Spatiotemporal patterns, driving factors and seasonal risk of mosquito-borne disease importation into China

Abstract

With the rapid increase of Chinese international travel, labour service and business, the pressure of imported mosquito-borne infectious diseases into China is also on the rise, and a better understanding of this phenomenon is required to enable appropriate public health actions. The main purpose of this thesis is to examine the spatiotemporal patterns, driving factors and seasonal risk of the importation and onward transmission for two mosquito-borne diseases, malaria and dengue, in China. Multidisciplinary approaches have been used and a variety of datasets has been integrated, including disease incidence, air travel, environment, and international investment. The analyses presented demonstrate that the spatiotemporal patterns of malaria and dengue have changed significantly in mainland China over the last decade, with an expanded geographic range and increasing incidence of imported infections. However, the geographic extent of autochthonous malaria in China has shrunk significantly due to malaria control and elimination activities, while the incidence of locally transmitted dengue has increased dramatically since 1990. The importation of mosquito-borne diseases is driven by transmission rates in origin countries, increasing travel, as well as investment patterns and economic ties. Taking dengue as an example, the seasonally changing risk and geographic expansion of mosquito-borne disease spread from Southeast Asia into China has been quantified, with emerging routes highlighted. These findings have important public health significance in formulating strategies and technical guidance for mitigating infections in travellers, improving the capacity of screening, diagnosis and treatment, reducing the risk of morbidity, and strengthening surveillance and investigation capabilities, so as to enable timely interruption of the seasonal onward transmission of imported mosquito-borne diseases.

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Identifiers

ORCID for Shengjie Lai: orcid.org/0000-0001-9781-8148

ORCID for Andrew Tatem: orcid.org/0000-0002-7270-941X

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