Dengue as an acute infectious disease threatens global public health and has sparked broad research interest. However, existing studies generally ignore the spatial dependencies involved in dengue forecast, and consideration of temporal periodicity is absent. In this work, we propose a spatiotemporal component fusion model (STCFM) to solve the dengue risk forecast issue. Considering that mosquitoes are an important vector of dengue transmission, we introduce feature factors involving mosquito abundance and spatiotemporal lags to model temporal trends and spatial distributions separately on the basis of statistical properties. Specifically, we conduct multiscale modeling of temporal dependencies to enhance the forecast capability of relevant periods by capturing the historical variation patterns of the data across different segments in the temporal dimension. In the spatial dimension, we quantify the multivariate spatial correlation analysis as additional features to strengthen the spatial feature representation and adopt the ConvLSTM model to learn spatial dependencies adequately. The final forecast results are obtained by stacking strategy fusion in ensemble learning. We conduct experiments on real dengue datasets. The results indicate that STCFM improves prediction accuracy through effective spatiotemporal feature representations and outperforms candidate models with a reasonable component construction strategy.

Background In May 2021, the SARS-CoV-2 Delta variant led to the first local outbreak in China in Guangzhou City. We explored the epidemiological characteristics and spatial-temporal clustering of this outbreak. Methods Based on the 153 cases in the SARS-CoV-2 Delta variant outbreak, the Knox test was used to analyze the spatial-temporal clustering of the outbreak. We further explored the spatial-temporal clustering by gender and age groups, as well as compared the changes of clustering strength (S) value between the two outbreaks in Guangzhou. Results The result of the Knox analysis showed that the areas at short distances and brief periods presented a relatively high risk. The strength of clustering of male-male pairs was higher. Age groups showed that clustering was concentrated in cases aged ≤ 18 years matched to 18–59 years and cases aged 60+ years. The strength of clustering of the outbreak declined after the implementation of public health measures. The change of strength of clustering at time intervals of 1–5 days decreased greater in 2021 (S = 129.19, change rate 38.87%) than that in 2020 (S = 83.81, change rate 30.02%). Conclusions The outbreak of SARS-CoV-2 Delta VOC in Guangzhou has obvious spatial-temporal clustering. The timely intervention measures are essential role to contain this outbreak of high transmission.

目的 调查中越边境地区文山州富宁县蚊虫种类构成及其带毒率,为当地制定有效虫媒传染病防控措施提供依据.方法 选择中越边境地区富宁县3个村作为调查点,采用灯诱法通宵诱捕蚊虫,对所捕蚊虫进行分类、计数,并采用RT-PCR方法检测重要虫媒传染病感染情况.结果 共捕获蚊虫2亚科4属10种6 145只,其中中华按蚊(2 409只,39.20％)、骚扰阿蚊(2 094只,34.08％)和三带喙库蚊(1 519只,24.72％)属当地优势蚊种.经黄病毒属、甲病毒属、布尼亚病毒属通用引物及乙型脑炎病毒和版纳病毒特异性引物基因扩增及凝胶电泳检测,仅布尼亚病毒属阳性率3.26％(3/92),其余均为阴性.结论 中越边境地区富宁县蚊虫种类丰富,中华按蚊、骚扰阿蚊和三代喙库蚊属当地优势蚊种,存在疟疾、乙型脑炎等重要虫媒传染病感染风险,当地相关部门应加强虫媒传染病监测.

Objective To explore spatial-temporal clustering of coronavirus disease 2019 (COVID-19) cases in an outbreak epidemic in Guangzhou city, Guangdong province and to provide evidences for developing COVID-19 prevention and control measures. MethodsThe data on 215 local COVID-19 cases reported in Guangzhou city from April 4 to May 2, 2020 were collected and the cases′ demographics and spatial-temporal distribution were described statistically. Knox test was used to identify possible spatial-temporal clustering of the cases by given specific critical thresholds. The spatial thresholds for the distance between the two cases′ residential address were set varying from 0 to 1000 meters (m) with an interval of 100 m; the temporal thresholds for the time interval between the two cases′ incident time were set varying from 1 to 15 days with an interval of 1 day. The strength of clustering (S-value) and relative risk (RR) of clustering for each gender- and age-group-specific case pair were calculated to analyze temporal-spatial clustering of case pairs. ResultsThe S-value and RR of the COVID-19 case pairs decreased with the increment in pairs′ spatial distance and time interval. The RR value was the highest for a pair with the nearest spatial distance under the interval time of 1 day. For a case pair with the time interval of 1 day, the RR was 2.4 when the spatial distance between the pair′s two cases being 100 m, while the RR was only 1.2 when the spatial distance being 3 kilometers (km). For male-male pairs, the S-value was higher under the time interval of 1 – 5 days with a spatial distance less than 300 m; for female-female pairs, the S-value was higher under the time interval of 1 – 7 days with a spatial distance less than 400 m; and for male-female pairs, the S-value was higher under the time interval of 1 – 4 days with a spatial distance less than 500 m. A stronger trend of spatial-temporal clustering was observed among female-female case pairs than among male-male case pairs. For age-group-specific case pairs, the S-value of child-child pairs with the time interval of 1 day was significantly higher than that of other age-group pairs and the S-value of middle-aged-youth pairs was higher under the time interval of 1 – 5 days with a spatial distance of less than 300 m. ConclusionSpatial-temporal clustering with between gender and age group differences was observed among the COVID-19 cases of an outbreak epidemic in Guangzhou city.

目的了解云南省登革热流行及聚集特征,为今后针对性防控措施的制定和完善提供依据。方法从中国疾病预防控制信息系统收集云南省2013-2020年报告的登革热病例数据,利用ArcMap 10.7软件绘制分布地图、SaTScan v9.3软件进行空间扫描分析。结果 2013-2020年,云南省106个县（区）累计报告登革热病例14 031例,其中本地病例11 505例、境外输入病例2 507例、省外输入病例19例;疫情呈"锯齿状"升高态势。总体疫情扫描探测出2个一级聚类区和2个二级聚类区（均P＜0.05）,一级聚类区为景洪市[对数似然比（LLR）=22 647.97]和瑞丽市（LLR=10 125.08）,二级聚类区为勐腊县（LLR=1 167.76）和耿马县（LLR=1 061.22）。2013、2015、2017和2019年均扫描探测出一级聚类区。本地病例出现在边境10个县,境外输入病例主要来源于东南亚和非洲国家,缅甸、柬埔寨和老挝是主要来源国。上半年以输入病例为主、下半年以本地病例为主,7月开始上升,8-10月达高峰期,11月开始下降。发病数男女性别比为1∶0.88,15～60岁年龄组占79.78%,发病前5位人群构成分别为商业服务人员（20.95%）、农民（20.52%）、家务及待业人员（11.17%）、离退人员（8.97%）和学生（7.31%）。结论云南省登革热疫情形势严峻,亟待做好输入病例管控、媒介伊蚊监测及控制工作,为登革热可持续控制提供保障。

目的 通过检测中缅边境地区恶性疟原虫Kelch 13螺旋体蛋白基因(Kelch 13-propeller,K13)突变的动态变化情况,为当地恶性疟治疗策略的制定提供科学依据.方法 收集以往中缅边境地区中国云南省西双版纳州景洪市、缅甸克钦邦拉咱市和佤邦第二特区勐冒县恶性疟病例滤纸血标本175份,采用巢式PCR法扩增K13基因第426～676位点片段,对扩增产物测序并进行统计分析.结果 2001年西双版纳州景洪市30份滤纸血中仅1份检出恶性疟原虫K13基因F446I突变;2006年标本未检测到突变.缅甸拉咱市恶性疟原虫K13基因共检测到5种突变(F446I、C469Y、Y511H、E556D和P574L),其中以F446I突变为主,突变率由2001年的45％(9/20)降低至2012年的25％(10/40);勐冒县2009年标本中未检测到K13基因突变.结论 中缅边境地区缅甸拉咱市恶性疟原虫K13基因存在较多类型的突变,以F446I突变为主,提示该地区恶性疟原虫可能存在青蒿素抗性,建议加强对中缅边境地区恶性疟原虫药物抗性监测.

目的 调查中缅边境地区蚊虫对4种建筑类型房屋的侵入情况,为制定当地疾病媒介控制策略与措施提供依据.方法 2021年5-6月,在中国盈江那邦镇和缅甸克钦邦第二特区拉咱市选择不同居民建筑类型房屋采用诱蚊灯通宵诱捕成蚊,形态学分类鉴定成蚊种类并计数分析.结果 共捕获2亚科10亚属18种3419只成蚊,其中中国那邦镇2亚科7亚属14种1715只,缅甸拉咱市2亚科10亚属17种1704只.两地区优势蚊种均为致倦库蚊,占比分别为59.24％(1016/1715)和82.04％(1398/1704).微小按蚊属于两地区的主要疟疾媒介种类,占比分别为17.66％(303/1715)和3.40％(58/1704)(x2=184.147,P＜0.05).竹扒房、木质结构、砖混结构和钢混结构建筑类型房屋捕获蚊虫比例分别为42.84％、27.14％、21.35％和8.67％,差异有统计学意义(x 2=184.147,P＜0.05);捕获微小按蚊比例分别为43.21％、48.75％、4.16％和3.88％,差异有统计学意义(x2=955.889,P＜0.05).结论 中缅边境地区的中国那邦镇和缅甸拉咱市居民点蚊虫种类丰富,致倦库蚊为当地优势蚊种,微小按蚊属当地疟疾主要媒介.砖混结构和钢混结构房屋阻挡蚊虫侵入房屋效果较好,可减少人蚊接触几率,减少蚊媒病的传播.

介绍澜沧江—湄公河合作疟疾和登革热联防联控项目热带病援外培训的主要经验和做法,并对培训的组织、教学内容和形式采取定量和定性相结合的方式进行调查.结果显示,援外培训取得较好效果,提升了学员热带病防控知识和关键技能,并使其了解了全球和区域热带病形势,分享了我国和其他国家的防控经验,促进了区域热带病联防联控开展.但培训还需要结合实际需求、采用适当的方法,考虑师资和语言对培训效果的影响,使培训取得更好的效果.

目的 了解云南省棘球蚴病疫情变化趋势,为优化棘球蚴病防治工作提供参考.方法 收集中国疾病预防控制信息系统中2005—2020年云南省棘球蚴病患者个案信息,采用描述性流行病学方法进行数据分析.结果 2005—2020年,云南省16个州(市)的65个县(区)累计报告棘球蚴病134例.报告病例数排前三位的州(市)是大理州(37例)、昆明市(20例)和迪庆州(10例);报告发病率排前三位的是迪庆州(0.1571/10万)、怒江州(0.0928/10万)和大理州(0.0654/10万).网报病例中男女比例为1:1;职业以农(牧)民为主,共报告74例(占55.22％),其次为学生17例(占12.69％);所有病例中年龄最小1岁,最大81岁,21～50岁最多,共报告70例(占52.24％).82.84％(111/134)的病例在发病当年即诊断为棘球蚴病,17.16％(23/134)的病例在发病第二年及以后诊断出;病例报告单位主要为医院(109例,占81.34％),其次为疾控中心(16例,占11.94％).结论 云南省棘球蚴病网报病例数逐渐增多,但仍存在一定的漏报现象,应加强疫情报告管理,针对重点地区和重点人群积极开展棘球蚴病筛查和健康教育工作.

登革热、疟疾等重要虫媒传染病是澜湄次区域频发的热带传染病,对区域社会生产和人民生活构成重大威胁.为了控制区域虫媒病的传播,建没澜湄次区域虫媒传染病联防联控平台,作为响应我国“一带一路”倡议的典型案例,平台利用现代信息技术,增强对虫媒传染病的监测、预测、预警能力,便于相关组织或机构及时制定应对措施.

Countries along the Lancang/Mekong River have similar pathogens & vectors causing tropical diseases with similar characteristics and patterns of transmission,so they have the same challenges in terms of disease control.Based on Control of Malaria & Dengue through Lancang-Mekong Cooperation (LMC),this paper summarizes some of the major challenges posed by vector-borne diseases in Yunnan Province,China and countries along the Lancang/Mekong River.This paper also analyzes and assesses the areas where collaboration is needed,targeted efforts,and had a common understanding of these challenges among countries participating in LMC.

目的了解云南省主城区埃及伊蚊和白纹伊蚊的种群密度、分布、地区差异、孳生习性等特征。 方法在云南省129个县（市、区）主城区开展伊蚊调查，采用布雷图指数（BI）法，调查居民区和特殊场所（包括城区公园绿地、废旧物品回收站、轮胎收购站和医院等）的所有积水容器，有媒介伊蚊幼蚊或蛹孳生计为阳性，并采集阳性容器内的幼蚊，鉴定蚊种。采用描述性统计方法对基本情况进行表述，χ2检验比较分析不同地区、不同生态环境伊蚊孳生场所的差异，采用趋势χ2检验分析海拔与蚊虫孳生密度的关系。 结果云南省129个县（市、区）的主城区发现伊蚊媒介分布的有71个，占55.04%，其中城区仅有白纹伊蚊分布的为68个，占52.71%；埃及伊蚊和白纹伊蚊共同分布的有3个，占2.33%。共调查37 198户，阳性1 068户，发现积水容器167 206个，阳性2 135个，BI均值为5.74，房屋指数（HI）为2.87%，容器指数（CI）为1.28%。特殊场所的BI和CI均显著高于居民区的BI和CI（χ2=4 509.220，P 结论白纹伊蚊在云南省分布较广泛，局部地区埃及伊蚊已成为优势蚊种；特殊场所伊蚊孳生高于居民区，边境地区蚊虫密度较高；随着海拔的升高，媒介伊蚊密度逐渐降低，2 000 m以上未发现伊蚊孳生；各县（市、区）的伊蚊孳生容器在居民区主要以水桶、轮胎、废弃罐等为主，特殊场所以轮胎、其他废弃容器等为主。

OBJECTIVE To investigate the epidemiological characteristics of malaria and implementation of the "1-3-7" approach in malaria elimination in Yunnan Province, so as to provide the data support for the development of post-elimination surveillance interventions. METHODS All data pertaining to malaria cases in Yunnan Province from 2014 to 2019 were captured from the Notifiable Disease Reporting System of Chinese Center for Disease Control and Prevention, and the changes in the epidemic situation of malaria were analyzed during the 5-year period. In addition, the core indexes regarding the "1-3-7" approach in malaria elimination of Yunnan Province from 2014 to 2019 were retrieved from the Malaria Control System in the Parasitic Disease Information Reporting System, and all changes in the indexes were descriptively analyzed. RESULTS During the period from 2014 to 2019, a total of 2 283 malaria cases were reported in Yunnan Province, including 1 927 cases with vivax malaria, 326 cases with plasmodium malaria, 29 cases with other species of malaria, and one case with unidentified species. There were 64 local cases, 2 219 overseas imported cases. Among the 2 283 malaria cases, the male/female ratio was 4.58∶1, and 80.25% of the cases were aged from 15 to 50 years. Farmer (70.00%) was the predominant occupation, and 76.70% (1 751/2 283) of the cases were identified in 25 border counties (districts). Malaria cases were reported in each month during the 5-year period, and the number of malaria cases increased from April, peaked on May to July, and started to decline on August. From 2014 to 2019, the reporting rate of malaria cases within 24 hours upon diagnosis was 100%, and the detection of malaria cases was 99.69% (2 276/ 2 283) in the laboratory, with a 99.65% (2 275/2 283) rate of definite diagnosis. In addition, the percentage of individual epidemiological investigations within 3 days was 100.00% (2 283/2 283), and the number of epidemic foci survey and treatment within 7 days was 576 during the 3-year period from 2017 to 2019. The goal of malaria elimination was achieved in Yunnan Province on June, 2020. CONCLUSIONS Malaria has been eliminated in Yunnan Province, and management of overseas imported malaria is the primary challenge to consolidate the malaria elimination achievements in the future. However, the approach in malaria elimination remains to be maintained, and the role of the Yunnan Provincial Malaria Diagnostic Reference Laboratory requires to be strengthened.

In moving toward malaria elimination, finer scale malaria risk maps are required to identify hotspots for implementing surveillance-response activities, allocating resources, and preparing health facilities based on the needs and necessities at each specific area. This study aimed to demonstrate the use of multi-criteria decision analysis (MCDA) in conjunction with geographic information systems (GISs) to create a spatial model and risk maps by integrating satellite remote-sensing and malaria surveillance data from 18 counties of Yunnan Province along the China-Myanmar border. The MCDA composite and annual models and risk maps were created from the consensus among the experts who have been working and know situations in the study areas. The experts identified and provided relative factor weights for nine socioeconomic and disease ecology factors as a weighted linear combination model of the following: ([Forest coverage × 0.041] + [Cropland × 0.086] + [Water body × 0.175] + [Elevation × 0.297] + [Human population density × 0.043] + [Imported case × 0.258] + [Distance to road × 0.030] + [Distance to health facility × 0.033] + [Urbanization × 0.036]). The expert-based model had a good prediction capacity with a high area under curve. The study has demonstrated the novel integrated use of spatial MCDA which combines multiple environmental factors in estimating disease risk by using decision rules derived from existing knowledge or hypothesized understanding of the risk factors via diverse quantitative and qualitative criteria using both data-driven and qualitative indicators from the experts. The model and fine MCDA risk map developed in this study could assist in focusing the elimination efforts in the specifically identified locations with high risks.

The heterogeneity and complexity of malaria involves political and natural environments, socioeconomic development, cross-border movement, and vector biology; factors that cannot be changed in a short time. This study aimed to assess the impact of economic growth and cross-border movement, toward elimination of malaria in Yunnan Province during its pre-elimination phase. Malaria data during 2011-2016 were extracted from 18 counties of Yunnan and from 7 villages, 11 displaced person camps of the Kachin Special Region II of Myanmar. Data of per-capita gross domestic product (GDP) were obtained from Yunnan Bureau of Statistics. Data were analyzed and mapped to determine spatiotemporal heterogeneity at county and village levels. There were a total 2,117 malaria cases with 85.2% imported cases; most imported cases came from Myanmar (78.5%). Along the demarcation line, malaria incidence rates in villages/camps in Myanmar were significantly higher than those of the neighboring villages in China. The spatial and temporal trends suggested that increasing per-capita GDP may have an indirect effect on the reduction of malaria cases when observed at macro level; however, malaria persists owing to complex, multi-faceted factors including poverty at individual level and cross-border movement of the workforce. In moving toward malaria elimination, despite economic growth, cooperative efforts with neighboring countries are critical to interrupt local transmission and prevent reintroduction of malaria via imported cases. Cross-border workers should be educated in preventive measures through effective behavior change communication, and investment is needed in active surveillance systems and novel diagnostic and treatment services during the elimination phase.

目的 分析云南省登革热发病与伊蚊幼虫密度及气象因素的关系,对其滞后效应进行初步研究,为登革热监测预测预警提供依据.方法 收集云南省2017年登革热病例、伊蚊密度监测数据及其气象因子数据,运用皮尔森检验方法分析登革热疫情与伊蚊密度和气象因素的相关性及滞后效应.结果 云南省2017年登革热发病数与伊蚊密度、相对湿度、平均温度呈正相关关系,与降水量、平均风速呈负相关关系,均有统计学意义(R1=0.190、R2=0.012、R3=0.009、R4=-0.011、R5=-0.030,均P＜0.05),但与日照时长差异无统计学意义(R=0.000,P=0.440).伊蚊密度与相对湿度、降水量、平均温度、发病数呈正相关关系,与日照时长、平均风速呈负相关关系,且均有统计学意义(R1=0.196、R2=0.134、R3=0.214、R4=0.190、R5=-0.101、R6=-0.189,均P＜0.05).伊蚊密度、相对湿度、平均温度和平均风速对登革热未来30 d的发病均有滞后作用,日照时长在第10天后对登革热传播存在滞后作用(均P＜0.05).结论 气象因素通过影响伊蚊密度的变化而影响登革热疫情扩散和传播.及时掌握气象因素变化趋势,早期采取措施控制伊蚊密度是登革热防控的关键.蚊媒密度和关键气象因素对登革热发病期存在1个月以上的延迟作用.

<span id="ChDivSummary" name="ChDivSummary" class="abstract-text">建成辐射南亚东南亚辐射中心是云南省在国家"一带一路"倡议中的定位。为应对区域国家热带病共同挑战,我国自2005年以来在云南实施了疟疾和登革热联防联控项目,经过15年的建设,项目达成共识,形成合作框架,建立了5个联络办公室,21个跨境监测点和20个联合工作站。通过协调会、培训班、研究生培养、技术帮扶、"4.25国际疟疾日"宣传,联合调查,监测平台研发、联合实验室等一系列措施,初步建立了联防联控机制,项目成效显著,对我国公共卫生援外项目有一定启示。</span>

目的 探讨网格化管理在云南省景洪市登革热疫情防控中的应用效果,为制定当地登革热有效防控策略提供科学依据.方法 以2019年景洪市登革热防控网格化管理体系为基础,采用流行病学描述法和地理信息系统方法分析评价2019年景洪市登革热防控网格化管理效果.结果 2019年景洪市城区共划分28个登革热网格点,6月出现输入病例,7月出现登革热疫情暴发,9月为登革热病例高峰(1 775例);6-11月景洪市城区28个网格点每月平均布雷图指数(BI)分别为11.18、18.42、14.62、14.02、5.81和2.09,BI达标率分别为52.56％、44.76％、51.66％、46.57％、74.01％和91.71％,病例数分别为8、47、540、1 775、473和72例.结论 通过提高景洪市城区网格BI达标率的网格化管理可有效防控登革热疫情,建议当地进一步完善登革热网格化管理模式.

Objective To investigate the time distribution characteristics and the epidemic trends of imported malaria cases in Yunnan Province. Methods The malaria case records and epidemiological history data of Yunnan Province were collected, and the local infection cases were excluded. The data were statistical analyzed. Results The imported malaria cases had a sig-nificantly seasonal periodicity(Q=26.574,P<0.05)and epidemic trends(Q=35.487,P<0.05). The imported peak was in May,while February was the lowest month of imported cases,and the difference was significant(Z=-2.619,P<0.05). The simple seasonal prediction model was the best model(R2= 0.677,BIC = 4.867)for forecast while the residual sequence was white noise(Q=14.226,P>0.05). By using the model to predict the cases in January,February and March of 2016,the num-ber(95％CI)were 29(7-50),22(0-44)and 31(8-54),and the actual number of imported malaria cases were 29,24 and 38 cases respectively and all cases were included in the 95％CI. Conclusion The imported malaria cases in Yunnan Province had a significantly seasonal periodicity and epidemic trends,and the established model has good prediction on the recent cases.

OBJECTIVE:To understand the geographical features of malaria in Yunnan Province, so as to provide the reference for malaria elimination.METHODS:The data of malaria in Yunnan Province from 2012 to 2015 were collected and analyzed.RESULTS:Totally 2 586 malaria cases were reported in Yunnan Province from 2012 to 2015, in which 274 (10.60%) were local cases and 2 311 (89.37%) were abroad imported, and one (0.03%) was domestic imported. The imported malaria cases and local cases were analyzed according to the sources and locations respectively, and the arithmetic means of the numbers of imported and local cases were 96.29 and 10.96 respectively, the standard deviations of the numbers of imported and local cases were 421.18 and 19.12 respectively, and the difference of the means was not significant (Z = - 0.326, P > 0.10). Both the imported and local malaria cases could be clustered into five sections by the number of 5. The Herfendal-Hirshman indexes of the imported and local malaria cases were 8 121 and 1 598 respectively.CONCLUSIONS:There is no significant difference of the distribution between the imported and local malaria cases, and they should be attaching equal importance. The non-uniform degree of imported cases is higher than that of the local cases, while both of them could be divided into five major clusters in the prevention and control work.