Universidade Federal de Sergipe, Programa de Pós-Graduação em Enfermagem, São Cristóvão, SE, Brasil.
Secretaria Estadual de Saúde de Sergipe, Diretoria de Vigilância em Saúde, Aracaju, SE, Brasil.
Trans R Soc Trop Med Hyg. 2021 Aug 2;115(8):854-862. doi: 10.1093/trstmh/traa128.
Leptospirosis is an endemic disease in Brazil of social and economic relevance related to behavioural and socioenvironmental factors. This study aimed to analyse the spatiotemporal distribution of the incidence of leptospirosis and its association with social determinants in health in a state of northeastern Brazil.
An ecological study of temporal series with techniques of spatial analysis using secondary data of the cases of leptospirosis notified in the Information System of Notifiable Diseases of the state of Sergipe (2008-2017) was conducted. The analysis of temporal trends was performed using Poisson regression. Spatial analyses were performed using the Moran index, the local empirical Bayesian model, scan statistics and spatial regression.
The incidence rate decreased from 3.66 to 1.44 cases per 100 000 inhabitants in 2008 and 2017, respectively. Leptospirosis was associated with social inequities, mostly affecting males aged 20-49 y living in urban areas. The space-time scan indicated the formation of a risk cluster in municipalities in the metropolitan region of the state.
The data indicated the persistence of leptospirosis transmission, maintaining a pattern of high endemicity in some municipalities associated with social inequities. The study showed the temporal and spatial dynamics of the disease to better target specific actions for prevention and control.
钩端螺旋体病是巴西一种具有社会和经济意义的地方病，与行为和社会环境因素有关。本研究旨在分析东北部巴西一个州钩端螺旋体病发病率的时空分布及其与健康社会决定因素的关系。
利用塞阿拉州传染病报告信息系统（2008-2017 年）中报告的钩端螺旋体病病例的二级数据，进行了时间序列的生态研究，采用空间分析技术。采用泊松回归分析时间趋势。采用 Moran 指数、局部经验贝叶斯模型、扫描统计和空间回归进行空间分析。
发病率从 2008 年的 3.66 例/10 万居民降至 2017 年的 1.44 例/10 万居民。钩端螺旋体病与社会不平等有关，主要影响 20-49 岁的男性和居住在城市地区的人群。时空扫描显示，州内大都市区的一些城市形成了一个风险集群。
数据表明钩端螺旋体病的传播仍然存在，一些与社会不平等相关的城市的高地方性流行模式仍然存在。本研究显示了疾病的时空动态，以便更好地针对特定的预防和控制措施。
