Environmental and socio-economic determinants associated with the occurrence of cutaneous leishmaniasis in the northeast of Colombia

被引:13
|
作者
Gutierrez, Juan D. [1 ]
Martinez-Vega, Ruth [2 ]
Ramoni-Perazzi, Josefa [3 ]
Diaz-Quijano, Fredi A. [4 ]
Gutierrez, Reinaldo [5 ]
Ruiz, Freddy J. [6 ]
Botello, Hector A. [7 ]
Gil, Maria [1 ]
Gonzalez, Juan [1 ]
Palencia, Mario [1 ]
机构
[1] Univ Santander, Fac Ingn, GAIA, Bucaramanga 680003, Colombia
[2] Univ Santander, Fac Ciencias Salud, Escuela Med, Grp Invest Salud Comunid,UDES, Bucaramanga 680003, Colombia
[3] Univ Santander, Fac Ciencias Econ Adm & Contables, Grp Invest Ciempies, Bucaramanga 680003, Colombia
[4] Univ Sao Paulo, Dept Epidemiol, Fac Saude Publ, BR-01246904 Sao Paulo, Brazil
[5] Univ Pamplona, Grp Invest GIEPATI, Dept Bacteriol & Lab Clin, Pamplona 543050, Spain
[6] Univ Ind Santander, Grp Invest GIDROT, Escuela Econ & Adm, Fac Ciencias Humanas, Bucaramanga 680002, Colombia
[7] Univ Ind Santander, Grp Invest GIDROT, Bucaramanga 680002, Colombia
关键词
Cutaneous leishmaniasis; Determinants; Economics; Environmental; Negative binomial regression model; Social; DIPTERA; FOCUS; CITY;
D O I
10.1093/trstmh/try011
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background: Cutaneous leishmaniasis (CL) is a vector-borne disease that is widely distributed in most tropical regions. Colombia has experienced an important increase in its incidence during the last decade. There are CL transmission foci in the Colombian departments of Santander and Norte de Santander. Objectives: To identify environmental and socio-economic variables associated with CL incidence in the municipalities of the northeast of Colombia between 2007 and 2016. Methods: This was an ecological study of CL cases aggregated by municipality. The cases reported during the study period were analyzed with a negative binomial regression to obtain the adjusted incident rate ratio for environmental and socio-economic variables. Findings: During the study period, 10 924 cases of CL were reported, and 110 (86.6%) municipalities reported at least one CL case. The coverages of forest (aIRR 1.05, 95% CI 1.03-1.07), heterogeneous agricultural zones (aIRR 1.04, 95% CI 1.02-1.06) and permanent crops (aIRR 1.07, 95% CI 1.02-1.12) were associated with a higher incidence of CL. Conversely, urban functionality (aIRR 0.95, 95% CI 0.92-0.96), minimal-altitude above sea level (aIRR 0.84, 95% CI 0.79-0.90) and shrub coverage (aIRR 0.98, 95% CI 0.95-1.0) were negatively associated with the incidence of CL in the municipality. Main conclusions: Our results confirm the importance of environmental determinants, such as height above sea level, and coverage of forest, permanent crops and heterogeneous agricultural zones, for the occurrence of CL; these findings also suggest the importance of shrub coverage. Furthermore, urban functionality was a socio-economic determinant independently associated with CL incidence.
引用
收藏
页码:564 / 571
页数:8
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