2001-2022年阿克里市钩端螺旋体病病例时空、时空分析

Leonardo Augusto Kohara Melchior, Kívia Roberta Costa da Silva, Ana Elisa Pereira Silva, Francisco Chiaravalloti-Neto
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摘要

目的:确定2001 - 2022年阿克里州钩端螺旋体病高、低发病风险聚集性,并分析该州钩端螺旋体病发病的时间趋势和流行病学特征。方法:对巴西卫生服务机构强制报告的病例进行生态学研究。对于空间和时空的聚类分析,使用SaTScan软件计算相对风险(RR)。此外,使用Prais-Winsten线性回归和按性别和年龄组估计发病率的流行病学概况获得了时间趋势。结果:里约热内卢Branco、Bujari和Porto Acre存在高风险空间聚类(RR=2.94),主要发生在2013 - 2015年间,从时空聚类来看,RR=9.51;南克鲁塞罗市也呈现高风险空间聚集(RR=1.31)。该城市及其邻近城市的病例呈上升趋势,而该州其他城市的病例呈平稳趋势。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)。结论:钩端螺旋体病虽在我州流行,但在某些城市和年份发病率较高。因此,为了预防和控制疾病,有必要在特定地点和时期采取或大或小的力度。
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Spatial, temporal, and space-time analysis of leptospirosis cases in Acre, 2001-2022.

Objective: 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.

Methods: 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.

Results: 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).

Conclusion: 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.

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