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巴西巴伊亚州萨尔瓦多大都市区克氏锥虫病的流行病学指标。

Epidemiological indicators of Chagas disease in the metropolitan region of Salvador, Bahia, Brazil.

机构信息

Fundação Oswaldo Cruz, Instituto Gonçalo Moniz, Laboratório de Patologia e Biologia Molecular, Salvador, BA, Brasil.

Universidade Federal da Bahia, Faculdade de Medicina da Bahia, Salvador, BA, Brasil.

出版信息

Rev Soc Bras Med Trop. 2023 Feb 20;56:e0185. doi: 10.1590/0037-8682-0185-2022. eCollection 2023.

Abstract

BACKGROUND

Chagas disease (CD) is caused by Trypanosoma cruzi and transmitted by triatomines. Historical information from the 20th century demonstrates T. cruzi records in the metropolitan region of Salvador (MRS), the third largest urban agglomeration in the Brazilian Northeast and the eighth largest in Brazil, an area with intense migratory activity from CD-endemic regions. Therefore, this study aimed to evaluate CD indicators (prevalence and mortality) in the MRS.

METHODS

A mixed ecological and descriptive study was conducted using secondary data. We analyzed data from 2008 to 2015: deaths due to CD, self-reported cases of CD, and blood donors that were non-negative for T. cruzi infection.

RESULTS

São Francisco do Conde was one of the municipalities with the highest mortality rates due to CD. The seroprevalence rates varied by year and municipality; those with the highest values were 2008: Vera Cruz, 2009: Mata de São João, 2010: Dias D'Ávila, 2011 and 2015: São Francisco do Conde, 2012: São Sebastião do Passé, and 2013 and 2014: Pojuca. Spatial correlations between the municipalities were not detected.

CONCLUSIONS

We conclude that CD is present in the MRS. The indicators analyzed in the MRS are below-state-level data. Given the importance of indicator analysis for the surveillance and control of CD at the state and national levels, it is important to strengthen the surveillance program at the municipal level, including the regions classified as low risk for T. cruzi vector transmission.

摘要

背景

恰加斯病(CD)由克氏锥虫引起,通过锥蝽传播。20 世纪的历史资料显示,巴西北东北部第三大、巴西第八大的萨尔瓦多大都市区(MRS)有克氏锥虫记录,该地区人口流动活跃,来自 CD 流行地区。因此,本研究旨在评估 MRS 的 CD 指标(患病率和死亡率)。

方法

采用混合生态和描述性研究方法,利用二手资料进行分析。我们分析了 2008 年至 2015 年的数据:CD 死亡人数、CD 自述病例数和非 T. cruzi 感染的献血者。

结果

圣弗朗西斯科-多孔塞卡是 CD 死亡率最高的城市之一。血清阳性率因年份和城市而异;2008 年为维拉·克鲁兹最高,2009 年为马塔-德-圣若昂,2010 年为迪亚斯-达-伊夫拉,2011 年和 2015 年为圣弗朗西斯科-多孔塞卡,2012 年为圣塞巴斯蒂昂-杜帕塞,2013 年和 2014 年为波茹卡。各城市之间没有检测到空间相关性。

结论

我们得出结论,MRS 存在 CD。MRS 分析的指标低于州级数据。鉴于指标分析对州和国家层面 CD 监测和控制的重要性,有必要加强市级监测计划,包括被认为低 T. cruzi 传播风险的地区。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9677/9957123/b4b88f7c0a46/1678-9849-rsbmt-56-e0185-2022-gf1.jpg

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