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. 2024 Jan 20;22(1):81.
doi: 10.1186/s12967-024-04855-y.

Evaluating the long-term impact of COVID-19-associated public health interventions on zoonotic and vector-borne diseases in China: an interrupted time series analysis

Affiliations

Evaluating the long-term impact of COVID-19-associated public health interventions on zoonotic and vector-borne diseases in China: an interrupted time series analysis

Yongbin Wang et al. J Transl Med. .

Abstract

Background: The long-term impact of COVID-19-associated public health interventions on zoonotic and vector-borne infectious diseases (ZVBs) remains uncertain. This study sought to examine the changes in ZVBs in China during the COVID-19 pandemic and predict their future trends.

Methods: Monthly incidents of seven ZVBs (Hemorrhagic fever with renal syndrome [HFRS], Rabies, Dengue fever [DF], Human brucellosis [HB], Leptospirosis, Malaria, and Schistosomiasis) were gathered from January 2004 to July 2023. An autoregressive fractionally integrated moving average (ARFIMA) by incorporating the COVID-19-associated public health intervention variables was developed to evaluate the long-term effectiveness of interventions and forecast ZVBs epidemics from August 2023 to December 2025.

Results: Over the study period, there were 1,599,647 ZVBs incidents. HFRS and rabies exhibited declining trends, HB showed an upward trajectory, while the others remained relatively stable. The ARFIMA, incorporating a pulse pattern, estimated the average monthly number of changes of - 83 (95% confidence interval [CI] - 353-189) cases, - 3 (95% CI - 33-29) cases, - 468 (95% CI - 1531-597) cases, 2191 (95% CI 1056-3326) cases, 7 (95% CI - 24-38) cases, - 84 (95% CI - 222-55) cases, and - 214 (95% CI - 1036-608) cases for HFRS, rabies, DF, HB, leptospirosis, malaria, and schistosomiasis, respectively, although these changes were not statistically significant besides HB. ARFIMA predicted a decrease in HB cases between August 2023 and December 2025, while indicating a relative plateau for the others.

Conclusions: China's dynamic zero COVID-19 strategy may have exerted a lasting influence on HFRS, rabies, DF, malaria, and schistosomiasis, beyond immediate consequences, but not affect HB and leptospirosis. ARFIMA emerges as a potent tool for intervention analysis, providing valuable insights into the sustained effectiveness of interventions. Consequently, the application of ARFIMA contributes to informed decision-making, the design of effective interventions, and advancements across various fields.

Keywords: ARFIMA; COVID-19; Dynamic zero-case policy; Interrupted time series analyses; Intervention; Zoonotic and vector-borne diseases.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
The original series and the trend (the y-axis on the right) and cycle (the y-axis on the left) components decomposed by the HP method for a the HFRS incidence series, b the Rabies incidence series, c the DF incidence series, d the HB incidence series, e the Leptospirosis incidence series, f the Malaria incidence series, and g the Schistosomiasis incidence series. As depicted above, together there was a reduction in HFRS and rabies incidences; there was a relative stableness in DF, leptospirosis, malaria, and schistosomiasis incidences; there was a notable increase in HB incidence
Fig. 2
Fig. 2
The actual epidemic patterns and counterfactual predictions under the COVID-19-associated public health interventions between January 2020 and July 2023. a Counterfactual prediction for the HFRS incidence series, b counterfactual prediction for the rabies incidence series, c counterfactual prediction for the DF incidence series, d counterfactual prediction for the HB incidence series, e counterfactual prediction for the leptospirosis incidence series, f counterfactual prediction for the malaria incidence series, and g counterfactual prediction for the schistosomiasis incidence series. It can be seen that seemingly the COVID-19-related public health interventions led to a case reduction in HFRS, rabies, DF, malaria, and schistosomiasis incidences except for HB and leptospirosis which showed a rising tendency during the COVID-19 pandemic
Fig. 3
Fig. 3
The predicted epidemics from August 2023 to December 2025 under the ARFIMA considering the effects of the COVID-19 outbreak. a Prediction for the HFRS incidence series, b prediction for the rabies incidence series, c prediction for the DF incidence series, d prediction for the HB incidence series, e prediction for the leptospirosis incidence series, f prediction for the malaria incidence series, and g prediction for the schistosomiasis incidence series. As shown, the predicted trends remained at a relative plateau for HFRS, rabies, DF, leptospirosis, malaria, and schistosomiasis except for HB which predicted a decline

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