Mapping the transmission risk of Zika virus using machine learning models.

Zika virus, which has been linked to severe congenital abnormalities, is exacerbating global public health problems with its rapid transnational expansion fueled by increased global travel and trade. Suitability mapping of the transmission risk of Zika virus is essential for drafting public health plans and disease control strategies, which are especially important in areas where medical resources are relatively scarce. Predicting the risk of Zika virus outbreak has been studied in recent years, but the published literature rarely includes multiple model comparisons or predictive uncertainty analysis. Here, three relatively popular machine learning models including backward propagation neural network (BPNN), gradient boosting machine (GBM) and random forest (RF) were adopted to map the probability of Zika epidemic outbreak at the global level, pairing high-dimensional multidisciplinary covariate layers with comprehensive location data on recorded Zika virus infection in humans. The results show that the predicted high-risk areas for Zika transmission are concentrated in four regions: Southeastern North America, Eastern South America, Central Africa and Eastern Asia. To evaluate the performance of machine learning models, the 50 modeling processes were conducted based on a training dataset. The BPNN model obtained the highest predictive accuracy with a 10-fold cross-validation area under the curve (AUC) of 0.966 [95% confidence interval (CI) 0.965-0.967], followed by the GBM model (10-fold cross-validation AUC = 0.964[0.963-0.965]) and the RF model (10-fold cross-validation AUC = 0.963[0.962-0.964]). Based on training samples, compared with the BPNN-based model, we find that significant differences (p = 0.0258* and p = 0.0001***, respectively) are observed for prediction accuracies achieved by the GBM and RF models. Importantly, the prediction uncertainty introduced by the selection of absence data was quantified and could provide more accurate fundamental and scientific information for further study on disease transmission prediction and risk assessment.