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使用核密度估计方法调查巴西东北部的淋巴丝虫病。

Using kernel density estimates to investigate lymphatic filariasis in northeast Brazil.

机构信息

Oswaldo Cruz Foundation - FIOCRUZ, Rio de Janeiro, Brazil.

出版信息

Pathog Glob Health. 2012 May;106(2):113-7. doi: 10.1179/2047773212Y.0000000008.

Abstract

After more than 10 years of the Global Program to Eliminate Lymphatic Filariasis (GPELF) in Brazil, advances have been seen, but the endemic disease persists as a public health problem. The aim of this study was to describe the spatial distribution of lymphatic filariasis in the municipality of Jaboatão dos Guararapes, Pernambuco, Brazil. An epidemiological survey was conducted in the municipality, and positive filariasis cases identified in this survey were georeferenced in point form, using the GPS. A kernel intensity estimator was applied to identify clusters with greater intensity of cases. We examined 23 673 individuals and 323 individuals with microfilaremia were identified, representing a mean prevalence rate of 1·4%. Around 88% of the districts surveyed presented cases of filarial infection, with prevalences of 0-5·6%. The male population was more affected by the infection, with 63·8% of the cases (P<0·005). Positive cases were found in all age groups examined. The kernel intensity estimator identified the areas of greatest intensity and least intensity of filarial infection cases. The case distribution was heterogeneous across the municipality. The kernel estimator identified spatial clusters of cases, thus indicating locations with greater intensity of transmission. The main advantage of this type of analysis lies in its ability to rapidly and easily show areas with the highest concentration of cases, thereby contributing towards planning, monitoring, and surveillance of filariasis elimination actions. Incorporation of geoprocessing and spatial analysis techniques constitutes an important tool for use within the GPELF.

摘要

在巴西开展全球消灭淋巴丝虫病计划(GPELF)超过 10 年后,该病取得了显著进展,但作为一个公共卫生问题,该病仍在流行。本研究旨在描述巴西若昂阿维亚若市淋巴丝虫病的空间分布情况。在该市开展了一项流行病学调查,对该调查中发现的阳性丝虫病病例进行点形式的地理定位,使用全球定位系统(GPS)。应用核密度估计器来确定病例密度较大的聚类。我们共检查了 23673 人,发现 323 人带有微丝蚴,平均患病率为 1.4%。约 88%的调查区存在丝虫感染病例,患病率为 0-5.6%。受感染的男性比例更高,占病例的 63.8%(P<0.005)。在所有检查的年龄组中都发现了阳性病例。核密度估计器确定了丝虫感染病例的高发区和低发区。病例分布在全市范围内不均匀。核密度估计器确定了病例的空间聚类,从而指示了传播强度较大的地区。这种分析类型的主要优势在于其能够快速且轻松地显示病例最集中的地区,从而有助于规划、监测和监测消灭丝虫病的行动。地理处理和空间分析技术的应用是 GPELF 的一个重要工具。

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