利用MapMCDA工具分析摩洛哥动物狂犬病的空间流行病学:如何提高定性风险评估的合理性

M. Khayli, Mehdi Kechna, K. Zro, F. Kichou, Jaouad Berradae, M. Bouslikhane
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摘要

本文的目的是通过定性风险评估框架更好地表征摩洛哥动物狂犬病的空间分布。在摩洛哥,该病的发生既不明确分布,也不完全。因此,强烈建议采用风险评估方法来应对扭曲的地理格局。方法基于来自168个县的数据收集集,利用mapMCDA工具分析2004 - 2017年期间摩洛哥狂犬病空间流行病学的质变,包括先前工作中定义的摩洛哥动物狂犬病地理分布决定因素信息。结果为验证风险评估模型,将结果与研究期间报告的狂犬病病例进行比较。狂犬病风险估计的聚类具有决定性和高可靠性。在非常高和高风险的估计之间显示出显著的一致性。结论本研究首次尝试将MapMCDA应用于狂犬病。对于旨在避免与专家意见相关的主观性的规范过程,作者建议首先进行统计多成分分析,以提供风险因素的量化估计。这将是一个明智的决策工具,有助于设计有针对性的监测,并允许更好地转诊控制疾病的行动。
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Using MapMCDA Tool for the Spatial Epidemiology of Animal Rabies in Morocco: How to Improve the Rationality of a Qualitative Risk Assessment
Objective The objective behind this article is to better characterize spatial distribution of animal rabies in Morocco through qualitative risk assessment framework. In Morocco, the occurrence of the disease is neither clearly distributed nor complete. Therefore, risk assessment methods become strongly recommended to cope with distorted geographic patterns. Methods Based on data collection set from 168 counties, qualitative changes on spatial epidemiology of rabies were analysed by mapMCDA tool covering a period from 2004 to 2017 and including information on determinants of the geographic distribution of animal rabies in Morocco defined in previous work. Results To validate the risk assessment model, the results were compared to rabies cases reported during the study period. The clustering of the rabies risk estimates is decisive and highly reliable. A significant alignment was shown between the very high and high-risk estimates. Conclusion This study is the first attempt that has been made for using MapMCDA for rabies. For a normative process aiming to avoid subjectivity related to expert-opinions, authors suggest conducting initially a statistical multiple component analysis that will provide quantified estimates of risk factors. It would be an advisable decision-making tool that helps to design oriented surveillance and allows better referral of actions to control the disease.
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