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Int. J. Environ. Res. Public Health 2017, 14(7), 782; https://doi.org/10.3390/ijerph14070782

Environmental Drivers and Predicted Risk of Bacillary Dysentery in Southwest China

1
Ministry of Education Key Laboratory for Earth System Modeling, Department of Earth System Science, Tsinghua University, Beijing 100084, China
2
Joint Center for Global Change Studies, Beijing 100875, China
3
Center for Public Health Surveillance and Information Services, Chinese Center for Disease Control and Prevention, Beijing 102206, China
*
Author to whom correspondence should be addressed.
Academic Editor: Jon Øyvind Odland
Received: 2 June 2017 / Revised: 2 July 2017 / Accepted: 11 July 2017 / Published: 14 July 2017
(This article belongs to the Section Global Health)
View Full-Text   |   Download PDF [1553 KB, uploaded 14 July 2017]   |  

Abstract

Bacillary dysentery has long been a considerable health problem in southwest China, however, the quantitative relationship between anthropogenic and physical environmental factors and the disease is not fully understand. It is also not clear where exactly the bacillary dysentery risk is potentially high. Based on the result of hotspot analysis, we generated training samples to build a spatial distribution model. Univariate analyses, autocorrelation and multi-collinearity examinations and stepwise selection were then applied to screen the potential causative factors. Multiple logistic regressions were finally applied to quantify the effects of key factors. A bootstrapping strategy was adopted while fitting models. The model was evaluated by area under the receiver operating characteristic curve (AUC), Kappa and independent validation samples. Hotspot counties were mainly mountainous lands in southwest China. Higher risk of bacillary dysentery was found associated with underdeveloped socio-economy, proximity to farmland or water bodies, higher environmental temperature, medium relative humidity and the distribution of the Tibeto-Burman ethnicity. A predictive risk map with high accuracy (88.19%) was generated. The high-risk areas are mainly located in the mountainous lands where the Tibeto-Burman people live, especially in the basins, river valleys or other flat places in the mountains with relatively lower elevation and a warmer climate. In the high-risk areas predicted by this study, improving the economic development, investment in health care and the construction of infrastructures for safe water supply, waste treatment and sewage disposal, and improving health related education could reduce the disease risk. View Full-Text
Keywords: bacillary dysentery; anthropogenic environment; physical environment; logistic regression model; risk mapping; prevention and intervention bacillary dysentery; anthropogenic environment; physical environment; logistic regression model; risk mapping; prevention and intervention
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Zhang, H.; Si, Y.; Wang, X.; Gong, P. Environmental Drivers and Predicted Risk of Bacillary Dysentery in Southwest China. Int. J. Environ. Res. Public Health 2017, 14, 782.

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