尽管实施了非药物干预措施,2019年冠状病毒病(COVID-19)的威胁在全球范围内仍然很大。确定导致其传播的外部因素至关重要,特别是考虑到世界卫生组织强调获得水的建议,卫生,和卫生对遏制COVID-19至关重要。在获得卫生设施方面存在明显差异,在低收入和中等收入国家尤其明显。然而,对这些因素缺乏定量评估。本研究考察了各种环境,社会经济,水,卫生,卫生因素及其与COVID-19发病率的关系。菲律宾的所有地区都根据社会经济因素分为集群。利用领域知识建立了概念结构方程模型(SEM)。确定了每个簇的最佳拟合SEM,并估计了因素与COVID-19发病率之间的关联。相关分析表明,最低温度,在城市地区,相对湿度与每周COVID-19发病率呈正相关。最高温度,平均温度,风速,风向与农村地区每周COVID-19发病率呈负相关,时滞为0、3和7周。在城市地区(集群1),城市化率(1.00)等因素,面积(-0.93),发现人群(0.54)与每周COVID-19发病率相关。相反,在农村地区(集群2),因素包括面积(0.17),基本卫生(0.84),风向(0.83)与每周COVID-19发病率有关。这些因素与反映与COVID-19发病率相关的隐藏混杂因素的潜在变量有因果关系。必须指出,卫生因素仅在农村地区相关。改善菲律宾农村地区获得卫生设施的机会对于有效减轻未来大流行中的疾病传播至关重要。建议在未来的研究中确定未观察到的混杂因素与COVID-19发病率的因果效应。
Despite the implementation of non-pharmaceutical interventions, the threat of coronavirus disease 2019 (COVID-19) remains significant on a global scale. Identifying external factors contributing to its spread is crucial, especially given the World Health Organization\'s recommendation emphasizing access to water, sanitation, and hygiene as essential in curbing COVID-19. There is a notable discrepancy in access to sanitation facilities, particularly evident in low- and middle-income countries. However, there is a lack of quantitative assessments regarding these factors. This
study examines various environmental, socioeconomic, water, sanitation, and hygiene factors and their associations with COVID-19 incidence. All regions in the Philippines were categorized into clusters based on socioeconomic factors. A conceptual structural equation model (SEM) was developed using domain knowledge. The best-fitting SEM for each cluster was determined, and associations between factors and COVID-19 incidence were estimated. The correlation analysis revealed that rainfall, minimum temperature, and relative humidity were positively correlated with weekly COVID-19 incidence in urban regions. Maximum temperature, mean temperature, wind speed, and wind direction were negatively correlated with weekly COVID-19 incidence in rural regions, with time lags of 0, 3, and 7 weeks. In urban regions (Cluster 1), factors such as urbanization rate (1.00), area (-0.93), and population (0.54) were found to be associated with weekly COVID-19 incidence. Conversely, in rural regions (Cluster 2), factors including area (0.17), basic sanitation (0.84), and wind direction (0.83) showed associations with weekly COVID-19 incidence. These factors were causally associated with a latent variable reflecting the hidden confounders associated with COVID-19 incidence. It is important to note that sanitation factors were associated only in rural regions. Improving access to sanitation facilities in rural regions of the Philippines is imperative to effectively mitigate disease transmission in future pandemics. Identification of the causal effect of unobserved confounders with COVID-19 incidence is recommended for future research.