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城市化和疟疾在流行地区有着上下文关系:加纳的时间和空间研究

Merveille Koissi Savi^1,2, Bhartendu Pandey^3,4, Anshuman Swain^5,6

¹Center for Development Research (ZEF), University of Bonn, North Rhine-Westphalia, Germany.

PLOS global public health

|May 30, 2024

概括

城市化不仅减少了加纳疟疾的流行. 环境因素,如靠近水和增加夜间照明在农村地区显著影响疟疾率,需要有针对性的干预措施.

科学领域:

公共卫生公共卫生
流行病学流行病学
环境科学环境科学

背景情况:

疟疾仍然是西非,特别是加纳的主要死亡原因.
现有的研究表明,城市化和疟疾患病率之间存在反向关系,但在流行地区并不总是观察到这种情况.
城市化,环境因素和疟疾传播之间的复杂相互作用需要进一步调查.

研究的目的:

调查加纳城市化程度与疟疾患病率之间的关联.
确定在农村,郊区和城市环境中疟疾流行的主要决定因素.
在城市化背景下为疟疾决策开发数据驱动工具.

主要方法:

利用了区级流行病学数据 (2015-2018) 以及加纳的健康,卫生和教育数据.
采用多层模型和时间序列分解来分析疟疾模式.
根据城市化指标将地区分为农村,郊区和城市类别,并使用集群特定的随机森林进行决定性预测.

主要成果:

疟疾的流行受到季节性的影响,尽管这种趋势在城市和郊区不那么明显.
城市地区的流行率略低,但存在高传播的口袋,通常与水体的接近有关.
农村地区夜光反射率增加与疟疾患病率更高相关,而在郊区没有发现这种联系.

结论:

仅仅城市化并不是加纳疟疾流行率下降的主要驱动因素.
环境因素,包括水的近距离和农村夜间照明强度,对于理解和管理在不断变化的城市景观中的疟疾至关重要.
一个互动的决策支持工具"malDecision"已经开发出来,以帮助公共卫生干预.

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