PDF(Pubmed)
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.
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.
摘要：
背景：灌区斑疹伤寒的大规模爆发及其作为媒介传播的立克次体病在新的地区出现，突出了对这种疾病的持续忽视。本研究旨在探讨中国斑疹伤寒的长期变化及区域主导因素,目的是为疾病预防和控制提供有价值的见解。
方法：本研究利用贝叶斯时空层次模型（BSTHM）研究了2006-2018年中国南方和北方斑疹伤寒的时空异质性，并分析了环境因子与斑疹伤寒的关系。此外,使用GeoDetector模型来评估两个地区地理和社会经济因素的主要影响。
结果：斑疹伤寒表现出季节性规律，通常发生在夏季和秋季（6月至11月），十月的高峰。地理上,高风险地区,或热点，集中在南方，而低风险地区，或冷点，位于北部。此外，斑疹伤寒的分布受环境和社会经济因素的影响。在北方和南方，主导因子为月归一化植被指数(NDVI)和温度。每四分位距NDVI（IQR）的增加导致中国北方斑疹伤寒风险降低7.580％，南部地区增长19.180%。同样，温度升高1IQR可使北部斑疹伤寒的风险降低10.720％，而南部则增加15.800％。就地理和社会经济因素而言，文盲率和海拔是各自地区的关键决定因素，q值为0.844和0.882。
结论：这些结果表明，适当的气候，环境,和社会条件会增加斑疹伤寒的风险。本研究为合理配置资源和控制斑疹伤寒的发生提供了有益的建议和依据。
方法：本研究利用贝叶斯时空层次模型（BSTHM）研究了2006-2018年中国南方和北方斑疹伤寒的时空异质性，并分析了环境因子与斑疹伤寒的关系。此外,使用GeoDetector模型来评估两个地区地理和社会经济因素的主要影响。
结果：斑疹伤寒表现出季节性规律，通常发生在夏季和秋季（6月至11月），十月的高峰。地理上,高风险地区,或热点，集中在南方，而低风险地区，或冷点，位于北部。此外，斑疹伤寒的分布受环境和社会经济因素的影响。在北方和南方，主导因子为月归一化植被指数(NDVI)和温度。每四分位距NDVI（IQR）的增加导致中国北方斑疹伤寒风险降低7.580％，南部地区增长19.180%。同样，温度升高1IQR可使北部斑疹伤寒的风险降低10.720％，而南部则增加15.800％。就地理和社会经济因素而言，文盲率和海拔是各自地区的关键决定因素，q值为0.844和0.882。
结论：这些结果表明，适当的气候，环境,和社会条件会增加斑疹伤寒的风险。本研究为合理配置资源和控制斑疹伤寒的发生提供了有益的建议和依据。
