Department of Epidemiology and Biostatistics, School of Public Health, Fudan University, Shanghai, China.
Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China.
Epidemiol Health. 2024;46:e2024039. doi: 10.4178/epih.e2024039. Epub 2024 Mar 13.
To achieve the ambitious goal of eliminating schistosome infections, the Chinese government has implemented diverse control strategies. This study explored the progress of the 2 most recent national schistosomiasis control programs in an endemic area along the Yangtze River in China.
We obtained village-level parasitological data from cross-sectional surveys combined with environmental data in Anhui Province, China from 1997 to 2015. A convolutional neural network (CNN) based on a hierarchical integro-difference equation (IDE) framework (i.e., CNN-IDE) was used to model spatio-temporal variations in schistosomiasis. Two traditional models were also constructed for comparison with 2 evaluation indicators: the mean-squared prediction error (MSPE) and continuous ranked probability score (CRPS).
The CNN-IDE model was the optimal model, with the lowest overall average MSPE of 0.04 and the CRPS of 0.19. From 1997 to 2011, the prevalence exhibited a notable trend: it increased steadily until peaking at 1.6 per 1,000 in 2005, then gradually declined, stabilizing at a lower rate of approximately 0.6 per 1,000 in 2006, and approaching zero by 2011. During this period, noticeable geographic disparities in schistosomiasis prevalence were observed; high-risk areas were initially dispersed, followed by contraction. Predictions for the period 2012 to 2015 demonstrated a consistent and uniform decrease.
The proposed CNN-IDE model captured the intricate and evolving dynamics of schistosomiasis prevalence, offering a promising alternative for future risk modeling of the disease. The comprehensive strategy is expected to help diminish schistosomiasis infection, emphasizing the necessity to continue implementing this strategy.
为了实现消除血吸虫感染的宏伟目标,中国政府实施了多种控制策略。本研究探索了中国长江流域一个流行地区最近实施的两个国家血吸虫病控制项目的进展情况。
我们从 1997 年到 2015 年在中国安徽省获得了基于横断面调查的村级寄生虫学数据,并结合环境数据。使用基于层次积分差分方程(IDE)框架的卷积神经网络(CNN)(即 CNN-IDE)来模拟血吸虫病的时空变化。还构建了两个传统模型,并用两个评估指标进行比较:均方预测误差(MSPE)和连续排名概率得分(CRPS)。
CNN-IDE 模型是最优模型,总平均 MSPE 最低为 0.04,CRPS 为 0.19。1997 年至 2011 年,患病率呈显著趋势:从 2005 年的 1.6/1000 稳步上升,然后逐渐下降,2006 年稳定在约 0.6/1000 的较低水平,到 2011 年接近零。在此期间,观察到血吸虫病患病率存在明显的地理差异;高风险地区最初呈分散状态,随后收缩。对 2012 年至 2015 年期间的预测表明,患病率呈持续一致的下降趋势。
所提出的 CNN-IDE 模型捕捉到了血吸虫病患病率的复杂和不断演变的动态,为该疾病的未来风险建模提供了一个有前途的替代方案。综合策略有望帮助减少血吸虫感染,强调继续实施这一策略的必要性。