Pakzad Reza, Dabbagh-Moghaddam Arasb, Mohebali Mehdi, Safiri Saeid, Barati Mohammad
Infectious Diseases Research Center, AJA University of Medical Sciences, Tehran, Iran.
Department of Preventive Medicine, AJA University of Medical Sciences, Tehran, Iran.
J Parasit Dis. 2017 Dec;41(4):1114-1122. doi: 10.1007/s12639-017-0944-0. Epub 2017 Jul 25.
To investigate the time trend and distribution of cutaneous leishmaniasis in Iranian Army Units (IAUs) and general population (GP). with using census, Data on CL incidence in IAUs (from AJA University of Medical Sciences) and GP (from Ministry of Health) during 2005-2014 were extracted and entered into the GIS software. Cochran-Armitage test, choropleth map, hot-spot analysis and high/low clustering analysis were used to determine time trend, distribution of disease, hot-spots, and possible abnormal clustering, respectively. The number of infected individuals in IAUs and GP were 6533 and 153,499 respectively (with incidence rates of 143.68 per 100,000 and 25.86 per 100,000, respectively). Time trend analysis revealed the departure from linear trend for the incidence in IAUs ( < 0.001), but no such time trend was found in GP. According to choropleth maps; in IAUs, Khozestan from southwest, Esfahan from central and Kermanshah from west parts of Iran and among GP; Fars, Yazd, and Kerman in southern-east of Iran showed a high incidence rates. In IAUs, Esfahan and Khuzestan provinces was hot-spots of CL ( < 0.05), but in GP, provinces like Fars and Khorasan-shomali was hot-spots ( < 0.05). No clustering pattern of disease was observed in either study populations. Observed spatiotemporal variability in CL among IAUs and GP warrants proper health programs particularly to Khozestan and Esfahan in IAUs and Fars and Khorasan-shomali in GP are highly recommended.
调查伊朗陆军部队(IAUs)和普通人群(GP)中皮肤利什曼病的时间趋势和分布情况。利用人口普查数据,提取了2005 - 2014年期间IAUs(来自阿扎德医科大学)和GP(来自卫生部)中皮肤利什曼病(CL)的发病数据,并输入地理信息系统(GIS)软件。分别采用 Cochr an - Armitage检验、分级统计图、热点分析和高/低聚类分析来确定时间趋势、疾病分布、热点以及可能的异常聚类情况。IAUs和GP中的感染人数分别为6533人和153499人(发病率分别为每10万人143.68例和每10万人25.86例)。时间趋势分析显示IAUs的发病率偏离线性趋势(P < 0.001),但在GP中未发现这种时间趋势。根据分级统计图;在IAUs中,伊朗西南部的胡齐斯坦省、中部的伊斯法罕省和西部的克尔曼沙阿省,以及在GP中,伊朗东南部的法尔斯省、亚兹德省和克尔曼省发病率较高。在IAUs中,伊斯法罕省和胡齐斯坦省是CL的热点地区(P < 0.05),但在GP中,法尔斯省和霍拉桑 - 肖马利省等省份是热点地区(P < 0.05)。在这两个研究人群中均未观察到疾病的聚类模式。IAUs和GP中CL观察到的时空变异性需要适当的卫生项目,特别是强烈建议针对IAUs中的胡齐斯坦省和伊斯法罕省以及GP中的法尔斯省和霍拉桑 - 肖马利省开展相关项目。