高度城市化地区传染病流行的时空分异与风险预测研究：以珠三角地区登革热为例

Along with consecutively advanced urbanization, the residents in the highly urbanized area (HUA) have been affected by some kinds of epidemic infectious diseases, which demands early and accurate risk prediction for these diseases so as to reduce the hazard level to the greatest extent. However, there are still obvious limitations including the lean understanding and comprehension of these diseases’ epidemic features as well as the poor capability of predicting and preventing their risks. Aiming at above shortages, this project will select the Pearl River Delta as the study area and then conduct a systematic investigation on dengue fever (DF) in this highly urbanized region. As well as some spatial analysis techniques like remote sensing and geographic information system, a list of geographic, ecologic, epidemiologic models and methods should be substantially applied to explore the spatiotemporal differentiation of dengue fever transmission, disclose the featured impacts of urbanization labeled by land use change and population distribution on local meteorological factors. Then, the spatiotemporal correlation between featured urbanization and DF transmission in HUA, by which a series of assessment methods on the environmental suitability for DF transmission and special models for predicting transmission risk should be achieved and could comprehensively couple natural with socioeconomic factors. Subsequently, suggestions on preventing and controlling DF transmission risk would be reasonably raised against various environmental suitability of each cell unit. Successful investigation on featured impacts of progressing urbanization on DF transmission would be able to supply scientific evidences for safeguarding public health, optimizing urban development, and developing eco-civilization in China.

随着我国城市化进程的不断推进，传染病的流行已成为影响高度城市化地区居民健康的重要威胁，及早、准确预测高度城市化地区传染病的流行风险是最大限度降低其危害程度的迫切需求。然而，当前对高度城市化地区传染病流行特征的认识、理解以及流行风险的预测预估与防范等方面存在明显不足。针对以上问题，本项目拟以珠三角地区为典型研究区，应用地理学、生态学以及传染病流行病学相关模型与方法，结合遥感与地理信息系统等空间分析技术，探究研究区登革热流行的时空分异特征，揭示城市化进程中土地利用、人口分布变化及其对本地气候因素的影响特征，分析城市化进程与登革热流行特征之间的时空关联关系，综合考虑自然-社会影响因素，构建高度城市化地区登革热流行环境适宜性评价和风险预测的模型与方法体系，提出针对不同适宜性区域的登革热流行风险防范建议，为高度城市化地区的公共健康保障、城市优化发展以及生态文明建设提供科学依据。

高度城市化地区高发频发的传染病疫情是影响城市居民健康的重要威胁。当前在认识高度城市化地区传染病流行特征、理解其流行空间分异过程与影响因素、有效预测预估并防范其风险等方面的能力存在明显不足。本项目以珠三角地区为研究区，综合应用地理学、生态学以及传染病流行病学相关模型与方法，全面分析了研究区登革热流行与多个空间尺度上的时空分异特征，探析了研究区自然环境要素与社会经济条件在不同尺度上对登革热疫情的影响过程、机制及其流行环境适宜性评价策略，比较了研究区与滇缅边境等其他典型流行区疫情时空分异及其主要影响因素差异，构建了面向研究区登革热流行环境适宜性评价的自然-社会要素数据库，形成了基于城市空间扩张规律和生态位模型的区域登革热流行风险预测模型与方法体系。研究发现，珠三角是我国典型的“海空型”病例输入与本地疫情聚集地区，呈现以广佛为中心的疫情聚集格局，主导区域内登革热流行空间分异的因素是差异显著的人口密度、路网分布等社会经济条件而非差异不明显的气候因素；在未来（2050、2070年）将面临登革热的流行范围扩大、流行程度加深的压力；此外，在人口密集且流动性强、公共交通便利的中心城区，区大量存在但蚊媒监测体系亟需完善的城中村及附近区域扮演着登革热流行和扩散的“时空中转站”的角色。基于此，我们建议在密切关注登革热输入病例的同时，需要因地制宜采取防控策略，如：在高度城市化且连片的地区应实施突破行政单元限制的联防联控机制，构建并完善以城中村为节点的登革热疫情防控策略和措施体系。至此，本研究在高度城市化地区传染病流行时空分异格局、过程及其响应机制等方面取得了一定的进展，为持续推进城市化和应对气候变化背景下区域传染病流行风险防范能力的提高、城市居民公共健康的保障、城市化质量与发展水平的提升以及促进美丽、健康中国建设等方面提供重要的数据、方法和理论依据。