Biology Department, Universidad Icesi, Cali, Valle del Cauca, Colombia.
Am J Trop Med Hyg. 2010 Feb;82(2):243-50. doi: 10.4269/ajtmh.2010.09-0218.
Environmental risk factors for cutaneous leishmaniasis were investigated for the largest outbreak recorded in Colombia. The outbreak began in 2003 in Chaparral, and in the following five years produced 2,313 cases in a population of 56,228. Candidate predictor variables were land use, elevation, and climatic variables such as mean temperature and precipitation. Spatial analysis showed that incidence of cutaneous leishmaniasis was higher in townships with mean temperatures in the middle of the county's range. Incidence was independently associated with higher coverage with forest or shrubs (2.6% greater for each additional percent coverage, 95% credible interval [CI] = 0.5-4.9%), and lower population density (22% lower for each additional 100 persons/km(2), 95% CI = 7-41%). The extent of forest or shrub coverage did not show major changes over time. These findings confirmed the roles of climate and land use in leishmaniasis transmission. However, environmental variables were not sufficient to explain the spatial variation in incidence.
对哥伦比亚有记录以来最大的皮肤利什曼病爆发进行了环境风险因素调查。此次爆发始于 2003 年的沙帕拉尔，在接下来的五年里，在 56228 人的人群中产生了 2313 例病例。候选预测变量包括土地利用、海拔和气候变量，如平均温度和降水。空间分析表明，皮肤利什曼病的发病率在县内平均温度处于中间的乡镇较高。发病率与森林或灌木的覆盖率增加独立相关（每增加 1%的覆盖率，95%可信区间[CI]为 0.5-4.9%），与人口密度降低相关（每增加 100 人/平方公里，95%CI 为 7-41%）。森林或灌木覆盖率的范围在一段时间内没有发生重大变化。这些发现证实了气候和土地利用在利什曼病传播中的作用。然而，环境变量不足以解释发病率的空间变化。
