Distribution and Risk Factors of Scrub Typhus in South Korea, From 2013 to 2019: Bayesian Spatiotemporal Analysis
Bibliographic record
Abstract
Background: Scrub typhus (ST), also known as tsutsugamushi disease, is a common febrile vector-borne illness in South Korea, transmitted by trombiculid mites infected with Orientia tsutsugamushi, with rodents serving as the main hosts. Although vector-borne diseases like ST require both a One Health approach and a spatiotemporal perspective to fully understand their complex dynamics, previous studies have often lacked integrated analyses that simultaneously address disease dynamics, vectors, and environmental shifts. Objective: We aimed to explore spatiotemporal trends, high-risk areas, and risk factors of ST by simultaneously incorporating host and environmental information. Methods: ST cases were extracted from the 2013-2019 Korea National Health Insurance Service data at 250 municipal levels and by epidemiological weeks (International Classification of Diseases, Tenth Revision, Clinical Modification code: A75.3). Data on potential risk factors, including the maximum probability of rodent presence, area of dry field farming, forest coverage, woman farmer population, and financial independence, were obtained from publicly available sources. In particular, the maximum rodent presence probability was estimated using a maximum entropy model incorporating ecological and climate variables. Spatial autocorrelation was assessed using Global Moran I statistics with 999 Monte Carlo permutations. Spatial and temporal clusters were identified using Getis-Ord Gi* and hot and cold spot trend analyses. Bayesian hurdle models with a spatiotemporal interaction term, accounting for zero-inflated Poisson distribution, were used to identify associations between ST incidence and regional factors. Stratification analyses by gender and age group (0-39, 40-59, 60-79, and ≥80 years) were performed. Results: Between 2013 and 2019, 95,601 ST patients were reported. ST incidence had positive spatial autocorrelation (I=0.600; P=.01), with spatial expansion from southwestern to northeastern regions. Spatiotemporal models demonstrated better fit compared with spatial and temporal models, as indicated by lower Watanabe-Akaike information criterion (WAIC) values. Municipalities with higher rodent suitability (β coefficient=0.618; 95% credible interval [CrI] 0.425-0.812) and lower financial independence from central government (β coefficient=-0.304; 95% CrI -0.445 to -0.163) had higher likelihoods of increased ST incidence, even after adjusting for spatiotemporal autocorrelation. However, risk factors varied by age group: among individuals aged 40 years or older, ST incidence was positively associated with rodent suitability, while patients in the 0-39 years age group showed no association with rodent suitability (β coefficient=0.028; 95% CrI -0.072 to 0.126), and ST incidence was negatively associated with the women farmer population (β coefficient=-0.115; 95% Crl=-0.223 to -0.006). Conclusions: This is the first study to investigate ST in South Korea using a spatiotemporal framework grounded in a holistic One Health perspective. We elucidated the critical role of spatiotemporal dynamics in ST distribution, highlighting rodent suitability and economic independence as key drivers of disease distribution. Our findings lay the groundwork for evidence-based, region-specific intervention strategies and may inform targeted public health strategies in South Korea and other settings with similar ecological conditions.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".