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影响伊朗伊斯法罕地区皮肤利什曼病发病率的气候和环境因素。

Climate and environmental factors affecting the incidence of cutaneous leishmaniasis in Isfahan, Iran.

机构信息

Department of Environment, Tehran North Branch, Islamic Azad University, Tehran, Iran.

Communicable Diseases Management Center, Ministry of Health and Medical Education, Tehran, Iran.

出版信息

Environ Sci Pollut Res Int. 2018 Apr;25(12):11516-11526. doi: 10.1007/s11356-018-1340-8. Epub 2018 Feb 9.

Abstract

Cutaneous leishmaniasis (CL) is a vector-borne human disease caused by Leishmania, a parasite transmitted by sand flies. CL is endemic in the Isfahan Province, Iran. This study was designed to identify the climate and environmental factors associated with CL incidence in Isfahan Province. Data included incident cases of CL, climate, and environmental factors, which were collected across 23 districts of province from 2007 to 2015. Analyses were performed with generalized linear models (GLMs) to fit a function to the relationships between the response and predictors. We used negative binomial regression due to over-dispersed distribution of CL cases. The effects of all seven climate and environmental factors were found to be significant (all p < 0.01), and the model explained 40% of the deviance of CL incidence. There was a positive relation between mean temperature, relative humidity, and slope of area with disease incidence; however, negative association was demonstrated between maximum wind speed, rainfall, altitude, and vegetation cover with CL incidence. Cutaneous leishmaniasis continues to be a widespread challenge, especially in northwestern parts of Iran. Climate and environmental factors should be considered when selecting the most appropriate strategies for preventing and controlling CL.

摘要

皮肤利什曼病(CL)是一种由利什曼原虫引起的经媒介传播的人类疾病,由沙蝇传播。CL 在伊朗伊斯法罕省流行。本研究旨在确定与伊斯法罕省 CL 发病率相关的气候和环境因素。数据包括 2007 年至 2015 年期间从该省 23 个区收集的 CL 发病病例、气候和环境因素。采用广义线性模型(GLMs)对响应和预测因子之间的关系进行拟合函数分析。由于 CL 病例分布过度分散,我们使用负二项回归。结果发现所有七种气候和环境因素的影响均具有统计学意义(均 P<0.01),该模型解释了 CL 发病率变异的 40%。平均温度、相对湿度和区域坡度与疾病发病率呈正相关;然而,最大风速、降雨量、海拔和植被覆盖率与 CL 发病率呈负相关。皮肤利什曼病仍然是一个广泛存在的挑战,特别是在伊朗西北部。在选择预防和控制 CL 的最佳策略时,应考虑气候和环境因素。

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