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巴西蝎子螫伤及其与健康社会决定因素的关系:一项基于人群的生态学研究。

Scorpion envenomation in Brazil and its relationship with the social determinants of health: A population-based ecological study.

机构信息

Health Sciences Graduate Program, Federal University of Sergipe, Aracaju 49060-676, Brazil.

Malacology of Vectors Graduate Program, Institute of Oswaldo Cruz, Rio de Janeiro 21040-360, Brazil.

出版信息

Acta Trop. 2024 May;253:107165. doi: 10.1016/j.actatropica.2024.107165. Epub 2024 Feb 29.

Abstract

This study comprehensively analyzed cases of scorpion envenomation in Brazil, exploring the temporal trends and geographic patterns of such incidents between January 1, 2012, and December 31, 2022. Simultaneously, we assessed the correlation between scorpion envenomation and social determinants of health and social vulnerability. We conducted a population-based ecological study, gathering information on the number of scorpion envenomation cases in Brazil, as well as socioeconomic data and social vulnerability indicators across the 5,570 Brazilian municipalities. The season-trend model, based on the classical additive decomposition method, informed estimations of scorpion envenomation variations over time. The spatial correlation of scorpion envenomation with socioeconomic and vulnerability indicators was assessed using the Bivariate Moran's I. A total of 1,343,224 cases of scorpion envenomation were recorded in Brazil from Jan 2012 to Dec 2022. A single increasing time trend was observed for the entire country for this period (APC 8.94, P < 0.001). The seasonal analysis was significant for Brazil as a whole and all regions (p < 0.001), with peaks evident between October and November. The spatial distribution of cases was heterogeneous, with spatial clusters concentrated in the high-risk Southeast and Northeast regions. There was a high incidence of scorpion envenomation in municipalities facing social vulnerability, and, paradoxically, in those with better sanitation and waste collection. Our study revealed a heterogeneous geographical distribution of scorpion accidents in Brazil. Municipalities with higher social vulnerability exhibited a high incidence of scorpion envenomation.

摘要

这项研究全面分析了巴西蝎子螫伤的病例,探讨了 2012 年 1 月 1 日至 2022 年 12 月 31 日期间此类事件的时间趋势和地理模式。同时,我们评估了蝎子螫伤与健康和社会脆弱性的社会决定因素之间的相关性。我们进行了一项基于人群的生态研究,收集了巴西蝎子螫伤病例数量以及巴西 5570 个市的社会经济数据和社会脆弱性指标的信息。基于经典加法分解方法的季节趋势模型,用于估计随时间变化的蝎子螫伤变化。使用双变量 Moran's I 评估了蝎子螫伤与社会经济和脆弱性指标的空间相关性。2012 年 1 月至 2022 年 12 月期间,巴西共记录了 1343224 例蝎子螫伤病例。整个国家在这段时间内观察到单一的递增时间趋势(APC8.94,P<0.001)。季节分析对巴西整体和所有地区均具有重要意义(p<0.001),10 月至 11 月期间出现明显高峰。病例的空间分布不均匀,空间集群集中在高风险的东南部和东北部地区。社会脆弱性较高的城市发生蝎子螫伤的发病率较高,而在卫生和废物收集较好的城市,发病率反而较高。我们的研究揭示了巴西蝎子螫伤的地理分布不均。社会脆弱性较高的城市发生蝎子螫伤的发病率较高。

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