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Urban structure and the risk of influenza A (H1N1) outbreaks in municipal districts
作者姓名:Hong Xiao  Xiaoling Lin  Gerardo Chowell  Cunrui Huang  Lidong Gao  Biyun Chen  Zheng Wang  Liang Zhou  Xinguang He  Haining Liu  Xixing Zhang  Huisuo Yang
作者单位:[1]College of Resources and Environment Science, Hunan NormalUniversity, Changsha 410081, China [2]Mathematical, Computational and Modeling Sciences Center,School of Human Evolution and Social Change, Arizona StateUniversity, Tempe, AZ 85287, USA [3]Division of International Epidemiology and Population Studies,Fogarly International Center, National Institutes of Health,Bethesda, MD 20892, USA [4]Centre for Environment and Population Health, School ofEnvironment, Griffith University, Brisbane, QLD 4111,Australia [5]Hunan Provincial Center for Disease Control and Prevention,Changsha 410002, China [6]Department of Respiratory and Critical Care Medicine, BeijingInstitute of Respiratory Medicine, Beijing Chaoyang HospitalAffiliated to Capital Medical University, Beijing 100020, China [7]Changsh-a Municipal Center for Disease Prevention and Control,Changsha 410001, China [8]Center for Disease Control and Prevention of Beijing MilitaryRegion, Beijing 100042, China
基金项目:Acknowledgments We wish to express our thanks to the anony- mous referees for their helpful comments on an earlier draft of this article. This work was supported by the Key Discipline Construction Project in Hunan Province (2008001), the National Natural Science Foundation of China and the Scientific Research Fund of Hunan Provincial Education Department (13A051 ).
摘    要:Changsha was one of the most affected areas during the 2009 A (H 1N 1) influenza pandemic in China. Here, we analyze the spatial-temporal dynamics of the 2009 pan- demic across Changsha municipal districts, evaluate the relationship between case incidence and the local urban spatial structure and predict high-risk areas of influenza A (H1NI). We obtained epidemiological data on all cases of influenza A (H1NI) reported across municipal districts in Changsha dur- ing period May 2009-December 2010 and data on population density and basic geographic characteristics for 239 primary schools, 97 middle schools, 347 universities, 96 mails and markets, 674 business districts and 121 hospitals. Spatial- temporal K functions, proximity models and logistic regres- sion were used to analyze the spatial distribution pattern of influenza A (H1N1) incidence and the association between influenza A (HINI) cases and spatial risk factors and predict the infection risks. We found that the 2009 influenza A (H 1N 1 ) was driven by a transmission wave from the center of the study area to surrounding areas and reported cases increased significantly after September 2009. We also found that the distribution of influenza A (H 1N1) cases was associ- ated with population density and the presence of nearest public places, especially universities (OR = 10.166). The final pre- dictive risk map based on the multivariate logistic analysis showed high-risk areas concentrated in the center areas of the study area associated with high population density. Our find- ings support the identification of spatial risk factors and high- risk areas to guide the prioritization of preventive and miti- gation efforts against future influenza pandemics.

关 键 词:风险图  流感  甲型  城市结构  Logistic回归分析  logistic回归  城市空间结构  爆发
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