Determining the spatial distribution of environmental and socio-economic suitability for human leptospirosis in the face of limited epidemiological data.

BACKGROUND: Leptospirosis is among the leading zoonotic causes of morbidity and mortality worldwide. Knowledge about spatial patterns of diseases and their underlying processes have the potential to guide intervention efforts. However, leptospirosis is often an underreported and misdiagnosed disease and consequently, spatial patterns of the disease remain unclear. In the absence of accurate epidemiological data in the urban agglomeration of Santa Fe, we used a knowledge-based index and cluster analysis to identify spatial patterns of environmental and socioeconomic suitability for the disease and potential underlying processes that shape them. METHODS: We geocoded human leptospirosis cases derived from the Argentinian surveillance system during the period 2010 to 2019. Environmental and socioeconomic databases were obtained from satellite images and publicly available platforms on the web. Two sets of human leptospirosis determinants were considered according to the level of their support by the literature and expert knowledge. We used the Zonation algorithm to build a knowledge-based index and a clustering approach to identify distinct potential sets of determinants. Spatial similarity and correlations between index, clusters, and incidence rates were evaluated. RESULTS: We were able to geocode 56.36% of the human leptospirosis cases reported in the national epidemiological database. The knowledge-based index showed the suitability for human leptospirosis in the UA Santa Fe increased from downtown areas of the largest cities towards peri-urban and suburban areas. Cluster analysis revealed downtown areas were characterized by higher levels of socioeconomic conditions. Peri-urban and suburban areas encompassed two clusters which differed in terms of environmental determinants. The highest incidence rates overlapped areas with the highest suitability scores, the strength of association was low though (CSc r = 0.21, P < 0.001 and ESc r = 0.19, P < 0.001). CONCLUSIONS: We present a method to analyze the environmental and socioeconomic suitability for human leptospirosis based on literature and expert knowledge. The methodology can be thought as an evolutive and perfectible scheme as more studies are performed in the area and novel information regarding determinants of the disease become available. Our approach can be a valuable tool for decision-makers since it can serve as a baseline to plan intervention measures.

Differential impacts of ridesharing on alcohol-related crashes by socioeconomic municipalities: rate of technology adoption matters.

BACKGROUND: An emergent group of studies have examined the extent under which ridesharing may decrease alcohol-related crashes in countries such as United States, United Kingdom, Brazil, and Chile. Virtually all existent studies have assumed that ridesharing is equally distributed across socioeconomic groups, potentially masking differences across them. We contribute to this literature by studying how socioeconomic status at the municipal level impacts Uber's effect on alcohol-related crashes. METHODS: We use data provided by Chile's Road Safety Commission considering all alcohol-related crashes, and fatal and severe alcohol-related injuries that occurred between January 2013 and September 2013 (before Uber) and January and September 2014 (with Uber) in Santiago. We first apply spatial autocorrelation techniques to examine the level of spatial dependence between the location of alcohol-related crashes with and without Uber. We then apply random-effects meta-analysis to obtain risk ratios of alcohol-related crashes by considering socioeconomic municipality differences before and after the introduction of Uber. RESULTS: In both analyses, we find that the first 9 months of Uber in Santiago is associated with significant rate ratio decreases (RR = 0.71 [95% Confidence Interval (C.I.) 0.56, 0.89]) in high socioeconomic municipalities in all alcohol-related crashes and null (RR = 1.10 [95% C.I. 0.97, 1.23]) increases in low socioeconomic municipalities. No concomitant associations were observed in fatal alcohol-related crashes regardless of the socioeconomic municipality group. CONCLUSIONS: One interpretation for the decline in alcohol-related crashes in high socioeconomic municipalities is that Uber may be a substitute form of transport for those individuals who have access to credit cards, and thus, could afford to pay for this service at the time they have consumed alcohol. Slight increases of alcohol-related crashes in low socioeconomic municipalities should be studied further since this could be related to different phenomena such as increases in alcohol sales and consumption, less access to the provision of public transport services in these jurisdictions, or biases in police reports.

The Height of Children and Adolescents in Colombia. A Review of More than Sixty Years of Anthropometric Studies, 1957-2020.

In this article, we present a review of the studies on the heights of children and teenagers in Colombia published since 1957. We focus on examining the geographic coverage, features of the population studied, height measurement techniques, authors' profiles, and growth patterns in children. This relatively recent literature has been developed mainly by medical doctors who carried out rigorous measurements with highly specific time and space horizons. The first studies emphasized the differences among socioeconomic levels. Later, there was an interest in minority groups, such as indigenous people and Afro-descendants. Although most of the research lacked long-term vision, the overall balance shows that the country has been improving in anthropometric indicators over time, across territories, and in different socioeconomic groups.