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标题：Hyperendemicity, heterogeneity and spatial overlap of leprosy and cutaneous leishmaniasis in the southern Amazon region of Brazil
其他标题：Hyperendemicity, heterogeneity and spatial overlap of leprosy and cutaneous leishmaniasis in the southern Amazon region of Brazil
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作者：Amanda Gabriela de Carvalho ; João Gabriel Guimarães Luz ; João Victor Leite Dias 等
期刊名称：Geospatial Health
印刷版ISSN：1970-7096
出版年度：2020
卷号：15
期号：2
页码：293
DOI：10.4081/gh.2020.892
出版社：PAGEPress Publications
摘要：Neglected tropical diseases characterized by skin lesions are highly endemic in the state of Mato Grosso, Brazil. We analyzed the spatial distribution of leprosy and Cutaneous Leishmaniasis (CL) and identified the degree of overlap in their distribution. All new cases of leprosy and CL reported between 2008 and 2017 through the national reporting system were included in the study. Scan statistics together with univariate Global and Local Moran’s I were employed to identify clusters and spatial autocorrelation for each disease, with the spatial correlation between leprosy and CL measured by bivariate Global and Local Moran’s I. Finally, we evaluated the demographic characteristics of the patients. The number of leprosy (N = 28,204) and CL (N = 24,771) cases in Mato Grosso and the highly smoothed detection coefficients indicated hyperendemicity and spatial distribution heterogeneity. Scan statistics demonstrated overlap of high-risk clusters for leprosy (RR = 2.0; p <0.001) and CL (RR = 4.0; p <0.001) in the North and Northeast mesoregions. Global Moran’s I revealed a spatial autocorrelation for leprosy (0.228; p = 0.001) and CL (0.311; p = 0.001) and a correlation between them (0.164; p = 0.001). Both diseases were found to be concentrated in urban areas among men aged 31-60 years, of brown-skinned ethnicity and with a low educational level. Our findings indicate a need for developing integrated and spatially as well as socio-demographically targeted public health policies.
关键词：Leprosy; cutaneous leishmaniasis; neglected tropical diseases; epidemiology; spatial analysis; Brazil.