Moreno Eduardo Stramandinoli, Barata Rita de Cássia Barradas
Faculty of Medical Sciences, Santa Casa of São Paulo, São Paulo, SP, Brazil.
Rev Inst Med Trop Sao Paulo. 2011 Nov-Dec;53(6):335-9. doi: 10.1590/s0036-46652011000600007.
Until 1999 the endemic cases of Sylvatic Yellow Fever were located in the states of northern, midwestern and pre-Amazon regions. Since then, the disease progressively expanded its territory of occurrence, cases being registered beyond the traditional boundaries of endemism. The São Paulo State is considered to be part of this context, since after decades without registration of autochthonous cases of the disease, it reported, in 2000 and 2008-2009, epizootic occurrence in non-human primates and 30 cases in humans. Facts like these, added to the increase in incidences of serious adverse effects resulting from the Yellow Fever vaccination, have highlighted the importance of defining priority municipalities for vaccination against the disease in the state. Two groups of municipalities, some affected and some non-affected by YF, were compared for environmental variables related to the eco-epidemiology of the disease according to literature. The Multiple Correspondence Analysis (MCA) was used to pinpoint the factor able to differentiate the two groups of municipalities and define the levels of risk. The southeast region of the São Paulo State was considered to be the area with a higher number of municipalities classified as high risk and should be considered a priority for the application of prevention measures against Yellow Fever.
直到1999年，丛林型黄热病的地方性病例分布在北部、中西部和亚马逊河上游地区的各州。从那时起，该疾病逐渐扩大其发病区域，在传统的地方性边界之外也有病例记录。圣保罗州被认为处于这种情况之中，因为在几十年没有报告该疾病的本土病例之后，它在2000年以及2008 - 2009年报告了非人类灵长类动物的 epizootic 疫情以及30例人类病例。诸如此类的情况，再加上黄热病疫苗接种导致的严重不良反应发生率增加，凸显了确定该州黄热病疫苗接种优先城市 的重要性。根据文献，对两组城市进行了比较，一组受黄热病影响，一组未受影响，比较与该疾病生态流行病学相关的环境变量。使用多重对应分析（MCA）来找出能够区分两组城市的因素并确定风险水平。圣保罗州的东南部地区被认为是被列为高风险的城市数量较多的地区，应被视为黄热病预防措施应用的重点地区。
