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2008 - 2011年基尼系数衡量的社会经济不平等对哥伦比亚结核分枝杆菌和流感嗜血杆菌引起的脑膜炎发病率的影响

Influence of socio-economic inequality measured by the Gini coefficient on meningitis incidence caused by Mycobacterium tuberculosis and Haemophilus influenzae in Colombia, 2008-2011.

作者信息

Acevedo-Mendoza Wilmer F, Buitrago Gómez Diana Paola, Atehortua-Otero Miguel Ángel, Páez Miguel Ángel, Jiménez-Rincón Manuela, Lagos-Grisales Guillermo J, Rodríguez-Morales Alfonso J

机构信息

Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira (UTP), Pereira, Risaralda, Colombia.

Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira (UTP), Pereira, Risaralda, Colombia; Organización Latinoamericana para el Fomento de la Investigación en Salud (OLFIS), Riohacha, La Guajira, Colombia.

出版信息

Infez Med. 2017 Mar 1;25(1):8-12.

Abstract

Bacterial meningitis is an important cause of infectious neurological morbidity and mortality. Its incidence has decreased with the introduction of vaccination programmes against preventable agents. However, low-income and middle-income countries with poor access to health care still have a significant burden of the disease. Thus, the relationship between the Gini coefficient and H. influenzae and M. tuberculosis meningitis incidence in Colombia, during 2008-2011, was assessed. In this ecological study, the Gini coefficient was obtained from the Colombian Department of Statistics, incidence rates were calculated (cases/1,000,000 pop) and linear regressions were performed using the Gini coefficient, to assess the relationship between the latter and the incidence of meningitis. It was observed that when inequality increases in the Colombian departments, the incidence of meningitis also increases, with a significant association in the models (p<0.01) for both M. tuberculosis (r²=0.2382; p<0.001) and H. influenzae (r²=0.2509; p<0.001). This research suggests that high Gini coefficient values influence the incidence of Mycobacterium tuberculosis and Haemophilus influenzae meningitis, showing that social inequality is critical to disease occurrence. Early detection, supervised treatment, vaccination coverage, access to health care are efficient control strategies.

摘要

细菌性脑膜炎是传染性神经疾病发病和死亡的重要原因。随着针对可预防病原体的疫苗接种计划的推行,其发病率有所下降。然而,在医疗保健服务可及性差的低收入和中等收入国家,该疾病的负担仍然很重。因此,评估了2008 - 2011年期间哥伦比亚的基尼系数与流感嗜血杆菌和结核分枝杆菌脑膜炎发病率之间的关系。在这项生态学研究中,基尼系数取自哥伦比亚统计局,计算发病率(病例数/100万人口),并使用基尼系数进行线性回归,以评估其与脑膜炎发病率之间的关系。研究发现,当哥伦比亚各部门的不平等加剧时,脑膜炎发病率也会上升,在结核分枝杆菌(r² = 0.2382;p < 0.001)和流感嗜血杆菌(r² = 0.2509;p < 0.001)的模型中均存在显著关联。该研究表明,高基尼系数值会影响结核分枝杆菌和流感嗜血杆菌脑膜炎的发病率,表明社会不平等对疾病发生至关重要。早期检测、监督治疗、疫苗接种覆盖率、医疗保健服务可及性是有效的控制策略。

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