Nursing Graduate Program, Federal University of Maranhão, São Luís, Maranhão, Brazil.
Department of Nursing, Federal University of São Carlos, São Paulo, Brazil.
J Infect Dev Ctries. 2022 May 30;16(5):813-820. doi: 10.3855/jidc.15797.
Epidemiological investigations on tuberculosis-diabetes comorbidity using spatial analysis should be encouraged towards a more comprehensive view of the health of individuals affected by such comorbidity in different contexts. This study analyzes the territories vulnerable to tuberculosis-diabetes comorbidity in a municipality in northeastern Brazil using spatial analysis techniques.
An ecological study was carried out in Imperatriz, Maranhão, Brazil. Tuberculosis-diabetes cases reported in the Brazilian Notifiable Diseases Information System between 2009 and 2018 were analyzed. Kernel density estimation and spatial scanning techniques were used to identify the areas with the greatest occurrence of spatial clusters.
A heterogeneous spatial distribution was found, ranging from 0.00 to 4.12 cases/km2. The spatial scanning analysis revealed three high-risk spatial clusters with statistical significance (p < 0.05), involving eleven strictly urban sectors with a relative risk of 4.00 (95% CI: 2.60-6.80), 5.10 (95% CI: 2.75-7.30), and 6.10 (95% CI: 3.21-8.92), indicating that the population living in these areas had a high risk of tuberculosis-diabetes comorbidity.
The highest concentration of cases/km2, as well as risk clusters, were found in areas with high circulation of people and socio-economic and environmental vulnerabilities. Such findings reinforce the need for public health interventions to reduce social inequalities.
使用空间分析方法对结核病-糖尿病合并症进行流行病学研究，有助于更全面地了解不同背景下受此类合并症影响的个体的健康状况。本研究使用空间分析技术分析了巴西东北部一个城市中易受结核病-糖尿病合并症影响的地区。
在巴西马拉尼昂州的伊马普雷蒂兹进行了一项生态研究。对 2009 年至 2018 年期间巴西法定传染病报告系统中报告的结核病-糖尿病病例进行了分析。使用核密度估计和空间扫描技术来识别发生空间聚集的高风险地区。
发现存在异质的空间分布，范围从 0.00 到 4.12 例/平方公里。空间扫描分析揭示了三个具有统计学意义的高风险空间集群（p<0.05），涉及 11 个完全城市区域，相对风险为 4.00（95%CI：2.60-6.80）、5.10（95%CI：2.75-7.30）和 6.10（95%CI：3.21-8.92），表明生活在这些地区的人群患有结核病-糖尿病合并症的风险较高。
每平方公里病例的最高浓度以及风险集群都出现在人员流动量大、社会经济和环境脆弱性高的地区。这些发现加强了需要采取公共卫生干预措施来减少社会不平等的必要性。
