Department of Communicable Diseases, National Centre of Epidemiology, Instituto de Salud Carlos III, Madrid, Spain.
Epidemiology and Public Health Biomedical Network Research Consortium (CIBERESP), Madrid, Spain.
JMIR Public Health Surveill. 2024 May 27;10:e51191. doi: 10.2196/51191.
Understanding the patterns of disease importation through international travel is paramount for effective public health interventions and global disease surveillance. While global airline network data have been used to assist in outbreak prevention and effective preparedness, accurately estimating how these imported cases disseminate locally in receiving countries remains a challenge.
This study aimed to describe and understand the regional distribution of imported cases of dengue and malaria upon arrival in Spain via air travel.
We have proposed a method to describe the regional distribution of imported cases of dengue and malaria based on the computation of the "travelers' index" from readily available socioeconomic data. We combined indicators representing the main drivers for international travel, including tourism, economy, and visits to friends and relatives, to measure the relative appeal of each region in the importing country for travelers. We validated the resulting estimates by comparing them with the reported cases of malaria and dengue in Spain from 2015 to 2019. We also assessed which motivation provided more accurate estimates for imported cases of both diseases.
The estimates provided by the best fitted model showed high correlation with notified cases of malaria (0.94) and dengue (0.87), with economic motivation being the most relevant for imported cases of malaria and visits to friends and relatives being the most relevant for imported cases of dengue.
Factual descriptions of the local movement of international travelers may substantially enhance the design of cost-effective prevention policies and control strategies, and essentially contribute to decision-support systems. Our approach contributes in this direction by providing a reliable estimate of the number of imported cases of nonendemic diseases, which could be generalized to other applications. Realistic risk assessments will be obtained by combining this regional predictor with the observed local distribution of vectors.
了解通过国际旅行输入的疾病模式对于有效的公共卫生干预和全球疾病监测至关重要。虽然全球航空网络数据已被用于协助预防和有效准备爆发，但准确估计这些输入病例在接收国的本地传播仍然是一个挑战。
本研究旨在描述和了解通过航空旅行抵达西班牙的登革热和疟疾输入病例的区域分布。
我们提出了一种方法，通过计算从现成的社会经济数据中得出的“旅行者指数”来描述输入性登革热和疟疾病例的区域分布。我们结合了代表国际旅行主要驱动因素的指标，包括旅游、经济以及探亲访友，以衡量输入国每个地区对旅行者的相对吸引力。我们通过将报告的 2015 年至 2019 年西班牙的疟疾和登革热病例与计算结果进行比较，验证了这些估计的准确性。我们还评估了哪种动机对输入性疟疾和登革热病例的估计更为准确。
最佳拟合模型提供的估计与报告的疟疾病例（0.94）和登革热病例（0.87）高度相关，经济动机对输入性疟疾病例最相关，探亲访友对输入性登革热病例最相关。
对国际旅行者的本地活动的实际描述可以大大增强具有成本效益的预防政策和控制策略的设计，并为决策支持系统做出基本贡献。我们的方法通过提供可靠的非地方性疾病输入病例数的估计值，朝着这个方向做出了贡献，这些估计值可以推广到其他应用。通过将这种区域预测器与观察到的本地媒介分布相结合，可以获得更现实的风险评估。
