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两种被忽视的热带感染病的故事：利用地理信息系统评估巴西米纳斯吉拉斯州某地区血吸虫病和麻风病的时空重叠情况

A tale of two neglected tropical infections: using GIS to assess the spatial and temporal overlap of schistosomiasis and leprosy in a region of Minas Gerais, Brazil.

作者信息

Phillips David Alexander, Ferreira José Antonio, Ansah Deidra, Teixeira Herica Sa, Kitron Uriel, Filippis Thelma de, Alcântara Marcelo H de, Fairley Jessica K

机构信息

Augusta University/University of Georgia Medical Partnership, Athens, GA, United States.

Escola de Medicina, Faculdade da Saúde e Ecologia Humana, Vespasiano, MG, Brasil.

出版信息

Mem Inst Oswaldo Cruz. 2017 Apr;112(4):275-280. doi: 10.1590/0074-02760160395.

DOI:10.1590/0074-02760160395
PMID:28327791
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5354614/
Abstract

BACKGROUND

Despite public health efforts to reduce the global burden of leprosy, gaps remain in the knowledge surrounding transmission of infection. Helminth co-infections have been associated with a shift towards the lepromatous end of the disease spectrum, potentially increasing transmission in co-endemic areas.

OBJECTIVES

Using this biologically plausible association, we conducted a geographic information systems (GIS) study to investigate the spatial associations of schistosomiasis and leprosy in an endemic area of Minas Gerais (MG), Brazil.

METHODS

Data on new cases of Mycobacterium leprae and Schistosoma mansoni infections from 2007-2014 were retrieved from the Brazilian national notifiable diseases information system for seven municipalities in and surrounding Vespasiano, MG. A total of 139 cases of leprosy and 200 cases of schistosomiasis were mapped to a municipality level. For one municipality, cases were mapped to a neighborhood level and a stratified analysis was conducted to identify spatial associations.

FINDINGS

A relative risk of 6.80 [95% confidence interval (CI) 1.46 - 31.64] of leprosy was found in neighborhoods with schistosomiasis. Incidence rates of leprosy increased with corresponding incidence rates of schistosomiasis, and the temporal trends of both infections were similar.

CONCLUSIONS

The associations found in this project support the hypothesis that helminth infections may influence the transmission of leprosy in co-endemic areas.

摘要

背景

尽管为减轻全球麻风负担做出了公共卫生努力，但在感染传播相关知识方面仍存在差距。蠕虫共感染与疾病谱向瘤型端的转变有关，这可能会增加共流行地区的传播。

目的

利用这种生物学上合理的关联，我们开展了一项地理信息系统（GIS）研究，以调查巴西米纳斯吉拉斯州（MG）一个流行地区血吸虫病和麻风病的空间关联。

方法

从巴西国家法定传染病信息系统中检索了2007 - 2014年米纳斯吉拉斯州维斯帕西亚诺市及其周边七个市的麻风分枝杆菌和曼氏血吸虫新感染病例数据。总共139例麻风病例和200例血吸虫病例被绘制到市一级地图上。对于一个市，病例被绘制到社区一级，并进行分层分析以确定空间关联。

研究结果

在有血吸虫病的社区中，发现麻风病的相对风险为6.80[95%置信区间（CI）1.46 - 31.64]。麻风病发病率随血吸虫病相应发病率的增加而增加，且两种感染的时间趋势相似。

结论

本项目中发现的关联支持蠕虫感染可能影响共流行地区麻风病传播这一假说。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02e0/5354614/e65539dbb94b/0074-0276-mioc-112-4-0275-gf05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02e0/5354614/91ed513f2a15/0074-0276-mioc-112-4-0275-gf01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02e0/5354614/b9cb2700b5a1/0074-0276-mioc-112-4-0275-gf02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02e0/5354614/0f7dbcf447f2/0074-0276-mioc-112-4-0275-gf03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02e0/5354614/8bce414de9e8/0074-0276-mioc-112-4-0275-gf04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02e0/5354614/e65539dbb94b/0074-0276-mioc-112-4-0275-gf05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02e0/5354614/91ed513f2a15/0074-0276-mioc-112-4-0275-gf01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02e0/5354614/b9cb2700b5a1/0074-0276-mioc-112-4-0275-gf02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02e0/5354614/0f7dbcf447f2/0074-0276-mioc-112-4-0275-gf03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02e0/5354614/8bce414de9e8/0074-0276-mioc-112-4-0275-gf04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02e0/5354614/e65539dbb94b/0074-0276-mioc-112-4-0275-gf05.jpg

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