寨卡病毒在非洲和亚太地区资源有限国家的传入及传播可能性：一项建模研究
Potential for Zika virus introduction and transmission in resource-limited countries in Africa and the Asia-Pacific region: a modelling study.
作者信息
Bogoch Isaac I, Brady Oliver J, Kraemer Moritz U G, German Matthew, Creatore Maria I, Brent Shannon, Watts Alexander G, Hay Simon I, Kulkarni Manisha A, Brownstein John S, Khan Kamran
机构信息
Department of Medicine, Division of Infectious Diseases, University of Toronto, Toronto, Canada.
Divisions of Internal Medicine and Infectious Diseases, University Health Network, Toronto, Canada.
出版信息
Lancet Infect Dis. 2016 Nov;16(11):1237-1245. doi: 10.1016/S1473-3099(16)30270-5. Epub 2016 Sep 1.
BACKGROUND
As the epidemic of Zika virus expands in the Americas, countries across Africa and the Asia-Pacific region are becoming increasingly susceptible to the importation and possible local spread of the virus. To support public health readiness, we aim to identify regions and times where the potential health, economic, and social effects from Zika virus are greatest, focusing on resource-limited countries in Africa and the Asia-Pacific region.
METHODS
Our model combined transportation network analysis, ecological modelling of mosquito occurrences, and vector competence for flavivirus transmission, using data from the International Air Transport Association, entomological observations from Zika's primary vector species, and climate conditions using WorldClim. We overlaid monthly flows of airline travellers arriving to Africa and the Asia-Pacific region from areas of the Americas suitable for year-round transmission of Zika virus with monthly maps of climatic suitability for mosquito-borne transmission of Zika virus within Africa and the Asia-Pacific region.
FINDINGS
An estimated 2·6 billion people live in areas of Africa and the Asia-Pacific region where the presence of competent mosquito vectors and suitable climatic conditions could support local transmission of Zika virus. Countries with large volumes of travellers arriving from Zika virus-affected areas of the Americas and large populations at risk of mosquito-borne Zika virus infection include India (67 422 travellers arriving per year; 1·2 billion residents in potential Zika transmission areas), China (238 415 travellers; 242 million residents), Indonesia (13 865 travellers; 197 million residents), Philippines (35 635 travellers; 70 million residents), and Thailand (29 241 travellers; 59 million residents).
INTERPRETATION
Many countries across Africa and the Asia-Pacific region are vulnerable to Zika virus. Strategic use of available health and human resources is essential to prevent or mitigate the health, economic, and social consequences of Zika virus, especially in resource-limited countries.
FUNDING
Canadian Institutes of Health Research and the US Centers for Disease Control and Prevention.
背景
随着寨卡病毒疫情在美洲蔓延，非洲和亚太地区各国越来越容易受到该病毒输入及可能的本地传播影响。为支持公共卫生防范工作，我们旨在确定寨卡病毒对健康、经济和社会潜在影响最大的地区和时间，重点关注非洲和亚太地区资源有限的国家。
方法
我们的模型结合了交通网络分析、蚊虫出现情况的生态建模以及黄病毒传播的媒介能力，使用了国际航空运输协会的数据、寨卡病毒主要病媒物种的昆虫学观察结果以及来自世界气候数据库的气候条件数据。我们将每月从适合寨卡病毒全年传播的美洲地区抵达非洲和亚太地区的航空旅客流量，与非洲和亚太地区寨卡病毒蚊媒传播的气候适宜性月度地图叠加在一起。
结果
估计有26亿人生活在非洲和亚太地区的一些地区，这些地区存在有传播能力的蚊媒且气候条件适宜，可能支持寨卡病毒的本地传播。来自受寨卡病毒影响的美洲地区的旅客数量众多且有感染蚊媒传播寨卡病毒风险的国家包括印度（每年有67422名旅客抵达；潜在寨卡病毒传播地区有12亿居民）、中国（238415名旅客；2.42亿居民）、印度尼西亚（13865名旅客；1.97亿居民）、菲律宾（35635名旅客；7000万居民）和泰国（29241名旅客；5900万居民）。
解读
非洲和亚太地区的许多国家都易受寨卡病毒影响。合理利用现有的卫生和人力资源对于预防或减轻寨卡病毒对健康、经济和社会的影响至关重要，尤其是在资源有限的国家。
资金来源
加拿大卫生研究院和美国疾病控制与预防中心。
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