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首页> 外文期刊>The American Journal of Tropical Medicine and Hygiene >Spatiotemporal Tools for Emerging and Endemic Disease Hotspots in Small Areas: An Analysis of Dengue and Chikungunya in Barbados, 2013-2016
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Spatiotemporal Tools for Emerging and Endemic Disease Hotspots in Small Areas: An Analysis of Dengue and Chikungunya in Barbados, 2013-2016

机译：小区的新出现和地方病疾病热点的时空工具：2013 - 2016年巴巴多斯登革热和千坤村分析

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摘要

Dengue fever and other febrile mosquito-borne diseases place considerable health and economic burdens on small island nations in the Caribbean. Here, we used two methods of cluster detection to find potential hotspots of transmission of dengue and chikungunya in Barbados, and to assess the impact of input surveillance data and methodology on observed patterns of risk. Using Moran's I and spatial scan statistics, we analyzed the geospatial and temporal distribution of disease cases and rates across Barbados for dengue fever in 2013-2016, and a chikungunya outbreak in 2014. During years with high numbers of dengue cases, hotspots for cases were found with Moran's I in the south and central regions in 2013 and 2016, respectively. Using smoothed disease rates, clustering was detected in all years for dengue. Hotspots suggesting higher rates were not detected via spatial scan statistics, but coldspots suggesting lower than expected rates of disease activity were found in southwestern Barbados during high case years of dengue. No significant spatiotemporal structure was found in cases during the chikungunya outbreak. Spatial analysis of surveillance data is useful in identifying outbreak hotspots, potentially complementing existing early warning systems. We caution that these methods should be used in a manner appropriate to available data and reflecting explicit public health goals-managing for overall case numbers or targeting anomalous rates for further investigation.
机译：登革热和其他发热蚊虫疾病在加勒比地区的小岛屿国家安排了相当大的健康和经济负担。在这里，我们使用了两种群集检测方法，以便在巴巴多斯中寻找登革热和Chikungunya传输的潜在热点，并评估输入监测数据和方法对观察风险模式的影响。使用莫兰的I和空间扫描统计数据，我们分析了2013 - 2016年疾病病例的地理空间和时间分布，并在2013-2016划分的巴巴多斯患者，以及2014年的Chikungunya爆发。在大量登革热病例中，案件的热点在2013年和2016年的南部和中部地区发现了莫兰的我。使用平滑的疾病率，在登革热的所有年内都检测到聚类。暗示不通过空间扫描统计检测到更高速率的热点，但在登革热的高案例期间，在巴巴多斯西南部的疾病活动中发现了低于预期的疾病活动率。在Chikungunya爆发期间，在案件中未发现显着的时空结构。监控数据的空间分析对于识别爆发热点，可能会补充现有的预警系统。我们注意，这些方法应以适合可用数据的方式使用，并反映出明确的公共卫生目标 - 管理整体案例编号或针对进一步调查的异常利率。

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