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[用于识别登革热高发风险区域的时空风险模型]

[Temporal-spatial risk model to identify areas at high-risk for occurrence of dengue fever].

作者信息

Galli Bruno, Chiaravalloti Neto Francisco

机构信息

Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, SP, Brasil.

出版信息

Rev Saude Publica. 2008 Aug;42(4):656-63. doi: 10.1590/s0034-89102008005000032. Epub 2008 May 9.

Abstract

OBJECTIVE

To apply the temporal-spatial model to assess high-risk areas for the occurrence of dengue fever.

METHODS

A total of 11,989 confirmed, autochthonous dengue fever cases, geocoded by address in the city of São José do Rio Preto (Southeastern Brazil), between September of 2001 and August of 2006, were included in the study. Frequency, duration and intensity indices were used to assess the severity and magnitude of transmission. The local indicator of spatial association was adopted to identify significant spatial clusters (p-value<0.05). The values of the three indices were considered high in a spatial unit when their standard values were positive and the respective local indicator of spatial association values were significant.

RESULTS

Of all the geocoded dengue fever cases, 38.1% occurred in the urban spatial units, classified as highest-risk: 19.4% in 2001-2002, 13.9% in 2002-2003, 2.8% in 2003-2004, 16.7% in 2004-2005, and 21.3% in 2005-2006. The utilization of three risk measures enabled to identify higher-risk areas for the occurrence of dengue fever, concentrated in the city's northern region. Even though case notification data are subject to bias, this information is available in the health services and can lead to important conclusions, recommendations and hypotheses.

CONCLUSIONS

The non-complex, notification-based procedures adopted in the study could be routinely used by services that are responsible for dengue fever surveillance and control to identify high-risk areas.

摘要

目的

应用时空模型评估登革热发生的高危地区。

方法

本研究纳入了2001年9月至2006年8月间在巴西东南部里约普雷图市按地址进行地理编码的11989例确诊的本地登革热病例。采用频率、持续时间和强度指数来评估传播的严重程度和规模。采用空间关联局部指标来识别显著的空间聚集区(p值<0.05)。当三个指数的标准值为正且各自的空间关联局部指标值显著时,在一个空间单元中认为这三个指数的值较高。

结果

在所有地理编码的登革热病例中,38.1%发生在城市空间单元,被归类为最高风险:2001 - 2002年为19.4%,2002 - 2003年为13.9%,2003 - 2004年为2.8%,2004 - 2005年为16.7%,2005 - 2006年为21.3%。利用三种风险测量方法能够识别出登革热发生的高风险地区,这些地区集中在该市北部地区。尽管病例报告数据存在偏差,但这些信息在卫生服务机构中是可获取的,并且能够得出重要的结论、建议和假设。

结论

本研究采用的基于报告的非复杂程序可被负责登革热监测和控制的服务机构常规用于识别高风险地区。

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