加利福尼亚州球孢子菌病的季节性:2000-2021 年季节性动态的气候决定因素和时空变异性纵向监测研究

IF 7 Q1 HEALTH CARE SCIENCES & SERVICES
Alexandra K. Heaney , Simon K. Camponuri , Jennifer R. Head , Philip Collender , Amanda Weaver , Gail Sondermeyer Cooksey , Alexander Yu , Duc Vugia , Seema Jain , Abinash Bhattachan , John Taylor , Justin V. Remais
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引用次数: 0

摘要

背景球孢子菌病是美国西部一种新出现的真菌疾病,它的季节性模式鲜为人知,包括强周期性时期、季节性间隔和季节性时间的变化,而这些特征都微乎其微,其致病因素也无法解释。近年来,球孢子菌病发病率显著上升,而我们对年内和年际季节性的了解有限,这阻碍了对疾病传播的重要驱动因素(包括气候条件)的识别。在本研究中,我们旨在描述加利福尼亚州流行地区球孢子菌病的季节性特征,并估计干旱条件与球孢子菌病季节性周期和时间之间的关系。方法我们分析了加利福尼亚州 2000 年至 2021 年期间所有报告的球孢子菌病发病病例数据,以描述发病的季节性模式,并对 17 个发病率持续较高的县进行了小波分析,以评估发病的主要周期性、功率和时间。我们使用分布式滞后非线性建模框架评估了季节性参数与加利福尼亚州干旱指标之间的关联。研究结果所有县的发病率都表现出年度周期性(即 12 个月的主要小波周期性),但不同地区和年份的季节性强度和时间具有相当大的异质性。平均而言,12 个月的周期性在南圣华金河谷和中央海岸最为明显。此外,南圣华金河谷和南部内陆地区的年季节周期比沿海和北部各县要早,但到研究期结束时,各县的年周期时间变得更加一致。干旱条件与年度季节性周期的强烈衰减有关,在干旱结束后的 1-2 年中,季节性峰值变得更加明显。我们的结论是,干旱条件不会在全年均匀地增加球孢子菌病的发病风险,反而会促使风险集中在特定的日历期间(9 月至 12 月)。这些发现对公共卫生准备工作以及未来季节性气候模式和极端事件的变化如何影响空间和时间上的球孢子菌病风险具有重要意义。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Coccidioidomycosis seasonality in California: a longitudinal surveillance study of the climate determinants and spatiotemporal variability of seasonal dynamics, 2000–2021

Background

Coccidioidomycosis, an emerging fungal disease in the western USA, exhibits seasonal patterns that are poorly understood, including periods of strong cyclicity, aseasonal intervals, and variation in seasonal timing that have been minimally characterized, and unexplained as to their causal factors. Coccidioidomycosis incidence has increased markedly in recent years, and our limited understanding of intra- and inter-annual seasonality has hindered the identification of important drivers of disease transmission, including climate conditions. In this study, we aim to characterize coccidioidomycosis seasonality in endemic regions of California and to estimate the relationship between drought conditions and coccidioidomycosis seasonal periodicity and timing.

Methods

We analysed data on all reported incident cases of coccidioidomycosis in California from 2000 to 2021 to characterize seasonal patterns in incidence, and conducted wavelet analyses to assess the dominant periodicity, power, and timing of incidence for 17 counties with consistently high incidence rates. We assessed associations between seasonality parameters and measures of drought in California using a distributed lag nonlinear modelling framework.

Findings

All counties exhibited annual cyclicity in incidence (i.e., a dominant wavelet periodicity of 12 months), but there was considerable heterogeneity in seasonal strength and timing across regions and years. On average, 12-month periodicity was most pronounced in the Southern San Joaquin Valley and Central Coast. Further, the annual seasonal cycles in the Southern San Joaquin Valley and the Southern Inland regions occurred earlier than those in coastal and northern counties, yet the timing of annual cycles became more aligned among counties by the end of the study period. Drought conditions were associated with a strong attenuation of the annual seasonal cycle, and seasonal peaks became more pronounced in the 1–2 years after a drought ended.

Interpretation

We conclude that drought conditions do not increase the risk of coccidioidomycosis onset uniformly across the year, but instead promote increased risk concentrated within a specific calendar period (September to December). The findings have important implications for public health preparedness, and for how future shifts in seasonal climate patterns and extreme events may impact spatial and temporal coccidioidomycosis risk.

Funding

National Institutes of Health.

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来源期刊
CiteScore
8.00
自引率
0.00%
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期刊介绍: The Lancet Regional Health – Americas, an open-access journal, contributes to The Lancet's global initiative by focusing on health-care quality and access in the Americas. It aims to advance clinical practice and health policy in the region, promoting better health outcomes. The journal publishes high-quality original research advocating change or shedding light on clinical practice and health policy. It welcomes submissions on various regional health topics, including infectious diseases, non-communicable diseases, child and adolescent health, maternal and reproductive health, emergency care, health policy, and health equity.
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