Wijers Irene G M, Sánchez Gómez Amaya, Taveira Jiménez Jose Antonio
Sección de Epidemiología. Servicio de Salud Pública Área 7. Subdirección de Epidemiologia. Dirección General de Salud Pública. Comunidad de Madrid. España.
Servicio de Medicina Preventiva y Gestión de Calidad, Hospital General Universitario Gregorio Marañon. Madrid. España.
Rev Esp Salud Publica. 2017 Jun 21;91:e201706033.
Sexually transmitted diseases are a significant public health problem. Within the Madrid Autonomous Region, the districts with the highest syphilis and gonorrhea incidences are part of the same Public Health Service (Servicio de Salud Pública del Área 7, SSPA 7). The objective of this study was to identify, by spatial analysis, clusters of syphilis and gonorrhea infections in this SSPA in Madrid.
All confirmed syphilis and gonorrhea cases registered in SSPA 7 in Madrid were selected. Moran's I was calculated in order to identify the existence of spatial autocorrelation and a cluster analysis was performed. Clusters and cumulative incidences (CI) per health zone were mapped.
The district with most cases was Centro (CI: 67.5 and 160.7 per 100.000 inhabitants for syphilis and gonorrhea, respectively) with the highest CI (120.0 and 322.6 per 100.000 inhabitants) in the Justicia health zone.91.6% of all syphilis cases and 89.6% of gonorrhea cases were among men who have sex with men (MSM). Moran's I was 0.54 and 0.55 (p=0.001) for syphilis and gonorrhea, respectively. For syphilis, a cluster was identified including the six health zones of the Centro district, with a relative risk (RR)of 6.66 (p=0.001). For gonorrhea, a cluster was found including the Centro district, three health zones of the Chamberí district and one of Latina (RR 5.05; p=0.001).
Centro was the district with most cases of syphilis and gonorrhea and the most affected population were MSM. For both infections, clusters were found with an important overlap. By identifying the most vulnerable health zones and populations, these results can help to design public health measures for preventing sexually transmitted diseases.
性传播疾病是一个重大的公共卫生问题。在马德里自治区，梅毒和淋病发病率最高的地区属于同一个公共卫生服务机构（第7区公共卫生服务机构，SSPA 7）。本研究的目的是通过空间分析确定马德里该SSPA内梅毒和淋病感染的聚集区。
选取马德里SSPA 7登记的所有确诊梅毒和淋病病例。计算莫兰指数以确定空间自相关的存在，并进行聚类分析。绘制每个卫生区的聚集区和累积发病率（CI）图。
病例最多的区是中心区（梅毒和淋病的CI分别为每10万居民67.5例和160.7例），在司法卫生区CI最高（每10万居民120.0例和322.6例）。所有梅毒病例的91.6%和淋病病例的89.6%发生在男男性行为者（MSM）中。梅毒和淋病的莫兰指数分别为0.54和0.55（p = 0.001）。对于梅毒，确定了一个聚集区，包括中心区的六个卫生区，相对风险（RR）为6.66（p = 0.001）。对于淋病，发现一个聚集区，包括中心区、尚贝里区的三个卫生区和拉蒂纳区的一个卫生区（RR 5.05；p = 0.001）。
中心区是梅毒和淋病病例最多的区，受影响最大的人群是男男性行为者。对于这两种感染，都发现了有重要重叠的聚集区。通过确定最脆弱的卫生区和人群，这些结果有助于设计预防性传播疾病的公共卫生措施。
