Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland ; University of Basel, Basel, Switzerland.
PLoS Negl Trop Dis. 2013 May 9;7(5):e2213. doi: 10.1371/journal.pntd.0002213. Print 2013.
Leishmaniasis is endemic in 98 countries with an estimated 350 million people at risk and approximately 2 million cases annually. Brazil is one of the most severely affected countries.
We applied Bayesian geostatistical negative binomial models to analyze reported incidence data of cutaneous and visceral leishmaniasis in Brazil covering a 10-year period (2001-2010). Particular emphasis was placed on spatial and temporal patterns. The models were fitted using integrated nested Laplace approximations to perform fast approximate Bayesian inference. Bayesian variable selection was employed to determine the most important climatic, environmental, and socioeconomic predictors of cutaneous and visceral leishmaniasis.
For both types of leishmaniasis, precipitation and socioeconomic proxies were identified as important risk factors. The predicted number of cases in 2010 were 30,189 (standard deviation [SD]: 7,676) for cutaneous leishmaniasis and 4,889 (SD: 288) for visceral leishmaniasis. Our risk maps predicted the highest numbers of infected people in the states of Minas Gerais and Pará for visceral and cutaneous leishmaniasis, respectively.
CONCLUSIONS/SIGNIFICANCE: Our spatially explicit, high-resolution incidence maps identified priority areas where leishmaniasis control efforts should be targeted with the ultimate goal to reduce disease incidence.
利什曼病流行于 98 个国家，估计有 3.5 亿人面临风险，每年约有 200 万例病例。巴西是受影响最严重的国家之一。
我们应用贝叶斯地理统计负二项式模型分析了巴西 10 年来（2001-2010 年）皮肤和内脏利什曼病的报告发病率数据。特别强调了时空模式。该模型使用集成嵌套拉普拉斯近似法进行快速近似贝叶斯推断。采用贝叶斯变量选择来确定皮肤和内脏利什曼病最重要的气候、环境和社会经济预测因子。
对于两种类型的利什曼病，降水和社会经济指标被确定为重要的风险因素。预测 2010 年皮肤利什曼病的病例数为 30189 例（标准差[SD]：7676），内脏利什曼病为 4889 例（SD：288）。我们的风险图预测，内脏和皮肤利什曼病的感染人数最多的州分别是米纳斯吉拉斯州和帕拉州。
结论/意义：我们的空间显式、高分辨率发病率图确定了需要将利什曼病控制工作集中的重点地区，最终目标是降低疾病发病率。
