Szwarcwald C L, Bastos F I, Barcellos C, Esteves M A, Castilho E A
Departamento de Informações em Saúde, Centro de Informação Científica e Tecnológica, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, 21045-900, Brasil.
Cad Saude Publica. 2001 Sep-Oct;17(5):1123-40. doi: 10.1590/s0102-311x2001000500014.
This study uses a spatial-temporal model to analyze the spatial spread of the AIDS epidemic (adult cases) in the municipality of Rio de Janeiro, Brazil, during three periods: 1988-1990, 1991-1993, and 1994-1996. City districts were used as the geographic units of analysis. A spatial analysis was also performed for pediatric AIDS cases due to vertical HIV transmission, according to period of birth, 1985-90 and 1991-96. For total adult AIDS cases, the initial period was characterized by a polygonal cluster located around the harbor area, which expanded from west to east. Among homosexual cases, in situ growth predominated, and a decrease in the intensity of the diffusion process was observed from the second to the final period. Among heterosexual cases, the epidemic displayed a relevant geographic spread, mainly from 1988-1990 to 1991-1993. Among female cases in the final time period, a cluster of high incidence rates was found towards the northwest, including very poor areas. Among pediatric cases in 1991-1996, a significant correlation was found between AIDS incidence rates and poverty levels in the respective municipal districts. The results suggest that a more complete understanding of AIDS spatial-temporal dynamics can make a major contribution to preventive measures.
本研究使用时空模型分析了巴西里约热内卢市艾滋病疫情(成人病例)在三个时期的空间传播情况,这三个时期分别为:1988 - 1990年、1991 - 1993年和1994 - 1996年。分析的地理单位为城市各区。还根据出生时期(1985 - 1990年和1991 - 1996年)对因垂直传播感染艾滋病毒的儿童艾滋病病例进行了空间分析。对于成人艾滋病病例总数,初期的特点是在港口区域周围形成了一个多边形聚集区,并从西向东扩展。在同性恋病例中,原地增长占主导,且从第二个时期到最后一个时期观察到传播过程强度有所下降。在异性恋病例中,疫情呈现出显著的地理传播,主要发生在1988 - 1990年至1991 - 1993年期间。在最后一个时期的女性病例中,在西北部发现了一个高发病率聚集区,包括非常贫困的地区。在1991 - 1996年的儿童病例中,发现各市区的艾滋病发病率与贫困水平之间存在显著相关性。结果表明,更全面地了解艾滋病时空动态可为预防措施做出重大贡献。