Associated Laboratory TERRA, Institute of Geography and Spatial Planning, University of Lisbon, Lisbon, Portugal.
Associated Laboratory TERRA, Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon, Lisbon, Portugal.
Front Public Health. 2024 Jul 3;12:1359167. doi: 10.3389/fpubh.2024.1359167. eCollection 2024.
Nowadays, epidemiological modeling is applied to a wide range of diseases, communicable and non-communicable, namely AIDS, Ebola, influenza, Dengue, Malaria, Zika. More recently, in the context of the last pandemic declared by the World Health Organization (WHO), several studies applied these models to SARS-CoV-2. Despite the increasing number of researches using spatial analysis, some constraints persist that prevent more complex modeling such as capturing local epidemiological dynamics or capturing the real patterns and dynamics. For example, the unavailability of: (i) epidemiological information such as the frequency with which it is made available; (ii) sociodemographic and environmental factors (e.g., population density and population mobility) at a finer scale which influence the evolution patterns of infectious diseases; or (iii) the number of cases information that is also very dependent on the degree of testing performed, often with severe territorial disparities and influenced by context factors. Moreover, the delay in case reporting and the lack of quality control in epidemiological information is responsible for biases in the data that lead to many results obtained being subject to the ecological fallacy, making it difficult to identify causal relationships. Other important methodological limitations are the control of spatiotemporal dependence, management of non-linearity, ergodicy, among others, which can impute inconsistencies to the results. In addition to these issues, social contact, is still difficult to quantify in order to be incorporated into modeling processes. This study aims to explore a modeling framework that can overcome some of these modeling methodological limitations to allow more accurate modeling of epidemiological diseases. Based on Geographic Information Systems (GIS) and spatial analysis, our model is developed to identify group of municipalities where population density (vulnerability) has a stronger relationship with incidence (hazard) and commuting movements (exposure). Specifically, our framework shows how to operate a model over data with no clear trend or seasonal pattern which is suitable for a short-term predicting (i.e., forecasting) of cases based on few determinants. Our tested models provide a good alternative for when explanatory data is few and the time component is not available, once they have shown a good fit and good short-term forecast ability.
如今,流行病学模型被应用于广泛的疾病,包括传染病和非传染病,如艾滋病、埃博拉、流感、登革热、疟疾、寨卡。最近,在世界卫生组织(WHO)宣布的上一次大流行背景下,一些研究将这些模型应用于 SARS-CoV-2。尽管越来越多的研究使用空间分析,但仍存在一些限制因素,这些因素阻碍了更复杂的建模,例如捕捉局部流行病学动态或捕捉真实的模式和动态。例如,存在以下方面的不足:(i)流行病学信息的可用性,例如可用频率;(ii)社会人口学和环境因素(例如人口密度和人口流动性)的细化程度,这些因素影响传染病的演变模式;或(iii)病例信息的数量,这也非常依赖于所进行的检测程度,往往存在严重的地域差异,并受到背景因素的影响。此外,病例报告的延迟以及流行病学信息的质量控制不足,导致数据存在偏差,从而使许多研究结果受到生态谬误的影响,使得识别因果关系变得困难。其他重要的方法学限制因素包括时空依赖性的控制、非线性的管理、遍历性等,这些因素会给结果带来不一致性。除了这些问题之外,社会接触仍然难以量化,以便纳入建模过程。本研究旨在探索一种建模框架,可以克服一些建模方法上的局限性,从而更准确地对传染病进行建模。基于地理信息系统(GIS)和空间分析,我们的模型旨在确定一些城市地区,这些地区的人口密度(脆弱性)与发病率(危害)和通勤活动(暴露)之间存在更强的关系。具体来说,我们的框架展示了如何在没有明显趋势或季节性模式的数据上运行模型,这适用于基于少数决定因素进行短期预测(即病例预测)。我们测试的模型提供了一个很好的替代方案,适用于解释性数据较少且时间成分不可用时的情况,因为它们表现出了良好的拟合度和短期预测能力。