绘制和空间统计数据以改善被忽视的热带疾病控制工作:哥伦比亚的猪肉tape虫案例研究

This week, as part of the LCNTDR collection series,马修·迪克森(Matthew Dixon)discusses how mapping as spatial statistics improve NTD control using pork tapeworm in Colombia as a case study.

被忽视的热带疾病(NTD)通常以特定的地理模式为特征,例如感染是聚集在主机中(humans and animals), over short distances (e.g., household and village level). This has important implications for disease control efforts.

这些模式通过称为空间统计的特定分支(或地统计学)正式研究。这些统计方法已用于NTD,包括睡眠病(人类非洲锥虫病),蜗牛热/比尔哈兹(Schistosomiasis)和象素病(淋巴细胞病)(淋巴丝虫病),以识别NTD非常流行的地方。

cross-sectional surveys, which record levels of infection at one specific point in time, coupled with information on geographic location, provide the best source of data for understanding spatial distributions of NTDs.

通常,对于NTD,次要数据源(例如疾病注册机构)在低资源环境中很少获得。取而代之的是,在一个特定时间点记录感染水平的横断面调查,再加上有关地理位置的信息,提供了了解NTD的空间分布的最佳数据源。但是,对于一些研究最少的NTD中,大规模的,全国范围内的横断面调查也很少见。

Using a large cross-sectional dataset in Colombia to understand the distribution of pork tapeworm
在2008年至2010年之间,在哥伦比亚进行了一项此类调查。taenia solium; an important zoonotic NTD described in detail这里.

图1.哥伦比亚玻利瓦尔部的现场调查团队拍摄的照片(2009年)。
Credit: Instituto Nacional de Salud (INS) Colombia.

The survey data are enriched with household and individual level information which can be used to explore associations between risk factors and seropositivity (presence of antibodies, indicating exposure). As no knownT. soliuminterventions have been adopted in the country since the time of the survey, this dataset was also considered likely to represent the current endemic situation forT. soliumin Colombia.

对该调查数据的初步分析published in 2012,研究了全国各地的血清阳性(抗体水平的总体,人口水平度量)以及对危险因素和血清阳性关联的初步评估(不考虑数据如何在空间结构上)。

women, people with less education as well as displaced people were at increased odds of exposure

我们使用空间统计数据来证明这些高级定量方法如何帮助改善国家计划,以设计进一步的流行病学研究和国家控制策略。因此,我们分析中的方法是在市政级别在空间相关的测量值(最高120-140 km)。

我们的分析表明,妇女,受教育程度较低的人以及流离失所的人的暴露几率增加,这可能会为未来的有针对性控制工作的基础提供依据。我们还揭示了市政当局水平的地理集群,在该城市水平上,暴露于测量的风险因素所能解释的高度,请参见图2。

Figure 2. Hotspots of variation in seroprevalence of T. solium cysticercus antibodies (at the municipality level) not explained by the measured risk factors in the dataset (left-plot) and seroprevalence by municipality (right-plot). Higher than expected variation in orange/ red municipalities coincides with those municipalities recording a higher seroprevalence (northern and southern Colombia), and lower than expected variation in blue municipalities, coinciding with municipalities recording a low seroprevalence (central Colombia). These plots refer to Figures 1 and 2 in Galipó et al. 2021 (under the Creative Commons Attribution 4.0 International License: http://creativecommons.org/licenses/by/4.0/).

这些所谓的热点城市主要在该国的北部和南部发现,该地区与较高的接触水平(血清阳性)重叠。因此,本研究要求在哥伦比亚进行更多地理专注的研究,以确定其他可能的暴露驱动力T. solium.

为未来强大的NTD映射设置基础
This type of work also provides the foundation for producing country-wide seroprevalence maps, using further advanced空间统计通过预测原始调查未捕获或代表的地理区域中的血清阳性来进行技术。

如果是T. solium, understanding infection levels and risk across entire countries will be vital to effectively measuring the new World Health Organization (WHO) NTD 2021-2030 road map milestones,which are centred on the number of countries achieving “intensifiedT. solium到2030年在高流行区域的控制”。

In most reported endemic countries, the spatial distribution ofT. soliumis poorly understood, therefore there is an opportunity to apply these methods where large-scale cross-sectional surveys have been conducted or are planned. Similarly, understanding the spatial co-distribution with other NTDs, such asschistosomiasis对于设计具有成本效益的可持续控制计划将很重要与现有的NTD程序集成(since the taenicide praziquantel, which kills the adultT. solium人类的蠕虫还可以治疗人类的斑点虫)。

In 2019,Bayer AGcommitted to donate taenicide treatments for mass treatment programmes to control the adultT. soliumworm in humans. For countries to access taenicide donations through theWHO, detailed rapid “mapping” must be conducted to identifyT. solium感染水平和“焦点控制”领域。尽管大规模的横截面数据集和进行此类分析的专业知识的要求将具有挑战性。

AnSCI Foundation与国际牲畜研究所和Makerere University合作,乌干达的项目正在制定快速映射协议,以支持国家。该协议基于系统审查(流行数据)和T. solium攻读硕士学位的风险ing with widely available data sources, such as Demographic and Health Surveys (DHS) and Gridded Livestock of the World (GLW) database.

如果是T. solium和likely across the NTD field, utilising spatial statistics more widely therefore provides a timely opportunity to support countries as they move towards more effective control policies.


Matthew A Dixon(代表Galipó等人的作者。2021年,以及伦敦帝国学院/ SCI基金会的更广泛的囊肿模型小组,包括乌干达的主要合作者).

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