建立傳染病傳播的個人暴露風險評估架構

人口移動行為是影響傳染病中，人類與病媒接觸、暴露的重要影響因子，因此差異化不同個體之間接觸與暴露的程度，是重要的研究課題。近年的研究趨勢係以高解析度的定位裝置進行個人活動行為的資料收集，進行基於個人的環境汙染物暴露評估，或探討個體行為的差異對疾病傳播的影響等。然而，以傳染病擴散模式進行個人化的健康風險評估，尚未有清楚的學術討論。因此，本研究目的在於架構個人化的疾病暴露風險評估模式，以此評估在傳染病爆發的環境下，個體的移動行為所導致的暴露感染機率，進行個人化的傳染病暴露風險評估。本研究將發展個人化傳染病傳播的暴露風險評估的系統架構，將分為：一、以開發智慧型手機應用程式作為個人端的風險管理介面，進行個人行為資訊的收集以及環境風險分布、個人風險指標等疫情資訊等資訊傳遞的功能；二、透過傳染病數學模式的建立，模擬在校園爆發呼吸道傳染病的群聚感染疫情，並將個人的行為資訊與傳染病傳播風險分布整合分析，進行個人化的傳染病暴露風險評估。本研究以國立台灣大學公館校區的環境進行試作，建立校園傳染病傳播的分析模式，以修課資料庫中學生的修課行為描述校園教學大樓的網絡關係，建立傳染病擴散分析模式，模擬傳染病於校園教學大樓間傳播的過程與風險分布。另一方面，整合學生個人的修課與移動行為進行傳染病暴露風險評估，並進一步討論學生修課行為特性、知曉疫情的行為改變機制與個人暴露風險之間的關係。藉由建立個人傳染病傳播的暴露風險評估架構，本研究得以進一步探討行為與個人傳染病風險暴露之間的關係，研究發現在集中的行為特性下，個人的傳染病風險較低，例如將課程安排在少數幾天而非均勻地安排在一週；另一方面，在行為改變機制上發現請假的行為機制對於個人的傳染病風險有降低的效果，但對於整體疫情傳播速度與嚴重程度的抑制效果則需要在多數學生都採取請假措施時才得以彰顯。在防疫概念上，本研究的發現在傳染病爆發時，對於個人行為的安排能提供概略性的方向，對於權責單位則需宣導學生衛生與防疫意識。在模式建構上，此系統架構提供了行為改變的相關研究進行實證分析的視野，希冀未來資通訊技術更加蓬勃發達時能進行實際應用。

關鍵字

傳染病擴散；個人化暴露風險評估；決策支援；行為改變；人口移動

並列摘要

Human mobility is an important risk factor affecting disease transmission. Therefore, understanding detailed spatial behaviors and interactions among individuals is a fundamental issue. Past studies using high-resolution human contacts data from smart phones with GPS logs have captured spatial-temporal heterogeneity and daily contact patterns among individuals. However, measuring personalized exposed risk of infectious disease transmission is still under development. The purpose of the study is to establish a framework for assessing personalized exposed risk of infectious disease transmission. The framework consists of two components: the first is client-side smart phone-based risk assessment module. We developed Android application for collecting individual mobility data and displaying the personalized exposed risk score. The second component is the server-side epidemic simulation model. The simulation model calculated the personalized exposed risk score based on individual mobility data from the client-side Android application. We used NTU main campus as a pilot study to demonstrate the feasibility of the framework. We analyzed the records of students’ taking course and modeled the spatial interaction relationships among classroom buildings due to students’ mobility around the campus. Each student who installed the client-side risk assessment module in his/her smart phone receives the real-time personalized exposed risk score when an epidemic outbreak on the NTU campus. Furthermore, we explored the relationships between personalized exposed risk score and course taking behaviors including a simple behavior change mechanism. The study proposed a framework for measuring real-time personalized exposed risk. Each student at the campus could understand the spatial diffusion of disease transmission and make better spatial decisions based on personalized exposed risk scores to avoid getting infectious diseases.

並列關鍵字

infectious diseases ； personalized exposure assessment ； behavior change ； decision making ； human mobility

參考文獻

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國際替代計量

建立傳染病傳播的個人暴露風險評估架構

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