Gutiérrez J D, Martínez-Vega R A
Universidad de Santander, Facultad de Ingeniería, Grupo Ambiental de Investigación Aplicada-GAIA.
Universidad de Santander, Facultad de Ciencias de la Salud, Escuela de Medicina, Grupo de investigación Salud-Comunid-UDES, Bucaramanga.
Trans R Soc Trop Med Hyg. 2018 Mar 1;112(3):115-123. doi: 10.1093/trstmh/try032.
In Colombia, human leptospirosis (HL) is a disease that has had a mandatory notification rule since 2007. Humans usually acquire the infection through water contaminated with animal urine that comes into direct contact with cutaneous lesions, eyes or mucous membranes.
To analyze the spatiotemporal variability in the occurrence of HL cases in Colombia between 2007 and 2016, and its relation with the El Niño Southern Oscillation (ENSO) cycle and the consequent anomalies in rainfall in spatiotemporal clusters.
An ecological study of the HL cases, aggregated by municipality, and reported between 2007 and 2016, is presented.
During the period of study, 9928 cases of HL were reported, and 58.9% of the municipalities reported at least one case of leptospirosis. Six spatiotemporal clusters were identified-five were in the Andean region and one was in the Caribbean region. The assessment of the ENSO cycle and rainfall anomalies suggests the importance of La Niña episodes, and excess rainfall periods in the occurrence of cases of HL.
Our results demonstrate the importance of the ENSO cycle, rainfall periods and periods with excess rainfall in the occurrence of cases and outbreaks of HL in Colombia, and suggest the importance of the topography of valleys and flood zones as zones in which the risk of infection is elevated.
在哥伦比亚，自2007年起，人类钩端螺旋体病（HL）就属于须强制报告的疾病。人类通常通过接触被动物尿液污染的水而感染，这些水会直接接触皮肤损伤、眼睛或黏膜。
分析2007年至2016年期间哥伦比亚HL病例发生情况的时空变化，及其与厄尔尼诺南方涛动（ENSO）周期以及由此导致的时空聚集区降雨异常的关系。
呈现了一项对2007年至2016年期间按市汇总报告的HL病例进行的生态学研究。
在研究期间，共报告了9928例HL病例，58.9%的市报告了至少1例钩端螺旋体病。确定了6个时空聚集区，其中5个位于安第斯地区，1个位于加勒比地区。对ENSO周期和降雨异常的评估表明，拉尼娜事件以及降雨过多时期在HL病例发生中具有重要意义。
我们的结果表明，ENSO周期、降雨期和降雨过多期在哥伦比亚HL病例和疫情发生中具有重要意义，并表明山谷和洪泛区的地形作为感染风险升高区域的重要性。
