暴雨洪涝影响感染性腹泻发病的环境-社会因素与社会驱动过程模型构建
Review on environmental-social factors and social driving process model construction of infectious diarrhea affected by rainstorm and flood
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摘要:
感染性腹泻是一个重要的公共卫生问题，对全球疾病总负担影响较大。气候变化背景下极端强降雨增多，洪涝事件频发。大部分研究表明暴雨和洪涝事件后，人群感染性腹泻的发病明显增加。当前对于暴雨洪涝事件通过何种作用路径影响感染性腹泻发病，其中的关键环节、环境-社会因素相互作用机制缺乏系统性总结。本综述从环境因素、社会经济与文化因素、人群及个体易感因素等进行了全面的文献梳理。从驱动病原体传播扩散，影响卫生设施和（或）饮用水处理基础设施，个体及行为因素调节作用，以及长期效应等方面，探讨了暴雨洪涝事件对感染性腹泻发病影响的潜在作用机制。最终，在借鉴“压力-状态-响应”的模型基础上，构建暴雨洪涝对感染性腹泻发病影响的社会驱动过程的概念模型。本模型给未来定量建模等研究方向提供一定的参考，有利于指导公共卫生部门在暴雨洪涝后精准地找到降低感染性腹泻发病的因素，从而采取针对性干预措施。
Abstract: Infectious diarrhea is an important public health problem, which has a significant impact on global disease burden. Under the background of climate change, rainstorms increase and floods occur frequently. Most studies show that the incidences of infectious diarrhea disease increase significantly after rainstorm and flood events. However, there is a lack of systematic summary on the path of rainstorm and flood events affecting the incidence of infectious diarrhea, including the key links and mechanisms underlying environmental-social interaction. This study comprehensively combed the literature from environmental factors, socio-economic and cultural factors, and population and individual susceptibility factors. The potential mechanisms of infectious diarrhea caused by rainstorm and flood events were discussed from the aspects of spreading of pathogens, affecting sanitation facilities and (or) drinking water treatment infrastructure, the regulatory role of individual and behavioral factors, and long-term effects. Based on the "pressure-state-response" model, a social driving process model of rainstorm and flood leading to incidence of infectious diarrhea was constructed. This model could provide reference for future quantitative modeling and other research directions. It is helpful to guide the public health departments to accurately identify factors affecting the incidence of infectious diarrhea after rainstorm and flood, so as to take targeted intervention measures.
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