Method for epidemiological zoning by complex of indices with random volumetric accuracy for management decision support system

FIELD: medicine.

SUBSTANCE: invention refers to medicine. The method characterised by the fact that a chosen territory map is covered with regular-hexagon cells equal in area; the epidemiologically significant findings are aggregated on the base by spatial addition; the findings are recorded in an attributive cell table and processed, so secondary parameters are derived, including: the number of patients, total length of an epidemic period, population, rate of growth of the number of patients; thereafter, the cells having related values are clustered; a degree of epidemic risk - maximum, moderate and low - is calculated for each cluster; that is followed by building an epidemic risk map and zoning the territory by combining the clusters; the high epidemic risk clusters include the cells having the maximum values, and the moderate and low risk clusters include those with the medium and minimum values.

EFFECT: increasing the epidemiological zoning accuracy.

2 dwg, 1 tbl

 

The invention relates to medicine, in particular epidemiology, and can be used to assess the epidemiological situation and planning sanitation and anti-epidemic measures.

Epidemiological zoning is to differentiate areas according to risk of complications epidemiology.

The basis laid zoning evaluation criteria and comparison areas on one or several indicators.

The known method of epidemiological zoning of the territory, which consists in counting the incidence of administrative territories, allowing to rank the areas and to prioritize the activities of epidemiological surveillance [1]. However, the use of this type of zoning is only one characteristic - morbidity (or the absolute number of patients) as a basis for zoning, makes the assessment of the epidemiological risk devoid of time and group settings, and does not consider the influence of risk factors. In addition, the boundaries of natural foci of infectious diseases often do not coincide with the boundaries of administrative districts, which makes zoning uninformative.

The known method of epidemiological zoning by analyzing several �nazimah epidemiological indicators for the description of the administrative districts. A measure of the significance of epidemiological indicators is computed by experts, namely the expert on the basis of grading assessment determines the importance of individual indicators based on their own experience [2, 3]. When selecting indicators for the zoning currently the parameter "number of patients" is the most succinct integral expression of epidemiological risk (on site), however the correct use of this parameter can be provided comparable compare areas by area and number of population. As an indicator, which determines the exposure of risk factors, is used the number of years the registration of patients in this administrative district or for the portion of the territory. In this approach, the sum of the years in which it was registered, at least one patient.

The disadvantage of this method of zoning is the subjectivity of the expert assessment regarding the significance of individual indicators and, consequently, a low frequency of occurrence method when using the opinions of other experts. In this case the expert has to compare the diverse magnitude. For example, to determine the ranking of areas according to the risk of acute intestinal infections, the proportion of households having no sanitation, twice �agree, than the proportion of people without access to Central water supply. In addition, the disjunction administrative territories by area, the number of resident population, landscape structure and population density leads to loss of important information when calculating the average (aggregated) indicators and the impossibility of a correct comparison areas.

In addition, this method has a low resolution in the most significant range of values of high epidemiological risk because of the limited accuracy of the method determine the exposure, because the same number of years of registration for many of the areas with different and high epidemiological status of this figure is the same (maximum).

The object of the invention is to provide a method that allows to objectively rank the investigated area according to the degree of epidemiological risk.

The technical result is to increase the informative, objective assessment of epidemiological risk and the accuracy of epidemiological zoning.

The technical result is achieved in that the electronic map of the study area is covered with a grid of equal-area cells in the form of regular hexagons, obtained on the basis of the spatial connection�Oia aggregated information on epidemiologically important indicators, when this data is written into the attribute table of cells with their subsequent processing and calculation of additional indicators: number of patients, the total duration of the epidemic period, the population, the rate of growth in the number of patients, further cells with similar values together in clusters, for each cluster calculate the degree of epidemiological risk (high, medium, low; with subsequent epidemiological risk mapping and zoning of the territory by merging clusters.

The method is as follows.

At the first stage of the territory is covered with a grid of equal-area cells with a size comparable with the average settlement. The advantages of coating the territory polygons of the same size are clarity, greater spatial accuracy, the ability to use absolute indicators of epidemiological risk and the possibility of varying the dimensions of standard sections.

The choice of optimal parameters of regular coatings for effective zoning in epidemiological risk is to justify the square of the standard of the site and its forms. The traditional way of subtyping on-site standard parcels can be considered the division into square areas, lines which pass VD�l of Parallels and meridians, each of which is optionally improve the accuracy is divided into four equal sections.

This method of division is convenient for its simplicity and can even be implemented without the use of computer technology. However, from the point of view of spatial analysis, square mesh has two major drawbacks. First, the size of these standard sections are not the same at different latitudes, because as the distance from the equator to the poles, the plots are becoming a trapezoidal shape and their size decreases. Secondly, the Central point of the square cells are at different distances from the centers of neighboring cells.

These features square mesh important from the point of view of spatial analysis, as they contribute to distortion in the calculation of objects or phenomena that are geographically located diagonally with respect to the grid.

From the point of view of spatial analysis, the optimal form of coverage to account for the environment of the point object is a circle. However, a solid regular coating with the use of a circle has area double crossing that distorts the accounting for settlements and patients located in this zone.

In this regard, the proposed use is closest to the circumference and thus lacking the disadvantages of a square grid, the solid form regularly�about coverage consisting of regular hexagons.

When building a layer of regular hexagons determining parameter is the length of the rib that defines the area of the shape. The choice of the length of the edges is carried out based on the prevailing conditions of contamination sampling epidemiological survey maps and can range from 2-5 miles for one subject of the Russian Federation, up to 15-30 km at the zoning at the national level and between 30 km and more for the global coatings.

At the next stage through a spatial join in a geographic information system (GIS) on the basis of aggregated information on human settlements and the sick, and the data is written to the attribute table of the hexagons. This table is subjected to pre-processing to obtain indicators for clustering. The number of patients is obtained by summing all patients registered within the given hexagon. The total duration of the epidemic period is also determined for each hexagon by processing of dates disease patients. The population is calculated as the sum of the inhabitants of all settlements located within the cell. The rate of growth in the number of patients is calculated as the ratio of the number of patients for on�last year of observation to the long-term average (arithmetic mean for the five years which are not included last year).

After the described processing table takes a finished look, while the rows are marked with unique identifiers hexagons, and each column shows the number of patients, the total duration of the epidemic period, the population and the growth rates of the patients on this site.

The cell site with the specified attributes are objects clustering into 3 homogeneous groups characterized by different degrees of epidemiological risk. The basic idea and purpose of cluster analysis is classification (differentiation) of the sample of objects into subsets called clusters so that each cluster consisted of similar objects, and objects of different clusters differed significantly.

The similarity of the territories by the combination of features in the cluster is determined through a multivariate statistical procedure. The fundamental advantage of cluster analysis is the independence of the clustering results from the subjective opinion of an expert concerning the ownership of certain areas to certain risk categories.

Epidemiological interpretation of the significance of the obtained clusters is performed according to average values of the indicators and is that the parts of the territory, representing the maximum risk, relative�dynamism to the first group of cells, representing the maximum epidemiological risk for the population due to the long exposure of risk factors in relation to a large number of residents. The cluster is characterized by medium epidemiological risk, belong to the second group and the third group of cells with low epidemiological risk.

At the next stage, the mapping of epidemiological risk, i.e. the new data on the epidemiological status of standard plots are visualized using GIS, which is the result of the corresponding stage of zoning.

Method epidemiological zoning was tested on the example of the Astrakhan region.

For epidemiological zoning of the territory of the Astrakhan region in respect of epidemic manifestations of Astrakhan spotted fever map of the Astrakhan region with the help of GIS is divided into 12670 standard plots in the form of regular hexagons with an area - 5.9 km2and an edge length of 1.5 km. On the basis of aggregated information on human settlements and patients through a spatial join. Data on population, number of patients and duration of the epidemic period are recorded in the attribute table field of hexagons. Data aggregation for each standard and record the obtained value� in the destination table shown in Fig.1.

The table resulting from the aggregation of data is subjected to pre-processing to obtain indicators for clustering. The number of patients is obtained by summing all patients registered within a given hexagon. The total duration of the epidemic period is also determined for each hexagon by processing of dates disease patients. The population is calculated as the sum of the inhabitants of all settlements located within a standard plot.

After the described processing table takes a finished look, while the rows are marked with unique identifiers hexagons, and each column shows the number of patients, the total duration of the epidemic period and the population. According to the results of preliminary processing of 12670 standard plots the incidence observed in 223 and was held clustering. As a result of clustering 223 hexagons identified three homogeneous groups characterized by different degrees of epidemiological risk. Characteristics of the clusters are presented in table.1. According to the table to the first cluster assigned 9 standard parcels with an average specific number of patients 45±5 (mean ± standard. MIS.), the average total duration of the epidemic period 618±4 and the number of resident population of more than three thousand people in one area.

The second cluster is related 26 standard plots. This cluster was characterized by the average number of patients 18±1 to the site an average total duration of the epidemic period 320±14 days and a population of from one to three thousand people.

The third cluster included 188 standard sections, each of which registered an average of 3±0,2 patients, the average total duration of the epidemic period was 28±3, and the number of inhabitants did not exceed one thousand people.

Epidemiological interpretation of the significance of the obtained clusters is that the parts of the territory belonging to the first cluster, represent the maximum epidemiological risk for the population due to the long exposure of risk factors in relation to a large number of residents. The second cluster is characterized by the average epidemiological risk, and the third - lowest. Other 12447 standard plots, in which the incidence of EPL not previously reported, were described as minimal threat.

The final stage of the epidemiological zoning is visualization using GIS the resulting clustering of the data. Evaluating the profiles of the obtained clusters, it should be noted that the maximum epidemiological risk is identified for the territory, composing�th only 0.07% of the total area of the Astrakhan region. Fig.2 presents a map of the epidemiological zoning of the territory of the Astrakhan region, illustrating the desired areas with the highest, medium and low epidemiological risk.

Thus, the proposed method epidemiological zoning based on clustering of cells, characterized by high spatial accuracy through the use of a large number of cells instead of administrative regions. Maps of epidemiological risk, obtained by clustering of cells demonstrate a prognostic value, since they consider the tendency to rise or fall in the incidence. Epidemiological zoning on a range of indicators carried out by means of clustering, has an objective basis that determines its advantage over point-based risk assessment, which is Central to the expert opinion.

The method proposed zoning on the basis of these advantages, improves the process of decision-making in the area of defining the scope and priority areas for preventive and anti-epidemic measures.

Literature

1. Belyakov V. D. Modern aspects of the study of epidemic process in relation to zoonotic natural focal infections, Vestn. THE ACADEMY OF MEDICAL SCIENCES OF THE USSR. - 1980. - No. 10. - P. 15-19.

2. Prokh�B. B. s Medico-ecological zoning and regional forecast of population health in Russia. M.: Publishing house of Mr. Kostin. 1996. - 72 S.

3. Trofimov A. M., Zabotin Y. I., Panasyuk M. V., Rubtsov, V. A. Quantitative methods of zoning and classification. - Kazan: publishing house of Kazanski. Univ. - 1985. - 120 p.

Table 1
No. clusterThe number of patientsThe duration of the epidemic period (days)Population (thousands)RiskThe number of parcels
145±5618±41>3Maximum9
218±1320±141-3Average26
33±0,228±3<1Low188
000 -Minimum12447

Method epidemiological zoning on a range of indicators with arbitrary spatial accuracy, characterized by the fact that the card selected is covered by a grid of equal-area cells in the form of regular hexagons; on the basis of the way spatial joins aggregated information on epidemiologically important indicators, while data is written into the attribute table of cells with their subsequent processing and calculation of additional indicators: number of patients, the total duration of the epidemic period, the population, the rate of growth in the number of patients, further cells with similar values together in clusters, for each cluster calculate the degree of epidemiological risk - maximum, average, low - with subsequent epidemiological risk mapping and zoning of the territory by merging clusters, while clusters with high epidemiological risk are the cells with the highest value of the index, middle and low, respectively, with the intermediate and minimum scores.



 

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