Melchior Leonardo Augusto Kohara, da Silva Kívia Roberta Costa, Silva Ana Elisa Pereira, Chiaravalloti-Neto Francisco
Universidade Federal do Acre, Postgraduate Program in Health Sciences in Western Amazon - Rio Branco (AC), Brasil.
Universidade de São Paulo, Faculty of Public Health, Postgraduate Degree in Public Health - São Paulo (SP), Brasil.
Rev Bras Epidemiol. 2024 Dec 16;27:e240063. doi: 10.1590/1980-549720240063. eCollection 2024.
To identify clusters of high and low risk for the occurrence of leptospirosis in space and space-time in Acre, between 2001 and 2022, as well as to characterize temporal trends and epidemiological profiles of the disease in the state.
An ecological study of cases mandatorily reported by health services in Brazil. For the analysis of clusters in space and space-time, the SaTScan software was used, which calculated the relative risks (RR). Additionally, temporal trends were obtained using Prais-Winsten linear regression and epidemiological profiles estimated by incidences by sex and age group.
A high-risk spatial cluster was identified in Rio Branco, Bujari, and Porto Acre (RR=2.94), occurring mainly between 2013 and 2015, according to the space-time cluster (RR=9.51). The municipality of Cruzeiro do Sul also showed a high-risk spatial cluster (RR=1.31). This municipality and contiguous municipalities showed an increasing temporal trend in cases, while the other municipalities in the state showed a stationary temporal trend. The disease mainly affected men between 20 and 59 years old, followed by young people aged 10 to 19 years. However, the RR of leptospirosis in older women was 2.1 times higher than in older men (95%CI 1.6-2.9).
The findings indicated that leptospirosis, although endemic in the state, had a more significant incidence in certain municipalities and years. Therefore, it is necessary to act with greater or lesser intensity in specific locations and periods, both for the prevention and control of the disease.
确定2001年至2022年期间阿克里州钩端螺旋体病在空间和时空上的高风险和低风险聚集区，并描述该州该病的时间趋势和流行病学特征。
对巴西卫生服务机构强制报告的病例进行生态学研究。为分析空间和时空聚集区，使用了SaTScan软件，该软件计算相对风险（RR）。此外，使用Prais-Winsten线性回归获得时间趋势，并按性别和年龄组估计发病率来描述流行病学特征。
根据时空聚集区（RR=9.51），在里奥布兰科、布亚里和阿克里港发现了一个高风险空间聚集区（RR=2.94），主要发生在2013年至2015年之间。南克鲁塞罗市也显示出高风险空间聚集区（RR=1.31）。该市及相邻市镇的病例呈现上升的时间趋势，而该州其他市镇则呈现平稳的时间趋势。该病主要影响20至59岁的男性，其次是10至19岁的年轻人。然而，老年女性钩端螺旋体病的RR比老年男性高2.1倍（95%CI 1.6-2.9）。
研究结果表明，钩端螺旋体病虽然在该州为地方病，但在某些市镇和年份发病率更高。因此，有必要在特定地点和时期采取或大或小的力度行动，以预防和控制该病。
