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利用地理空间方法确定印度报告的儿童肠套叠住院患者的区域性流行率。

Geospatial methodology for determining the regional prevalence of hospital-reported childhood intussusception in patients from India.

机构信息

The INCLEN Trust International, New Delhi, India.

出版信息

Sci Rep. 2024 Mar 20;14(1):6664. doi: 10.1038/s41598-024-57187-8.

Abstract

Both developed and developing countries carry a large burden of pediatric intussusception. Sentinel site surveillance-based studies have highlighted the difference in the regional incidence of intussusception. The objectives of this manuscript were to geospatially map the locations of hospital-confirmed childhood intussusception cases reported from sentinel hospitals, identify clustering and dispersion, and reveal the potential causes of the underlying pattern. Geospatial analysis revealed positive clustering patterns, i.e., a Moran's I of 0.071 at a statistically significant (p value < 0.0010) Z score of 16.14 for the intussusception cases across India (cases mapped n = 2221), with 14 hotspots in two states (Kerala = 6 and Tamil Nadu = 8) at the 95% CI. Granular analysis indicated that 67% of the reported cases resided < 50 km from the sentinel hospitals, and the average travel distance to the sentinel hospital from the patient residence was calculated as 47 km (CI 95% min 1 km-max 378 km). Easy access and facility referral preferences were identified as the main causes of the existing clustering pattern of the disease. We recommend designing community-based surveillance studies to improve the understanding of the prevalence and regional epidemiological burden of the disease.

摘要

发展中国家和发达国家都面临着小儿肠套叠的巨大负担。基于哨点监测的研究强调了肠套叠区域性发病率的差异。本文的目的是对来自哨点医院报告的医院确诊的儿童肠套叠病例的位置进行地理空间制图,确定聚集和离散情况,并揭示潜在的发病模式原因。地理空间分析显示存在正聚集模式,即印度肠套叠病例的 Moran's I 为 0.071,在统计学上显著(p 值 < 0.0010),Z 分数为 16.14(病例映射 n = 2221),两个邦(喀拉拉邦= 6 和泰米尔纳德邦= 8)有 14 个热点处于 95%置信区间内。细粒度分析表明,67%的报告病例居住在距离哨点医院 < 50 公里的范围内,从患者居住地到哨点医院的平均旅行距离计算为 47 公里(95%置信区间最小 1 公里-最大 378 公里)。容易获得和机构转诊偏好被认为是该疾病现有聚集模式的主要原因。我们建议设计基于社区的监测研究,以提高对疾病的流行和区域性流行病学负担的认识。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/21e2/10954623/ed7c41ba726c/41598_2024_57187_Fig1_HTML.jpg

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