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Comparative Spatial Dynamics of Japanese Encephalitis and Acute Encephalitis Syndrome in Nepal

机译：尼泊尔日本脑炎和急性脑炎综合症的空间动态比较

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Japanese Encephalitis (JE) is a vector-borne disease of major importance in Asia. Recent increases in cases have spawned the development of more stringent JE surveillance. Due to the difficulty of making a clinical diagnosis, increased tracking of common symptoms associated with JE—generally classified as the umbrella term, acute encephalitis syndrome (AES) has been developed in many countries. In Nepal, there is some debate as to what AES cases are, and how JE risk factors relate to AES risk. Three parts of this analysis included investigating the temporal pattern of cases, examining the age and vaccination status patterns among AES surveillance data, and then focusing on spatial patterns of risk factors. AES and JE cases from 2007–2011 reported at a district level (n = 75) were examined in relation to landscape risk factors. Landscape pattern indices were used to quantify landscape patterns associated with JE risk. The relative spatial distribution of landscape risk factors were compared using geographically weighted regression. Pattern indices describing the amount of irrigated land edge density and the degree of landscape mixing for irrigated areas were positively associated with JE and AES, while fragmented forest measured by the number of forest patches were negatively associated with AES and JE. For both JE and AES, the local GWR models outperformed global models, indicating spatial heterogeneity in risks. Temporally, the patterns of JE and AES risk were almost identical; suggesting the relative higher caseload of AES compared to JE could provide a valuable early-warning signal for JE surveillance and reduce diagnostic testing costs. Overall, the landscape variables associated with a high degree of landscape mixing and small scale irrigated agriculture were positively linked to JE and AES risk, highlighting the importance of integrating land management policies, disease prevention strategies and promoting healthy sustainable livelihoods in both rural and urban-fringe developing areas.
机译：日本脑炎（JE）是在亚洲最重要的媒介传播疾病。最近病例的增加催生了更严格的脑电图监测的发展。由于难以进行临床诊断，对与JE相关的常见症状（通常归类为总称）的追踪越来越多，许多国家已开发出急性脑炎综合征（AES）。在尼泊尔，关于什么是AES病例以及JE危险因素与AES风险之间的关系存在争议。该分析的三个部分包括调查病例的时间模式，检查AES监测数据中的年龄和疫苗接种状况模式，然后关注风险因素的空间模式。在地区级别报告的2007-2011年AES和JE病例（n = 75）被调查与景观风险因素相关。景观格局指数用于量化与JE风险相关的景观格局。使用地理加权回归比较景观风险因素的相对空间分布。描述灌溉土地边缘密度的数量和灌溉区域的景观混合程度的格局指数与JE和AES正相关，而由林地数量衡量的零散森林与AES和JE负相关。对于JE和AES而言，本地GWR模型的性能优于全局模型，表明风险的空间异质性。暂时而言，JE和AES风险的模式几乎相同。这表明与JE相比，AES的案件处理量相对较高，可以为JE监视提供有价值的预警信号，并降低诊断测试成本。总体而言，与高度景观融合和小规模灌溉农业相关的景观变量与JE和AES风险呈正相关关系，突出了整合土地管理政策，疾病预防策略和促进城乡健康可持续生计的重要性，边缘开发区。

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