Erazo Carlos, Pereira Susan M, Costa Maria da Conceição N, Evangelista-Filho Delsuc, Braga José Ueleres, Barreto Mauricio L
Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Bahia, Brazil,
Departamento de Epidemiologia e Métodos Quantitativos em Saúde, Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.
Rev Panam Salud Publica. 2014 Jul;36(1):24-30.
To investigate spatial tuberculosis (TB) distribution patterns and the association between living conditions and incidence of the disease in Salvador, Bahia, Brazil.
An ecological study with neighborhood as the unit of analysis. Data was collected from the Notifiable Diseases Information System (Sistema de Informação de Agravos de Notificação, SINAN) and the Brazilian Institute of Geography and Statistics (Instituto Brasileiro de Geografia e Estatística, IBGE). Rates of TB incidence were transformed and smoothed. Spatial analysis was applied to identify spatial auto-correlation and "hotspot" areas of high and low risk. The relationship between TB and living conditions was confirmed by spatial linear regression.
The incidence of TB in Salvador displayed heterogeneous patterns, with higher rates occurring in neighborhoods with poor living conditions in 1995 - 1996. Over the study period, disease occurrence declined, particularly in less-privileged strata. In 2004 - 2005, the association between living conditions and TB was no longer observed.
The heterogeneous spatial distribution of TB in Salvador previously reflected inequalities related to living conditions. Improvements in such conditions and health care for the less privileged may have contributed to observed changes.
调查巴西巴伊亚州萨尔瓦多市肺结核（TB）的空间分布模式以及生活条件与该病发病率之间的关联。
一项以社区为分析单位的生态学研究。数据收集自法定传染病信息系统（Sistema de Informação de Agravos de Notificação，SINAN）和巴西地理与统计研究所（Instituto Brasileiro de Geografia e Estatística，IBGE）。对肺结核发病率进行转换和平滑处理。应用空间分析来识别空间自相关性以及高风险和低风险的“热点”区域。通过空间线性回归确定肺结核与生活条件之间的关系。
萨尔瓦多市的肺结核发病率呈现出异质性模式，在1995 - 1996年，生活条件较差的社区发病率较高。在研究期间，发病率下降，尤其是在贫困阶层中。在2004 - 2005年，未再观察到生活条件与肺结核之间的关联。
萨尔瓦多市肺结核的异质性空间分布先前反映了与生活条件相关的不平等现象。生活条件的改善以及为贫困人群提供的医疗保健可能促成了所观察到的变化。
