气候与登革热传播:证据与启示

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[背景]气候通过矢量动力学、药物研发和蚊子/人类的相互作用而影响登革热的生态。虽然人们已认识到这些关系,但是气候变化对传播途径的影响尚不清楚。研究人员采用气候驱动统计模型和基于过程的模型,来完善这些关系的知识,并预测气候变化对登革热发生的影响,但得到的结果却并不一致。[目的]明确气候对登革热病毒生态学的主要影响,并评估以气候为基础的登革热模型在描述气候和登革热之间关联、模拟疫情并预测气候变化方面的能力。[方法]回顾实验室研究、现场研究和统计学分析中有关气候与登革热之间直接和间接关联的证据,这些研究均涉及虫媒、登革热发病率和气候条件之间关联。评估以气候为驱动因子、基于过程的登革热模型的潜在作用,并提出建议以提高其性能。[结果和讨论]气候变量与影响登革热传播的因素之间具有复杂的关系。一个气候变量可能通过该系统的一个方面增强登革热的潜在传播力,同时又通过该系统的另一个方面减弱这种潜在的传播力。这种复杂性至少可以部分解释登革热与气候之间在统计学关联上的不一致性。基于过程的模型能够解释复杂的动力学,但往往忽略登革热生态的重要方面,特别是病毒形成与宿主-物种的相互作用。[结论]整合并应用现有的关于气候对登革热病毒生态各方面影响的知识,将有助于指引今后的研究,并促进更有效地预测气候变化对登革热发病的影响。 [Background] Climate affects dengue ecology through vector dynamics, drug discovery and mosquito / human interaction. Although these relationships have been recognized, the impact of climate change on the route of transmission is unclear. Researchers used climate-driven statistical models and process-based models to refine their knowledge of these relationships and predict the effects of climate change on dengue fever, but the results were inconsistent. [Purpose] To identify the major impacts of climate on dengue virus ecology and to assess the capacity of climate-based dengue models to describe the link between climate and dengue, simulate epidemics and predict climate change. [Method] Reviewing evidence from laboratory studies, field studies and statistical analyzes regarding the direct and indirect link between climate and dengue fever, all of which involve the link between insect vectors, the incidence of dengue fever and climatic conditions. Assess the potential role of climate-driven, process-based dengue models and make recommendations to improve their performance. [Results and Discussion] There is a complex relationship between climate variables and the factors that affect the spread of dengue fever. A climate variable may enhance the potential transmission of dengue through one aspect of the system while at the same time mitigating this potential transmission through another aspect of the system. This complexity at least partially accounts for the statistical discrepancy between dengue fever and climate. Process-based models can explain complex kinetics, but often ignore important aspects of dengue ecology, particularly the formation of virus-host-species interactions. [Conclusions] The integration and application of existing knowledge about the impact of climate on the dengue virus ecology in all its aspects will help to guide future research and promote more effective projections of the impact of climate change on the incidence of dengue fever.
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