Mapping the global risk of chikungunya virus endemicity and autochthonous transmission following importation.

BACKGROUND

Chikungunya virus, emerging as an increasingly significant global health threat, poses significant uncertainty regarding the global risk of its endemicity and autochthonous transmission following importation.

METHODS

In this study, we established a multi-source database spanning 70 years (1953-2023), synthesizing 4515 geolocated records of human, vector, and animal infections alongside clinical metadata. Three machine learning algorithms were utilized to analyze the ecological factors associated with CHIKV occurrences in regions characterized by endemic or autochthonous transmission following importation. Subsequently, the respective risk distributions of CHIKV occurrences were projected and used the SHAP method to rank feature importance and interpret model predictions.

RESULTS

Machine learning frameworks that stratifying endemic zones and importation-transmission prone regions have revealed consistent ecological drivers, albeit with significantly discrepant rankings of feature importance. The habitat suitability indices of Aedes aegypti and Aedes albopictus, as indicated by the Shapley values analysis, were identified as the most significant contributing factors for endemic occurrence and autochthonous transmission following importation, respectively. Population density, human footprint index, precipitation, thermal conditions, and the habitat suitability indices of other mosquito vectors also play crucial roles in the transmission within the two regions. Notably, temperate regions with established Ae. albopictus populations, including southern United States, most parts of Western Europe, East Asia, West Asia and Australia, emerged as high-risk hotspots for autochthonous transmission following importation.

CONCLUSIONS

This study assesses the potential risks of endemic occurrence and post-import autochthonous transmission of CHIKV, respectively. The frameworks provide insights for informing vaccine deployment strategies and mitigating globalization-driven arboviral threats.