巴西中西部内脏利什曼病的空间分布模式及其与社会经济方面、环境指数和犬类感染的相关性。

Human visceral leishmaniasis in Central-Western Brazil: Spatial patterns and its correlation with socioeconomic aspects, environmental indices and canine infection.

机构信息

School of Medicine, Institute of Exact and Natural Sciences, Federal University of Rondonópolis, 5055 Estudantes Avenue, Rondonópolis, Mato Grosso 78735-901, Brazil; Post-graduation Program in Health Sciences, Faculty of Medicine, Federal University of Mato Grosso, Cuiabá, Brazil.

School of Medicine, Federal University of Jequitinhonha and Mucuri Valleys, Teófilo Otoni, Brazil.

出版信息

Acta Trop. 2021 Sep;221:105965. doi: 10.1016/j.actatropica.2021.105965. Epub 2021 May 21.

Abstract

In this ecological study, we investigated spatial patterns of human visceral leishmaniasis (VL) incidence, its correlation with socioeconomic aspects, environmental indices (obtained through remote sensing) and canine VL during 2011-2016 in the municipality of Rondonópolis, a relevant endemic area for VL in Central-Western Brazil. Human VL cases were georeferenced and point patterns were analyzed by univariate Ripley's K function and Kernel density estimation (KDE). Poisson-based scan statistics were used to investigate spatial and spatiotemporal clusters of human VL incidence at the neighborhood level. Socioeconomic and environmental characteristics were compared between neighborhoods within and outside spatial human VL clusters. Also, we assessed the correlation between smoothed human VL incidence and canine VL seropositivity rates within and between neighborhoods. Human VL cases were clustered up to 2000 m; four hotspots were identified by KDE in peripheral areas. Spatial and spatiotemporal low-risk clusters for human VL were identified in central and southern areas. Neighborhoods within spatial low-risk cluster presented higher mean income, literacy rate, sanitary sewage service coverage and lower altitude, compared to the rest of the municipality. A positive correlation was found between the occurrence of human and canine VL. On the northern outskirts, high human VL incidence was spatially correlated with high canine VL seropositivity in surrounding neighborhoods. In conclusion, human VL demonstrated a heterogeneous, aggregated and peripheral spatial pattern. This distribution was correlated with intra-urban socioeconomic differences and canine VL seropositivity at the neighborhood level.

摘要

在这项生态研究中,我们调查了 2011 年至 2016 年巴西中西部罗ndonópolis 市人类内脏利什曼病(VL)发病率的空间模式及其与社会经济方面、环境指数(通过遥感获得)和犬类 VL 的相关性。人类 VL 病例进行了地理定位,并通过单变量 Ripley 的 K 函数和核密度估计(KDE)分析点模式。泊松基于扫描统计用于调查邻里水平的人类 VL 发病率的空间和时空聚类。还比较了空间人类 VL 集群内和外的邻里之间的社会经济和环境特征。此外,我们评估了平滑的人类 VL 发病率与邻里内和邻里之间犬类 VL 血清阳性率之间的相关性。人类 VL 病例聚集在 2000 米以内;通过 KDE 在周边地区确定了四个热点。在中心和南部地区确定了空间和时空低风险人类 VL 集群。与该市其他地区相比,空间低风险集群内的邻里具有更高的平均收入、识字率、卫生污水服务覆盖率和更低的海拔。发现人类和犬类 VL 的发生之间存在正相关。在北郊,高人类 VL 发病率与周围邻里的高犬类 VL 血清阳性率存在空间相关性。总之,人类 VL 表现出不均匀、聚集和外围的空间模式。这种分布与城市内部的社会经济差异以及邻里犬类 VL 血清阳性率相关。

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