Conflict and human African trypanosomiasis
Conflict and human African trypanosomiasis
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DOI：
10.1016/j.socscimed.2010.06.006
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发表时间：
2011-02-01
影响因子：
5.4
通讯作者：
Breau, Sebastien
中科院分区：
文献类型：
--
作者：
Berrang-Ford, Lea;Lundine, Jamie;Breau, Sebastien
非洲人类锥虫病 (HAT) 在撒哈拉以南非洲重新出现，成为一种对公共卫生具有重要意义的疾病。撒哈拉以南非洲消除 HAT 的成功取决于受影响国家控制、消除或减轻发病率决定因素的可行性。冲突已被广泛认为是许多国家 HAT 死灰复燃以及政治不稳定和资源匮乏地区 HAT 持续发生的一个促成因素。尽管对冲突的作用有广泛的轶事和定性认识，但在受影响的非洲国家的人口层面上尚未对这一主题进行定量研究。我们描述了过去 30 年来受 HAT 影响的非洲国家 HAT 发生率与冲突相关进程之间的定性和定量关联。收集了 1976 年至 2004 年撒哈拉以南非洲 35 个受影响国家的 HAT 和冲突相关数据。描述性统计和单变量推论统计以及负二项式回归模型用于评估 HAT 与冲突之间的关联。时空扫描统计数据用于识别重要的发病簇。过去 30 年 HAT 的集中发生主要发生在冲突或社会政治不稳定时期。 HAT 案件在发生冲突、高度政治恐怖和国际内战的国家和年份中发生的频率明显更高。结果表明，冲突事件的开始和发生率高峰之间有大约 10 年的滞后期。我们建议在基于 GIS（地理信息系统）的 HAT 政策和干预风险评估中明确考虑和量化社会政治措施，例如冲突和恐怖指数。 (C) 2010 Elsevier Ltd. 保留所有权利。
Human African Trypanosomiasis (HAT) has reemerged in sub-Saharan Africa as a disease of major public health importance. The success of HAT elimination in sub-Saharan Africa is subject to the feasibility of controlling, eliminating, or mitigating the determinants of incidence in affected countries. Conflict has been widely recognized and cited as a contributing factor to the resurgence of HAT in many countries, as well as to continuing HAT incidence in politically unstable and resource-poor regions. Despite extensive anecdotal and qualitative recognition of the role of conflict, there has been no quantitative research of this topic at the population level in affected African countries. We characterize the qualitative and quantitative associations between HAT incidence and conflict-related processes in HAT-affected African countries over the past 30 years. HAT and conflict-related data were collected for 35 affected countries in sub-Saharan Africa for the years 1976-2004. Descriptive and univariate inferential statistics, as well as negative binomial regression modeling, are used to assess the associations between HAT and conflict. A space-time scan statistic is used to identify significant incidence clusters. Clusters of HAT incidence over the past 30 years have predominantly coincided with periods of conflict or socio-political instability. HAT cases occurred significantly more often in countries and during years with conflict, high political terror, and internationalized civil war. The results indicate a lag period between the start of conflict events and a peak in incidence of approximately 10 years. We recommend explicit consideration and quantification of socio-political measures such as conflict and terror indices in GIS (Geographic Information Systems)based risk assessments for HAT policy and intervention. (C) 2010 Elsevier Ltd. All rights reserved.