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Pan K, Lin F, Xue H, Cai Q, Huang R. Exploring the influencing factors of scrub typhus in Gannan region, China, based on spatial regression modelling and geographical detector. Infect Dis Model 2025; 10:28-39. [PMID: 39319284 PMCID: PMC11419818 DOI: 10.1016/j.idm.2024.09.003] [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: 07/29/2024] [Revised: 09/05/2024] [Accepted: 09/10/2024] [Indexed: 09/26/2024] Open
Abstract
Scrub typhus is a significant public health issue with a wide distribution and is influenced by various determinants. However, in order to effectively eradicate scrub typhus, it is crucial to identify the specific factors that contribute to its incidence at a detailed level. Therefore, the objective of our study is to identify these influencing factors, examine the spatial variations in incidence, and analyze the interplay of two factors on scrub typhus incidence, so as to provide valuable experience for the prevention and treatment of scrub typhus in Gannan and to alleviate the economic burden of the local population.This study employed spatial autocorrelation analyses to examine the dependent variable and ordinary least squares model residuals. Additionally, spatial regression modelling and geographical detector were used to analyze the factors influencing the annual mean 14-year incidence of scrub typhus in the streets/townships of Gannan region from 2008 to 2021. The results of spatial1 autocorrelation analyses indicated the presence of spatial correlation. Among the global spatial regression models, the spatial lag model was found to be the best fitting model (log likelihood ratio = -319.3029, AIC = 666.6059). The results from the SLM analysis indicated that DEM, mean temperature, and mean wind speed were the primary factors influencing the occurrence of scrub typhus. For the local spatial regression models, the multiscale geographically weighted regression was determined to be the best fitting model (adjusted R2 = 0.443, AICc = 726.489). Further analysis using the MGWR model revealed that DEM had a greater impact in Xinfeng and Longnan, while the southern region was found to be more susceptible to scrub typhus due to mean wind speed. The geographical detector results revealed that the incidence of scrub typhus was primarily influenced by annual average normalized difference vegetation index. Additionally, the interaction between GDP and the percentage of grassland area had a significant impact on the incidence of scrub typhus (q = 0.357). This study illustrated the individual and interactive effects of natural environmental factors and socio-economic factors on the incidence of scrub typhus; and elucidated the specific factors affecting the incidence of scrub typhus in various streets/townships. The findings of this study can be used to develop effective interventions for the prevention and control of scrub typhus.
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Affiliation(s)
- Kailun Pan
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, 341000, Jiangxi, China
| | - Fen Lin
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, 341000, Jiangxi, China
| | - Hua Xue
- Ganzhou Municipal Center for Disease Control and Prevention, Ganzhou, 341000, Jiangxi, China
| | - Qingfeng Cai
- Ganzhou Municipal Center for Disease Control and Prevention, Ganzhou, 341000, Jiangxi, China
| | - Renfa Huang
- Ganzhou Municipal Center for Disease Control and Prevention, Ganzhou, 341000, Jiangxi, China
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Wang Q, Ma T, Ding FY, Lim A, Takaya S, Saraswati K, Hao MM, Jiang D, Fang LQ, Sartorius B, Day NPJ, Maude RJ. A systematic review of environmental covariates and methods for spatial or temporal scrub typhus distribution prediction. ENVIRONMENTAL RESEARCH 2024; 263:120067. [PMID: 39341542 DOI: 10.1016/j.envres.2024.120067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Revised: 09/22/2024] [Accepted: 09/25/2024] [Indexed: 10/01/2024]
Abstract
BACKGROUND Scrub typhus is underdiagnosed and underreported but emerging as a global public health problem. To inform future burden and prediction studies we examined through a systematic review the potential effect of environmental covariates on scrub typhus occurrence and the methods which have been used for its prediction. METHODS In this systematic review, we searched PubMed, Scopus, Web of Science, China National Knowledge Infrastructure and other databases, with no language and publication time restrictions, for studies that investigated environmental covariates or utilized methods to predict the spatial or temporal human. Data were manually extracted following a set of queries and systematic analysis was conducted. RESULTS We included 68 articles published in 1978-2024 with relevant data from 7 countries/regions. Significant environmental risk factors for scrub typhus include temperature (showing positive or inverted-U relationships), precipitation (with positive or inverted-U patterns), humidity (exhibiting complex positive, inverted-U, or W-shaped associations), sunshine duration (with positive, inverted-U associations), elevation, the normalized difference vegetation index (NDVI), and the proportion of cropland. Socioeconomic and biological factors were rarely explored. Autoregressive Integrated Moving Average (ARIMA) (n = 8) and ecological niche modelling (ENM) approach (n = 11) were the most popular methods for predicting temporal trends and spatial distribution of scrub typhus, respectively. CONCLUSIONS Our findings summarized the evidence on environmental covariates affecting scrub typhus occurrence and the methodologies used for predictive modelling. We review the existing knowledge gaps and outline recommendations for future studies modelling disease prediction and burden. TRIAL REGISTRATION PROSPERO CRD42022315209.
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Affiliation(s)
- Qian Wang
- Mahidol Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Tian Ma
- Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China; College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, China
| | - Fang-Yu Ding
- Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China; College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, China.
| | - Ahyoung Lim
- London School of Hygiene & Tropical Medicine, London, UK
| | - Saho Takaya
- London School of Hygiene & Tropical Medicine, London, UK
| | - Kartika Saraswati
- Mahidol Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore; Oxford University Clinical Research Unit Indonesia, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Meng-Meng Hao
- Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China; College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, China
| | - Dong Jiang
- Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China; College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, China
| | - Li-Qun Fang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Benn Sartorius
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK; Centre for Clinical Research (UQCCR), Faculty of Medicine, University of Queensland, Brisbane, Australia; Department of Health Metric Sciences, School of Medicine, University of Washington, Seattle, USA
| | - Nicholas P J Day
- Mahidol Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Richard J Maude
- Mahidol Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK; The Open University, Milton Keynes, UK
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He J, Ma Q, Teng Z, Zhou J, Zhao N, Liang W, Lu M, Li S, Qin T. Epidemiological and clinical characteristics of scrub typhus in Guizhou Province, China: An outbreak study of scrub typhus. PLoS Negl Trop Dis 2024; 18:e0011963. [PMID: 38442086 PMCID: PMC10914282 DOI: 10.1371/journal.pntd.0011963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 02/02/2024] [Indexed: 03/07/2024] Open
Abstract
The reported cases of scrub typhus (ST) have continued to escalate, with outbreaks occurring regionally in China. These pose an increasing public health threat at a time when public health has been overwhelmed. During the period from July to August 2022, in Rongjiang County, Guizhou Province, China, 13 out of 21 fever patients were diagnosed with scrub typhus, based on epidemiological investigation and blood test analysis. The major clinical symptoms of these patients showed fever, chills, headache, eschar, fatigue and pneumonia, which were accompanied by a rise in C-reactive protein, neutrophils, alanine transaminase (ALT) and aspartate aminotransferase (AST). Furthermore, nearly half of them exhibited abnormal electrocardiogram activity. Through semi-nested PCR, Sanger sequencing and phylogenetic tree construction, the Karp strain of Orientia tsutsugamushi (O. tsutsugamushi) was confirmed as the pathogen causing ST in Rongjiang County, which shared the same evolutionary branch with O. tsutsugamushi isolated from wild mouse liver or spleen, indicating that the wild mouse plays an important role in transmitting the disease. In contrast to the sporadic cases in the past, our study is the first to disclose an epidemic and the corresponding clinical characteristics of ST in Guizhou province, which is of great significance for the prevention and treatment of regional illnesses.
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Affiliation(s)
- Jia He
- 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, People’s Republic of China
| | - Qing Ma
- Guizhou Center for Disease Control and Prevention, Guizhou, People’s Republic of 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, People’s Republic of China
| | - Jingzhu Zhou
- Guizhou Center for Disease Control and Prevention, Guizhou, People’s Republic of China
| | - Na Zhao
- 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, People’s Republic of China
| | - Wenqin Liang
- Guizhou Center for Disease Control and Prevention, Guizhou, People’s Republic of China
| | - Miao Lu
- 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, People’s Republic of China
| | - Shijun Li
- Guizhou Center for Disease Control and Prevention, Guizhou, People’s Republic of 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, People’s Republic of China
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Ogawa T, Tsuzuki S, Ohbe H, Matsui H, Fushimi K, Yasunaga H, Kutsuna S. Analysis of Differences in Characteristics of High-Risk Endemic Areas for Contracting Japanese Spotted Fever, Tsutsugamushi Disease, and Severe Fever With Thrombocytopenia Syndrome. Open Forum Infect Dis 2024; 11:ofae025. [PMID: 38312217 PMCID: PMC10836194 DOI: 10.1093/ofid/ofae025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 01/13/2024] [Indexed: 02/06/2024] Open
Abstract
Background Tick-borne infections, including tsutsugamushi disease, Japanese spotted fever, and severe fever with thrombocytopenia syndrome (SFTS), are prevalent in East Asia with varying geographic distribution and seasonality. This study aimed to investigate the differences in the characteristics among endemic areas for contracting each infection. Methods We conducted an ecologic study in Japan, using data from a nationwide inpatient database and publicly available geospatial data. We identified 4493 patients who were hospitalized for tick-borne infections between July 2010 and March 2021. Mixed-effects modified Poisson regression analysis was used to identify factors associated with a higher risk of contracting each tick-borne disease (Tsutsugamushi, Japanese spotted fever, and SFTS). Results Mixed-effects modified Poisson regression analysis revealed that environmental factors, such as temperature, sunlight duration, elevation, precipitation, and vegetation, were associated with the risk of contracting these diseases. Tsutsugamushi disease was positively associated with higher temperatures, farms, and forests, whereas Japanese spotted fever and SFTS were positively associated with higher solar radiation and forests. Conclusions Our findings from this ecologic study indicate that different environmental factors play a significant role in the risk of transmission of tick-borne infections. Understanding the differences can aid in identifying high-risk areas and developing public health strategies for infection prevention. Further research is needed to address causal relationships.
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Affiliation(s)
- Takahisa Ogawa
- Department of Orthopedic, Saku General Hospital Saku Medical Center, Nagano, Japan
- Department of Health Policy and Informatics, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shinya Tsuzuki
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Hiroyuki Ohbe
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Hiroki Matsui
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Kiyohide Fushimi
- Department of Health Policy and Informatics, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hideo Yasunaga
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Satoshi Kutsuna
- Department of Infection Control and Prevention, Graduate School of Medicine, Faculty of Medicine, Osaka University, Osaka, Japan
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Pan K, Huang R, Xu L, Lin F. Exploring the effects and interactions of meteorological factors on the incidence of scrub typhus in Ganzhou City, 2008-2021. BMC Public Health 2024; 24:36. [PMID: 38167033 PMCID: PMC10763082 DOI: 10.1186/s12889-023-17423-8] [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: 08/22/2023] [Accepted: 12/06/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Scrub typhus poses a substantial risk to human life and wellbeing as it is transmitted by vectors. Although the correlation between climate and vector-borne diseases has been investigated, the impact of climate on scrub typhus remains inadequately comprehended. The objective of this study is to investigate the influence of meteorological conditions on the occurrence of scrub typhus in Ganzhou City, Jiangxi Province. METHODS: From January 1, 2008 to December 31, 2021, we gathered weekly records of scrub typhus prevalence alongside meteorological data in Ganzhou city. In order to investigate the correlation between meteorological factors and scrub typhus incidence, we utilized distributional lag nonlinear models and generalized additive models for our analysis. RESULTS Between 2008 and 2021, a total of 5942 cases of scrub typhus were recorded in Ganzhou City. The number of females affected exceeded that of males, with a male-to-female ratio of 1:1.86. Based on the median values of these meteorological factors, the highest relative risk for scrub typhus occurrence was observed when the weekly average temperature reached 26 °C, the weekly average relative humidity was 75%, the weekly average sunshine duration lasted for 2 h, and the weekly mean wind speed measured 2 m/s. The respective relative risks for these factors were calculated as 3.816 (95% CI: 1.395-10.438), 1.107 (95% CI: 1.008-1.217), 2.063 (95% CI: 1.022-4.165), and 1.284 (95% CI: 1.01-1.632). Interaction analyses showed that the risk of scrub typhus infection in Ganzhou city escalates with higher weekly average temperature and sunshine duration. CONCLUSION The findings of our investigation provide evidence of a correlation between environmental factors and the occurrence of scrub typhus. As a suggestion, utilizing environmental factors as early indicators could be recommended for initiating control measures and response strategies.
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Affiliation(s)
- Kailun Pan
- School of Public Health and Health Management, Gannan Medical University, Jiangxi Province, Ganzhou, 341000, China
| | - Renfa Huang
- Ganzhou Municipal Center for Disease Control and Prevention, Jiangxi Province, Ganzhou, 341000, China.
| | - Lingui Xu
- School of Public Health and Health Management, Gannan Medical University, Jiangxi Province, Ganzhou, 341000, China
| | - Fen Lin
- School of Public Health and Health Management, Gannan Medical University, Jiangxi Province, Ganzhou, 341000, China.
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