Department of Epidemiology, Faculty of Health, Ilam University of Medical Sciences, Ilam, Iran; Student Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran.
Clinical Microbiology Research Center, Ilam University of Medical Sciences, Ilam, Iran.
Int J Infect Dis. 2018 Feb;67:129-136. doi: 10.1016/j.ijid.2017.10.017. Epub 2017 Nov 6.
To investigate the distribution and trends associated with brucellosis incidence rates in Iran from 2011 to 2014.
The reported incidence rates of brucellosis for the years 2011-2014 were collected and entered into GIS 10.1. The Cochran-Armitage test for linear trends, choropleth maps, hot-spot analysis, and high-low clustering analysis were used to investigate patterns of the disease over the study period and by season, and to identify high-risk areas and any clustering of the disease. The significance level was set at p<0.05.
A total of 68493 cases of brucellosis were reported during the study period, giving an average brucellosis incidence rate for this period of 38.67/100000. In 2011, the highest rate of brucellosis was observed in Koohrang County of Chaharmahal-Bakhtiari Province, with 317/100 000. In the subsequent years, 2012-2014, Charuymaq County of East-Azerbaijan Province had incidence rates of 384, 534, and 583/100000, respectively. However, the incidence rate of the disease did not follow a linear trend (p<0.001). The maximum and minimum incidence rates of the disease occurred in mid-summer and mid-winter, respectively. The results of the hot-spot analysis showed that the distribution of the disease was highest in the mountainous areas of Iran, particularly along the Zagros mountain range and in most cities near the Zagros Mountains (p<0.01). In addition, the cluster analysis showed a clustering pattern in these high incidence areas (p<0.01).
There were significant differences in the geographic distribution of brucellosis, with the incidence rates being highest in most of the cities in the west and north-west of the country. The incidence of this disease also increased during the summer. It is important to take these patterns into account when allocating resources to combat this disease and to ensure that health programs and other interventions focus on the areas of greatest need.
调查 2011 至 2014 年伊朗布鲁氏菌病发病率的分布和趋势。
收集并输入 2011-2014 年布鲁氏菌病报告发病率至 GIS 10.1。采用 Cochran-Armitage 线性趋势检验、面域图、热点分析和高低聚类分析，研究研究期间和季节的疾病模式，并确定高风险地区和疾病的聚类。显著性水平设为 p<0.05。
研究期间共报告布鲁氏菌病 68493 例，平均发病率为 38.67/100000。2011 年，Chaharmahal-Bakhtiari 省 Koohrang 县的布鲁氏菌病发病率最高，为 317/100000。随后的 2012-2014 年，东阿塞拜疆省 Charuymaq 县的发病率分别为 384、534 和 583/100000。然而，疾病发病率没有呈现线性趋势（p<0.001）。疾病的最高和最低发病率分别出现在仲夏和隆冬。热点分析结果表明，疾病分布最高的地区是伊朗的山区，特别是扎格罗斯山脉沿线和扎格罗斯山脉附近的大多数城市（p<0.01）。此外，聚类分析显示这些高发病率地区存在聚类模式（p<0.01）。
布鲁氏菌病的地理分布存在显著差异，该国西部和西北部的大多数城市发病率最高。该病的发病率在夏季也有所增加。在分配资源以防治这种疾病时，考虑到这些模式非常重要，以确保卫生计划和其他干预措施集中在最需要的地区。
