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登革熱疫情的空間趨勢分析

Spatial trend analysis of dengue fever outbreak

摘要


目標:台灣今年面臨最嚴重的登革熱疫情,導致創下歷史性最高的發生及死亡個數,且經歷這個世紀最嚴峻的酷熱氣候,登革熱個案不斷攀升,因此有系統的控制登革熱疫情的傳播,是衛生部門一項很大的挑戰。本研究將探討大台南地區登革熱案例的分布與風險人口在地理區域之關連性。方法:利用台南市所提供含有地理定位的開放資料(open data),分析登革熱爆發後之三個月,從五月二十一日到八月二十一日止。並透過地理資訊系統之經驗貝氏克利金法(Empirical Bayesian Kriging, EBK)及反距加權法(Inverse Distance Weighted, IDW),分別進行大台南地區之登革熱案例分布與風險人口的擴散模式之推估。結果:結果顯示,病例熱區與傳統市場及夜市商圈位置一致,其中舊台南縣87%的病例發生在傳統市場及夜市商圈1000 公尺內,成人約10 分鐘步行路程範圍,且台南市登革熱熱區與老年人口具有統計上的顯著關係。結論:此次登革熱疫情飆升,其爆發地點恰巧為台南市北區,也是舊台南市老年人口最集中之地區,所以造成疫情嚴重現象。舊台南縣地區之疫情,皆由傳統市場及夜市商圈往外擴散,未來預防策略應以該地區做為首要防疫之重點。透過政府開放資料的大數據分析,結合地理資訊工具之應用,更能提供詳盡而即時的結果,以做為防治登革熱之衛生政策的實證建議。

並列摘要


Objectives: Facing the worst outbreak of mosquito-borne dengue fever in decades and a record hot summer in Taiwan in 2015. the frontline public health workers are urgently in need of strategy to control the transmission of the disease. This study was conducted to utilize Geographic Information System (GIS) tools to provide the necessary information on hotspot areas and population at highest risk of this disease outbreak. Methods: This study used open data from Tainan city government which provided ongoing geocoding dengue fever cases since May 21, 2015. In this study, we examined the outbreak of dengue fever cases in Tainan area during the period between May 21 and August 21, 2015. Empirical Bayesian Kriging and Inverse Distance Weighted model were used to interpolate the data. Results: The cumulative dengue incidence was monitored in the first three months since May 21. The result indicated that there were areas with especially high incidence. These hotspot areas within Tainan County were found to have strong geographical correlation with traditional markets and with night markets. Eighty-seven percent (87%) of cases occurred within a 1000m range (about 10 minutes walkability). This range was correlated with the highest density of elderly population. GIS tools thus were useful in pinpointing high-risk areas of occurrence of dengue fever to receive priority regulatory actions. Conclusions: The dengue fever in Tainan City, broke out in its North District where elderly residents were especially concentrated, favoring the development of a rampant epidemic situation. Future prevention plans should focus on traditional market and night market areas to curtail dengue fever from spreading. Open data from government are useful in facilitating analysis of situation for making timely evidence-based recommendations. GIS tools appear to be superior to the traditional data analysis in providing useful information for public health authorities.

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