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Chang T, Min KD, Cho SI, Kim Y. Associations of meteorological factors and dynamics of scrub typhus incidence in South Korea: A nationwide time-series study. ENVIRONMENTAL RESEARCH 2024; 245:117994. [PMID: 38151145 DOI: 10.1016/j.envres.2023.117994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 12/01/2023] [Accepted: 12/18/2023] [Indexed: 12/29/2023]
Abstract
Scrub typhus, also known as Tsutsugamushi disease, is a climate-sensitive vector-borne disease that poses a growing public health threat. However, studies on the association between scrub typhus epidemics and meteorological factors in South Korea need to be complemented. Therefore, we aimed to analyze the association among ambient temperature, precipitation, and the incidence of scrub typhus in South Korea. First, we obtained data on the weekly number of scrub typhus cases and concurrent meteorological variables at the city-county level (Si-Gun) in South Korea between 2001 and 2019. Subsequently, a two-stage meta-regression analysis was conducted. In the first stage, we conducted time-series regression analyses using a distributed lag nonlinear model (DLNM) to investigate the association between temperature, precipitation, and scrub typhus incidence at each location. In the second stage, we employed a multivariate meta-regression model to combine the association estimates from all municipalities, considering regional indicators, such as mite species distribution, Normalized Difference Vegetation Index (NDVI), and urban-rural classification. Weekly mean temperature and weekly total precipitation exhibited a reversed U-shaped nonlinear association with the incidence of scrub typhus. The overall cumulative association with scrub typhus incidence peaked at 18.7 C° (with RRs of 9.73, 95% CI: 5.54-17.10) of ambient temperature (reference 9.7 C°) and 162.0 mm (with RRs of 1.87, 95% CI: 1.02-3.83) of precipitation (reference 2.8 mm), respectively. These findings suggest that meteorological factors contribute to scrub typhus epidemics by interacting with vectors, reservoir hosts, and human behaviors. This information serves as a reference for future public health policies and epidemiological research aimed at controlling scrub typhus infections.
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Affiliation(s)
- Taehee Chang
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, 08826, Republic of Korea
| | - Kyung-Duk Min
- College of Veterinary Medicine, Chungbuk National University, 28644, Republic of Korea
| | - Sung-Il Cho
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, 08826, Republic of Korea; Institute of Health and Environment, Seoul National University, Seoul, 08826, Republic of Korea.
| | - Yoonhee Kim
- Department of Global Environmental Health, Graduate School of Medicine, University of Tokyo, Tokyo, 113-0033, Japan.
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Han L, Zhang Y, Jin X, Ren H, Teng Z, Sun Z, Xu J, Qin T. Changing epidemiologic patterns of typhus group rickettsiosis and scrub typhus in China, 1950-2022. Int J Infect Dis 2024; 140:52-61. [PMID: 38163619 DOI: 10.1016/j.ijid.2023.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 12/22/2023] [Accepted: 12/28/2023] [Indexed: 01/03/2024] Open
Abstract
OBJECTIVES We conducted a systematic analysis of the notifiable rickettsial diseases in humans in China during 1950-2022. METHODS We utilized descriptive statistics to analyze the epidemiological characteristics, clinical manifestations, and diagnostic characteristics of typhus group rickettsiosis (TGR) and scrub typhus (ST) cases. RESULTS Since the 1950s, there have been variations in the incidence rate of TGR and ST in China, with a downtrend for TGR and an uptrend for ST. The South became a high-incidence area of TGR, whereas the North was previously the high-incidence area. ST cases were concentrated in the South and the geographic area of ST spread northward and westward. The seasonality of TGR and ST were similar in the South but distinct in the North. Most TGR and ST cases were reported by county-level medical institutions, whereas primary institutions reported the least. Delayed diagnosis was associated with fatal outcomes of TGR and ST. Cases in low-incidence provinces, confirmed by laboratory tests and reported from county/municipal-level institutions had higher odds of delayed diagnoses. CONCLUSIONS Our study revealed significant changes in the epidemiological characteristics of TGR and ST in China, which can provide useful information to enhance the control and prevention strategies of rickettsial diseases in China.
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Affiliation(s)
- Ling Han
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yunfei Zhang
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiaojing Jin
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hongyu Ren
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhongqiu Teng
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhaobin Sun
- State Key Laboratory of Severe Weather, Chinese Academy of Meteorological Sciences, China Meteorological Administration, Beijing, China
| | - Jianguo Xu
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Tian Qin
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
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Qian J, Wu Y, Zhu C, Chen Q, Chu H, Liu L, Wang C, Luo Y, Yue N, Li W, Yang X, Yi J, Ye F, He J, Qi Y, Lu F, Wang C, Tan W. Spatiotemporal heterogeneity and long-term impact of meteorological, environmental, and socio-economic factors on scrub typhus in China from 2006 to 2018. BMC Public Health 2024; 24:538. [PMID: 38383355 PMCID: PMC10880311 DOI: 10.1186/s12889-023-17233-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 11/15/2023] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND Large-scale outbreaks of scrub typhus combined with its emergence in new areas as a vector-borne rickettsiosis highlight the ongoing neglect of this disease. This study aims to explore the long-term changes and regional leading factors of scrub typhus in China, with the goal of providing valuable insights for disease prevention and control. METHODS This study utilized a Bayesian space-time hierarchical model (BSTHM) to examine the spatiotemporal heterogeneity of scrub typhus and analyze the relationship between environmental factors and scrub typhus in southern and northern China from 2006 to 2018. Additionally, a GeoDetector model was employed to assess the predominant influences of geographical and socioeconomic factors in both regions. RESULTS Scrub typhus exhibits a seasonal pattern, typically occurring during the summer and autumn months (June to November), with a peak in October. Geographically, the high-risk regions, or hot spots, are concentrated in the south, while the low-risk regions, or cold spots, are located in the north. Moreover, the distribution of scrub typhus is influenced by environment and socio-economic factors. In the north and south, the dominant factors are the monthly normalized vegetation index (NDVI) and temperature. An increase in NDVI per interquartile range (IQR) leads to a 7.580% decrease in scrub typhus risk in northern China, and a 19.180% increase in the southern. Similarly, of 1 IQR increase in temperature reduces the risk of scrub typhus by 10.720% in the north but increases it by 15.800% in the south. In terms of geographical and socio-economic factors, illiteracy rate and altitude are the key determinants in the respective areas, with q-values of 0.844 and 0.882. CONCLUSIONS These results indicated that appropriate climate, environment, and social conditions would increase the risk of scrub typhus. This study provided helpful suggestions and a basis for reasonably allocating resources and controlling the occurrence of scrub typhus.
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Affiliation(s)
- Jiaojiao Qian
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China
- Nanjing Bioengineering (Gene) Technology Center for Medicines, Nanjing, China
| | - Yifan Wu
- Nanjing Bioengineering (Gene) Technology Center for Medicines, Nanjing, China
| | - Changqiang Zhu
- Nanjing Bioengineering (Gene) Technology Center for Medicines, Nanjing, China
| | - Qiong Chen
- Nanjing Bioengineering (Gene) Technology Center for Medicines, Nanjing, China
| | - Hongliang Chu
- Center for Disease Prevention and Control of Jiangsu Province, Nanjing, Jiangsu, China
| | - Licheng Liu
- Nanjing Bioengineering (Gene) Technology Center for Medicines, Nanjing, China
| | - Chongcai Wang
- Hainan International Travel Healthcare Center, Haikou, Hainan, China
| | - Yizhe Luo
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China
- Nanjing Bioengineering (Gene) Technology Center for Medicines, Nanjing, China
| | - Na Yue
- Nanjing Bioengineering (Gene) Technology Center for Medicines, Nanjing, China
| | - Wenhao Li
- Nanjing Bioengineering (Gene) Technology Center for Medicines, Nanjing, China
| | - Xiaohong Yang
- Nanjing Bioengineering (Gene) Technology Center for Medicines, Nanjing, China
| | - Jing Yi
- Department of Transfusion Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Fuqiang Ye
- Nanjing Bioengineering (Gene) Technology Center for Medicines, Nanjing, China
| | - Ji He
- Xiamen International Travel Health Care Center (Xiamen Customs Port Outpatient Department), Xiamen, China
| | - Yong Qi
- Nanjing Bioengineering (Gene) Technology Center for Medicines, Nanjing, China
| | - Fei Lu
- College of Information Engineering, Zhejiang University of Technology, Liuhe Rd. 288, Hangzhou, 310023, China.
| | - Chunhui Wang
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China.
- Nanjing Bioengineering (Gene) Technology Center for Medicines, Nanjing, China.
| | - Weilong Tan
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China.
- Nanjing Bioengineering (Gene) Technology Center for Medicines, Nanjing, China.
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Liu L, Xiao Y, Wei X, Li X, Duan C, Jia X, Jia R, Guo J, Chen Y, Zhang X, Zhang W, Wang Y. Spatiotemporal epidemiology and risk factors of scrub typhus in Hainan Province, China, 2011-2020. One Health 2023; 17:100645. [PMID: 38024283 PMCID: PMC10665174 DOI: 10.1016/j.onehlt.2023.100645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 10/09/2023] [Accepted: 10/11/2023] [Indexed: 12/01/2023] Open
Abstract
Background The re-emergence of scrub typhus in the southern provinces of China in recent decades has been validated, thereby attracting the attention of public health authorities. There has been a spatial and temporal expansion of scrub typhus in Hainan Province, but the epidemiological characteristics, environmental drivers, and potential high-risk areas for scrub typhus have not yet been investigated. Objective The aims of this study were to characterize the spatiotemporal epidemiology of scrub typhus, identify dominant environmental risk factors, and map potential risk areas in Hainan Province from 2011 to 2020. Methods The spatiotemporal dynamics of scrub typhus in Hainan Province between 2011 and 2020 were analyzed using spatial analyses and seasonal-trend decomposition using regression (STR). The maximum entropy (MaxEnt) model was applied to determine the key environmental predictors and environmentally suitable areas for scrub typhus, and the demographic diversity of the predicted suitable zones was evaluated. Results During 2011-2020, 3260 scrub typhus cases were recorded in Hainan Province. The number of scrub typhus cases increased continuously each year, particularly among farmers (67.61%) and individuals aged 50-59 years (23.25%) who were identified as high-risk groups. A dual epidemic peak was detected, emerging annually from April to June and from July to October. The MaxEnt-based risk map illustrated that highly suitable areas, accounting for 25.36% of the total area, were mainly distributed in the northeastern part of Hainan Province, where 75.43% of the total population lived. Jackknife tests revealed that ground surface temperature, elevation, cumulative precipitation, evaporation, land cover, population density, and ratio of dependents were the most significant environmental factors. Conclusion In this study, we gained insights into the spatiotemporal epidemiological dynamics, pivotal environmental drivers, and potential risk map of scrub typhus in Hainan Province. These results have important implications for researchers and public health officials in guiding future prevention and control strategies for scrub typhus.
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Affiliation(s)
- Lisha Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Yang Xiao
- Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Xianyu Wei
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Xuan Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Chunyuan Duan
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, China Medical University, Shenyang, China
| | - Xinjing Jia
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, China Medical University, Shenyang, China
| | - Ruizhong Jia
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Jinpeng Guo
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, China Medical University, Shenyang, China
| | - Yong Chen
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, China Medical University, Shenyang, China
| | - Xiushan Zhang
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Wenyi Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, China Medical University, Shenyang, China
| | - Yong Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, China Medical University, Shenyang, China
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Song WY, Lv Y, Yin PW, Yang YY, Guo XG. Potential distribution of Leptotrombidium scutellare in Yunnan and Sichuan Provinces, China, and its association with mite-borne disease transmission. Parasit Vectors 2023; 16:164. [PMID: 37194039 DOI: 10.1186/s13071-023-05789-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 04/27/2023] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND Leptotrombidium scutellare is one of the six main vectors of scrub typhus in China and is a putative vector of hemorrhagic fever with renal syndrome (HFRS). This mite constitutes a large portion of the chigger mite community in southwest China. Although empirical data on its distribution are available for several investigated sites, knowledge of the species' association with human well-being and involvement in the prevalence of mite-borne diseases remains scarce. METHODS Occurrence data on the chigger mite were obtained from 21 years (2001-2021) of field sampling. Using boosted regression tree (BRT) ecological models based on climate, land cover and elevation variables, we predicted the environmental suitability for L. scutellare in Yunnan and Sichuan Provinces. The potential distribution range and shifts in the study area for near-current and future scenarios were mapped and the scale of L. scutellare interacting with human activities was evaluated. We tested the explanatory power of the occurrence probability of L. scutellare on incidences of mite-borne diseases. RESULTS Elevation and climate factors were the most important factors contributing to the prediction of the occurrence pattern of L. scutellare. The most suitable habitats for this mite species were mainly concentrated around high-elevation areas, with predictions for the future showing a trend towards a reduction. Human activity was negatively correlated with the environmental suitability of L. scutellare. The occurrence probability of L. scutellare in Yunnan Province had a strong explanatory power on the epidemic pattern of HFRS but not scrub typhus. CONCLUSIONS Our results emphasize the exposure risks introduced by L. scutellare in the high-elevation areas of southwest China. Climate change may lead to a range contraction of this species towards areas of higher elevation and lessen the associated exposure risk. A comprehensive understanding of the transmission risk requires more surveillance efforts.
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Affiliation(s)
- Wen-Yu Song
- Vector Laboratory, Institute of Pathogens and Vectors, Yunnan Provincial Key Laboratory for Zoonosis Control and Prevention, Dali University, Dali, 671000, Yunnan, China
- State Key Laboratory of Genetic Resources and Evolution, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, 650223, Yunnan, China
| | - Yan Lv
- Vector Laboratory, Institute of Pathogens and Vectors, Yunnan Provincial Key Laboratory for Zoonosis Control and Prevention, Dali University, Dali, 671000, Yunnan, China
| | - Peng-Wu Yin
- Vector Laboratory, Institute of Pathogens and Vectors, Yunnan Provincial Key Laboratory for Zoonosis Control and Prevention, Dali University, Dali, 671000, Yunnan, China
| | - Yi-Yu Yang
- Department of Mathematics and Computer Science, Dali University, Dali, 671003, Yunnan, China
| | - Xian-Guo Guo
- Vector Laboratory, Institute of Pathogens and Vectors, Yunnan Provincial Key Laboratory for Zoonosis Control and Prevention, Dali University, Dali, 671000, Yunnan, China.
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Li X, Wei X, Yin W, Soares Magalhaes RJ, Xu Y, Wen L, Peng H, Qian Q, Sun H, Zhang W. Using ecological niche modeling to predict the potential distribution of scrub typhus in Fujian Province, China. Parasit Vectors 2023; 16:44. [PMID: 36721181 PMCID: PMC9887782 DOI: 10.1186/s13071-023-05668-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 01/13/2023] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Despite the increasing number of cases of scrub typhus and its expanding geographical distribution in China, its potential distribution in Fujian Province, which is endemic for the disease, has yet to be investigated. METHODS A negative binomial regression model for panel data mainly comprising meteorological, socioeconomic and land cover variables was used to determine the risk factors for the occurrence of scrub typhus. Maximum entropy modeling was used to identify the key predictive variables of scrub typhus and their ranges, map the suitability of different environments for the disease, and estimate the proportion of the population at different levels of infection risk. RESULTS The final multivariate negative binomial regression model for panel data showed that the annual mean normalized difference vegetation index had the strongest correlation with the number of scrub typhus cases. With each 0.1% rise in shrubland and 1% rise in barren land there was a 75.0% and 37.0% increase in monthly scrub typhus cases, respectively. In contrast, each unit rise in mean wind speed in the previous 2 months and each 1% increase in water bodies corresponded to a decrease of 40.0% and 4.0% in monthly scrub typhus cases, respectively. The predictions of the maximum entropy model were robust, and the average area under the curve value was as high as 0.864. The best predictive variables for scrub typhus occurrence were population density, annual mean normalized difference vegetation index, and land cover types. The projected potentially most suitable areas for scrub typhus were widely distributed across the eastern coastal area of Fujian Province, with highly suitable and moderately suitable areas accounting for 16.14% and 9.42%, respectively. Of the total human population of the province, 81.63% reside in highly suitable areas for scrub typhus. CONCLUSIONS These findings could help deepen our understanding of the risk factors of scrub typhus, and provide information for public health authorities in Fujian Province to develop more effective surveillance and control strategies in identified high risk areas in Fujian Province.
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Affiliation(s)
- Xuan Li
- grid.186775.a0000 0000 9490 772XDepartment of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China ,grid.488137.10000 0001 2267 2324Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Xianyu Wei
- grid.186775.a0000 0000 9490 772XDepartment of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China ,grid.488137.10000 0001 2267 2324Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Wenwu Yin
- grid.198530.60000 0000 8803 2373Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ricardo J. Soares Magalhaes
- grid.1003.20000 0000 9320 7537Spatial Epidemiology Laboratory, School of Veterinary Science, The University of Queensland, Brisbane, Australia ,grid.1003.20000 0000 9320 7537Child Health Research Center, The University of Queensland, Brisbane, Australia
| | - Yuanyong Xu
- grid.488137.10000 0001 2267 2324Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Liang Wen
- grid.488137.10000 0001 2267 2324Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Hong Peng
- grid.488137.10000 0001 2267 2324Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Quan Qian
- grid.488137.10000 0001 2267 2324Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Hailong Sun
- grid.186775.a0000 0000 9490 772XDepartment of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China ,grid.488137.10000 0001 2267 2324Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Wenyi Zhang
- grid.186775.a0000 0000 9490 772XDepartment of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China ,grid.488137.10000 0001 2267 2324Chinese PLA Center for Disease Control and Prevention, Beijing, China
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Han L, Sun Z, Li Z, Zhang Y, Tong S, Qin T. Impacts of meteorological factors on the risk of scrub typhus in China, from 2006 to 2020: A multicenter retrospective study. Front Microbiol 2023; 14:1118001. [PMID: 36910234 PMCID: PMC9996048 DOI: 10.3389/fmicb.2023.1118001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 02/08/2023] [Indexed: 02/25/2023] Open
Abstract
Scrub typhus is emerging as a global public health threat owing to its increased prevalence and remarkable geographic expansion. However, it remains a neglected disease, and possible influences of meteorological factors on its risk are poorly understood. We conducted the largest-scale research to assess the impact of meteorological factors on scrub typhus in China. Weekly data on scrub typhus cases and meteorological factors were collected across 59 prefecture-level administrative regions from 2006 to 2020. First, we divided these regions into 3 regions and analyzed the epidemiological characteristics of scrub typhus. We then applied the distributed lag nonlinear model, combined with multivariate meta-analysis, to examine the associations between meteorological factors and scrub typhus incidence at the total and regional levels. Subsequently, we identified the critical meteorological predictors of scrub typhus incidence and extracted climate risk windows. We observed distinct epidemiological characteristics across regions, featuring obvious clustering in the East and Southwest with more even distribution and longer epidemic duration in the South. The mean temperature and relative humidity had profound effects on scrub typhus with initial-elevated-descendent patterns. Weather conditions of weekly mean temperatures of 25-33°C and weekly relative humidity of 60-95% were risk windows for scrub typhus. Additionally, the heavy rainfall was associated with sharp increase in scrub typhus incidence. We identified specific climatic signals to detect the epidemic of scrub typhus, which were easily monitored to generalize. Regional heterogeneity should be considered for targeted monitoring and disease control strategies.
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Affiliation(s)
- Ling Han
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhaobin Sun
- Institute of Urban Meteorology, China Meteorological Administration, Beijing, China.,China Meteorological Administration Urban Meteorology Key Laboratory, Beijing, China
| | - Ziming Li
- Institute of Urban Meteorology, China Meteorological Administration, Beijing, China
| | - Yunfei Zhang
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Shilu Tong
- Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,School of Public Health, Institute of Environment and Population Health, Anhui Medical University, Hefei, China.,Center for Global Health, Nanjing Medical University, Nanjing, China.,School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia
| | - Tian Qin
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
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Ding F, Wang Q, Hao M, Maude RJ, John Day NP, Lai S, Chen S, Fang L, Ma T, Zheng C, Jiang D. Climate drives the spatiotemporal dynamics of scrub typhus in China. GLOBAL CHANGE BIOLOGY 2022; 28:6618-6628. [PMID: 36056457 PMCID: PMC9825873 DOI: 10.1111/gcb.16395] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 07/12/2022] [Indexed: 06/15/2023]
Abstract
Scrub typhus is a climate-sensitive and life-threatening vector-borne disease that poses a growing public health threat. Although the climate-epidemic associations of many vector-borne diseases have been studied for decades, the impacts of climate on scrub typhus remain poorly understood, especially in the context of global warming. Here we incorporate Chinese national surveillance data on scrub typhus from 2010 to 2019 into a climate-driven generalized additive mixed model to explain the spatiotemporal dynamics of this disease and predict how it may be affected by climate change under various representative concentration pathways (RCPs) for three future time periods (the 2030s, 2050s, and 2080s). Our results demonstrate that temperature, precipitation, and relative humidity play key roles in driving the seasonal epidemic of scrub typhus in mainland China with a 2-month lag. Our findings show that the change of projected spatiotemporal dynamics of scrub typhus will be heterogeneous and will depend on specific combinations of regional climate conditions in future climate scenarios. Our results contribute to a better understanding of spatiotemporal dynamics of scrub typhus, which can help public health authorities refine their prevention and control measures to reduce the risks resulting from climate change.
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Affiliation(s)
- Fangyu Ding
- Institute of Geographic Sciences and Natural Resources ResearchChinese Academy of SciencesBeijingChina
- College of Resources and EnvironmentUniversity of Chinese Academy of SciencesBeijingChina
| | - Qian Wang
- Nuffield Department of Medicine, Centre for Tropical Medicine and Global HealthUniversity of OxfordOxfordUK
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical MedicineMahidol UniversityBangkokThailand
| | - Mengmeng Hao
- Institute of Geographic Sciences and Natural Resources ResearchChinese Academy of SciencesBeijingChina
- College of Resources and EnvironmentUniversity of Chinese Academy of SciencesBeijingChina
| | - Richard James Maude
- Nuffield Department of Medicine, Centre for Tropical Medicine and Global HealthUniversity of OxfordOxfordUK
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical MedicineMahidol UniversityBangkokThailand
- Harvard TH Chan School of Public HealthHarvard UniversityBostonMassachusettsUSA
| | - Nicholas Philip John Day
- Nuffield Department of Medicine, Centre for Tropical Medicine and Global HealthUniversity of OxfordOxfordUK
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical MedicineMahidol UniversityBangkokThailand
| | - Shengjie Lai
- WorldPop, School of Geography and Environmental ScienceUniversity of SouthamptonSouthamptonUK
| | - Shuai Chen
- Institute of Geographic Sciences and Natural Resources ResearchChinese Academy of SciencesBeijingChina
- College of Resources and EnvironmentUniversity of Chinese Academy of SciencesBeijingChina
| | - Liqun Fang
- State Key Laboratory of Pathogen and BiosecurityBeijing Institute of Microbiology and EpidemiologyBeijingChina
| | - Tian Ma
- Institute of Geographic Sciences and Natural Resources ResearchChinese Academy of SciencesBeijingChina
- College of Resources and EnvironmentUniversity of Chinese Academy of SciencesBeijingChina
| | - Canjun Zheng
- Chinese Center for Disease Control and PreventionBeijingChina
| | - Dong Jiang
- Institute of Geographic Sciences and Natural Resources ResearchChinese Academy of SciencesBeijingChina
- College of Resources and EnvironmentUniversity of Chinese Academy of SciencesBeijingChina
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Luo Y, Zhang L, Lv H, Zhu C, Ai L, Qi Y, Yue N, Zhang L, Wu J, Tan W. How meteorological factors impacting on scrub typhus incidences in the main epidemic areas of 10 provinces, China, 2006-2018. Front Public Health 2022; 10:992555. [PMID: 36339235 PMCID: PMC9628745 DOI: 10.3389/fpubh.2022.992555] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 09/22/2022] [Indexed: 01/26/2023] Open
Abstract
Scrub typhus, caused by Orientia tsutsugamushi, is a serious public health problem in the Asia-Pacific region, threatening the health of more than one billion people. China is one of the countries with the most serious disease burden of scrub typhus. Previous epidemiological evidence indicated that meteorological factors may affect the incidence of scrub typhus, but there was limited evidence for the correlation between local natural environment factors dominated by meteorological factors and scrub typhus. This study aimed to evaluate the correlation between monthly scrub typhus incidence and meteorological factors in areas with high scrub typhus prevalence using a distributed lag non-linear model (DLNM). The monthly data on scrub typhus cases in ten provinces from 2006 to 2018 and meteorological parameters were obtained from the Public Health Science Data Center and the National Meteorological Data Sharing Center. The results of the single-variable and multiple-variable models showed a non-linear relationship between incidence and meteorological factors of mean temperature (Tmean), rainfall (RF), sunshine hours (SH), and relative humidity (RH). Taking the median of meteorological factors as the reference value, the relative risks (RRs) of monthly Tmean at 0°C, RH at 46%, and RF at 800 mm were most significant, with RRs of 2.28 (95% CI: 0.95-5.43), 1.71 (95% CI: 1.39-2.09), and 3.33 (95% CI: 1.89-5.86). In conclusion, relatively high temperature, high humidity, and favorable rainfall were associated with an increased risk of scrub typhus.
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Affiliation(s)
- Yizhe Luo
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China,Nanjing Bioengineering (Gene) Technology Centre for Medicine, Nanjing, China
| | - Longyao Zhang
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Heng Lv
- Nanjing Bioengineering (Gene) Technology Centre for Medicine, Nanjing, China
| | - Changqiang Zhu
- Nanjing Bioengineering (Gene) Technology Centre for Medicine, Nanjing, China
| | - Lele Ai
- Nanjing Bioengineering (Gene) Technology Centre for Medicine, Nanjing, China
| | - Yong Qi
- Nanjing Bioengineering (Gene) Technology Centre for Medicine, Nanjing, China
| | - Na Yue
- Nanjing Bioengineering (Gene) Technology Centre for Medicine, Nanjing, China
| | - Lingling Zhang
- College of Life Science, Fujian Agriculture and Forestry University, Fuzhou, China
| | - Jiahong Wu
- Guizhou Medical University, School of Basic Medical Sciences, Guiyang, China,Jiahong Wu
| | - Weilong Tan
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China,Nanjing Bioengineering (Gene) Technology Centre for Medicine, Nanjing, China,*Correspondence: Weilong Tan
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He J, Wang Y, Liu P, Yin W, Wei X, Sun H, Xu Y, Li S, Soares Magalhaes RJ, Guo Y, Zhang W. Co-effects of global climatic dynamics and local climatic factors on scrub typhus in mainland China based on a nine-year time-frequency analysis. One Health 2022; 15:100446. [PMID: 36277104 PMCID: PMC9582591 DOI: 10.1016/j.onehlt.2022.100446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 09/04/2022] [Accepted: 10/11/2022] [Indexed: 11/29/2022] Open
Abstract
Background Scrub Typhus (ST) is a rickettsial disease caused by Orientia tsutsugamushi. The number of ST cases has been increasing in China during the past decades, which attracts great concerns of the public health. Methods We obtained monthly documented ST cases greater than 54 cases in 434 counties of China during 2012-2020. Spatiotemporal wavelet analysis was conducted to identify the ST clusters with similar pattern of the temporal variation and explore the association between ST variation and El Niño and La Niña events. Wavelet coherency analysis and partial wavelet coherency analysis was employed to further explore the co-effects of global and local climatic factors on ST. Results Wavelet cluster analysis detected seven clusters in China, three of which are mainly distributed in Eastern China, while the other four clusters are located in the Southern China. Among the seven clusters, summer and autumn-winter peak of ST are the two main outbreak periods; while stable and fluctuated periodic feature of ST series was found at 12-month and 4-(or 6-) month according to the wavelet power spectra. Similarly, the three-character bands were also found in the associations between ST and El Niño and La Niña events, among which the 12-month period band showed weakest climate-ST association and the other two bands owned stronger association, indicating that the global climate dynamics may have short-term effects on the ST variations. Meanwhile, 12-month period band with strong association was found between the four local climatic factors (precipitation, pressure, relative humidity and temperature) and the ST variations. Further, partial wavelet coherency analysis suggested that global climatic dynamics dominate annual ST variations, while local climatic factors dominate the small periods. Conclusion The ST variations are not directly attributable to the change in large-scale climate. The existence of these plausible climatic determinants stimulates the interests for more insights into the epidemiology of ST, which is important for devising prevention and early warning strategies.
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Affiliation(s)
- Junyu He
- Ocean College, Zhejiang University, Zhoushan, China,Ocean Academy, Zhejiang University, Zhoushan, China
| | - Yong Wang
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Ping Liu
- Department of General Practice, Chinese PLA General Hospital-Sixth Medical Center, Beijing, China
| | - Wenwu Yin
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xianyu Wei
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Hailong Sun
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Yuanyong Xu
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Ricardo J. Soares Magalhaes
- Spatial Epidemiology Laboratory, School of Veterinary Science, The University of Queensland, Brisbane, Australia,Child Health Research Center, The University of Queensland, Brisbane, Australia
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia,Correspondence to: Y Guo, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia.
| | - Wenyi Zhang
- Chinese PLA Center for Disease Control and Prevention, Beijing, China,Correspondence to: W Zhang, Chinese PLA Center for Disease Control and Prevention, 20 Dong-Da Street, Fengtai District, Beijing 100071, China.
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11
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Qian L, Wang Y, Wei X, Liu P, Magalhaes RJS, Qian Q, Peng H, Wen L, Xu Y, Sun H, Yin W, Zhang W. Epidemiological characteristics and spatiotemporal patterns of scrub typhus in Fujian province during 2012–2020. PLoS Negl Trop Dis 2022; 16:e0010278. [PMID: 36174105 PMCID: PMC9553047 DOI: 10.1371/journal.pntd.0010278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 10/11/2022] [Accepted: 09/13/2022] [Indexed: 12/02/2022] Open
Abstract
Background Scrub typhus has become a serious public health concern in the Asia-Pacific region including China. There were new natural foci continuously recognized and dramatically increased reported cases in mainland China. However, the epidemiological characteristics and spatiotemporal patterns of scrub typhus in Fujian province have yet to be investigated. Objective This study proposes to explore demographic characteristics and spatiotemporal dynamics of scrub typhus cases in Fujian province, and to detect high-risk regions between January 2012 and December 2020 at county/district scale and thereby help in devising public health strategies to improve scrub typhus prevention and control measures. Method Monthly cases of scrub typhus reported at the county level in Fujian province during 2012–2020 were collected from the National Notifiable Disease Surveillance System. Time-series analyses, spatial autocorrelation analyses and space-time scan statistics were applied to identify and visualize the spatiotemporal patterns of scrub typhus cases in Fujian province. The demographic differences of scrub typhus cases from high-risk and low-risk counties in Fujian province were also compared. Results A total of 11,859 scrub typhus cases reported in 87 counties from Fujian province were analyzed and the incidence showed an increasing trend from 2012 (2.31 per 100,000) to 2020 (3.20 per 100,000) with a peak in 2018 (4.59 per 100,000). There existed two seasonal peaks in June-July and September-October every year in Fujian province. A significant positive spatial autocorrelation of scrub typhus incidence in Fujian province was observed with Moran’s I values ranging from 0.258 to 0.471 (P<0.001). Several distinct spatiotemporal clusters mainly concentrated in north and southern parts of Fujian province. Compared to low-risk regions, a greater proportion of cases were female, farmer, and older residents in high-risk counties. Conclusions These results demonstrate a clear spatiotemporal heterogeneity of scrub typhus cases in Fujian province, and provide the evidence in directing future researches on risk factors and effectively assist local health authorities in the refinement of public health interventions against scrub typhus transmission in the high risk regions. Scrub typhus is a vector-borne zoonotic disease caused by Orientia tsutsugamushi and is popular in the Asia-Pacific area. Nowadays scrub typhus has been recognized as a considerable burden on public health in Fujian province. We explored the epidemiological characteristics, spatiotemporal patterns and diffusion characteristics of scrub typhus, and detected high-risk regions at the county level in Fujian province between January 2012 and December 2020. Our results indicated that the majority of cases were reported in June-July and September-October and that that middle aged and elderly people were more prone to infection every year in Fujian province. The spatial autocorrelation analysis revealed clustering in geographic distribution of cases and several distinct spatiotemporal clusters were identified in north and southern parts of Fujian province. Compared with cases from low-risk areas, a higher proportion of cases were female, farmer, and older residents in high-risk counties.
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Affiliation(s)
- Li Qian
- Department of Health Statistics, College of Preventive Medicine, Army Medical University, Chongqing, China
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Yong Wang
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Xianyu Wei
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Ping Liu
- Department of General Practice, Chinese PLA General Hospital-Sixth Medical Center, Beijing, China
| | - Ricardo J. Soares Magalhaes
- Spatial Epidemiology Laboratory, School of Veterinary Science, The University of Queensland, Brisbane, Australia
- Child Health Research Center, The University of Queensland, Brisbane, Australia
| | - Quan Qian
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Hong Peng
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Liang Wen
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Yuanyong Xu
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Hailong Sun
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Wenwu Yin
- Chinese Center for Disease Control and Prevention, Beijing, China
- * E-mail: (WY); (WZ)
| | - Wenyi Zhang
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
- * E-mail: (WY); (WZ)
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12
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Cao Y, Li M, Haihambo N, Zhu Y, Zeng Y, Jin J, Qiu J, Li Z, Liu J, Teng J, Li S, Zhao Y, Zhao X, Wang X, Li Y, Feng X, Han C. Oscillatory properties of class C notifiable infectious diseases in China from 2009 to 2021. Front Public Health 2022; 10:903025. [PMID: 36033737 PMCID: PMC9402928 DOI: 10.3389/fpubh.2022.903025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 07/19/2022] [Indexed: 01/22/2023] Open
Abstract
Background Epidemics of infectious diseases have a great negative impact on people's daily life. How it changes over time and what kind of laws it obeys are important questions that researchers are always interested in. Among the characteristics of infectious diseases, the phenomenon of recrudescence is undoubtedly of great concern. Understanding the mechanisms of the outbreak cycle of infectious diseases could be conducive for public health policies to the government. Method In this study, we collected time-series data for nine class C notifiable infectious diseases from 2009 to 2021 using public datasets from the National Health Commission of China. Oscillatory power of each infectious disease was captured using the method of the power spectrum analysis. Results We found that all the nine class C diseases have strong oscillations, which could be divided into three categories according to their oscillatory frequencies each year. Then, we calculated the oscillation power and the average number of infected cases of all nine diseases in the first 6 years (2009-2015) and the next 6 years (2015-2021) since the update of the surveillance system. The change of oscillation power is positively correlated to the change in the number of infected cases. Moreover, the diseases that break out in summer are more selective than those in winter. Conclusion Our results enable us to better understand the oscillation characteristics of class C infectious diseases and provide guidance and suggestions for the government's prevention and control policies.
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Affiliation(s)
- Yanxiang Cao
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Meijia Li
- Faculty of Psychology and Center for Neuroscience, Vrije Universiteit Brussel, Brussels, Belgium
| | - Naem Haihambo
- Faculty of Psychology and Center for Neuroscience, Vrije Universiteit Brussel, Brussels, Belgium
| | - Yuyao Zhu
- College of Environmental Sciences and Engineering, Peking University, Beijing, China
| | - Yimeng Zeng
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Jianhua Jin
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Jinyi Qiu
- School of Artificial Intelligence, Beijing Normal University, Beijing, China
| | - Zhirui Li
- Baoding First Central Hospital, Baoding, China
| | - Jiaxin Liu
- Department of Psychology, University of Washington, Washington, SA, United States
| | - Jiayi Teng
- School of Psychology, Philosophy and Language Science, University of Edinburgh, Edinburgh, United Kingdom
| | - Sixiao Li
- Faculty of Arts, Humanities and Cultures, School of Music, University of Leeds, Leeds, United Kingdom
| | - Yanan Zhao
- China Academy of Chinese Medical Sciences, Institute of Acupuncture and Moxibustion, Beijing, China
| | - Xixi Zhao
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Xuemei Wang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yaqiong Li
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Xiaoyang Feng
- Institute of Mental Health, Peking University Sixth Hospital, Beijing, China
| | - Chuanliang Han
- Shenzhen Key Laboratory of Neuropsychiatric Modulation and Collaborative Innovation Center for Brain Science, Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Brain Cognition and Brain Disease Institute, Shenzhen Institute of Advanced Technology, Shenzhen–Hong Kong Institute of Brain Science, Shenzhen Fundamental Research Institutions, Shenzhen, China
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13
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Zhao C, Liu K, Jiang C, Wei X, Song S, Wu X, Wen X, Fu T, Shen L, Shao Z, Li Q. Epidemic characteristics and transmission risk prediction of brucellosis in Xi'an city, Northwest China. Front Public Health 2022; 10:926812. [PMID: 35937257 PMCID: PMC9355750 DOI: 10.3389/fpubh.2022.926812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 06/29/2022] [Indexed: 12/05/2022] Open
Abstract
Human brucellosis (HB) has re-emerged in China since the mid-1990s, and exhibited an apparent geographic expansion shifted from the traditional livestock regions to the inland areas of China. It is often neglected in non-traditional epidemic areas, posing a serious threat to public health in big cities. We carried out a retrospective epidemiological study in Xi'an, the largest city in northwestern China. It utilizes long-term surveillance data on HB during 2008–2021 and investigation data during 2014–2021. A total of 1989 HB cases were reported in Xi'an, consisting of 505 local cases, i.e., those located in Xi'an and 1,484 non-local cases, i.e., those located in other cities. Significantly epidemiological heterogeneity was observed between them, mainly owing to differences in the gender, occupation, diagnostic delays, and reporting institutions. Serological investigations suggested that 59 people and 1,822 animals (sheep, cattle, and cows) tested positive for brucellosis from 2014 to 2021, with the annual average seroprevalence rates were 1.38 and 1.54%, respectively. The annual animal seroprevalence rate was positively correlated with the annual incidence of non-local HB cases. Multivariate boosted regression tree models revealed that gross domestic product, population density, length of township roads, number of farms, and nighttime lights substantially contributed to the spatial distribution of local HB. Approximately 7.84 million people inhabited the potential infection risk zones in Xi'an. Our study highlights the reemergence of HB in non-epidemic areas and provides a baseline for large and medium-sized cities to identify regions, where prevention and control efforts should be prioritized in the future.
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Affiliation(s)
- Chenxi Zhao
- Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, Department of Epidemiology, School of Public Health, Air Force Medical University, Xi'an, China
- Department of Epidemiology, School of Public Health, Baotou Medical College, Baotou, China
| | - Kun Liu
- Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, Department of Epidemiology, School of Public Health, Air Force Medical University, Xi'an, China
| | - Chenghao Jiang
- Department of Geospatial Information Engineering, School of Remote Sensing and Information Engineering, Wuhan University, Wuhan, China
| | - Xiao Wei
- Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, Department of Epidemiology, School of Public Health, Air Force Medical University, Xi'an, China
| | - Shuxuan Song
- Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, Department of Epidemiology, School of Public Health, Air Force Medical University, Xi'an, China
| | - Xubin Wu
- Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, Department of Epidemiology, School of Public Health, Air Force Medical University, Xi'an, China
| | - Xiaohui Wen
- Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, Department of Epidemiology, School of Public Health, Air Force Medical University, Xi'an, China
| | - Ting Fu
- Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, Department of Epidemiology, School of Public Health, Air Force Medical University, Xi'an, China
| | - Li Shen
- Department of Geospatial Information Engineering, School of Remote Sensing and Information Engineering, Wuhan University, Wuhan, China
| | - Zhongjun Shao
- Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, Department of Epidemiology, School of Public Health, Air Force Medical University, Xi'an, China
- Zhongjun Shao
| | - Qian Li
- Department of Infectious Disease Control and Prevention, Xi'an Center for Disease Prevention and Control, Xi'an, China
- *Correspondence: Qian Li
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Linear and Machine Learning modelling for spatiotemporal disease predictions: Force-of-Infection of Chagas disease. PLoS Negl Trop Dis 2022; 16:e0010594. [PMID: 35853042 PMCID: PMC9337653 DOI: 10.1371/journal.pntd.0010594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 07/29/2022] [Accepted: 06/18/2022] [Indexed: 12/02/2022] Open
Abstract
Background Chagas disease is a long-lasting disease with a prolonged asymptomatic period. Cumulative indices of infection such as prevalence do not shed light on the current epidemiological situation, as they integrate infection over long periods. Instead, metrics such as the Force-of-Infection (FoI) provide information about the rate at which susceptible people become infected and permit sharper inference about temporal changes in infection rates. FoI is estimated by fitting (catalytic) models to available age-stratified serological (ground-truth) data. Predictive FoI modelling frameworks are then used to understand spatial and temporal trends indicative of heterogeneity in transmission and changes effected by control interventions. Ideally, these frameworks should be able to propagate uncertainty and handle spatiotemporal issues. Methodology/principal findings We compare three methods in their ability to propagate uncertainty and provide reliable estimates of FoI for Chagas disease in Colombia as a case study: two Machine Learning (ML) methods (Boosted Regression Trees (BRT) and Random Forest (RF)), and a Linear Model (LM) framework that we had developed previously. Our analyses show consistent results between the three modelling methods under scrutiny. The predictors (explanatory variables) selected, as well as the location of the most uncertain FoI values, were coherent across frameworks. RF was faster than BRT and LM, and provided estimates with fewer extreme values when extrapolating to areas where no ground-truth data were available. However, BRT and RF were less efficient at propagating uncertainty. Conclusions/significance The choice of FoI predictive models will depend on the objectives of the analysis. ML methods will help characterise the mean behaviour of the estimates, while LM will provide insight into the uncertainty surrounding such estimates. Our approach can be extended to the modelling of FoI patterns in other Chagas disease-endemic countries and to other infectious diseases for which serosurveys are regularly conducted for surveillance. Metrics such as the per susceptible rate of infection acquisition (Force-of-Infection) are crucial to understand the current epidemiological situation and the impact of control interventions for long-lasting diseases in which the infection event might have occurred many years previously, such as Chagas disease. FoI values are estimated from serological age profiles, often obtained in a few locations. However, when using predictive models to estimate the FoI over time and space (including areas where serosurveys had not been conducted), methods able to handle and propagate uncertainty must be implemented; otherwise, overconfident predictions may be obtained. Although Machine Learning (ML) methods are powerful tools, they may not be able to entirely handle this challenge. Therefore, the use of ML must be considered in relation to the aims of the analyses. ML will be more relevant to characterise the central trends of the estimates while Linear Models will help identify areas where further serosurveys should be conducted to improve the reliability of the predictions. Our approaches can be used to generate FoI predictions in other Chagas disease-endemic countries as well as in other diseases for which serological surveillance data are collected.
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Wang T, Meng F, Che T, Chen J, Zhang H, Ji Y, Fan Z, Zhao G, Zhang W, Jiang B, Xu Q, Lv C, Shi T, Ruan S, Liu L, Liu W, Yang Y, Fang L. Mapping the distributions of blood-sucking mites and mite-borne agents in China: a modeling study. Infect Dis Poverty 2022; 11:41. [PMID: 35397554 PMCID: PMC8994071 DOI: 10.1186/s40249-022-00966-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 03/28/2022] [Indexed: 11/10/2022] Open
Abstract
Background Emerging mite-borne pathogens and associated disease burdens in recent decades are raising serious public health concerns, yet their distributions and ecology remain under-investigated. We aim to describe the geographical distributions of blood-sucking mites and mite-borne agents and to assess their ecological niches in China. Methods We mapped 549 species of blood-sucking mites belonging to 100 genera at the county level and eight mite-associated agents detected from 36 species of blood-sucking mites in China during 1978–2020. Impacts of climatic and environmental factors on the ecology of 21 predominant vector mites and a leading pathogen, Orientia tsutsugamushi, were assessed using boosted regression tree (BRT) models, and model-predicted risks were mapped. We also estimated the model-predicted number, area and population size of affected counties for each of the 21 mite species in China. Results Laelaps echidninus is the leading mite species that potentially affects 744 million people, followed by La. jettmari (517 million) and Eulaelaps stabularis (452 million). Leptotrombidium scutellare is the mite species harboring the highest variety of mite-borne agents including four Rickettsia species and two viruses, followed by Eu. stabularis (2 agents), L. palpale (2) and La. echidninus (2). The top two agents that parasitize the largest number of mite species are O. tsutsugamushi (28 species) and hantavirus (8). Mammalian richness, annual mean temperature and precipitation of the driest quarter jointly determine the ecology of the mites, forming four clusters of major mite species with distinct geographic distributions. High-risk areas of O. tsutsugamushi are mainly distributed in southern and eastern coastal provinces where 71.5 million people live. Conclusions Ecological niches of major mite species and mite-borne pathogens are much more extensive than what have been observed, necessitating expansion of current filed surveillance. Graphic Abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s40249-022-00966-0.
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Wang T, Fan ZW, Ji Y, Chen JJ, Zhao GP, Zhang WH, Zhang HY, Jiang BG, Xu Q, Lv CL, Zhang XA, Li H, Yang Y, Fang LQ, Liu W. Mapping the Distributions of Mosquitoes and Mosquito-Borne Arboviruses in China. Viruses 2022; 14:v14040691. [PMID: 35458421 PMCID: PMC9031751 DOI: 10.3390/v14040691] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 03/11/2022] [Accepted: 03/24/2022] [Indexed: 12/20/2022] Open
Abstract
The geographic expansion of mosquitos is associated with a rising frequency of outbreaks of mosquito-borne diseases (MBD) worldwide. We collected occurrence locations and times of mosquito species, mosquito-borne arboviruses, and MBDs in the mainland of China in 1954−2020. We mapped the spatial distributions of mosquitoes and arboviruses at the county level, and we used machine learning algorithms to assess contributions of ecoclimatic, socioenvironmental, and biological factors to the spatial distributions of 26 predominant mosquito species and two MBDs associated with high disease burden. Altogether, 339 mosquito species and 35 arboviruses were mapped at the county level. Culex tritaeniorhynchus is found to harbor the highest variety of arboviruses (19 species), followed by Anopheles sinensis (11) and Culex pipiens quinquefasciatus (9). Temperature seasonality, annual precipitation, and mammalian richness were the three most important contributors to the spatial distributions of most of the 26 predominant mosquito species. The model-predicted suitable habitats are 60–664% larger in size than what have been observed, indicating the possibility of severe under-detection. The spatial distribution of major mosquito species in China is likely to be under-estimated by current field observations. More active surveillance is needed to investigate the mosquito species in specific areas where investigation is missing but model-predicted probability is high.
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Affiliation(s)
- Tao Wang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, China; (T.W.); (Z.-W.F.); (Y.J.); (J.-J.C.); (G.-P.Z.); (W.-H.Z.); (H.-Y.Z.); (B.-G.J.); (Q.X.); (C.-L.L.); (X.-A.Z.)
| | - Zheng-Wei Fan
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, China; (T.W.); (Z.-W.F.); (Y.J.); (J.-J.C.); (G.-P.Z.); (W.-H.Z.); (H.-Y.Z.); (B.-G.J.); (Q.X.); (C.-L.L.); (X.-A.Z.)
| | - Yang Ji
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, China; (T.W.); (Z.-W.F.); (Y.J.); (J.-J.C.); (G.-P.Z.); (W.-H.Z.); (H.-Y.Z.); (B.-G.J.); (Q.X.); (C.-L.L.); (X.-A.Z.)
| | - Jin-Jin Chen
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, China; (T.W.); (Z.-W.F.); (Y.J.); (J.-J.C.); (G.-P.Z.); (W.-H.Z.); (H.-Y.Z.); (B.-G.J.); (Q.X.); (C.-L.L.); (X.-A.Z.)
| | - Guo-Ping Zhao
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, China; (T.W.); (Z.-W.F.); (Y.J.); (J.-J.C.); (G.-P.Z.); (W.-H.Z.); (H.-Y.Z.); (B.-G.J.); (Q.X.); (C.-L.L.); (X.-A.Z.)
| | - Wen-Hui Zhang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, China; (T.W.); (Z.-W.F.); (Y.J.); (J.-J.C.); (G.-P.Z.); (W.-H.Z.); (H.-Y.Z.); (B.-G.J.); (Q.X.); (C.-L.L.); (X.-A.Z.)
| | - Hai-Yang Zhang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, China; (T.W.); (Z.-W.F.); (Y.J.); (J.-J.C.); (G.-P.Z.); (W.-H.Z.); (H.-Y.Z.); (B.-G.J.); (Q.X.); (C.-L.L.); (X.-A.Z.)
| | - Bao-Gui Jiang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, China; (T.W.); (Z.-W.F.); (Y.J.); (J.-J.C.); (G.-P.Z.); (W.-H.Z.); (H.-Y.Z.); (B.-G.J.); (Q.X.); (C.-L.L.); (X.-A.Z.)
| | - Qiang Xu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, China; (T.W.); (Z.-W.F.); (Y.J.); (J.-J.C.); (G.-P.Z.); (W.-H.Z.); (H.-Y.Z.); (B.-G.J.); (Q.X.); (C.-L.L.); (X.-A.Z.)
| | - Chen-Long Lv
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, China; (T.W.); (Z.-W.F.); (Y.J.); (J.-J.C.); (G.-P.Z.); (W.-H.Z.); (H.-Y.Z.); (B.-G.J.); (Q.X.); (C.-L.L.); (X.-A.Z.)
| | - Xiao-Ai Zhang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, China; (T.W.); (Z.-W.F.); (Y.J.); (J.-J.C.); (G.-P.Z.); (W.-H.Z.); (H.-Y.Z.); (B.-G.J.); (Q.X.); (C.-L.L.); (X.-A.Z.)
| | - Hao Li
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, China; (T.W.); (Z.-W.F.); (Y.J.); (J.-J.C.); (G.-P.Z.); (W.-H.Z.); (H.-Y.Z.); (B.-G.J.); (Q.X.); (C.-L.L.); (X.-A.Z.)
- Correspondence: (H.L.); (Y.Y.); (L.-Q.F.); (W.L.)
| | - Yang Yang
- College of Public Health and Health Professions and Emerging Pathogens Institute, University of Florida, Gainesville, FL 32611, USA
- Correspondence: (H.L.); (Y.Y.); (L.-Q.F.); (W.L.)
| | - Li-Qun Fang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, China; (T.W.); (Z.-W.F.); (Y.J.); (J.-J.C.); (G.-P.Z.); (W.-H.Z.); (H.-Y.Z.); (B.-G.J.); (Q.X.); (C.-L.L.); (X.-A.Z.)
- Correspondence: (H.L.); (Y.Y.); (L.-Q.F.); (W.L.)
| | - Wei Liu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, China; (T.W.); (Z.-W.F.); (Y.J.); (J.-J.C.); (G.-P.Z.); (W.-H.Z.); (H.-Y.Z.); (B.-G.J.); (Q.X.); (C.-L.L.); (X.-A.Z.)
- Correspondence: (H.L.); (Y.Y.); (L.-Q.F.); (W.L.)
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17
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Yang S, Liu X, Gao Y, Chen B, Lu L, Zheng W, Fu R, Yuan C, Liu Q, Li G, Chen H. Spatiotemporal Dynamics of Scrub Typhus in Jiangxi Province, China, from 2006 to 2018. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094599. [PMID: 33926106 PMCID: PMC8123664 DOI: 10.3390/ijerph18094599] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 04/15/2021] [Accepted: 04/20/2021] [Indexed: 01/04/2023]
Abstract
Background: Scrub typhus (ST) has become a significant potential threat to public health in Jiangxi. Further investigation is essential for the control and management of the spatiotemporal patterns of the disease. Methods: Time-series analyses, spatial distribution analyses, spatial autocorrelation analysis, and space-time scan statistics were performed to detect spatiotemporal dynamics distribution of the incidence of ST. Results: From 2006 to 2018, a total of 5508 ST cases occurred in Jiangxi, covering 79 counties. The number of ST cases increased continuously from 2006 to 2018, and there was obvious seasonality during the variation process in each year, with a primary peak in autumn (September to October) and a smaller peak in summer (June to August). From 2007 to 2018, the spatial distribution of the ST epidemic was significant heterogeneity, and Nanfeng, Huichang, Xunwu, Anyuan, Longnan, and Xinfeng were hotspots. Seven spatiotemporal clusters were observed using Kulldorff's space-time scan statistic, and the most likely cluster only included one county, Nanfeng county. The high-risk areas of the disease were in the mountainous, hilly region of Wuyi and the southern mountainous region of Jiangxi. Conclusions: Targeted interventions should be executed in high-risk regions for the precise prevention and control of ST.
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Affiliation(s)
- Shu Yang
- The Collaboration Unit for Field Epidemiology of State Key Laboratory of Infectious Disease Prevention and Control, Nanchang Center for Disease Control and Prevention, Nanchang 330038, China; (S.Y.); (W.Z.); (R.F.); (C.Y.)
| | - Xiaobo Liu
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (X.L.); (Y.G.); (L.L.); (Q.L.)
| | - Yuan Gao
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (X.L.); (Y.G.); (L.L.); (Q.L.)
| | - Baizhou Chen
- School of Geography and Information Engineering, China University of Geosciences, Wuhan 430078, China;
| | - Liang Lu
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (X.L.); (Y.G.); (L.L.); (Q.L.)
| | - Weiqing Zheng
- The Collaboration Unit for Field Epidemiology of State Key Laboratory of Infectious Disease Prevention and Control, Nanchang Center for Disease Control and Prevention, Nanchang 330038, China; (S.Y.); (W.Z.); (R.F.); (C.Y.)
| | - Renlong Fu
- The Collaboration Unit for Field Epidemiology of State Key Laboratory of Infectious Disease Prevention and Control, Nanchang Center for Disease Control and Prevention, Nanchang 330038, China; (S.Y.); (W.Z.); (R.F.); (C.Y.)
| | - Chenying Yuan
- The Collaboration Unit for Field Epidemiology of State Key Laboratory of Infectious Disease Prevention and Control, Nanchang Center for Disease Control and Prevention, Nanchang 330038, China; (S.Y.); (W.Z.); (R.F.); (C.Y.)
| | - Qiyong Liu
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (X.L.); (Y.G.); (L.L.); (Q.L.)
| | - Guichang Li
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (X.L.); (Y.G.); (L.L.); (Q.L.)
- Correspondence: (G.L.); (H.C.)
| | - Haiying Chen
- The Collaboration Unit for Field Epidemiology of State Key Laboratory of Infectious Disease Prevention and Control, Nanchang Center for Disease Control and Prevention, Nanchang 330038, China; (S.Y.); (W.Z.); (R.F.); (C.Y.)
- Correspondence: (G.L.); (H.C.)
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18
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Zhao GP, Wang YX, Fan ZW, Ji Y, Liu MJ, Zhang WH, Li XL, Zhou SX, Li H, Liang S, Liu W, Yang Y, Fang LQ. Mapping ticks and tick-borne pathogens in China. Nat Commun 2021; 12:1075. [PMID: 33597544 PMCID: PMC7889899 DOI: 10.1038/s41467-021-21375-1] [Citation(s) in RCA: 84] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 01/13/2021] [Indexed: 12/17/2022] Open
Abstract
Understanding ecological niches of major tick species and prevalent tick-borne pathogens is crucial for efficient surveillance and control of tick-borne diseases. Here we provide an up-to-date review on the spatial distributions of ticks and tick-borne pathogens in China. We map at the county level 124 tick species, 103 tick-borne agents, and human cases infected with 29 species (subspecies) of tick-borne pathogens that were reported in China during 1950-2018. Haemaphysalis longicornis is found to harbor the highest variety of tick-borne agents, followed by Ixodes persulcatus, Dermacentor nutalli and Rhipicephalus microplus. Using a machine learning algorithm, we assess ecoclimatic and socioenvironmental drivers for the distributions of 19 predominant vector ticks and two tick-borne pathogens associated with the highest disease burden. The model-predicted suitable habitats for the 19 tick species are 14‒476% larger in size than the geographic areas where these species were detected, indicating severe under-detection. Tick species harboring pathogens of imminent threats to public health should be prioritized for more active field surveillance.
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Affiliation(s)
- Guo-Ping Zhao
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P.R. China
- Logistics College of Chinese People's Armed Police Forces, Tianjin, P.R. China
| | - Yi-Xing Wang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P.R. China
| | - Zheng-Wei Fan
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P.R. China
| | - Yang Ji
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P.R. China
| | - Ming-Jin Liu
- College of Public Health and Health Professions and Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
| | - Wen-Hui Zhang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P.R. China
| | - Xin-Lou Li
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P.R. China
| | - Shi-Xia Zhou
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P.R. China
| | - Hao Li
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P.R. China
| | - Song Liang
- College of Public Health and Health Professions and Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
| | - Wei Liu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P.R. China.
| | - Yang Yang
- College of Public Health and Health Professions and Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA.
| | - Li-Qun Fang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P.R. China.
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19
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Xin H, Sun J, Yu J, Huang J, Chen Q, Wang L, Lai S, Clements ACA, Hu W, Li Z. Spatiotemporal and demographic characteristics of scrub typhus in Southwest China, 2006–2017: An analysis of population‐based surveillance data. Transbound Emerg Dis 2020; 67:1585-1594. [DOI: 10.1111/tbed.13492] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 01/09/2020] [Accepted: 01/13/2020] [Indexed: 01/31/2023]
Affiliation(s)
- Hualei Xin
- Key Laboratory of Surveillance and Early Warning on Infectious Disease Division of Infectious Disease Chinese Center for Disease Control and Prevention Beijing China
- Qingdao City Center for Disease Control and Prevention Qingdao China
| | - Junling Sun
- Key Laboratory of Surveillance and Early Warning on Infectious Disease Division of Infectious Disease Chinese Center for Disease Control and Prevention Beijing China
| | - Jianxing Yu
- Key Laboratory of Surveillance and Early Warning on Infectious Disease Division of Infectious Disease Chinese Center for Disease Control and Prevention Beijing China
- Ministry of Health Key Laboratory of Systems Biology of Pathogens and Dr. Christophe Mérieux Laboratory CAMS‐Foundation Mérieux Institute of Pathogen Biology Academy of Medical Sciences of China and Peking Union Medical College Beijing China
| | - Jilei Huang
- Key Laboratory of Surveillance and Early Warning on Infectious Disease Division of Infectious Disease Chinese Center for Disease Control and Prevention Beijing China
- Chinese Center for Disease Control and Prevention National Institute of Parasitic Diseases Shanghai China
| | - Qiulan Chen
- Key Laboratory of Surveillance and Early Warning on Infectious Disease Division of Infectious Disease Chinese Center for Disease Control and Prevention Beijing China
| | - Liping Wang
- Key Laboratory of Surveillance and Early Warning on Infectious Disease Division of Infectious Disease Chinese Center for Disease Control and Prevention Beijing China
| | - Shengjie Lai
- Key Laboratory of Surveillance and Early Warning on Infectious Disease Division of Infectious Disease Chinese Center for Disease Control and Prevention Beijing China
- WorldPop School of Geography and Environmental Science University of Southampton Southampton UK
- School of Public Health Key Laboratory of Public Health Safety Ministry of Education Fudan University Shanghai China
| | - Archie C. A. Clements
- Faculty of Health Sciences Curtin University Bentley WA Australia
- Telethon Kids Institute Nedlands WA Australia
| | - Wenbiao Hu
- School of Public Health and Social Work Institute of Health and Biomedical Innovation Queensland University of Technology Brisbane Australia
| | - Zhongjie Li
- Key Laboratory of Surveillance and Early Warning on Infectious Disease Division of Infectious Disease Chinese Center for Disease Control and Prevention Beijing China
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