Estimating leptospirosis incidence using hospital-based surveillance and a population-based health care utilization survey in Tanzania.
Estimating leptospirosis incidence using hospital-based surveillance and a population-based health care utilization survey in Tanzania.
复制标题
使用基于医院的监测和坦桑尼亚的基于人群的医疗保健利用调查来估计钩端螺旋体病的发病率。
DOI：
10.1371/journal.pntd.0002589
复制
发表时间：
2013
影响因子：
3.8
通讯作者：
Crump JA
中科院分区：
文献类型：
--
作者：
Biggs HM;Hertz JT;Munishi OM;Galloway RL;Marks F;Saganda W;Maro VP;Crump JA
钩端螺旋体病是一种被忽视的人畜共患病，在坦桑尼亚和撒哈拉以南非洲大部分地区的发病率尚不确定，因此缺乏数据来优先考虑用于公共卫生干预和疾病控制的资源。在这项研究中，我们估计了坦桑尼亚乞力马扎罗地区两个地区的钩端螺旋体病的发病率。我们在坦桑尼亚乞力马扎罗地区的两个地区进行了以人口为基础的家庭卫生保健利用调查，并在乞力马扎罗地区的两个医院发热哨点监测点发现了钩端螺旋体病病例。我们使用来自卫生保健利用调查的乘数和来自医院监测的病例数来计算钩端螺旋体病的发病率。共有810户家庭参加了卫生保健利用情况调查，并根据对发烧情况下寻求卫生保健问题的回答得出了乘数。在居住在这两个地区的一年发烧监测中登记的患者中，588人中有42人(7.14%)符合确诊或可能的钩端螺旋体病的病例定义。在应用乘数来考虑医院选择、检测敏感性和研究登记后，我们估计每年钩端螺旋体病的总发病率为每10万人75-102例。我们计算了坦桑尼亚乞力马扎罗地区两个地区的钩端螺旋体病高发病率，那里的钩端螺旋体病发病率以前是未知的。乘数方法，如本研究中使用的，可能是一种可行的方法，在资源有限的情况下，提高对被忽视的疾病，如钩端螺旋体病的发病率估计的可用性。钩端螺旋体病是一种在世界各地发生的人畜共患传染病，由螺旋体钩端螺旋体引起。在包括坦桑尼亚在内的撒哈拉以南非洲大部分地区，钩端螺旋体病的发病率尚不清楚。发病率估计在确定疾病预防和控制资源的优先顺序方面很重要。在这项研究中，我们使用乘数法计算了坦桑尼亚乞力马扎罗地区两个地区的钩端螺旋体病发病率。我们使用了一项基于人群的调查的答复，该调查询问参与者及其家庭成员在发烧时将在哪里寻求医疗保健，以及在监测中的两家医院发现的钩端螺旋体病病例数量，以计算估计发病率。我们计算了研究区域以前未被发现的钩端螺旋体病的高发病率。这对优先开展坦桑尼亚钩端螺旋体病公共卫生控制措施的进一步研究和审议具有重要意义。
The incidence of leptospirosis, a neglected zoonotic disease, is uncertain in Tanzania and much of sub-Saharan Africa, resulting in scarce data on which to prioritize resources for public health interventions and disease control. In this study, we estimate the incidence of leptospirosis in two districts in the Kilimanjaro Region of Tanzania. We conducted a population-based household health care utilization survey in two districts in the Kilimanjaro Region of Tanzania and identified leptospirosis cases at two hospital-based fever sentinel surveillance sites in the Kilimanjaro Region. We used multipliers derived from the health care utilization survey and case numbers from hospital-based surveillance to calculate the incidence of leptospirosis. A total of 810 households were enrolled in the health care utilization survey and multipliers were derived based on responses to questions about health care seeking in the event of febrile illness. Of patients enrolled in fever surveillance over a 1 year period and residing in the 2 districts, 42 (7.14%) of 588 met the case definition for confirmed or probable leptospirosis. After applying multipliers to account for hospital selection, test sensitivity, and study enrollment, we estimated the overall incidence of leptospirosis ranges from 75–102 cases per 100,000 persons annually. We calculated a high incidence of leptospirosis in two districts in the Kilimanjaro Region of Tanzania, where leptospirosis incidence was previously unknown. Multiplier methods, such as used in this study, may be a feasible method of improving availability of incidence estimates for neglected diseases, such as leptospirosis, in resource constrained settings. Leptospirosis is a zoonotic infection that occurs worldwide and is caused by a spirochete, Leptospira spp. The incidence of leptospirosis is unknown in most of sub-Saharan Africa, including Tanzania. Incidence estimates are important in prioritizing resources for disease prevention and control. In this study, we calculated leptospirosis incidence in 2 districts in the Kilimanjaro Region of Tanzania using a multiplier method. We used responses from a population-based survey that asked where participants and their household members would seek health care in the event of fever along with the number of leptospirosis cases found at 2 hospitals under surveillance to calculate estimated incidence. We calculated a high incidence of leptospirosis in the study area that was previously unrecognized. This has important implications for prioritizing further research and consideration of public health control measures for leptospirosis in Tanzania.
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DOI：
10.4269/ajtmh.2006.74.114
发表时间：
2006-01-01
影响因子：
3.3
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