2001 - 2015年巴伊亚州的麻风病传播：基于联合点回归和空间扫描统计的建模
Leprosy transmission in Bahia, 2001-2015: modeling based on Jointpoint regression and spatial scan statistics.
作者信息
Souza Carlos Dornels Freire de, Luna Carlos Feitosa, Magalhães Mônica de Avelar Figueiredo Mafra
机构信息
Universidade Federal de Alagoas, Departamento de Medicina, Arapiraca, AL, Brasil.
Fundação Instituto Oswaldo Cruz, Programa de Pós-Graduação em Saúde Pública, Recife, PE, Brasil.
出版信息
Epidemiol Serv Saude. 2019;28(1):e2018065. doi: 10.5123/S1679-49742019000100015. Epub 2019 Apr 8.
OBJECTIVE
to describe the trend and the spatial distribution of leprosy in the state of Bahia, Brazil, 2001-2015.
METHODS
this was a mixed ecological study of epidemiological indicators of leprosy; Jointpoint regression was used for the temporal analysis, while spatial scan statistics were used to identify clusters of the disease; the trend was classified as stationary, increasing or decreasing; we calculated the annual percent change (APC) and average annual percent change (AAPC).
RESULTS
there was a reduction in prevalence (AAPC = -5.6; p<0,001), treatment dropout (AAPC = -13.7; p<0.001), and females with leprosy (AAPC = -0.6; p<0.001); the new grade II case coefficient (AAPC = 2.7; p<0.001) and the proportion of multibacillary cases (AAPC = 2,2; p<0.001) showed a growing trend; spatial distribution was heterogeneous and concentrated in three regions in particular (north, west and south of the state), with variation between the indicators.
CONCLUSION
persisting leprosy transmission in the state, late diagnosis and high hidden prevalence is suggested.
目的
描述2001 - 2015年巴西巴伊亚州麻风病的流行趋势和空间分布。
方法
这是一项关于麻风病流行病学指标的混合生态学研究；采用Joinpoint回归进行时间分析，同时使用空间扫描统计来识别疾病聚集区；趋势分为稳定、上升或下降；我们计算了年度百分比变化（APC）和平均年度百分比变化（AAPC）。
结果
患病率（AAPC = -5.6；p<0.001）、治疗中断率（AAPC = -13.7；p<0.001）和女性麻风病患者比例（AAPC = -0.6；p<0.001）均有所下降；新二级病例系数（AAPC = 2.7；p<0.001）和多菌型病例比例（AAPC = 2.2；p<0.001）呈上升趋势；空间分布不均，尤其集中在该州的三个地区（北部、西部和南部），各指标之间存在差异。
结论
提示该州麻风病传播持续存在，存在诊断延迟和高隐匿患病率。
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