Tuberculosis space-temporal distribution from 2011 to 2016 in the municipality of Maputo, Mozambique / Distribución espacio-temporal de la tuberculosis de 2011 al 2016 en el municipio de Maputo, Mozambique

Abstract: Objective: Carry out a spatial-temporal characterization of the incidence of tuberculosis (TB) in Maputo, Mozambique. Method: a descriptive ecological study of tuberculosis cases reported in an information system. The annual mean incidence rate and the number of TB notification cases in the municipality of Maputo from 2011 to 2016 were analyzed. Descriptive statistics were used with calculations of measures of central tendency (mean) and an application of the Poisson linear regression model. Trimester notifications were stratified by district, clinical form, and age group. The quarterly average temperature of the evaluated area was added as a covariate in the model seasonal. Results: 34,623 TB cases were notified from 2011 to 2016, with a trimester average of 1,443 cases. The average annual incidence was higher in the Kampfumo district, with 909.8 per 100 thousand inhabitants (95% CI 854.1 - 968.2); almost twice as much as the incidence of the municipality of Maputo, 527.8 (95% CI 514, 3-541.6), and the country of Mozambique, 551 (95% CI 356 - 787). The clinical diagnosis of the tested cases was higher concerning the bacteriological diagnosis; 44%, and 35%, respectively. Conclusion: Maputo had similar incidence rates to the country of Mozambique, however, there was a heterogeneity rate by district and a reduction in the number of TB cases in both the general population (not co-infected with HIV) and those over 15 years old, being higher in the first trimester.

Resumen: Objetivo: realizar una caracterización espacio-temporal de la incidencia de tuberculosis (TB) en Maputo, Mozambique. Método: estudio ecológico descriptivo de casos de tuberculosis reportados en un sistema de información. Se analizó la tasa de incidencia media anual y el número de casos de notificación de TB en el municipio de Maputo entre 2011 y 2016. Se utilizó estadística descriptiva para calcular las medidas de tendencia central (media) y la aplicación del modelo de regresión lineal de Poisson Las notificaciones trimestrales se estratificaron por distrito, forma clínica y grupo de edad. Resultados: se notificaron 34,623 casos de TB entre 2011 y 2016, con un promedio trimestral de 1,443 casos. La incidencia anual promedio fue mayor en el distrito de Kampfumo, 909.8 por cada 100 mil habitantes (IC 95% 854.1 - 968.2), casi el doble que la incidencia del municipio de Maputo, 527.8 (IC 95% 514 , 3-541.6), y el país de Mozambique, 551 (95% CI 356 - 787). El diagnóstico clínico de los casos fue mayor en relación al diagnóstico bacteriológico, 44% y 35%, respectivamente. Conclusión: Maputo tuvo tasas de incidencia similares a las del país, sin embargo, hubo una heterogeneidad en las tasas por distrito y una reducción en el número de casos de TB en la población general (no coinfectados con VIH) y en los mayores de 15 años, siendo mayores en el primer trimestre.

Spatial-temporal analysis of leprosy in a priority Brazilian northeast municipality for disease control / Análisis espacio-temporal de la lepra en municipio del noreste brasileño prioritario para el control de la enfermedad / Análise espaço-temporal da hanseníase em município do Nordeste brasileiro prioritário para o controle da doença

ABSTRACT Objectives: to analyze the spatial-temporal distribution of leprosy in a priority municipality for leprosy control. Methods: ecological study, conducted in a city in the Northeast of Brazil, whose analysis units were census sectors. The study used compulsory notification data for cases registered between 2008 and 2017. TerraView software and the Batch Geocode tool was used for geocoding. The detection of spatial-temporal agglomerations of high relative risks was done by scanning statistics. Results: the spatial-temporal distribution of cases was heterogeneous, creating four agglomerations of high relative risks in the urban area of the municipality between the years 2008 and 2012; and annual prevalence rates classified from high to hyperendemic. Conclusions: areas of higher risk and concentration of the disease in space-time were linked to the characteristics of high population density and social vulnerability of these spaces, raising the prioritization of health professionals' actions, systems, and services for control, and monitoring the disease.

RESUMEN Objetivos: analizar distribución espacio-temporal de lepra en municipio prioritario para control de la enfermedad. Métodos: estudio ecológico, realizado en municipio brasileño, cuyas unidades de análisis fueron sectores censuales. Utilizaron datos de notificación obligatoria relativos a casos registrados entre 2008 y 2017. Para geocodificación, utilizaron el software TerraView y herramienta Batch Geocode. Detección de aglomerados espacio-temporales de altos riesgos relativos realizada por estadística de barredura. Resultados: distribución espacio-temporal de los casos fue heterogénea, con formación de cuatro aglomerados de altos riesgos relativos en la zona urbana del municipio entre 2008 y 2012; y tasas de prevalencia año clasificadas de altas a hiperendémicas. Conclusiones: áreas de mayor riesgo y concentración de la enfermedad en el espacio-tiempo estuvieron relacionadas a las características de alta densidad demográfica y de vulnerabilidad social de esos espacios, suscitando la priorización de acciones de los profesionales, sistemas y servicios de salud para control y vigilancia de la enfermedad.

RESUMO Objetivos: analisar a distribuição espaço-temporal da hanseníase em município prioritário para controle da doença. Métodos: estudo ecológico, realizado em município do Nordeste brasileiro, cujas unidades de análise foram setores censitários. Utilizaram-se dados de notificação compulsória relativos aos casos registrados entre 2008 e 2017. Para geocodificação, utilizaram-se o software TerraView e a ferramenta Batch Geocode. A detecção de aglomerados espaço-temporais de altos riscos relativos foi feita por estatística de varredura. Resultados: a distribuição espaço-temporal dos casos foi heterogênea, com formação de quatro aglomerados de altos riscos relativos na zona urbana do município entre os anos de 2008 e 2012; e taxas de prevalência-ano classificadas de altas a hiperendêmicas. Conclusões: áreas de maior risco e concentração da doença no espaço-tempo estiveram atreladas às características de alta densidade demográfica e de vulnerabilidade social desses espaços, suscitando a priorização de ações dos profissionais, sistemas e serviços de saúde para controle e vigilância da doença.

Spatial-temporal analysis of leprosy in a priority Brazilian northeast municipality for disease control / Análisis espacio-temporal de la lepra en municipio del noreste brasileño prioritario para el control de la enfermedad / Análise espaço-temporal da hanseníase em município do Nordeste brasileiro prioritário para o controle da doença

ABSTRACT Objectives: to analyze the spatial-temporal distribution of leprosy in a priority municipality for leprosy control. Methods: ecological study, conducted in a city in the Northeast of Brazil, whose analysis units were census sectors. The study used compulsory notification data for cases registered between 2008 and 2017. TerraView software and the Batch Geocode tool was used for geocoding. The detection of spatial-temporal agglomerations of high relative risks was done by scanning statistics. Results: the spatial-temporal distribution of cases was heterogeneous, creating four agglomerations of high relative risks in the urban area of the municipality between the years 2008 and 2012; and annual prevalence rates classified from high to hyperendemic. Conclusions: areas of higher risk and concentration of the disease in space-time were linked to the characteristics of high population density and social vulnerability of these spaces, raising the prioritization of health professionals' actions, systems, and services for control, and monitoring the disease.

RESUMEN Objetivos: analizar distribución espacio-temporal de lepra en municipio prioritario para control de la enfermedad. Métodos: estudio ecológico, realizado en municipio brasileño, cuyas unidades de análisis fueron sectores censuales. Utilizaron datos de notificación obligatoria relativos a casos registrados entre 2008 y 2017. Para geocodificación, utilizaron el software TerraView y herramienta Batch Geocode. Detección de aglomerados espacio-temporales de altos riesgos relativos realizada por estadística de barredura. Resultados: distribución espacio-temporal de los casos fue heterogénea, con formación de cuatro aglomerados de altos riesgos relativos en la zona urbana del municipio entre 2008 y 2012; y tasas de prevalencia año clasificadas de altas a hiperendémicas. Conclusiones: áreas de mayor riesgo y concentración de la enfermedad en el espacio-tiempo estuvieron relacionadas a las características de alta densidad demográfica y de vulnerabilidad social de esos espacios, suscitando la priorización de acciones de los profesionales, sistemas y servicios de salud para control y vigilancia de la enfermedad.

RESUMO Objetivos: analisar a distribuição espaço-temporal da hanseníase em município prioritário para controle da doença. Métodos: estudo ecológico, realizado em município do Nordeste brasileiro, cujas unidades de análise foram setores censitários. Utilizaram-se dados de notificação compulsória relativos aos casos registrados entre 2008 e 2017. Para geocodificação, utilizaram-se o software TerraView e a ferramenta Batch Geocode. A detecção de aglomerados espaço-temporais de altos riscos relativos foi feita por estatística de varredura. Resultados: a distribuição espaço-temporal dos casos foi heterogênea, com formação de quatro aglomerados de altos riscos relativos na zona urbana do município entre os anos de 2008 e 2012; e taxas de prevalência-ano classificadas de altas a hiperendêmicas. Conclusões: áreas de maior risco e concentração da doença no espaço-tempo estiveram atreladas às características de alta densidade demográfica e de vulnerabilidade social desses espaços, suscitando a priorização de ações dos profissionais, sistemas e serviços de saúde para controle e vigilância da doença.

Varredura espaço-temporal para identificação de áreas de risco para hospitalização de crianças por asma em Mato Grosso / Space-time scan for identification of risk areas for hospitalization of children due to asthma in Mato Grosso, Brazil

RESUMO: Introdução: A asma resulta de complexa interação entre fatores genéticos, ambientais e socioeconômicos e representa um importante problema de saúde pública mundial. O objetivo deste trabalho foi identificar áreas prioritárias para ações de controle de asma em crianças. Método: Estudo ecológico no qual foi utilizada a varredura espaço-temporal. Selecionaram-se as autorizações de internação hospitalar pagas, não eletivas, de curta permanência (tipo 1), segundo o ano de ocorrência e o local de residência. Os períodos de análise compreendem os anos de 2001-2004 e 2005-2012. Resultados: O cluster primário de alto risco esteve localizado na região do entorno de Barra do Bugres nos dois períodos de estudo (risco relativo = 8,17, no primeiro período, e 10,37, no segundo). O número de clusters de alto risco aumentou de 8, no período 2001-2004, para 9, entre 2005-2012; enquanto os clusters de baixo risco diminuíram de 6, no período inicial, para 4, no último. As áreas prioritárias para atenção e intervenção às crianças com asma são a região do entorno de Barra do Bugres, que se manteve nos dois períodos com clusters primários de alto risco, e a borda leste e nordeste do estado, que apresentou aumento do risco. Além disso, houve aumento de 87% do número de municípios de alto risco e diminuição em 28% dos municípios de proteção. Conclusão: Conclui-se que as áreas prioritárias para a atenção à saúde, nas quais aumentou o risco de internação por asma em crianças, são o entorno de Barra do Bugres e Porto Estrela e a borda leste e nordeste do estado.

ABSTRACT: Introduction: Asthma is the result of a complex interaction between genetic, environmental and socioeconomic factors. It represents a serious global public health problem. The goal of this study was to identify geographic areas for priority actions in order to control of asthma in children. Method: Ecological study that space-time statistic Scan was used. Non-elective, short-stay (type 1) paid authorizations of hospitalizations were selected according to hospitalizations year and children place of residence. Results: In the two periods of the study, the high risk primary cluster was located in the region of Barra do Bugres (relative risk = 8.17, in the first period, and 10.37, in the second). The number of high-risk clusters increased from 8, in the period 2001-2004, to 9, in 2005-2012; while low-risk clusters decreased from 6, in the initial period, to 4, in the latest. The priority geographic areas for attention and intervention for children with asthma are the region around Barra do Bugres, which remained in the two periods with high risk primary clusters and the southwest border of the State that presented increase of the risk. Furthermore, there was an increase of 87% in the number of high risk counties and a reduction of 28% of the counties of protection. Conclusion: In conclusion, the surroundings areas of Barra do Bugres and Porto Estrela and the east and northeast border of the state are priority for health care, once there was an increased risk of hospitalization of children due to asthma.

Spatial-temporal analysis of enterovirus infection in Macao Special Administrative Region, China,2011-2016 / 中华流行病学杂志

Objective To understand the spatial-temporal distribution of enterovirus infection in Macao Special Administrative Region,China,from 2011 to 2016.Methods The incidence data of cnterovirus infections in child care settings and primary schools in Macao during this period,which were confirmed by the Health Bureau,were used for the spatial-temporal analysis.Bernoulli model was used as probability model.Software SPSS 20.0 was used for descriptive statistics of the study cases,and software SaTScan 9.4.4 was used for spatial and temporal scanning.Finally,software Google Earth was used for visualization of geographical information.Results A total of 330 enterovirus infection events were reported in Macao from 2011 to 2016.The infection event number was highest in 2014 (101,30.6％),the infections mainly occurred during May to June.A case clustering area with a radius of 0.7 km (high rates) was observed in northeast of Macao from 2011 to 2013 (log likelihood rate=13.4,P＜0.001,RR=1.4).Conclusion The annual prevention of enterovirus infection and related health education should be started in February and March in Macao,and the key area is the northeast of Macao island.

Spatial-temporal analysis of enterovirus infection in Macao Special Administrative Region, China,2011-2016 / 中华流行病学杂志

Objective To understand the spatial-temporal distribution of enterovirus infection in Macao Special Administrative Region,China,from 2011 to 2016.Methods The incidence data of cnterovirus infections in child care settings and primary schools in Macao during this period,which were confirmed by the Health Bureau,were used for the spatial-temporal analysis.Bernoulli model was used as probability model.Software SPSS 20.0 was used for descriptive statistics of the study cases,and software SaTScan 9.4.4 was used for spatial and temporal scanning.Finally,software Google Earth was used for visualization of geographical information.Results A total of 330 enterovirus infection events were reported in Macao from 2011 to 2016.The infection event number was highest in 2014 (101,30.6％),the infections mainly occurred during May to June.A case clustering area with a radius of 0.7 km (high rates) was observed in northeast of Macao from 2011 to 2013 (log likelihood rate=13.4,P＜0.001,RR=1.4).Conclusion The annual prevention of enterovirus infection and related health education should be started in February and March in Macao,and the key area is the northeast of Macao island.

Analysis on impact of meteorological factors on incidence of hand, foot and mouth disease based on Bayes spatial-temporal theory / 中华流行病学杂志

Objective To understand the impact of meteorological factors on the incidence of hand,foot and mouth disease (HFMD) and the epidemiological characteristics of HFMD in China.Methods Bayesian hierarchical model[Besag,York,and Mollie' (BYM) model] was used to fit the data.The fitting effects of uncorrelated heterogeneity (UH) model,correlated heterogeneity (CH) model and spatial and temporal interaction model were compared and the best model was selected to analyze the meteorological factors influencing the incidence of HFMD.Results The UH +CH model with spatial and temporal interaction had best fitting effect (DIC=35 507.2).Rainfall(RR=1.051 7,95％ CI:1.050 4-1.052 5),average temperature (RR=1.089 6,95％ CI:1.078 1-1.106 9),average relative humidity (RR=l.089 0,95％CI:1.082 1-1.091 2),average air pressure (RR=l.076 4,95％ CI:1.074 8-1.077 9) and hours of sunshine (RR=1.0851,95％ CI:1.0798-1.0875) were the meteorological factors influencing the incidence of HFMD.Conclusion The incidence of HFMD had spatial and temporal clustering characteristics.The meteorological factors were closely related with the incidence of HFMD.

Spatial analysis on new smear-positive pulmonary tuberculosis in China, 2003-2008 / 中华流行病学杂志

Objective To analyze the notification status on new sputum-smear positive pulmonary tuberculosis (TB) over the recent years in China, and identify the clusters to address the related reasons. Methods To spatially and temporally scan the data regarding notification, and to display the results via geographic information system. Results (1) Spatial analysis identified 6clusters and their relative risks ranged from 1.03 to 1.83 with statistical significance; (2) Temporal analysis identified there were clusters between 2005 and 2007 in terms of notification on new sputum-smear positive pulmonary TB, and the relative risk was 1.27 (P=0.001); (3) Spatial and temporal analysis identified 2 clusters and the relative risks of the first class cluster and the second class cluster were 1.35 and 1.49 respectively with statistical significance. Provinces included in the first class cluster were basically the same as these in spatial analysis. Conclusion Distribution of the notification on new sputum-smear positive pulmonary TB was not stochastic at space, time and space-time, and clusters did exist in China.