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麻风病与社会剥夺:巴西东北部地方病流行状态下优先区域的定义

Leprosy and social deprivation: Definition of priority areas in an endemic state Northeastern Brazil.

作者信息

Souza Carlos Dornels Freire de, Magalhães Mônica Avelar Figueiredo Mafra, Luna Carlos Feitosa

机构信息

Universidade Federal de Alagoas - Arapiraca (AL), Brasil.

Fundação Oswaldo Cruz - Recife (PE), Brasil.

出版信息

Rev Bras Epidemiol. 2020 Feb 21;23:e200007. doi: 10.1590/1980-549720200007. eCollection 2020.

Abstract

INTRODUCTION

Leprosy is a disease that reserves close relation with social and economic conditions. Brazil is the only country that has not yet reached the goal of eliminating the disease as a public health problem.

OBJECTIVE

This study aimed to analyze social deprivation in the municipalities of Bahia and its relation with the detection of new cases of leprosy in the population.

METHODS

It is an ecological study conducted in the state of Bahia, from 2001 to 2015. Variables analyzed: detection rate of new cases, social deprivation index (SDI) and Hansen's disease in children under 15 years of age. The SDI was built on four variables: socioeconomic performance index, per capita income, proportion of extremely poor, and household density. For spatial analysis, local empirical bayesian modeling and global and local Moran statistics were used. Statistical analysis used multivariate, spatial and logistic regression, odds ratio calculation and analysis of variance.

RESULTS

Leprosy showed heterogeneous distribution in the state, with concentration in the north-west and south axis. 60.4% (n = 252) of the municipalities presented very low life conditions. An association was observed between living conditions and the detection of leprosy, with higher coefficients in the municipality group with better living conditions (p < 0.001).

CONCLUSION

It was concluded that the worst conditions acted as an impediment to the diagnosis, while increasing the risk of illness. Good conditions have the opposite effect.

摘要

引言

麻风病是一种与社会和经济状况密切相关的疾病。巴西是唯一一个尚未实现将该疾病作为公共卫生问题予以消除目标的国家。

目的

本研究旨在分析巴伊亚州各城市的社会剥夺情况及其与人群中新发麻风病病例检出率的关系。

方法

这是一项于2001年至2015年在巴伊亚州开展的生态学研究。分析的变量包括:新病例检出率、社会剥夺指数(SDI)以及15岁以下儿童的 Hansen 病情况。SDI基于四个变量构建:社会经济表现指数、人均收入、极端贫困人口比例以及家庭密度。对于空间分析,采用了局部经验贝叶斯建模以及全局和局部莫兰统计量。统计分析使用了多变量、空间和逻辑回归、比值比计算以及方差分析。

结果

麻风病在该州呈现出异质性分布,集中在西北和南部轴线地区。60.4%(n = 252)的城市生活条件非常差。观察到生活条件与麻风病检出之间存在关联,在生活条件较好的城市组中系数更高(p < 0.001)。

结论

得出的结论是,最差的条件对诊断构成阻碍,同时增加了患病风险。良好的条件则具有相反的效果。

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