摘要：Background Discoveries that emerging and re-emerging pathogens have their origin in environmental change has created an urgent need to understand how these environmental changes impact disease burden. In this article we present a framework that provides a context from which to examine the relationship between environmental changes and disease transmission and a structure from which to unite disparate pieces of information from a variety of disciplines. Methods The framework integrates three interrelated characteristics of environment–disease relationships: a ) Environmental change manifests in a complex web of ecologic and social factors that may ultimately impact disease; these factors are represented as those more distally related and those more proximally related to disease. b ) Transmission dynamics of infectious pathogens mediate the effects that environmental changes have on disease. c ) Disease burden is the outcome of the interplay between environmental change and the transmission cycle of a pathogen. Results To put this framework into operation, we present a matrix formulation as a means to define important elements of this system and to summarize what is known and unknown about the these elements and their relationships. The framework explicitly expresses the problem at a systems level that goes beyond the traditional risk factor analysis used in public health, and the matrix provides a means to explicitly express the coupling of different system components. Conclusion This coupling of environmental and disease transmission processes provides a much-needed construct for furthering our understanding of both specific and general relationships between environmental change and infectious disease.
关键词：environmental change; infectious disease; interdisciplinary; system theory; transmission dynamics
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