ABSTRACT
INTRODUCTION: Despite the implementation of control strategies at the national scale, the malaria burden remains high in Mali, with more than 2.8 million cases reported in 2019. In this context, a new approach is needed, which accounts for the spatio-temporal variability of malaria transmission at the local scale. This study aimed to describe the spatio-temporal variability of malaria incidence and the associated meteorological and environmental factors in the health district of Kati, Mali. METHODS: Daily malaria cases were collected from the consultation records of the 35 health areas of Kati's health district, for the period 2015-2019. Data on rainfall, relative humidity, temperature, wind speed, the normalized difference vegetation index, air pressure, and land use-land cover were extracted from open-access remote sensing sources, while data on the Niger River's height and flow were obtained from the National Department of Hydraulics. To reduce the dimension and account for collinearity, strongly correlated meteorological and environmental variables were combined into synthetic indicators (SI), using a principal component analysis. A generalized additive model was built to determine the lag and the relationship between the main SIs and malaria incidence. The transmission periods were determined using a change-point analysis. High-risk clusters (hotspots) were detected using the SatScan method and were ranked according to risk level, using a classification and regression tree analysis. RESULTS: The peak of the malaria incidence generally occurred in October. Peak incidence decreased from 60 cases per 1000 person-weeks in 2015, to 27 cases per 1000 person-weeks in 2019. The relationship between the first SI (river flow and height, relative humidity, and rainfall) and malaria incidence was positive and almost linear. A non-linear relationship was found between the second SI (air pressure and temperature) and malaria incidence. Two transmission periods were determined per year: a low transmission period from January to July-corresponding to a persisting transmission during the dry season-and a high transmission period from July to December. The spatial distribution of malaria hotspots varied according to the transmission period. DISCUSSION: Our study confirmed the important variability of malaria incidence and found malaria transmission to be associated with several meteorological and environmental factors in the Kati district. The persistence of malaria during the dry season and the spatio-temporal variability of malaria hotspots reinforce the need for innovative and targeted strategies.
Subject(s)
Malaria , Humans , Incidence , Mali/epidemiology , Malaria/prevention & control , Seasons , Temperature , Spatio-Temporal AnalysisABSTRACT
Se realizó un estudio observacional, descriptivo y transversal de los 86 pacientes que recibieron trasplante renal en el Hospital General Docente Dr Juan Bruno Zayas Alfonso" de Santiago de Cuba, desde diciembre del 2008 hasta igual mes del 2013, con vistas a caracterizarles y determinar las complicaciones quirúrgicas en ellos. Entre los hallazgos más relevantes, se obtuvo que 29 pacientes presentaron al menos una complicación, con predominio de las urológicas, y 50 por ciento requirió tratamiento quirúrgico. A los 12 meses de evolución, 29 pacientes (33,7 por ciento ) mostraban pérdida de la función renal y solo en 8 de ellos (9,3 por ciento ) estaba asociada a complicaciones quirúrgicas. Finalmente se comprobó que no existía una marcada relación entre los tipos de complicaciones quirúrgicas registradas y la capacidad funcional del órgano luego del trasplante(AU)
An observational, descriptive and cross-sectional study of the 86 patients who had a renal transplantation in Dr Juan Bruno Zayas Alfonso Teaching General Hospital in Santiago de Cuba was carried out from December, 2008 to the same month of 2013, with the aim of characterizing them and to determine their surgical complications. Among the most relevant findings there were that 29 patients presented at least a complication, with prevalence of the urological ones, and 50 percent required surgical treatment. After 12 months of clinical course, 29 patients (33.7 percent ) showed loss of the renal function and just in 8 of them (9.3 percent ) it was associated with surgical complications. Finally it was proven that a marked relationship didn't exist between the types of registered surgical complications and the functional capacity of the organ after the transplantation(AU)
Subject(s)
Humans , Male , Female , Kidney Transplantation , Intraoperative Complications , Secondary Care , Kidney/physiology , Postoperative Complications , Epidemiology, Descriptive , Cross-Sectional StudiesABSTRACT
Se realizó un estudio observacional, descriptivo y transversal de los 86 pacientes que recibieron trasplante renal en el Hospital General Docente "Dr. Juan Bruno Zayas Alfonso" de Santiago de Cuba, desde diciembre del 2008 hasta igual mes del 2013, con vistas a caracterizarles y determinar las complicaciones quirúrgicas en ellos. Entre los hallazgos más relevantes, se obtuvo que 29 pacientes presentaron al menos una complicación, con predominio de las urológicas, y 50 % requirió tratamiento quirúrgico. A los 12 meses de evolución, 29 pacientes (33,7 %) mostraban pérdida de la función renal y solo en 8 de ellos (9,3 %) estaba asociada a complicaciones quirúrgicas. Finalmente se comprobó que no existía una marcada relación entre los tipos de complicaciones quirúrgicas registradas y la capacidad funcional del órgano luego del trasplante.
An observational, descriptive and cross-sectional study of the 86 patients who had a renal transplantation in "Dr. Juan Bruno Zayas Alfonso" Teaching General Hospital in Santiago de Cuba was carried out from December, 2008 to the same month of 2013, with the aim of characterizing them and to determine their surgical complications. Among the most relevant findings there were that 29 patients presented at least a complication, with prevalence of the urological ones, and 50% required surgical treatment. After 12 months of clinical course, 29 patients (33.7%) showed loss of the renal function and just in 8 of them (9.3%) it was associated with surgical complications. Finally it was proven that a marked relationship didn't exist between the types of registered surgical complications and the functional capacity of the organ after the transplantation.
