是什么在推动一种流行病的传播？梅毒在北卡罗来纳州农村一条州际公路沿线的蔓延。
What's driving an epidemic? The spread of syphilis along an interstate highway in rural North Carolina.
作者信息
Cook R L, Royce R A, Thomas J C, Hanusa B H
机构信息
Department of Medicine, University of North Carolina at Chapel Hill, USA.
出版信息
Am J Public Health. 1999 Mar;89(3):369-73. doi: 10.2105/ajph.89.3.369.
OBJECTIVES
The purpose of this study was to determine whether county syphilis rates were increased along Interstate Highway 95 (I-95) in North Carolina during a recent epidemic.
METHODS
Ecological data on syphilis cases demographic data, highway data, and drug activity data were used to conduct a cross-sectional and longitudinal study of North Carolina countries from 1985 to 1994. Crude and adjusted incidence rate ratios (IRRs) were determined by means of standard and longitudinal Poisson regression models adjusted for sociodemographic factors and drug use.
RESULTS
Ten-year syphilis rates in I-95 counties greatly exceeded rates in non-I-95 counties (38 vs 16 cases per 100,000 persons) and remained higher after adjustment for race, age, sex, poverty, large cities, and drug activity (adjusted IRR = 2.05, 95% confidence interval [CI] = 1.84, 2.28). Syphilis rates were stable until 1989, when rates increased sharply in I-95 counties but remained stable in non-I-95 counties. Increased drug activity in I-95 counties preceded the rise in syphilis cases.
CONCLUSIONS
A better understanding of the relationship between high-ways and the spread of sexually transmitted diseases may guide future prevention interventions.
目的
本研究旨在确定在近期的梅毒流行期间，北卡罗来纳州沿95号州际公路（I-95）各县的梅毒发病率是否有所上升。
方法
利用梅毒病例的生态数据、人口统计学数据、公路数据和毒品活动数据，对1985年至1994年北卡罗来纳州各县进行横断面和纵向研究。通过针对社会人口学因素和毒品使用情况进行调整的标准和纵向泊松回归模型，确定粗发病率和调整发病率比值（IRRs）。
结果
I-95沿线各县的十年梅毒发病率大大超过非I-95沿线各县（每10万人中分别为38例和16例），在对种族、年龄、性别、贫困、大城市和毒品活动进行调整后仍较高（调整后的IRR = 2.05，95%置信区间[CI] = 1.84，2.28）。梅毒发病率在1989年之前保持稳定，之后I-95沿线各县发病率急剧上升，而非I-95沿线各县保持稳定。I-95沿线各县毒品活动增加先于梅毒病例数上升。
结论
更好地理解公路与性传播疾病传播之间的关系，可能会为未来的预防干预措施提供指导。
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