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The mortality rates and the space-time patterns of John Snow’s cholera epidemic map

机译:约翰·斯诺霍乱疫情地图的死亡率和时空分布

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Background Snow’s work on the Broad Street map is widely known as a pioneering example of spatial epidemiology. It lacks, however, two significant attributes required in contemporary analyses of disease incidence: population at risk and the progression of the epidemic over time. Despite this has been repeatedly suggested in the literature, no systematic investigation of these two aspects was previously carried out. Using a series of historical documents, this study constructs own data to revisit Snow’s study to examine the mortality rate at each street location and the space-time pattern of the cholera outbreak. Methods This study brings together records from a series of historical documents, and prepares own data on the estimated number of residents at each house location as well as the space-time data of the victims, and these are processed in GIS to facilitate the spatial-temporal analysis. Mortality rates and the space-time pattern in the victims’ records are explored using Kernel Density Estimation and network-based Scan Statistic, a recently developed method that detects significant concentrations of records such as the date and place of victims with respect to their distance from others along the street network. The results are visualised in a map form using a GIS platform. Results Data on mortality rates and space-time distribution of the victims were collected from various sources and were successfully merged and digitised, thus allowing the production of new map outputs and new interpretation of the 1854 cholera outbreak in London, covering more cases than Snow’s original report and also adding new insights into their space-time distribution. They confirmed that areas in the immediate vicinity of the Broad Street pump indeed suffered from excessively high mortality rates, which has been suspected for the past 160 years but remained unconfirmed. No distinctive pattern was found in the space-time distribution of victims’ locations. Conclusions The high mortality rates identified around the Broad Street pump are consistent with Snow’s theory about cholera being transmitted through contaminated water. The absence of a clear space-time pattern also indicates the water-bourne, rather than the then popular belief of air bourne, nature of cholera. The GIS data constructed in this study has an academic value and would cater for further research on Snow’s map.
机译:背景Snow在Broad Street地图上的工作被广泛认为是空间流行病学的开创性例子。但是,它缺乏当代疾病发病率分析所需的两个重要属性:处于危险中的人群和随着时间推移的流行病进展。尽管在文献中已经多次提出这一点,但是以前没有对这两个方面进行系统的研究。这项研究使用一系列历史文献,构建了自己的数据,以重新研究Snow的研究,以研究每个街道位置的死亡率和霍乱暴发的时空模式。方法:本研究收集了一系列历史文献中的记录,并准备了有关每个房屋位置上的估计居民人数的数据以及受害者的时空数据,并在GIS中对其进行处理,以利于空间分析。时间分析。使用内核密度估计和基于网络的“扫描统计”(Scan Statistic),探索了受害者记录中的死亡率和时空模式,该方法是最近开发的一种方法,该方法可以检测到大量记录,例如受害者离他们的距离和日期,地点。街道网络上的其他人。使用GIS平台以地图形式显示结果。结果从各种来源收集了有关受害者的死亡率和时空分布的数据,并将其成功合并并数字化,从而可以制作新的地图输出和对1854年伦敦霍乱疫情的新解释,涉及的范围比斯诺的原始病例多报告,并为其时空分布添加新见解。他们确认,百老汇水泵附近地区确实遭受过高的死亡率,在过去的160年中一直有人怀疑这是死亡率,但尚未得到证实。在受害者位置的时空分布中没有发现明显的模式。结论在Broad Street泵附近发现的高死亡率与Snow关于霍乱通过受污染水传播的理论相一致。缺乏清晰的时空模式也表明了水源性霍乱,而不是当时流行的对空气源性霍乱的信仰。这项研究中构建的GIS数据具有学术价值,可以满足对Snow地图的进一步研究。

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