活动对于降低风险至关重要。相反，在人口密度低的地区，实施应急活动的必要性可能不太明显。本研究对登革热管理的意义可为资源有限的卫生当局提供有价值的见解。
