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A quantitative risk assessment approach for mosquito-borne diseases: malaria re-emergence in southern France

机译:蚊媒疾病的定量风险评估方法:法国南部再次出现疟疾

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Background The Camargue region is a former malaria endemic area, where potential Anopheles vectors are still abundant. Considering the importation of Plasmodium due to the high number of imported malaria cases in France, the aim of this article was to make some predictions regarding the risk of malaria re-emergence in the Camargue. Methods Receptivity (vectorial capacity) and infectivity (vector susceptibility) were inferred using an innovative probabilistic approach and considering both Plasmodium falciparum and Plasmodium vivax. Each parameter of receptivity (human biting rate, anthropophily, length of trophogonic cycle, survival rate, length of sporogonic cycle) and infectivity were estimated based on field survey, bibliographic data and expert knowledge and fitted with probability distributions taking into account the variability and the uncertainty of the estimation. Spatial and temporal variations of the parameters were determined using environmental factors derived from satellite imagery, meteorological data and entomological field data. The entomological risk (receptivity/infectivity) was calculated using 10,000 different randomly selected sets of values extracted from the probability distributions. The result was mapped in the Camargue area. Finally, vulnerability (number of malaria imported cases) was inferred using data collected in regional hospitals. Results The entomological risk presented large spatial, temporal and Plasmodium species-dependent variations. The sensitivity analysis showed that susceptibility, survival rate and human biting rate were the three most influential parameters for entomological risk. Assessment of vulnerability showed that among the imported cases in the region, only very few were imported in at-risk areas. Conclusion The current risk of malaria re-emergence seems negligible due to the very low number of imported Plasmodium. This model demonstrated its efficiency for mosquito-borne diseases risk assessment.
机译:背景Camargue地区是以前的疟疾流行地区,那里潜在的按蚊媒介仍然很丰富。考虑到由于法国大量疟疾输入病例导致疟原虫的进口,本文的目的是对Camargue疟疾再次出现的风险做出一些预测。方法采用创新的概率方法并结合恶性疟原虫和间日疟原虫,推论了接受能力(媒介能力)和传染性(媒介敏感性)。根据实地调查,书目数据和专家知识估算接受度的每个参数(人类咬伤率,嗜人性,滋养周期的长度,存活率,孢子体周期的长度)和传染性,并考虑到变异性和估计的不确定性。使用从卫星图像,气象数据和昆虫学现场数据得出的环境因素来确定参数的时空变化。使用从概率分布中提取的10,000个不同的随机选择的值集来计算昆虫学风险(接受性/传染性)。结果被映射到了Camargue地区。最后,利用在地区医院收集的数据推断出易感性(输入疟疾的病例数)。结果昆虫学风险表现出较大的时空,血浆和疟原虫物种依赖性变化。敏感性分析表明,易感性,存活率和人咬率是昆虫学风险的三个最有影响力的参数。脆弱性评估表明,在该区域的进口病例中,只有高危地区的进口病例很少。结论由于疟原虫的进口数量很少,目前疟疾再发的风险似乎可以忽略不计。该模型证明了其在蚊媒疾病风险评估中的效率。

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