CAJ | 학술논문

目的应用常微分方程(ODE)模型研究基孔肯雅热(CHIK)在社区暴发及流行的传播动力学规律,并评价灭蚊、病例隔离等关键控制措施的效果.方法根据CHIK的疾病自然史建立适合CHIK暴发特点的ODE模型.收集中国CHIK暴发疫情数据,将模型与实际疫情数据拟合,获得模型关键参数,模拟无干预情况下的暴发疫情特点.然后加入灭蚊和隔离措施,评价不同干预措施的防控效果.结果 ODE模型显示,在无干预的情况下,在11 000人的社区中输入1例病例,累计发病人数将超过941人,罹患率超过8.55％.不同时间采取隔离措施,结果显示,由于病毒已经在蚊虫中持续存在了一定时间,隔离效果不理想,发病人数和自然状态相比虽有降低,但疫情持续时间却未见减少;不同时间采取灭蚊措施,防控效果显著,越早灭蚊,效果越好;"灭蚊+隔离"措施的效果与只采取灭蚊措施的效果相同.结论在CHIK的暴发疫情处置中,最重要的防控措施为灭蚊,但在不能杀灭所有蚊虫时需要采取病例防蚊隔离措施.
목적 응용상미분방정(ODE)모형연구기공긍아열(CHIK)재사구폭발급류행적전파동역학규률,병평개멸문、병례격리등관건공제조시적효과.방법 근거CHIK적질병자연사건립괄합CHIK폭발특점적ODE모형.수집중국CHIK폭발역정수거,장모형여실제역정수거의합,획득모형관건삼수,모의무간예정황하적폭발역정특점.연후가입멸문화격리조시,평개불동간예조시적방공효과.결과 ODE모형현시,재무간예적정황하,재11 000인적사구중수입1례병례,루계발병인수장초과941인,리환솔초과8.55％.불동시간채취격리조시,결과현시,유우병독이경재문충중지속존재료일정시간,격리효과불이상,발병인수화자연상태상비수유강저,단역정지속시간각미견감소;불동시간채취멸문조시,방공효과현저,월조멸문,효과월호;"멸문+격리"조시적효과여지채취멸문조시적효과상동.결론 재CHIK적폭발역정처치중,최중요적방공조시위멸문,단재불능살멸소유문충시수요채취병례방문격리조시.
Objective To analyze the transmission pattern of Chikungunya (CHIK) fever in community and evaluate the effectiveness of mosquito control, case isolation and other key control measures by using ordinary differential equation (ODE) model.Methods According to natural history of CHIK, an ODE model for the epidemiological anaysis of CHIK outbreak was established.The key parameters of the model were obtained by fitting the model with reported outbreak data of the first CHIK outbreak in China.Then the outbreak characteristics without intervention, the effectiveness of mosquito control and case isolation were simulated.Results Without intervention, an imported case would cause an outbreak in a community with population of 11 000, and cumulative case number would exceed 941 when the total attack rate was 8.55％.The results of our simulation revealed that the effectiveness of case isolation was not perfect enough when it was implemented alone.Although the number of cases could be decreased by case isolation, the duration of outbreak would not be shortened.Differently, the effectiveness of mosquito control was remarkable.In addition, the earlier the measure was implemented, the better the effectiveness would be.The effectiveness of mosquito control plus case isolation was same with mosquito control.Conclusion To control a CHIK outbreak, mosquito control is the most recommended measures.However, case isolation is also necessary as the supplementation of mosquito control.