Using big data to predict pertussis infections in Jinan city, China: a time series analysis

Combined short-term exposure to meteorological, pollution factors and pertussis in different groups from Jining, China

Background

Previous studies have typically explored daily lagged relationships among pertussis and meteorology, with little assessment of effect and interaction among pollutants mixtures.

Methods

Our researchers collected pertussis cases data from 2017-2022 as well as meteorological and contaminative factors for the Jining region. First, we reported the application of the Moving Epidemic Method (MEM) to estimate epidemic threshold and intensity level. Then we developed a Weighted Quantile Sum (WQS) regression and Bayesian Kernel Machine Regression (BKMR) model to assess single, multiple effects and interaction of meteorological and pollution factors on pertussis cases for different sex, delayed and epidemic threshold groups.

Results

There has been a yearly upward trend in the incidence of pertussis in Jining regions. High prevalence threshold years were in 2018-2019, the epidemic peak was mainly concentrated in 32 weeks. Totally, pertussis infections disease was separately 2.1% (95% confidence Interval (CI) = 1.3, 2.8) and 1.1% (95% CI = 0.3, 1.9) higher per decile increase in temperature and sulphur dioxide (SO2). And pertussis infections disease was 1.1% lower per decile increase in humidity. In the different stratified analyses, air pressure was a strong negative effect in males and in the lagged 11-20 days group, with 7.3 and 14.7%, respectively. Sulphur dioxide had a relatively weak positive effect in males, females and the group after 20 days lag, ranging from 0.5 to 0.6%. The main positive effectors affecting the onset of disease at low and high threshold levels were ozone (O3) and SO2, respectively, while the negative effectors were SO2 and carbon monoxide (CO), respectively.

Conclusions

This is the first mathematically based study of seasonal threshold of pertussis in China, which allows accurate estimation of epidemic level. Our findings support that short-term exposure to pollutants is the risk factor for pertussis. We should concentrate on pollutants monitoring and effect modeling.

Precision public health, the key for future outbreak management: A scoping review

Background

Precision Public Health (PPH) is a newly emerging field in public health medicine. The application of various types of data allows PPH to deliver more tailored interventions to a specific population within a specific timeframe. However, the application of PPH possesses several challenges and limitations that need to be addressed.

Objective

We aim to provide evidence of the various use of PPH in outbreak management, the types of data that could be used in PPH application, and the limitations and barriers in the application of the PPH approach.

Methods and analysis

Articles were searched in PubMed, Web of Science, and Science Direct. Our selection of articles was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) for Scoping Review guidelines. The outcome of the evidence assessment was presented in narrative format instead of quantitative.

Results

A total of 27 articles were included in the scoping review. Most of the articles (74.1%) focused on PPH applications in performing disease surveillance and signal detection. Furthermore, the data type mostly used in the studies was surveillance (51.9%), environment (44.4), and Internet query data. Most of the articles emphasized data quality and availability (81.5%) as the main barriers in PPH applications followed by data integration and interoperability (29.6%).

Conclusions

PPH applications in outbreak management utilize a wide range of data sources and analytical techniques to enhance disease surveillance, investigation, modeling, and prediction. By leveraging these tools and approaches, PPH contributes to more effective and efficient outbreak management, ultimately reducing the burden of infectious diseases on populations. The limitation and challenges in the application of PPH approaches in outbreak management emphasize the need to strengthen the surveillance systems, promote data sharing and collaboration among relevant stakeholders, and standardize data collection methods while upholding privacy and ethical principles.

Impact of outdoor air pollution on the incidence of pertussis in China: a time-series study

BACKGROUND

The increasing number of pertussis cases worldwide over the past two decades has challenged healthcare workers, and the role of environmental factors and climate change cannot be ignored. The incidence of pertussis has increased dramatically in mainland China since 2015, developing into a serious public health problem. The association of meteorological factors on pertussis has attracted attention, but few studies have examined the impact of air pollutants on this respiratory disease.

METHODS

In this study, we analyzed the relationship between outdoor air pollution and the pertussis incidence. The study period was from January 2013 to December 2018, and monthly air pollutant data and the monthly incidence of patients in 31 provinces of China were collected. Distributed lag nonlinear model (DLNM) analysis was used to estimate the associations between six air pollutants and monthly pertussis incidence in China.

RESULTS

We found a correlation between elevated pertussis incidence and short-term high monthly CO2 and O3 exposure, with a 10 μg/m3 increase in NO2 and O3 being significantly associated with increased pertussis incidence, with RR values of 1.78 (95% CI: 1.29-2.46) and 1.51 (95% CI: 1.16-1.97) at a lag of 0 months, respectively. Moreover, PM2.5 and SO2 also played key roles in the risk of pertussis surged. These associations remain significant after adjusting for long-term trend, seasonality and collinearity.

CONCLUSIONS

Overall, these data reinforce the evidence of a link between incidence and climate identified in regional and local studies. These findings also further support the hypothesis that air pollution is responsible for the global resurgence of pertussis. Based on this we suggest that public health workers should be encouraged to consider the risks of the environment when focusing on pertussis prevention and control.

Climate and human health: a review of publication trends in the International Journal of Biometeorology

The climate-health nexus is well documented in the field of biometeorology. Since its inception, Biometeorology has in many ways become the umbrella under which much of this collaborative research has been conducted. Whilst a range of review papers have considered the development of biometeorological research and its coverage in this journal, and a few have reviewed the literature on specific diseases, none have focused on the sub-field of climate and health as a whole. Since its first issue in 1957, the International Journal of Biometeorology has published a total of 2183 papers that broadly consider human health and its relationship with climate. In this review, we identify a total of 180 (8.3%, n = 2183) of these papers that specifically focus on the intersection between meteorological variables and specific, named diagnosable diseases, and explore the publication trends thereof. The number of publications on climate and health in the journal increases considerably since 2011. The largest number of publications on the topic was in 2017 (18) followed by 2021 (17). Of the 180 studies conducted, respiratory diseases accounted for 37.2% of the publications, cardiovascular disease 17%, and cerebrovascular disease 11.1%. The literature on climate and health in the journal is dominated by studies from the global North, with a particular focus on Asia and Europe. Only 2.2% and 8.3% of these studies explore empirical evidence from the African continent and South America respectively. These findings highlight the importance of continued research on climate and human health, especially in low- and lower-middle-income countries, the populations of which are more vulnerable to climate-sensitive illnesses.

Exploring the Quantitative Assessment of Spatial Risk in Response to Major Epidemic Disasters in Megacities: A Case Study of Qingdao

With the global spread of various human-to-human epidemics, public health issues have become a focus of attention. Therefore, it is of great importance to improve the quantitative risk assessment of the construction of resilient cities in terms of epidemic disasters. Starting with the dimensions of social activities and material space, this paper took Qingdao, China, with a population of 5 million, as an example, and took its seven municipal districts as the research scope. In this paper, five risk factors, including the Population density index, Night light index, Closeness index of roads, Betweenness index of roads and Functional mixed nuclear density index were selected for weighted superposition analysis. We conducted a quantitative assessment of the spatial risk of epidemic disaster so as to obtain the classification and spatial structure of the epidemic disaster risk intensity. The results show that: ① The roads with a large traffic flow are most likely to lead to the risk of urban spatial agglomeration, and the areas with a large population density and large mixture of infrastructure functions are also important factors causing the risk of epidemic agglomeration. ② The analysis results regarding the population, commerce, public services, transportation, residence, industry, green space and other functional places can reflect the high-risk areas for epidemic diseases with different natures of transmission. ③ The risk intensity of epidemic disasters is divided into five risk grade areas. Among them, the spatial structure of epidemic disasters, composed of the first-level risk areas, is characterized by "one main area, four secondary areas, one belt and multiple points" and has the characteristics of spatial diffusion. ④ Catering, shopping, life services, hospitals, schools and transportation functional places are more likely to cause crowd gathering. The management of these places should be focused on prevention and control. At the same time, medical facilities should be established at fixed points in all high-risk areas to ensure the full coverage of services. In general, the quantitative assessment of the spatial risk of major epidemic disasters improves the disaster risk assessment system in the construction of resilient cities. It also focuses on risk assessment for public health events. It is helpful to accurately locate the agglomeration risk areas and epidemic transmission paths that are prone to outbreak or cause epidemic transmission in cities so as to assist the relevant practitioners in containing the epidemic from the initial stage of transmission in a timely manner and prevent the further spread of the epidemic.

A potential tool for predicting epidemic trends and outbreaks of scrub typhus based on Internet search big data analysis in Yunnan Province, China

Introduction

Scrub typhus, caused by Orientia tsutsugamushi, is a neglected tropical disease. The southern part of China is considered an important epidemic and conserved area of scrub typhus. Although a surveillance system has been established, the surveillance of scrub typhus is typically delayed or incomplete and cannot predict trends in morbidity. Internet search data intuitively expose the public's attention to certain diseases when used in the public health area, thus reflecting the prevalence of the diseases.

Methods

In this study, based on the Internet search big data and historical scrub typhus incidence data in Yunnan Province of China, the autoregressive integrated moving average (ARIMA) model and ARIMA with external variables (ARIMAX) model were constructed and compared to predict the scrub typhus incidence.

Results

The results showed that the ARIMAX model produced a better outcome than the ARIMA model evaluated by various indexes and comparisons with the actual data.

Conclusions

The study demonstrates that Internet search big data can enhance the traditional surveillance system in monitoring and predicting the prevalence of scrub typhus and provides a potential tool for monitoring epidemic trends of scrub typhus and early warning of its outbreaks.

Developing spatio-temporal approach to predict economic dynamics based on online news

Economic forecasting is a scientific decision-making tool, and it is one of the important basis for the government to formulate economic plans, predict the implementation of the plan, and guide the implementation of the plan. Current knowledge about the use of online news in the prediction of economic patterns in China is limited, especially considering the spatio-temporal dynamics over time. This study explored the spatio-temporal patterns of economic output values in Yinzhou, Ningbo, China between 2018 and 2021, and proposed generalized linear model (GLM) and Geographically weighted regression (GWR) model to predict the dynamics using online news data. The results indicated that there were spatio-temporal variations in the economic dynamics in the study area. The online news showed a great potential to predict economic dynamics, with better performance in the GWR model. The findings suggested online news combining with spatio-temporal approach can better forecast economic dynamics, which can be seen as a pre-requisite for developing an online news-based surveillance system The advanced spatio-temporal analysis enables governments to garner insights about the patterns of economic dynamics over time, which may enhance the ability of government to formulate economic plans and to predict the implementation of the plan. The proposed model may be extended to greater geographic area to validate such approach.

Forecasting the future number of pertussis cases using data from Google Trends

Background

Alternative methods could be used to enhance the monitoring and forecasting of re-emerging conditions such as pertussis. Here, whether data on the volume of Internet searching on pertussis could complement traditional modeling based solely on reported case numbers was assessed.

Methods

SARIMA models were fitted to describe reported weekly pertussis case numbers over a four-year period in Germany. Pertussis-related Google Trends data (GTD) was added as an external regressor. Predictions were made by the models, both with and without GTD, and compared with values within the validation dataset over a one-year and for a two-weeks period.

Results

Predictions of the traditional model using solely reported case numbers resulted in an RMSE (residual mean squared error) of 192.65 and 207.8, a mean absolute percentage error (MAPE) of 58.59 and 72.1, and a mean absolute error (MAE) 169.53 and 190.53 for the one-year and for the two-weeks period, respectively. The GTD expanded model achieved better forecasting accuracy (RMSE: 144.22 and 201.78), a MAPE 43.86, and 68.54 and a MAE of 124.46 and 178.96. Corrected Akaike Information Criteria also favored the GTD expanded model (1750.98 vs. 1746.73). The difference between the predictive performances was significant when using a two-sided Diebold-Mariano test (DM value: 6.86, p < 0.001) for the one-year period.

Conclusion

Internet-based surveillance data enhanced the predictive ability of a traditionally based model and should be considered as a method to enhance future disease modeling.

•

Pertussis-related Google Trends Data (GTD) showed a weak but significant correlation with the reported weekly number of pertussis cases.

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We fitted a SARIMA models to estimate reported weekly pertussis case numbers

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The GTD-expanded models achieved significantly better predictive accuracy than the traditional model over a one-year-period.

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Corrected Akaike Information Criteria also favored the GTD-Expanded SARIMA model.

•

The use of GTD should be considered as a method to enhance pertussis forecasting.

WITHDRAWN: Usage of deep learning in environmental health risk assessment

Ahead of Print article withdrawn by publisher.

Use of meteorological parameters for forecasting scarlet fever morbidity in Tianjin, Northern China

The scarlet fever incidence has increased drastically in recent years in China. However, the long-term relationship between climate variation and scarlet fever remains contradictory, and an early detection system is lacking. In this study, we aim to explore the potential long-term effects of variations in monthly climatic parameters on scarlet fever and to develop an early scarlet-fever detection tool. Data comprising monthly scarlet fever cases and monthly average climatic variables from 2004 to 2017 were retrieved from the Notifiable Infectious Disease Surveillance System and National Meteorological Science Center, respectively. We used a negative binomial multivariable regression to assess the long-term impacts of weather parameters on scarlet fever and then built a novel forecasting technique by integrating an autoregressive distributed lag (ARDL) method with a nonlinear autoregressive neural network (NARNN) based on the significant meteorological drivers. Scarlet fever was a seasonal disease that predominantly peaked in spring and winter. The regression results indicated that a 1 °C increment in the monthly average temperature and a 1-h increment in the monthly aggregate sunshine hours were associated with 17.578% (95% CI 7.674 to 28.393%) and 0.529% (95% CI 0.035 to 1.025%) increases in scarlet fever cases, respectively; a 1-hPa increase in the average atmospheric pressure at a 1-month lag was associated with 12.996% (95% CI 9.972 to 15.919%) decrements in scarlet fever cases. Based on the model evaluation criteria, the best-performing basic and combined approaches were ARDL(1,0,0,1) and ARDL(1,0,0,1)-NARNN(5, 22), respectively, and this hybrid approach comprised smaller performance measures in both the training and testing stages than those of the basic model. Climate variability has a significant long-term influence on scarlet fever. The ARDL-NARNN technique with the incorporation of meteorological drivers can be used to forecast the future epidemic trends of scarlet fever. These findings may be of great help for the prevention and control of scarlet fever.

Big data analytics as a tool for fighting pandemics: a systematic review of literature

Infectious and contagious diseases represent a major challenge for health systems worldwide, either in private or public sectors. More recently, with the increase in cases related to these problems, combined with the recent global pandemic of COVID-19, the need to study strategies to treat these health disturbs is even more latent. Big Data, as well as Big Data Analytics techniques, have been addressed in this context with the possibility of predicting, mapping, tracking, monitoring, and raising awareness about these epidemics and pandemics. Thus, the purpose of this study is to identify how BDA can help in cases of pandemics and epidemics. To achieve this purpose, a systematic review of literature was carried out using the methodology Methodi Ordinatio. The rigorous search resulted in a portfolio of 45 articles, retrived from scientific databases. For the collection and analysis of data, the softwares NVivo 12 and VOSviewer were used. The content analysis sought to identify how Big Data and Big Data Analytics can help fighting epidemics and pandemics. The types and sources of data used in cases of previous epidemics and pandemics were identified, as well as techniques for treating these data. The results showed that the main sources of data come from social media and Internet search engines. The most common techniques for analyzing these data involve the use of statistics, such as correlation and regression, combined with other techniques. Results shows that there is a fruitiful field of study to be explored by both areas, Big Data and Health.

The long-term effects of meteorological parameters on pertussis infections in Chongqing, China, 2004-2018

Evidence on the long-term influence of climatic variables on pertussis is limited. This study aims to explore the long-term quantitative relationship between weather variability and pertussis. Data on the monthly number of pertussis cases and weather parameters in Chongqing in the period of 2004-2018 were collected. Then, we used a negative binomial multivariable regression model and cointegration testing to examine the association of variations in monthly meteorological parameters and pertussis. Descriptive statistics exhibited that the pertussis incidence rose from 0.251 per 100,000 people in 2004 to 3.661 per 100,000 persons in 2018, and pertussis was a seasonal illness, peaked in spring and summer. The results from the regression model that allowed for the long-term trends, seasonality, autoregression, and delayed effects after correcting for overdispersion showed that a 1 hPa increment in the delayed one-month air pressure contributed to a 3.559% (95% CI 0.746-6.293%) reduction in the monthly number of pertussis cases; a 10 mm increment in the monthly aggregate precipitation, a 1 °C increment in the monthly average temperature, and a 1 m/s increment in the monthly average wind velocity resulted in 3.641% (95% CI 0.960-6.330%), 19.496% (95% CI 2.368-39.490%), and 3.812 (95% CI 1.243-11.690)-fold increases in the monthly number of pertussis cases, respectively. The roles of the mentioned weather parameters in the transmission of pertussis were also evidenced by a sensitivity analysis. The cointegration testing suggested a significant value among variables. Climatic factors, particularly monthly temperature, precipitation, air pressure, and wind velocity, play a role in the transmission of pertussis. This finding will be of great help in understanding the epidemic trends of pertussis in the future, and weather variability should be taken into account in the prevention and control of pertussis.

Time series analysis of temporal trends in hemorrhagic fever with renal syndrome morbidity rate in China from 2005 to 2019

Hemorrhagic fever with renal syndrome (HFRS) is seriously endemic in China with 70%~90% of the notified cases worldwide and showing an epidemic tendency of upturn in recent years. Early detection for its future epidemic trends plays a pivotal role in combating this threat. In this scenario, our study investigates the suitability for application in analyzing and forecasting the epidemic tendencies based on the monthly HFRS morbidity data from 2005 through 2019 using the nonlinear model-based self-exciting threshold autoregressive (SETAR) and logistic smooth transition autoregressive (LSTAR) methods. The experimental results manifested that the SETAR and LSTAR approaches presented smaller values among the performance measures in both two forecasting subsamples, when compared with the most extensively used seasonal autoregressive integrated moving average (SARIMA) method, and the former slightly outperformed the latter. Descriptive statistics showed an epidemic tendency of downturn with average annual percent change (AAPC) of -5.640% in overall HFRS, however, an upward trend with an AAPC = 1.213% was observed since 2016 and according to the forecasts using the SETAR, it would seemingly experience an outbreak of HFRS in China in December 2019. Remarkably, there were dual-peak patterns in HFRS incidence with a strong one occurring in November until January of the following year, additionally, a weak one in May and June annually. Therefore, the SETAR and LSTAR approaches may be a potential useful tool in analyzing the temporal behaviors of HFRS in China.

An Advanced Data-Driven Hybrid Model of SARIMA-NNNAR for Tuberculosis Incidence Time Series Forecasting in Qinghai Province, China

Purpose

Qinghai province has invariably been under an ongoing threat of tuberculosis (TB), which has not only been an obstacle to local development but also hampers the prevention and control process for ending the TB epidemic. Forecasting for future epidemics will serve as the base for early detection and planning resource requirements. Here, we aim to develop an advanced detection technique driven by the recent TB incidence series, by fusing a seasonal autoregressive integrated moving average (SARIMA) with a neural network nonlinear autoregression (NNNAR).

Methods

We collected the TB incidence data between January 2004 and December 2016. Subsequently, the subsamples from January 2004 to December 2015 were employed to measure the efficiency of the single SARIMA, NNNAR, and hybrid SARIMA-NNNAR approaches, whereas the hold-out subsamples were used to test their predictive performances. We finally selected the best-performing technique by considering minimum metrics including the mean absolute error, root-mean-squared error, mean absolute percentage error and mean error rate .

Results

During 2004–2016, the reported TB cases totaled 71,080 resulting in the morbidity of 97.624 per 100,000 persons annually in Qinghai province and showed notable peak activities in late winter and early spring. Moreover, the TB incidence rate was surging by 5% per year. According to the above-mentioned criteria, the best-fitting basic and hybrid techniques consisted of SARIMA(2,0,2)(1,1,0)₁₂, NNNAR(7,1,4)₁₂ and SARIMA(2,0,2)(1,1,0)₁₂-NNNAR(3,1,7)₁₂, respectively. Amongst them, the hybrid technique showed superiority in both mimic and predictive parts, with the lowest values of the measured metrics in both the parts. The sensitivity analysis indicated the same results.

Conclusion

The best-mimicking SARIMA-NNNAR hybrid model outperforms the best-simulating basic SARIMA and NNNAR models, and has a potential application in forecasting and assessing the TB epidemic trends in Qinghai. Furthermore, faced with the major challenge of the ongoing upsurge in TB incidence in Qinghai, there is an urgent need for formulating specific preventive and control measures.