Table_1_Geo-temporal patterns to design cost-effective interventions for zoonotic diseases -the case of brucellosis in the country of Georgia.DOCX

IntroductionControl of zoonosis can benefit from geo-referenced procedures. Focusing on brucellosis, here the ability of two methods to distinguish disease dissemination patterns and promote cost-effective interventions was compared.MethodGeographical data on bovine, ovine and human brucellosis reported in the country of Georgia between 2014 and 2019 were investigated with (i) the Hot Spot (HS) analysis and (ii) a bio-geographical (BG) alternative.ResultsMore than one fourth of all sites reported cases affecting two or more species. While ruminant cases displayed different patterns over time, most human cases described similar geo-temporal features, which were associated with the route used by migrant shepherds. Other human cases showed heterogeneous patterns. The BG approach identified small areas with a case density twice as high as the HS method. The BG method also identified, in 2018, a 2.6–2.99 higher case density in zoonotic (human and non-human) sites than in non-zoonotic sites (which only reported cases affecting a single species) –a finding that, if corroborated, could support cost-effective policy-making.DiscussionThree dissemination hypotheses were supported by the data: (i) human cases induced by sheep-related contacts; (ii) human cases probably mediated by contaminated milk or meat; and (iii) cattle and sheep that infected one another. This proof-of-concept provided a preliminary validation for a method that may support cost-effective interventions oriented to control zoonoses. To expand these findings, additional studies on zoonosis-related decision-making are recommended.

地理标记的防控措施在动物源性传染病的控制中具有重要意义。本项研究聚焦于布鲁氏菌病，对比了两种方法在区分疾病传播模式和促进成本效益干预措施方面的能力。研究方法包括：对2014年至2019年间在格鲁吉亚境内报告的牛、羊及人类布鲁氏菌病地理数据，运用（i）热点分析（HS）和（ii）生物地理学（BG）替代法进行探究。研究结果：超过四分之一的所有报告病例影响两种或更多物种。在反刍动物病例随时间表现出不同模式的同时，大多数人类病例描述了相似的地理时间特征，这些特征与游牧牧羊人使用的路线相关。其他人类病例则显示出异质性的模式。BG方法识别出病例密度比HS方法高出两倍的小区域。此外，BG方法在2018年还发现，动物源性（人类和非人类）场所的病例密度比非动物源性场所（仅报告影响单一物种的病例）高出2.6至2.99倍——这一发现若得到证实，将支持成本效益政策的制定。讨论部分：数据支持了三种传播假说：（i）由与羊相关的接触引起的人类病例；（ii）可能由受污染的牛奶或肉类介导的人类病例；（iii）相互感染的家畜和羊。这一概念验证为一种可能支持控制动物源性传染病成本效益干预措施的方法提供了初步验证。为扩展这些发现，建议进行更多关于动物源性传染病相关决策的研究。