Santa Casa of São Paulo School of Medical Sciences, São Paulo, Brazil.
PLoS Negl Trop Dis. 2012;6(7):e1658. doi: 10.1371/journal.pntd.0001658. Epub 2012 Jul 3.
Yellow fever (YF) is endemic in much of Brazil, where cases of the disease are reported every year. Since 2008, outbreaks of the disease have occurred in regions of the country where no reports had been registered for decades, which has obligated public health authorities to redefine risk areas for the disease. The aim of the present study was to propose a methodology of environmental risk analysis for defining priority municipalities for YF vaccination, using as example, the State of São Paulo, Brazil. The municipalities were divided into two groups (affected and unaffected by YF) and compared based on environmental parameters related to the disease's eco-epidemiology. Bivariate analysis was used to identify statistically significant associations between the variables and virus circulation. Multiple correspondence analysis (MCA) was used to evaluate the relationship among the variables and their contribution to the dynamics of YF in Sao Paulo. The MCA generated a factor that was able to differentiate between affected and unaffected municipalities and was used to determine risk levels. This methodology can be replicated in other regions, standardized, and adapted to each context.
黄热病（YF）在巴西大部分地区流行，每年都有该病病例报告。自 2008 年以来，该病在巴西数十年未报告病例的地区爆发，这迫使公共卫生当局重新定义该病的风险地区。本研究的目的是提出一种环境风险分析方法，以确定优先进行黄热病疫苗接种的市，以巴西圣保罗州为例。这些市分为两组（受黄热病影响和不受黄热病影响），并根据与该病生态流行病学相关的环境参数进行比较。使用双变量分析来确定变量与病毒传播之间的统计学显著关联。使用多元对应分析（MCA）来评估变量之间的关系及其对圣保罗黄热病动态的贡献。MCA 生成了一个能够区分受影响和未受影响的市的因子，并用于确定风险水平。这种方法可以在其他地区复制、标准化并适应每个环境。
