Space-time risk cluster of visceral leishmaniasis in Brazilian endemic region with high social vulnerability: An ecological time series study.
Space-time risk cluster of visceral leishmaniasis in Brazilian endemic region with high social vulnerability: An ecological time series study.
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DOI：
10.1371/journal.pntd.0009006
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发表时间：
2021-01
影响因子：
3.8
通讯作者：
de Moura TR
中科院分区：
文献类型：
--
作者：
Ribeiro CJN;Dos Santos AD;Lima SVMA;da Silva ER;Ribeiro BVS;Duque AM;Peixoto MVS;Dos Santos PL;de Oliveira IM;Lipscomb MW;de Araújo KCGM;de Moura TR
尽管内脏利什曼病（VL）在巴西大部分地区流行，但东北地区是该国发病率和死亡率最高的地区。分析VL病例的时空动态，以确定VL传播的时间趋势和高风险地区，以及巴西东北部疾病与社会脆弱性的关联。我们使用空间分析技术进行了一项生态时间序列研究，使用了2000年至2017年巴西东北部1，794个城市的所有VL确诊病例。社会脆弱性指数（SVI）被用来表示社会脆弱性。采用局部经验贝叶斯方法对发病率进行标准化和平滑处理。通过分段线性回归检查时间趋势。时空分析包括单变量和双变量全局和局部Moran指数和时空扫描统计。发病率保持稳定，在每10万居民4.84至3.52例之间。男性（62.71%）、儿童和青少年（63.27%）、非白人（69.75%）和城市居民（62.58%）的患病率较高。在成年男性受试者（≥ 40岁）和城市居民中观察到新发病例增加趋势。重要的是，VL发生率表现出直接的空间依赖性。在塞尔唐次区域和中北次区域确定了空间和时空集群，与社会脆弱性高的地区重叠。VL是巴西东北部一个持续存在的健康问题，与社会脆弱性有关。VL病例在社会弱势城市的时空聚集要求制定部门间监测和控制公共政策，重点是减少不平等和改善区域居民的生活条件。内脏利什曼病（VL）仍然是一个世界性的健康问题，不断增加的死亡率被观察到。巴西的流行病学情况是VL传播扩大，特别是在东北地区。在本研究中，我们分析了VL的情况下，其与巴西东北部的社会脆弱性的时空动态。简而言之，分析了2000年至2017年期间所有VL确诊病例的数据以及巴西东北部1，794个城市的社会脆弱性指数（SVI）。结果显示，VL继续不均匀地传播，在社会最脆弱的地区存在时空高风险集群。我们观察到40岁以上男性受试者和城市居民新发病例呈增加趋势。我们的研究代表了第一次调查，表明VL和社会脆弱性之间的关联在巴西东北部地区。这些研究结果有助于通过更好地了解疾病分布，有效地优先考虑具有较高脆弱性的城市，来预防、监测和控制VL。因此，减少社会不平等和改善生活条件应成为与VL控制有关的公共卫生政策规划的一部分。
Despite visceral leishmaniasis (VL) being epidemic in most Brazilian regions, the Northeast region is responsible for the highest morbidity and mortality outcomes within the country. To analyse the spatiotemporal dynamics of VL cases to identify the temporal trends and high-risk areas for VL transmission, as well as the association of the disease with social vulnerability in Brazilian Northeast. We carried out an ecological time series study employing spatial analysis techniques using all VL confirmed cases of 1,794 municipalities of Brazilian Northeast between the years 2000 to 2017. The Social Vulnerability Index (SVI) was used to represent the social vulnerability. Incidence rates were standardized and smoothed by the Local Empirical Bayesian Method. Time trends were examined through segmented linear regression. Spatiotemporal analysis consisted of uni- and bivariate Global and Local Moran indexes and space-time scan statistics. Incidence rate remained stable and ranged from 4.84 to 3.52 cases/100,000 inhabitants. There was higher case prevalence between males (62.71%), children and adolescents (63.27%), non-white (69.75%) and urban residents (62.58%). Increasing trends of new cases were observed among adult male subjects (≥ 40 years old) and urban residents. Importantly, VL incidence showed a direct spatial dependence. Spatial and space-time clusters were identified in sertão and meio-norte sub-regions, overlapping with high social vulnerability areas. VL is a persistent health issue in Brazilian Northeast and associated with social vulnerability. Space-time clustering of VL cases in socially vulnerable municipalities demands intersectoral public policies of surveillance and control, with focus on reducing inequalities and improving living conditions for regional inhabitants. Visceral leishmaniasis (VL) remains a worldwide health issue, with increasing rates of mortality being observed. Brazil has an epidemiological scenario of expanding VL transmission, especially in the Northeast region. In the present study, we analysed spatiotemporal dynamics of VL cases and its association with social vulnerability in Brazilian Northeast. Briefly, data was analysed of all VL confirmed cases during the years of 2000 to 2017 and the Social Vulnerability Index (SVI) from 1,794 municipalities of Brazilian Northeast. Results revealed that VL continues to spread heterogeneously, with space-time high-risk clusters in the most socially vulnerable areas. We observed increasing trends of new cases among male subjects ≥ 40 years of age and urban residents. Our study represents the first investigation that demonstrates associations between VL and social vulnerability in the Northeast region of Brazil. These findings could contribute to VL prevention, surveillance, and control through better understanding of disease distribution, affording effective prioritization of municipalities with higher vulnerability. Thus, reduction of social inequality and better living conditions should be part of the planning of public health policies related to VL control.
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影响因子：
1.7
作者：
Campos, Roseane;Santos, Marcio;de Almeida, Roque Pacheco
通讯作者：
de Almeida, Roque Pacheco
DOI：
10.1111/jdv.15596
发表时间：
2019-08-01
影响因子：
9.2
作者：
de Souza, C. D. F.;Rocha, V. S.;Santos, V. S.
通讯作者：
Santos, V. S.
影响因子：
3.3
作者：
Boelaert, M.;Meheus, F.;Sundar, S.
通讯作者：
Sundar, S.
DOI：
10.1093/trstmh/try058
发表时间：
2018-07-01
影响因子：
2.2
作者：
de Freitas Rocha, Anarya Teresa;de Espindola, Giovana Mira;Nery Costa, Carlos Henrique
通讯作者：
Nery Costa, Carlos Henrique
影响因子：
3.6
作者：
ANSELIN, L
通讯作者：
ANSELIN, L