Doctor of Public Health Program, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand.
Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
Sci Rep. 2024 Sep 12;14(1):21327. doi: 10.1038/s41598-024-71807-3.
Dengue, a zoonotic viral disease transmitted by Aedes mosquitoes, poses a significant public health concern throughout the Lao People's Democratic Republic (Lao PDR). This study aimed to describe spatial-temporal patterns and quantify the effects of environmental and climate variables on dengue transmission at the district level. The dengue data from 2015 to 2020 across 148 districts of Lao PDR were obtained from the Lao PDR National Center for Laboratory and Epidemiology (NCLE). The association between monthly dengue occurrences and environmental and climate variations was investigated using a multivariable Zero-inflated Poisson regression model developed in a Bayesian framework. The study analyzed a total of 72,471 dengue cases with an incidence rate of 174 per 100,000 population. Each year, incidence peaked from June to September and a large spike was observed in 2019. The Bayesian spatio-temporal model revealed a 9.1% decrease (95% credible interval [CrI] 8.9%, 9.2%) in dengue incidence for a 0.1 unit increase in monthly normalized difference vegetation index at a 1-month lag and a 5.7% decrease (95% CrI 5.3%, 6.2%) for a 1 cm increase in monthly precipitation at a 6-month lag. Conversely, dengue incidence increased by 43% (95% CrI 41%, 45%) for a 1 °C increase in monthly mean temperature at a 3-month lag. After accounting for covariates, the most significant high-risk spatial clusters were detected in the southern regions of Lao PDR. Probability analysis highlighted elevated trends in 45 districts, emphasizing the importance of targeted control strategies in high-risk areas. This research underscores the impact of climate and environmental factors on dengue transmission, emphasizing the need for proactive public health interventions tailored to specific contexts in Lao PDR.
登革热是一种由伊蚊传播的人畜共患病毒性疾病，在老挝人民民主共和国（老挝）构成了重大的公共卫生关切。本研究旨在描述空间-时间模式，并量化环境和气候变量对区县级登革热传播的影响。本研究从老挝国家实验室和流行病学中心（NCLE）获取了 2015 年至 2020 年期间老挝 148 个区的登革热数据。采用贝叶斯框架下建立的多变量零膨胀泊松回归模型，研究了每月登革热发生与环境和气候变化之间的关联。研究共分析了 72471 例登革热病例，发病率为每 10 万人 174 例。每年发病率从 6 月到 9 月达到峰值，并在 2019 年出现了一个大高峰。贝叶斯时空模型显示，每月归一化差异植被指数每增加 0.1 个单位，滞后 1 个月时登革热发病率降低 9.1%（95%可信区间[CrI] 8.9%，9.2%），每月降水每增加 1 厘米，滞后 6 个月时发病率降低 5.7%（95% CrI 5.3%，6.2%）。相反，每月平均温度每升高 1°C，滞后 3 个月时登革热发病率增加 43%（95% CrI 41%，45%）。在考虑了协变量后，在老挝南部地区检测到了最显著的高风险空间聚类。概率分析突出显示了 45 个区发病率升高的趋势，强调了在高风险地区采取有针对性的控制策略的重要性。本研究强调了气候和环境因素对登革热传播的影响，强调了在老挝这样的背景下，需要有针对性地开展公共卫生干预措施。
