Melo Helen Aline, Rossoni Diogo Francisco, Teodoro Ueslei
Postgraduate Program in Health Sciences, Universidade Estadual de Maringá, Maringá, PR, Brazil.
Department of Statistics, Universidade Estadual de Maringá, Maringá, Paraná, Brazil.
PLoS One. 2017 Sep 22;12(9):e0185401. doi: 10.1371/journal.pone.0185401. eCollection 2017.
The geographic distribution of cutaneous leishmaniasis (CL) makes it a disease of major clinical importance in Brazil, where it is endemic in the state of Paraná. The objective of this study was to analyze the spatial distribution of CL in Paraná between 2001 and 2015, based on data from the Sistema de Informação de Agravos de Notificação (Information System for Notifiable Diseases) regarding autochthonous CL cases. Spatial autocorrelation was performed using Moran's Global Index and the Local Indicator of Spatial Association (LISA). The construction of maps was based on categories of association (high-high, low-low, high-low, and low-high). A total of 4,557 autochthonous cases of CL were registered in the state of Paraná, with an annual average of 303.8 (± 135.2) and a detection coefficient of 2.91. No correlation was found between global indices and their respective significance in 2001 (I = -0.456, p = 0.676), but evidence of spatial autocorrelation was found in other years (p< 0.05). In the construction and analysis of the cluster maps, areas with a high-high positive association were found in the Ivaí-Pirapó, Tibagi, Cinzas-Laranjinha, and Ribeira areas. The state of Paraná should keep a constant surveillance over CL due to the prominent presence of socioeconomic and environmental factors such as the favorable circumstances for the vectors present in peri-urban and agriculture áreas.
皮肤利什曼病(CL)的地理分布使其在巴西成为具有重要临床意义的疾病,在巴拉那州呈地方性流行。本研究的目的是基于可通报疾病信息系统(Sistema de Informação de Agravos de Notificação)中有关本地CL病例的数据,分析2001年至2015年期间巴拉那州CL的空间分布情况。使用莫兰全局指数(Moran's Global Index)和空间关联局部指标(Local Indicator of Spatial Association,LISA)进行空间自相关分析。地图构建基于关联类别(高高、低低、高低和低高)。巴拉那州共登记了4557例本地CL病例,年平均病例数为303.8(±135.2),检出系数为2.91。2001年未发现全局指数与其各自显著性之间存在相关性(I = -0.456,p = 0.676),但在其他年份发现了空间自相关的证据(p < 0.05)。在聚类地图的构建和分析中,在伊瓦伊 - 皮拉波(Ivaí-Pirapó)、蒂巴吉(Tibagi)、辛扎斯 - 拉兰热尼亚(Cinzas-Laranjinha)和里贝拉(Ribeira)地区发现了高高正相关区域。由于存在社会经济和环境因素,如城郊和农业地区有利于病媒生存的条件,巴拉那州应持续监测CL。
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