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JAGS model specification for spatiotemporal epidemiological modelling 用于时空流行病学建模的 JAGS 模型规范
IF 3.4 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-02-28 DOI: 10.1016/j.sste.2024.100645
Dinah Jane Lope, Haydar Demirhan

Bayesian inference in modelling infectious diseases using Bayesian inference using Gibbs Sampling (BUGS) is notable in the last two decades in parallel with the advancements in computing and model development. The ability of BUGS to easily implement the Markov chain Monte Carlo (MCMC) method brought Bayesian analysis to the mainstream of infectious disease modelling. However, with the existing software that runs MCMC to make Bayesian inferences, it is challenging, especially in terms of computational complexity, when infectious disease models become more complex with spatial and temporal components, in addition to the increasing number of parameters and large datasets. This study investigates two alternative subscripting strategies for creating models in Just Another Gibbs Sampler (JAGS) environment and their performance in terms of run times. Our results are useful for practitioners to ensure the efficiency and timely implementation of Bayesian spatiotemporal infectious disease modelling.

在过去的二十年里,随着计算和模型开发的进步,使用吉布斯采样贝叶斯推断法(BUGS)建立传染病模型的贝叶斯推断法引人注目。BUGS 能够轻松实现马尔可夫链蒙特卡罗(MCMC)方法,这使贝叶斯分析成为传染病建模的主流。然而,利用现有的运行 MCMC 的软件进行贝叶斯推断,当传染病模型变得越来越复杂时,除了参数数量和大型数据集不断增加外,还包含空间和时间成分,这就具有挑战性,特别是在计算复杂性方面。本研究调查了在 Just Another Gibbs Sampler(JAGS)环境中创建模型的两种可选下标策略及其在运行时间方面的性能。我们的研究结果有助于从业人员确保高效、及时地实施贝叶斯时空传染病建模。
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引用次数: 0
Modelling the spatial risk pattern of dementia in Denmark using residential location data: A registry-based national cohort 利用居住地数据模拟丹麦痴呆症的空间风险模式:基于登记的全国队列
IF 3.4 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-02-09 DOI: 10.1016/j.sste.2024.100643
Prince M. Amegbor , Clive E. Sabel , Laust H. Mortensen , Amar J. Mehta

Dementia is a major global public health concern that is increasingly leading to morbidity and mortality among older adults. While studies have focused on the risk factors and care provision, there is currently limited knowledge about the spatial risk pattern of the disease. In this study, we employ Bayesian spatial modelling with a stochastic partial differential equation (SPDE) approach to model the spatial risk using complete residential history data from the Danish population and health registers. The study cohort consisted of 1.6 million people aged 65 years and above from 2005 to 2018. The results of the spatial risk map indicate high-risk areas in Copenhagen, southern Jutland and Funen. Individual socioeconomic factors and population density reduce the intensity of high-risk patterns across Denmark. The findings of this study call for the critical examination of the contribution of place of residence in the susceptibility of the global ageing population to dementia.

痴呆症是一个重大的全球公共卫生问题,越来越多地导致老年人发病和死亡。虽然研究主要集中在风险因素和护理服务方面,但目前对该疾病的空间风险模式了解有限。在本研究中,我们采用贝叶斯空间模型和随机偏微分方程 (SPDE) 方法,利用丹麦人口和健康登记册中的完整居住史数据建立空间风险模型。研究队列包括 2005 年至 2018 年间 160 万 65 岁及以上人口。空间风险图的结果表明,哥本哈根、日德兰半岛南部和富能岛为高风险地区。个人社会经济因素和人口密度降低了丹麦各地高风险模式的强度。这项研究的结果要求对居住地在全球老龄人口易患痴呆症方面的作用进行严格审查。
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引用次数: 0
Anaemia prevalence and socio-demographic factors among women of reproductive age (WRA): A geospatial analysis of empowered action group (EAG) states in India "育龄妇女(WRA)中的贫血患病率和社会人口因素:印度赋权行动小组(EAG)各邦的地理空间分析"
IF 3.4 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-02-09 DOI: 10.1016/j.sste.2024.100644
Manabindra Barman

Anaemia remains a major nutritional-related health concern for women under reproductive age (WRA) in developing nations like India as well as the Indian EAG states. According to NFHS round-5, EAG states constitute 57% of WRA having any form of anaemia, higher than many other states of India and other developed and developing nations. This study aimed to assess the frequency of anaemia among the WRA in India's eight EAG states. Also, it attempts to analyse the causes associated with anaemia by the women's background characteristics with spatial correlation with its co-variates across 291 districts of the EAG states. One of the most current Demographic and Health Survey's (DHS) cross-sectional data is the NFHS-5th (2019–21) round taken, conducted by the IIPS under the administration of MoHFW, India. This study only included 315,069 women under reproductive age (WRA). The variables related to anaemia among women's (WRA) background socio-demographic characteristics were assessed using bivariate statistics and multinominal logistic regression analysis to comprehend the spatial correlation between women and their determinant factors. Among the EAG states, the overall prevalence of anaemia was 57%, varying from 42.6% in Uttarakhand to 65.3% in Jharkhand. Multinominal logistic regression analyses reveal that the chances of anaemia are remarkably more prevalent in younger women (15–19 years of age), women living in rural areas, no educated and primary level educated women, women belonging to the middle to poorest wealth quintile, women no longer living together, women of the Christian religion, women who are not exposed to reading newspapers, underweight BMI women, and scheduled tribe women. Mainly, the prevalence is observed in the North-eastern and southeastern states of Bihar, Jharkhand, Odisha, Chhattisgarh, some parts of Madhya Pradesh, Uttar Pradesh, and Rajasthan, which is shown by the hotspot map. According to the findings of this study, numerous factors like family, socioeconomic, educational, awareness, and individual characteristics such as caste and domicile all lead to a risk of anaemia. The WRA suffers from anaemia as a result of their socioeconomic background and awareness, which leads to a lack of nourishment, and they seek nutrient deficiencies. To overcome this anaemia, multiple discipline policies and initiatives need to be taken targeting women's wellness and nutritional status by increasing women's education and socioeconomic status.

贫血仍然是印度等发展中国家以及印度东亚地区各邦育龄妇女(WRA)与营养相关的主要健康问题。根据第五轮国家人口与健康调查,东亚地区各邦有 57% 的育龄妇女患有任何形式的贫血症,高于印度其他许多邦以及其他发达国家和发展中国家。本研究旨在评估印度八个东亚地区邦的妇女和儿童贫血症发病率。此外,该研究还试图根据东亚地区各邦 291 个县的妇女背景特征及其空间相关共变量,分析与贫血相关的原因。最新的人口与健康调查(DHS)横断面数据之一是印度卫生和家庭福利部管理下的印度人口与健康调查研究所(IIPS)进行的第 5 次(2019-21 年)全国人口与健康调查。这项研究仅包括 315 069 名育龄妇女(WRA)。使用二元统计和多项式逻辑回归分析评估了妇女(WRA)背景社会人口特征中与贫血有关的变量,以了解妇女与其决定因素之间的空间相关性。在东亚地区各邦中,贫血症的总患病率为 57%,从北阿坎德邦的 42.6%到恰尔肯德邦的 65.3%不等。多项式逻辑回归分析表明,年轻妇女(15-19 岁)、生活在农村地区的妇女、未受过教育和初等教育的妇女、属于中等至最贫穷五分之一财富的妇女、不再同居的妇女、信奉基督教的妇女、不阅读报纸的妇女、体重指数(BMI)过低的妇女和在册部落妇女患贫血症的几率明显更高。主要流行于东北部和东南部的比哈尔邦、恰尔康得邦、奥迪沙邦、恰蒂斯加尔邦、中央邦的部分地区、北方邦和拉贾斯坦邦,如热点地图所示。根据这项研究的结果,家庭、社会经济、教育、意识以及种姓和住所等个人特征等众多因素都会导致贫血风险。由于社会经济背景和认识的原因,妇女和儿童营养不良,导致营养缺乏,从而患上贫血症。为了克服这种贫血症,需要通过提高妇女的教育水平和社会经济地位,针对妇女的健康和营养状况采取多种纪律政策和举措。
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引用次数: 0
Predicting COVID-19 hospitalizations: The importance of healthcare hotlines, test positivity rates and vaccination coverage 预测 COVID-19 住院情况:医疗热线、检测阳性率和疫苗接种覆盖率的重要性
IF 3.4 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-02-01 DOI: 10.1016/j.sste.2024.100636
Vera van Zoest , Karl Lindberg , Georgios Varotsis , Frank Badu Osei , Tove Fall

In this study, we developed a negative binomial regression model for one-week ahead spatio-temporal predictions of the number of COVID-19 hospitalizations in Uppsala County, Sweden. Our model utilized weekly aggregated data on testing, vaccination, and calls to the national healthcare hotline. Variable importance analysis revealed that calls to the national healthcare hotline were the most important contributor to prediction performance when predicting COVID-19 hospitalizations. Our results support the importance of early testing, systematic registration of test results, and the value of healthcare hotline data in predicting hospitalizations. The proposed models may be applied to studies modeling hospitalizations of other viral respiratory infections in space and time assuming count data are overdispersed. Our suggested variable importance analysis enables the calculation of the effects on the predictive performance of each covariate. This can inform decisions about which types of data should be prioritized, thereby facilitating the allocation of healthcare resources.

在这项研究中,我们建立了一个负二项回归模型,用于提前一周对瑞典乌普萨拉县的 COVID-19 住院人数进行时空预测。我们的模型利用了每周有关检测、疫苗接种和拨打全国医疗保健热线的汇总数据。变量重要性分析表明,在预测 COVID-19 住院人数时,拨打全国医疗保健热线是影响预测效果的最重要因素。我们的研究结果证明了早期检测、系统登记检测结果的重要性,以及医疗热线数据在预测住院情况方面的价值。假设计数数据过度分散,所提出的模型可应用于其他病毒性呼吸道感染住院治疗的时空建模研究。我们建议的变量重要性分析可以计算出每个协变量对预测效果的影响。这可以为优先考虑哪类数据提供决策依据,从而促进医疗资源的分配。
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引用次数: 0
Significance of weather condition, human mobility, and vaccination on global COVID-19 transmission 天气条件、人类流动性和疫苗接种对全球 COVID-19 传播的影响
IF 3.4 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-02-01 DOI: 10.1016/j.sste.2024.100635
Amandha Affa Auliya , Inna Syafarina , Arnida L. Latifah , Wiharto

The transmission growth rate of infectious diseases, particularly COVID-19, has forced governments to take immediate control decisions. Previous studies have shown that human mobility, weather condition, and vaccination are potential factors influencing virus transmission. This study investigates the contribution of weather conditions, namely temperature and precipitation, human mobility, and vaccination to coronavirus transmission. Three machine learning models: random forest (RF), XGBoost, and neural networks, are applied to predict the confirmed cases based on three aforementioned variables. All models’ prediction are evaluated via spatial and temporal analysis. The spatial analysis observes the model performance over countries on certain times. The temporal analysis looks at the model prediction of each country during the specified period. The models’ prediction results effectively indicate the transmission trend. The RF model performs best with a coefficient of determination of up to 89%. Meanwhile, all models confirm that vaccination is most significantly associated with COVID-19 cases.

传染病,尤其是 COVID-19 的传播增长率迫使各国政府立即做出控制决定。以往的研究表明,人员流动、天气状况和疫苗接种是影响病毒传播的潜在因素。本研究调查了天气条件(即温度和降水)、人员流动性和疫苗接种对冠状病毒传播的影响。研究采用了三种机器学习模型:随机森林(RF)、XGBoost 和神经网络,根据上述三个变量预测确诊病例。所有模型的预测均通过空间和时间分析进行评估。空间分析观察的是模型在特定时间在不同国家的表现。时间分析则考察模型在指定时间段内对每个国家的预测。模型的预测结果有效地显示了传播趋势。射频模型表现最佳,其决定系数高达 89%。同时,所有模型都证实接种疫苗与 COVID-19 病例的关系最为密切。
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引用次数: 0
Taking cues from machine learning, compartmental and time series models for SARS-CoV-2 omicron infection in Indian provinces 印度各省 SARS-CoV-2 Omicron 感染的机器学习、区隔和时间序列模型的启示
IF 3.4 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-02-01 DOI: 10.1016/j.sste.2024.100634
Subhash Kumar Yadav , Saif Ali Khan , Mayank Tiwari , Arun Kumar , Vinit Kumar , Yusuf Akhter

SARS-CoV-2, the virus responsible for COVID-19, posed a significant threat to the world. We analyzed COVID-19 dissemination data in the top ten Indian provinces by infection incidences using the Susceptible-Infectious-Removed (SIR) model, an Autoregressive Integrated Moving Average (ARIMA) time series model, a machine learning model based on the Random Forest, and distribution fitting. Outbreaks are expected to continue if the Basic Reproduction Number (R0) > 1, and infection waves are anticipated to end if the R0 < 1, as determined by the SIR model. Different parametric probability distributions are also fitted. Data collected from December 12, 2021, to March 31, 2022, encompassing data from both before and during the implementation of strict control measures. Based on the estimates of the model parameters, health agencies and government policymakers can develop strategies to combat the spread of the disease in the future, and the most effective technique can be recommended for real-world application for other outbreaks of COVID-19. The best method out of these could be also implemented further on the epidemiological data of other similar infectious agents.

SARS-CoV-2(COVID-19的致病病毒)对世界构成了重大威胁。我们利用易感-感染-移出(SIR)模型、自回归综合移动平均(ARIMA)时间序列模型、基于随机森林的机器学习模型和分布拟合,分析了印度感染发病率最高的十个省份的 COVID-19 传播数据。根据 SIR 模型,如果基本繁殖数(R0)为 1,则预计疫情将持续;如果 R0 为 1,则预计感染波将结束。还拟合了不同的参数概率分布。数据收集时间为 2021 年 12 月 12 日至 2022 年 3 月 31 日,包括严格控制措施实施前和实施期间的数据。根据对模型参数的估计,卫生机构和政府政策制定者可以制定未来抗击疾病传播的策略,并推荐最有效的技术用于实际应用。
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引用次数: 0
Chronic back pain prevalence at small area level in England - the design and validation of a 2-stage static spatial microsimulation model 英格兰小地区层面的慢性背痛患病率--两阶段静态空间微观模拟模型的设计与验证
IF 3.4 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-12-31 DOI: 10.1016/j.sste.2023.100633
Harrison Smalley, Kimberley Edwards

Spatially disaggregated estimates provide valuable insights into the nature of a disease. They highlight inequalities, aid public health planning and identify avenues for further research. Spatial microsimulation is advantageous in that it can be used to create large microdata sets with intact microlevel relationships between variables, which allows analysis of relationships between variables locally. This methodological paper outlines the design and validation of a 2-stage static spatial microsimulation model for chronic back pain prevalence across England, suitable for policy modelling. Data used was obtained from the Health Survey for England and the 2011 Census. Microsimulation was performed using SimObesity, a previously validated static deterministic program, and the synthetic chronic back pain microdataset was internally validated. The paper also highlights modelling considerations for researchers embarking on similar work, as well as future directions for research in this area of microsimulation.

按空间分列的估算值可提供有关疾病性质的宝贵见解。它们突出了不平等现象,有助于公共卫生规划,并确定了进一步研究的途径。空间微观模拟的优势在于,它可以用来创建大型微观数据集,并在变量之间建立完整的微观关系,从而对变量之间的关系进行局部分析。这篇方法论论文概述了英格兰慢性背痛患病率两阶段静态空间微观模拟模型的设计和验证,该模型适用于政策建模。所用数据来自英格兰健康调查和 2011 年人口普查。微观模拟使用 SimObesity 进行,这是一个先前经过验证的静态确定性程序,合成的慢性背痛微观数据集经过了内部验证。本文还强调了研究人员在开展类似工作时的建模注意事项,以及微观模拟这一领域的未来研究方向。
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引用次数: 0
Psychosis prevalence in London neighbourhoods; A case study in spatial confounding 伦敦街区的精神病流行率;空间混淆案例研究
IF 3.4 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-12-13 DOI: 10.1016/j.sste.2023.100631
Peter Congdon

Analysis of impacts of neighbourhood risk factors on mental health outcomes frequently adopts a disease mapping approach, with unknown neighbourhood influences summarised by random effects. However, such effects may show confounding with observed predictors, especially when such predictors have a clear spatial pattern. Here, the standard disease mapping model is compared to methods which account and adjust for spatial confounding in an analysis of psychosis prevalence in London neighbourhoods. Established area risk factors such as area deprivation, non-white ethnicity, greenspace access and social fragmentation are considered as influences on psychosis. The results show evidence of spatial confounding in the standard disease mapping model. Impacts expected on substantive grounds and available evidence are either nullified or reversed in direction. It is argued that the potential for spatial confounding to affect inferences about geographic disease patterns and risk factors should be routinely considered in ecological studies of health based on disease mapping.

在分析邻里风险因素对心理健康结果的影响时,通常会采用疾病分布图的方法,用随机效应来概括未知的邻里影响。然而,这些影响可能会与观察到的预测因素相混淆,尤其是当这些预测因素具有明显的空间模式时。在此,我们将标准疾病映射模型与考虑并调整空间混杂因素的方法进行比较,以分析伦敦街区的精神病患病率。已确定的地区风险因素,如地区贫困、非白人种族、绿地使用权和社会分化,都被视为对精神病的影响因素。结果显示,在标准疾病绘图模型中存在空间混杂的证据。根据实质性理由和现有证据所预期的影响要么无效,要么方向相反。本文认为,在基于疾病分布图的健康生态学研究中,应定期考虑空间混杂对地理疾病模式和风险因素推断的潜在影响。
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引用次数: 0
Spatial distribution and determinants of tuberculosis incidence in Mozambique: A nationwide Bayesian disease mapping study 莫桑比克结核病发病率的空间分布和决定因素:全国性贝叶斯疾病绘图研究。
IF 3.4 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-12-12 DOI: 10.1016/j.sste.2023.100632
Nelson Cuboia , Joana Reis-Pardal , Isabel Pfumo-Cuboia , Ivan Manhiça , Cláudia Mutaquiha , Luis Nitrogénio , Pereira Zindoga , Luís Azevedo

Introduction

Mozambique is a high-burden country for tuberculosis (TB). International studies show that TB is a disease that tends to cluster in specific regions, and different risk factors (HIV prevalence, migration, overcrowding, poverty, house condition, temperature, altitude, undernutrition, urbanization, and inadequate access to TB diagnosis and treatment) are reported in the literature to be associated with TB incidence. Although Mozambique has a higher burden of TB, the spatial distribution, and determinants of TB incidence at the sub-national level have not been studied yet for the whole country. Therefore, we aimed to analyze the spatial distribution and determinants of tuberculosis incidence across all 154 districts of Mozambique and identify the hotspot areas.

Method

We conducted an ecological study with the district as our unit of analysis, where we included all cases of tuberculosis diagnosed in Mozambique between 2016 and 2020. We obtained the data from the Mozambique Ministry of Health and other publicly available open sources. The predictor variables were selected based on the literature review and data availability at the district level in Mozambique. The parameters were estimated through Bayesian hierarchical Poisson regression models using Markov Chain Monte Carlo simulation.

Results

A total of 512 877 people were diagnosed with tuberculosis in Mozambique during our five-year study period. We found high variability in the spatial distribution of tuberculosis incidence across the country. Sixty-two districts out of 154 were identified as hotspot areas. The districts with the highest incidence rate were concentrated in the south and the country's central regions. In contrast, those with lower incidence rates were mainly in the north. In the multivariate analysis, we found that TB incidence was positively associated with the prevalence of HIV (RR: 1.23; 95 % CrI 1.13 to 1.34) and negatively associated with the annual average temperature (RR: 0.83; 95 % CrI 0.74 to 0.94).

Conclusion

The incidence of tuberculosis is unevenly distributed across the country. Lower average temperature and high HIV prevalence seem to increase TB incidence. Targeting interventions in higher-risk areas and strengthening collaboration between HIV and TB programs is paramount to ending tuberculosis in Mozambique, as established by the WHO's End TB strategy and the Sustainable Development Goals.

导言:莫桑比克是一个结核病负担沉重的国家。国际研究表明,肺结核是一种倾向于聚集在特定地区的疾病,文献报道不同的风险因素(艾滋病毒感染率、移民、过度拥挤、贫困、房屋条件、温度、海拔高度、营养不良、城市化以及无法获得充分的肺结核诊断和治疗)与肺结核发病率有关。虽然莫桑比克的结核病负担较重,但尚未对全国结核病发病率的空间分布和决定因素进行研究。因此,我们旨在分析莫桑比克所有 154 个县的结核病发病率的空间分布和决定因素,并确定热点地区:我们开展了一项以地区为分析单位的生态研究,纳入了 2016 年至 2020 年期间莫桑比克确诊的所有结核病例。我们从莫桑比克卫生部和其他公开来源获取数据。预测变量的选择基于文献综述和莫桑比克地区一级的数据可用性。利用马尔可夫链蒙特卡罗模拟,通过贝叶斯分层泊松回归模型对参数进行了估计:在五年的研究期间,莫桑比克共有 512 877 人被确诊为肺结核患者。我们发现全国结核病发病率的空间分布存在很大差异。有 62 个地区被确定为热点地区。发病率最高的地区集中在南部和中部地区。相比之下,发病率较低的地区主要集中在北部。在多变量分析中,我们发现结核病发病率与艾滋病毒感染率呈正相关(RR:1.23;95% CrI 1.13 至 1.34),与年平均气温呈负相关(RR:0.83;95% CrI 0.74 至 0.94):结论:全国结核病发病率分布不均。较低的平均气温和较高的艾滋病毒感染率似乎会增加结核病的发病率。根据世界卫生组织的 "终结结核病战略 "和可持续发展目标,在高风险地区采取有针对性的干预措施,并加强艾滋病项目与结核病项目之间的合作,对于在莫桑比克终结结核病至关重要。
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引用次数: 0
Examining associations between social vulnerability indices and COVID-19 incidence and mortality with spatial-temporal Bayesian modeling 利用时空贝叶斯模型研究社会脆弱性指数与COVID-19发病率和死亡率之间的关系
IF 3.4 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-11-18 DOI: 10.1016/j.sste.2023.100623
Daniel P. Johnson , Claudio Owusu

This study compares two social vulnerability indices, the U.S. CDC SVI and SoVI (the Social Vulnerability Index developed at the Hazards Vulnerability & Resilience Institute at the University of South Carolina), on their ability to predict the risk of COVID-19 cases and deaths. We utilize COVID-19 cases and deaths data for the state of Indiana from the Regenstrief Institute in Indianapolis, Indiana, from March 1, 2020, to March 31, 2021. We then aggregate the COVID-19 data to the census tract level, obtain the input variables, domains (components), and composite measures of both CDC SVI and SoVI data to create a Bayesian spatial-temporal ecological regression model. We compare the resulting spatial-temporal patterns and relative risk (RR) of SARS-CoV-2 infection (COVID-19 cases) and associated death. Results show there are discernable spatial-temporal patterns for SARS-CoV-2 infections and deaths with the largest contiguous hotspot for SARS-CoV-2 infections found in the southwest of the Indianapolis metropolitan area. We also observed one large contiguous hotspot for deaths that stretches across Indiana from the Cincinnati area in the southeast to just east and north of Terre Haute (southeast to west central). The spatial-temporal Bayesian model shows that a 1-percentile increase in CDC SVI was significantly (p ≤ 0.05) associated with an increased risk of SARS-CoV-2 infection by 6 % (RR = 1.06, 95 %CI = 1.04 -1.08). Whereas a 1-percentile increase in SoVI was significantly predicted to increase the risk of COVID-19 death by 45 % (RR = 1.45, 95 %CI =1.38 – 1.53). Domain-specific variables related to socioeconomic status, age, and race/ethnicity were shown to increase the risk of SARS-CoV-2 infections and deaths. There were notable differences in the relative risk estimates for SARS-CoV-2 infections and deaths when each of the two indices were incorporated in the model. Observed differences between the two social vulnerability indices and infection and death are likely due to alternative methodologies of formation and differences in input variables. The findings add to the growing literature on the relationship between social vulnerability and COVID-19 and further the development of COVID-19-specific vulnerability indices by illustrating the utility of local spatial-temporal analysis.

本研究比较了两种社会脆弱性指数,美国CDC的SVI和SoVI(社会脆弱性指数)。南卡罗来纳大学复原力研究所(Resilience Institute)的研究人员,他们预测COVID-19病例和死亡风险的能力。我们使用印第安纳州印第安纳波利斯注册管理研究所2020年3月1日至2021年3月31日的印第安纳州COVID-19病例和死亡数据。然后,我们将COVID-19数据汇总到普查区水平,获得CDC SVI和SoVI数据的输入变量、域(成分)和复合测度,建立贝叶斯时空生态回归模型。我们比较了结果的时空模式和SARS-CoV-2感染(COVID-19病例)和相关死亡的相对风险(RR)。结果表明,SARS-CoV-2感染和死亡具有明显的时空格局,其中最大的连续感染热点位于印第安纳波利斯大都市区西南部。我们还观察到一个巨大的连续死亡热点,从东南的辛辛那提地区延伸到特雷霍特的东部和北部(东南到中西部)。时空贝叶斯模型显示,CDC SVI每增加1个百分位数与SARS-CoV-2感染风险增加6%显著相关(p≤0.05)(RR = 1.06, 95% CI = 1.04 ~ 1.08)。然而,据预测,SoVI每增加1个百分点,COVID-19死亡风险就会增加45% (RR = 1.45, 95% CI =1.38 - 1.53)。与社会经济地位、年龄和种族/民族相关的特定领域变量被证明会增加SARS-CoV-2感染和死亡的风险。当将这两个指标纳入模型时,SARS-CoV-2感染和死亡的相对风险估计值存在显著差异。观察到的两种社会脆弱性指数以及感染和死亡之间的差异可能是由于不同的形成方法和输入变量的差异造成的。这一发现为越来越多的关于社会脆弱性与COVID-19之间关系的文献提供了补充,并通过说明局部时空分析的实用性,进一步开发了针对COVID-19的脆弱性指数。
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Spatial and Spatio-Temporal Epidemiology
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