2015-01-012024-05-13https://scholars.lib.ntu.edu.tw/handle/123456789/648392摘要：現狀的食媒性疾病監測系統，主要是衛生福利部疾病管制署的「法定傳染病監視通報系統」、「症狀監視通報系統」、「即時疫情監測及預警系統 (RODS)」及健保就診資料監測，還有食品藥物管理署的「食品中毒資訊系統」，但針對非屬法定傳染病的食媒性病原感染，並沒有完整建立的實驗室監測。故本計畫目的在於整合疾管署的實驗室監測資料與即時疫情監測資料，應用時空分析方法於偵測疫情爆發的時空群聚，建構一食媒性疾病監測及預警模式。本研究預計將從實驗室檢測資料中，依據病原體對個案進行分組與分析，建立通路網絡及時空群聚分析模式，並從症候群監測中出現特定症狀之個案，取出該個案的居住鄉鎮(健保資料庫居住地推估模式)、就醫地點、及個案發生時間等資訊，對已知同病原體的個案及相同症狀個案，分別找出確定的時空群聚事件及潛在的時空群聚事件，並分辨出個案是否屬於個體、家戶等不同尺度的事件。本研究將進一步比較這兩種不同的資料來源，進行不同尺度之間的群聚事件交叉比對與分析，評估其時空群聚的範圍。綜言之，本研究預計建立的食媒病原感染監測模式，將整合實驗室檢測結果與即時疫情群監測的資料，並進行時空群聚掃描分析與交叉比對，評估偵測出現時空群聚的潛在風險。該系統對於偵測食媒性病原感染群聚事件的評估，包括：1. 計算成功偵測群聚事件機率、確定誤報機率、及潛在可能群聚機率，並對此監測模式系統預警有效性的評估；2. 透過實驗室檢測資料之分析結果，截取已知確定的各尺度群聚與非群聚之案件的時序與空間分佈及獲取實驗室檢測結果的時間延遲資訊，計算模式分析結果是否成功偵測出時空群聚，及其與爆發群聚時間的延遲程度。<br> Abstract: Currnet foodborne disease surveillance data in Taiwan is from Notifiable Communicable Diseases Surveillance System, Real-time Outbreak and Disease Surveillance (RODS) of Taiwan Centers of Disease Control (Taiwan CDC) and National Health Insurance Database. However, there is no well-established laboratory surveillance system for non-notifiable foodborne pathogens. The objective of the project is to integrate rountine surveillance data from Taiwan CDC’s laboratory pathogen surveillance network and RODS to establish a framework for the early warning of monitoring spatial-temporal clustering of food-borne pathogens.We are attempted to stratify the surveillance data from Taian CDC’s laboratory pathogen surveillance network by demographic charactersitics and integrate with Point-of-Interest (POI) data to establish food distribution network and spatial-temporal clustering analysis model. We will also compare the results of disease clustering from the laboratory pathogen diagnosis and RODS for differentiating the clustering scales to assess the geographic ranges of disease clustering.In summary, by integrating the surveillance data of RODS with the laboratory pathogen diagnosis, we expect to establish a framework for the early warning of monitorin clustering of food-borne pathogens. The performance of the early warning surveillance system includes assessing the threshold of spatial-temporal clustering, successful rate of detecting the possible clusters of specific pathogens and lag-time between disease outbreak and laboratory comfirmation of the pathogen.食媒性病原體時空群聚早期預警疾病監測foodborne pathogensspatial-temporal clusteringearly warningdisease surveillance