Integrating Spatial Modelling and Space-Time Pattern Mining Analytics for Vector Disease-Related Health Perspectives: A Case of Dengue Fever in Pakistan

Unravelling the dynamics of mental health inequalities in England: A 12-year nationwide longitudinal spatial analysis of recorded depression prevalence

Background

Depression is one of the most significant public health issues, but evidence of geographic patterns and trends of depression is limited. We aimed to examine the spatio-temporal patterns and trends of depression prevalence among adults in a nationwide longitudinal spatial study in England and evaluate the influence of neighbourhood socioeconomic deprivation in explaining patterns.

Methods

Information on recorded depression prevalence was obtained from the indicator Quality and Outcomes Framework: Depression prevalence that measured the annual percentage of adults diagnosed with depression for Lower Super Output Areas (LSOA) from 2011 to 2022. We applied Cluster and Outlier Analysis using the Local Moran's I algorithm. Local effects of deprivation on depression in 2020 examined with Geographically Weighted Regression (GWR). Inequalities in recorded prevalence were presented using Prevalence Rate Ratios (PRR).

Results

The North West Region of England had the highest concentration of High-High clusters of depression, with 17.4% of the area having high values surrounded by high values in both space and time and the greatest percentage of areas with a high rate of increase (43.1%). Inequalities widened among areas with a high rate of increase in prevalence compared to those with a lower rate of increase, with the PRR increasing from 1.66 (99% CI 1.61-1.70) in 2011 to 1.81 (99% CI 1.76-1.85) by 2022. Deprivation explained 3%-39% of the variance in depression in 2020 across the country.

Conclusions

It is crucial to monitor depression's spatial patterns and trends and investigate mechanisms of mental health inequalities. Our findings can help identify priority areas and target prevention and intervention strategies in England. Evaluating mental health interventions in different geographic contexts can provide valuable insights to policymakers on the most effective and context-sensitive strategies, enabling them to allocate resources towards preventing the worsening of mental health inequalities.

Mitigating dengue incidence through advanced Aedes larval surveillance and control: A successful experience from Pakistan

Dengue fever is a viral disease caused by one of four dengue stereotypes (Flavivirus: Flaviviridae) that are primarily transmitted by Aedes albopictus (Skuse) and Aedes aegypti (L.). To safeguard public health, it is crucial to conduct surveys that examine the factors favouring the presence of these species. Our study surveyed 42 councils across four towns within the Bhakkar district of Punjab Province, by inspecting man-made or natural habitats containing standing water. First, door-to-door surveillance teams from the district health department were assigned to each council to surveillance Aedes species and dengue cases. Second, data collection through surveillance efforts, and validation procedures were implemented, and the verified data was uploaded onto the Dengue Tracking System by Third Party Validation teams. Third, data were analysed to identify factors influencing dengue fever cases. The findings demonstrated the following: (1) Predominantly, instances were discerned among individuals who had a documented history of having travelled beyond the confines of the province. (2) Containers associated with evaporative air coolers and tyre shops were responsible for approximately 30% of the Aedes developmental sites. (4) Variability in temperature was responsible for approximately 45% of the observed differences in the quantity of recorded Aedes mosquito developmental sites. (5) Implementation of dengue prevention initiatives precipitated a 50% reduction in Aedes-positive containers, alongside a notable 70% decline in reported cases of dengue fever during the period spanning 2019 to 2020, while the majority of reported cases were of external origin. Aedes control measures substantially curtailed mosquito populations and lowered vector-virus interactions. Notably, local dengue transmission was eliminated through advanced and effective Aedes control efforts, emphasising the need for persistent surveillance and eradication of larval habitats in affected regions.

Societal knowledge, attitude, and practices towards dengue and associated factors in epidemic-hit areas: Geoinformation assisted empirical evidence

Dengue is one of Pakistan's major health concerns. In this study, we aimed to advance our understanding of the levels of knowledge, attitudes, and practices (KAPs) in Pakistan's Dengue Fever (DF) hotspots. Initially, at-risk communities were systematically identified via a well-known spatial modeling technique, named, Kernel Density Estimation, which was later targeted for a household-based cross-sectional survey of KAPs. To collect data on sociodemographic and KAPs, random sampling was utilized (n = 385, 5 % margin of error). Later, the association of different demographics (characteristics), knowledge, and attitude factors-potentially related to poor preventive practices was assessed using bivariate (individual) and multivariable (model) logistic regression analyses. Most respondents (>90 %) identified fever as a sign of DF; headache (73.8 %), joint pain (64.4 %), muscular pain (50.9 %), pain behind the eyes (41.8 %), bleeding (34.3 %), and skin rash (36.1 %) were identified relatively less. Regression results showed significant associations of poor knowledge/attitude with poor preventive practices; dengue vector (odds ratio [OR] = 3.733, 95 % confidence interval [CI ] = 2.377-5.861; P < 0.001), DF symptoms (OR = 3.088, 95 % CI = 1.949-4.894; P < 0.001), dengue transmission (OR = 1.933, 95 % CI = 1.265-2.956; P = 0.002), and attitude (OR = 3.813, 95 % CI = 1.548-9.395; P = 0.004). Moreover, education level was stronger in bivariate analysis and the strongest independent factor of poor preventive practices in multivariable analysis (illiterate: adjusted OR = 6.833, 95 % CI = 2.979-15.672; P < 0.001) and primary education (adjusted OR = 4.046, 95 % CI = 1.997-8.199; P < 0.001). This situation highlights knowledge gaps within urban communities, particularly in understanding dengue transmission and signs/symptoms. The level of education in urban communities also plays a substantial role in dengue control, as observed in this study, where poor preventive practices were more prevalent among illiterate and less educated respondents.

Dengue hemorrhagic fever: a growing global menace

Dengue virus is an arthropod-borne virus, transmitted by Aedes aegypti among humans. In this review, we discussed the epidemiology of dengue hemorrhagic fever (DHF) as well as the disease's natural history, cycles of transmission, clinical diagnosis, aetiology, prevention, therapy, and management. A systematic literature search was done by databases such as PubMed and Google Scholar using search terms, 'dengue fever', 'symptoms and causes of dengue fever', 'dengue virus transmission', and 'strategies to control dengue'. We reviewed relevant literature to identify hazards related to DHF and the most recent recommendations for its management and prevention. Clinical signs and symptoms of dengue infection range from mild dengue fever (DF) to potentially lethal conditions like DHF or dengue shock syndrome (DSS). Acute-onset high fever, muscle and joint pain, myalgia, a rash on the skin, hemorrhagic episodes, and circulatory shock are among the most common symptoms. An early diagnosis is vital to lower mortality. As dengue virus infections are self-limiting, but in tropical and subtropical areas, dengue infection has become a public health concern. Hence, developing and executing long-term control policies that can reduce the global burden of DHF is a major issue for public health specialists everywhere.

A Systematic Review on Modeling Methods and Influential Factors for Mapping Dengue-Related Risk in Urban Settings

Dengue fever is an acute mosquito-borne disease that mostly spreads within urban or semi-urban areas in warm climate zones. The dengue-related risk map is one of the most practical tools for executing effective control policies, breaking the transmission chain, and preventing disease outbreaks. Mapping risk at a small scale, such as at an urban level, can demonstrate the spatial heterogeneities in complicated built environments. This review aims to summarize state-of-the-art modeling methods and influential factors in mapping dengue fever risk in urban settings. Data were manually extracted from five major academic search databases following a set of querying and selection criteria, and a total of 28 studies were analyzed. Twenty of the selected papers investigated the spatial pattern of dengue risk by epidemic data, whereas the remaining eight papers developed an entomological risk map as a proxy for potential dengue burden in cities or agglomerated urban regions. The key findings included: (1) Big data sources and emerging data-mining techniques are innovatively employed for detecting hot spots of dengue-related burden in the urban context; (2) Bayesian approaches and machine learning algorithms have become more popular as spatial modeling tools for predicting the distribution of dengue incidence and mosquito presence; (3) Climatic and built environmental variables are the most common factors in making predictions, though the effects of these factors vary with the mosquito species; (4) Socio-economic data may be a better representation of the huge heterogeneity of risk or vulnerability spatial distribution on an urban scale. In conclusion, for spatially assessing dengue-related risk in an urban context, data availability and the purpose for mapping determine the analytical approaches and modeling methods used. To enhance the reliabilities of predictive models, sufficient data about dengue serotyping, socio-economic status, and spatial connectivity may be more important for mapping dengue-related risk in urban settings for future studies.