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Toledo CRSD, Almeida ASD, Chaves SADM, Sabroza PC, Toledo LM, Caldas JP. Vulnerability to the transmission of human visceral leishmaniasis in a Brazilian urban area. Rev Saude Publica 2017; 51:49. [PMID: 28513764 PMCID: PMC5778952 DOI: 10.1590/s1518-8787.2017051006532] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 12/04/2015] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To analyze the determinants for the occurrence of human visceral leishmaniasis linked to the conditions of vulnerability. METHODS This is an ecological study, whose spatial analysis unit was the Territorial Analysis Unit in Araguaína, State of Tocantins, Brazil, from 2007 to 2012. We have carried out an analysis of the sociodemographic and urban infrastructure situation of the municipality. Normalized primary indicators were calculated and used to construct the indicators of vulnerability of the social structure, household structure, and urban infrastructure. From them, we have composed a vulnerability index. Kernel density estimation was used to evaluate the density of cases of human visceral leishmaniasis, based on the coordinates of the cases. Bivariate global Moran’s I was used to verify the existence of spatial autocorrelation between the incidence of human visceral leishmaniasis and the indicators and index of vulnerability. Bivariate local Moran’s I was used to identify spatial clusters. RESULTS We have observed a pattern of centrifugal spread of human visceral leishmaniasis in the municipality, where outbreaks of the disease have progressively reached central and peri-urban areas. There has been no correlation between higher incidences of human visceral leishmaniasis and worse living conditions. Statistically significant clusters have been observed between the incidences of human visceral leishmaniasis in both periods analyzed (2007 to 2009 and 2010 to 2012) and the indicators and index of vulnerability. CONCLUSIONS The environment in circumscribed areas helps as protection factor or increases the local vulnerability to the occurrence of human visceral leishmaniasis. The use of methodology that analyzes the conditions of life of the population and the spatial distribution of human visceral leishmaniasis is essential to identify the most vulnerable areas to the spread/maintenance of the disease.
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Affiliation(s)
| | - Andréa Sobral de Almeida
- Departamento de Endemias Samuel Pessoa. Escola Nacional de Saúde Pública. Fundação Oswaldo Cruz. Rio de Janeiro, RJ, Brasil
| | | | - Paulo Chagastelles Sabroza
- Departamento de Endemias Samuel Pessoa. Escola Nacional de Saúde Pública. Fundação Oswaldo Cruz. Rio de Janeiro, RJ, Brasil
| | - Luciano Medeiros Toledo
- Departamento de Endemias Samuel Pessoa. Escola Nacional de Saúde Pública. Fundação Oswaldo Cruz. Rio de Janeiro, RJ, Brasil
| | - Jefferson Pereira Caldas
- Programa de Pós-Graduação em Epidemiologia em Saúde Pública. Escola Nacional de Saúde Pública. Fundação Oswaldo Cruz. Rio de Janeiro, RJ, Brasil
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Scripcaru G, Mateus C, Nunes C. A decade of adverse drug events in Portuguese hospitals: space-time clustering and spatial variation in temporal trends. BMC Pharmacol Toxicol 2017; 18:34. [PMID: 28486949 PMCID: PMC5424420 DOI: 10.1186/s40360-017-0140-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 05/01/2017] [Indexed: 12/04/2022] Open
Abstract
Background The aim of this study is to identify the distribution by municipalities of adverse drug events (ADE) in Portugal, including adverse drug reactions (ADR) and accidental poisoning by drugs (AP), on municipality/years ADE rate clustering. Also we identify areas with different trends in time. Methods We used a national dataset of public hospital discharges in Continental Portugal from 2004 to 2013. Events were identified based on codes: from E930 to E949.9 (ADR) and from E850 to E858.9 (AP). Space-time clustering and spatial variation in temporal trends methods were applied in three different time-periods: globally, by year and grouped in 2 classes (periods of 5 years). Results A total of 9,320,076 patients were discharged within this period, with 133,688 patients (1.46%) having at least one ADE, 4% of them related with AP. Critical space-time identified clusters (p < 0.001) were the municipalities from Lisbon metropolitan area and Centro region area. The global rate increased at a 7.8% mean annual percentage change, with high space-time heterogeneity and variation in time trends clusters (p < 0.001). For whole period, 2004–2013, all clusters presented increasing trends. However when analyzed by period of 5 years we identified two clusters with decreasing trends in time in 2004–2008. Conclusion The impact of ADE is huge, with widely variations within country and in time, and represents an increasing challenge. Future research using individual and contextual risk factors are urgently needed to understand this spatiotemporal variability in order to promote local tailored and updated actions of prevention.
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Affiliation(s)
- Gianina Scripcaru
- Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Av Padre Cruz, 1600-560, Lisbon, Portugal.,AMGEN Biofarmaceutica, Lisbon, Portugal
| | - Ceu Mateus
- Health Economics Group Division of Health Research, Lancaster University, Lancaster, UK
| | - Carla Nunes
- Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Av Padre Cruz, 1600-560, Lisbon, Portugal. .,Centro de Investigação em Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal.
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Svechkina A, Zusman M, Rybnikova N, Portnov BA. Spatial identification of potential health hazards: a systematic areal search approach. Int J Health Geogr 2017; 16:5. [PMID: 28173815 PMCID: PMC5297159 DOI: 10.1186/s12942-017-0078-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 02/03/2017] [Indexed: 11/10/2022] Open
Abstract
Background and aims Large metropolitan areas often exhibit multiple morbidity hotspots. However, the identification of specific health hazards, associated with the observed morbidity patterns, is not always straightforward. In this study, we suggest an empirical approach to the identification of specific health hazards, which have the highest probability of association with the observed morbidity patterns. Methods The morbidity effect of a particular health hazard is expected to weaken with distance. To account for this effect, we estimate distance decay gradients for alternative locations and then rank these locations based on the strength of association between the observed morbidity and wind-direction weighted proximities to these locations. To validate this approach, we use both theoretical examples and a case study of the Greater Haifa Metropolitan Area (GHMA) in Israel, which is characterized by multiple health hazards. Results In our theoretical examples, the proposed approach helped to identify correctly the predefined locations of health hazards, while in the real-world case study, the main health hazard was identified as a spot in the industrial zone, which hosts several petrochemical facilities. Conclusion The proposed approach does not require extensive input information and can be used as a preliminary risk assessment tool in a wide range of environmental settings, helping to identify potential environmental risk factors behind the observed population morbidity patterns. Electronic supplementary material The online version of this article (doi:10.1186/s12942-017-0078-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Alina Svechkina
- Department of Natural Resources and Environmental Management, Faculty of Management, University of Haifa, 3498838, Mount Carmel, Haifa, Israel
| | - Marina Zusman
- Department of Natural Resources and Environmental Management, Faculty of Management, University of Haifa, 3498838, Mount Carmel, Haifa, Israel
| | - Natalya Rybnikova
- Department of Natural Resources and Environmental Management, Faculty of Management, University of Haifa, 3498838, Mount Carmel, Haifa, Israel
| | - Boris A Portnov
- Department of Natural Resources and Environmental Management, Faculty of Management, University of Haifa, 3498838, Mount Carmel, Haifa, Israel.
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Singh H, Fortington LV, Thompson H, Finch CF. An overview of geospatial methods used in unintentional injury epidemiology. Inj Epidemiol 2016; 3:32. [PMID: 28018997 PMCID: PMC5183571 DOI: 10.1186/s40621-016-0097-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2016] [Accepted: 11/27/2016] [Indexed: 12/20/2022] Open
Abstract
Background Injuries are a leading cause of death and disability around the world. Injury incidence is often associated with socio-economic and physical environmental factors. The application of geospatial methods has been recognised as important to gain greater understanding of the complex nature of injury and the associated diverse range of geographically-diverse risk factors. Therefore, the aim of this paper is to provide an overview of geospatial methods applied in unintentional injury epidemiological studies. Methods Nine electronic databases were searched for papers published in 2000–2015, inclusive. Included were papers reporting unintentional injuries using geospatial methods for one or more categories of spatial epidemiological methods (mapping; clustering/cluster detection; and ecological analysis). Results describe the included injury cause categories, types of data and details relating to the applied geospatial methods. Results From over 6,000 articles, 67 studies met all inclusion criteria. The major categories of injury data reported with geospatial methods were road traffic (n = 36), falls (n = 11), burns (n = 9), drowning (n = 4), and others (n = 7). Grouped by categories, mapping was the most frequently used method, with 62 (93%) studies applying this approach independently or in conjunction with other geospatial methods. Clustering/cluster detection methods were less common, applied in 27 (40%) studies. Three studies (4%) applied spatial regression methods (one study using a conditional autoregressive model and two studies using geographically weighted regression) to examine the relationship between injury incidence (drowning, road deaths) with aggregated data in relation to explanatory factors (socio-economic and environmental). Conclusion The number of studies using geospatial methods to investigate unintentional injuries has increased over recent years. While the majority of studies have focused on road traffic injuries, other injury cause categories, particularly falls and burns, have also demonstrated the application of these methods. Geospatial investigations of injury have largely been limited to mapping of data to visualise spatial structures. Use of more sophisticated approaches will help to understand a broader range of spatial risk factors, which remain under-explored when using traditional epidemiological approaches. Electronic supplementary material The online version of this article (doi:10.1186/s40621-016-0097-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Himalaya Singh
- Australian Collaboration for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, SMB Campus, PO Box 663, Ballarat, 3353, Australia. .,School of Health Sciences and Psychology, Faculty of Health, Federation University Australia, Ballarat, Australia.
| | - Lauren V Fortington
- Australian Collaboration for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, SMB Campus, PO Box 663, Ballarat, 3353, Australia
| | - Helen Thompson
- Centre for eResearch and Digital Innovation (CeRDI), Federation University Australia, Ballarat, Australia
| | - Caroline F Finch
- Australian Collaboration for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, SMB Campus, PO Box 663, Ballarat, 3353, Australia
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Rezaeian M, Zarghami M. Algorithm Characterization of Suicide: Introducing an Informative Categorization System. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2016; 10:e4544. [PMID: 27822281 PMCID: PMC5097447 DOI: 10.17795/ijpbs-4544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Revised: 04/11/2015] [Accepted: 10/29/2015] [Indexed: 11/25/2022]
Affiliation(s)
- Mohsen Rezaeian
- Epidemiology and Biostatistics Department, Occupational Environmental Research Center, Rafsanjan Medical School, Rafsanjan University of Medical Sciences, Rafsanjan, IR Iran
| | - Mehran Zarghami
- Department of Psychiatry, School of Medicine, Mazandaran University of Medical Sciences, Mazandaran, Sari, IR Iran; Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Mazandaran, Sari, IR Iran
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A multi-level analysis of the relationship between spatial clusters of outpatient-treated depression, risk factors and mental health service planning in Catalonia (Spain). J Affect Disord 2016; 201:42-9. [PMID: 27174850 DOI: 10.1016/j.jad.2016.04.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Revised: 03/31/2016] [Accepted: 04/16/2016] [Indexed: 11/20/2022]
Abstract
BACKGROUND Previous research identified high/low clusters of prevalence of outpatient-treated depression at municipal level in Catalonia (Spain). This study aims to analyse potential risk factors, both socioeconomic and related to the mental health service planning, which could influence the occurrence of hot/cold spots of depressed outpatients at two geographical levels: municipalities and service catchment areas. METHOD Hot/cold spots were examined in relation to socioeconomic indicators at municipal level, such as population density, unemployment, university education, personal income, and also those related to service planning at catchment area level, such as adequacy of healthcare, urbanicity, accessibility and the availability of mental health community centres. The analysis has been carried out through multilevel logistic regression models in order to consider the two different scales. RESULTS Hot spots are related to high population density, unemployment, urbanicity, the adequacy of provision of mental health services, and accessibility to mental health community centres at both study levels. On the other hand, the multilevel model weakly explains cold spots, associating them with high personal incomes. LIMITATIONS The dependent variables of the multi-level models are binary. This limits the interpretation of the results, since they cannot provide information about the variance of the dependent variables explained by the models. CONCLUSIONS The results described diverse risk factors at two levels which are related to a high likelihood of hot and cold spots of depression. The findings show the relevance of health planning in the distribution of diseases and the utilisation of healthcare services.
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Otto P, Schmid W. Detection of spatial change points in the mean and covariances of multivariate simultaneous autoregressive models. Biom J 2016; 58:1113-37. [PMID: 27374408 DOI: 10.1002/bimj.201500148] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Revised: 05/03/2016] [Accepted: 05/03/2016] [Indexed: 11/10/2022]
Abstract
In this paper, we propose a test procedure to detect change points of multidimensional autoregressive processes. The considered process differs from typical applied spatial autoregressive processes in that it is assumed to evolve from a predefined center into every dimension. Additionally, structural breaks in the process can occur at a certain distance from the predefined center. The main aim of this paper is to detect such spatial changes. In particular, we focus on shifts in the mean and the autoregressive parameter. The proposed test procedure is based on the likelihood-ratio approach. Eventually, the goodness-of-fit values of the estimators are compared for different shifts. Moreover, the empirical distribution of the test statistic of the likelihood-ratio test is obtained via Monte Carlo simulations. We show that the generalized Gumbel distribution seems to be a suitable limiting distribution of the proposed test statistic. Finally, we discuss the detection of lung cancer in computed tomography scans and illustrate the proposed test procedure.
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Affiliation(s)
- Philipp Otto
- Department of Statistics, European University Viadrina, Große Scharrnstraße 59, 15230 Frankfurt (Oder), Germany.
| | - Wolfgang Schmid
- Department of Statistics, European University Viadrina, Große Scharrnstraße 59, 15230 Frankfurt (Oder), Germany
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Ribeiro MC, Sousa AJ, Pereira MJ. A coregionalization model can assist specification of Geographically Weighted Poisson Regression: Application to an ecological study. Spat Spatiotemporal Epidemiol 2016; 17:1-13. [DOI: 10.1016/j.sste.2016.02.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 01/19/2016] [Accepted: 02/10/2016] [Indexed: 11/27/2022]
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Ford MM, Highfield LD. Exploring the Spatial Association between Social Deprivation and Cardiovascular Disease Mortality at the Neighborhood Level. PLoS One 2016; 11:e0146085. [PMID: 26731424 PMCID: PMC4701397 DOI: 10.1371/journal.pone.0146085] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Accepted: 12/11/2015] [Indexed: 11/18/2022] Open
Abstract
Cardiovascular disease (CVD), the leading cause of death in the United States, is impacted by neighborhood-level factors including social deprivation. To measure the association between social deprivation and CVD mortality in Harris County, Texas, global (Ordinary Least Squares (OLS) and local (Geographically Weighted Regression (GWR)) models were built. The models explored the spatial variation in the relationship at a census-tract level while controlling for age, income by race, and education. A significant and spatially varying association (p < .01) was found between social deprivation and CVD mortality, when controlling for all other factors in the model. The GWR model provided a better model fit over the analogous OLS model (R2 = .65 vs. .57), reinforcing the importance of geography and neighborhood of residence in the relationship between social deprivation and CVD mortality. Findings from the GWR model can be used to identify neighborhoods at greatest risk for poor health outcomes and to inform the placement of community-based interventions.
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Affiliation(s)
- Mary Margaret Ford
- St. Luke’s Episcopal Health Charities, Houston, Texas, United States of America
- * E-mail:
| | - Linda D. Highfield
- Department of Management, Policy & Community Health, University of Texas School of Public Health, Houston, Texas, United States of America
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BEIRANVAND R, KARIMI A, DELPISHEH A, SAYEHMIRI K, SOLEIMANI S, GHALAVANDI S. Correlation Assessment of Climate and Geographic Distribution of Tuberculosis Using Geographical Information System (GIS). IRANIAN JOURNAL OF PUBLIC HEALTH 2016; 45:86-93. [PMID: 27057526 PMCID: PMC4822399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Tuberculosis (TB) spread pattern is influenced by geographic and social factors. Nowadays Geographic Information System (GIS) is one of the most important epidemiological instrumentation identifying high-risk population groups and geographic areas of TB. The aim of this study was to determine the correlation between climate and geographic distribution of TB in Khuzestan Province using GIS during 2005-2012. METHODS Through an ecological study, all 6363 patients with definite diagnosis of TB from 2005 until the end of September 2012 in Khuzestan Province, southern Iran were diagnosed. Data were recorded using TB- Register software. Tuberculosis incidence based on the climate and the average of annual rain was evaluated using GIS. Data were analyzed through SPSS software. Independent t-test, ANOVA, Linear regression, Pearson and Eta correlation coefficient with a significance level of less than 5% were used for the statistical analysis. RESULTS The TB incidence was different in various geographic conditions. The highest mean of TB cumulative incidence rate was observed in extra dry areas (P= 0.017). There was a significant inverse correlation between annual rain rate and TB incidence rate (R= -0.45, P= 0.001). The lowest TB incidence rate (0-100 cases per 100,000) was in areas with the average of annual rain more than 1000 mm (P= 0.003). CONCLUSION The risk of TB has a strong relationship with climate and the average of annual rain, so that the risk of TB in areas with low annual rainfall and extra dry climate is more than other regions. Services and special cares to high-risk regions of TB are recommended.
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Affiliation(s)
- Reza BEIRANVAND
- Dept. of Epidemiology, Faculty of Medicine, Dezful University of Medical Sciences, Dezful, Iran
| | - Asrin KARIMI
- Dept. of Epidemiology, Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Ali DELPISHEH
- Dept. of Epidemiology, Faculty of Health, Ilam University of Medical Sciences, Ilam, Iran,Corresponding Author:
| | - Kourosh SAYEHMIRI
- Research Center for Prevention of Psychosocial Injuries, Ilam University of Medical Sciences, Ilam, Iran
| | - Samira SOLEIMANI
- Dept. of Environmental Health, Faculty of Health, Ilam University of Medical Sciences, Ilam, Iran
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Ahmadi A, Soori H, Mehrabi Y, Etemad K. Spatial analysis of myocardial infarction in Iran: National report from the Iranian myocardial infarction registry. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2015; 20:434-9. [PMID: 26487871 PMCID: PMC4590197 DOI: 10.4103/1735-1995.163955] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Background: Myocardial infarction (MI) is a leading cause of mortality and morbidity in Iran. No spatial analysis of MI has been conducted to date. The present study was conducted to determine the pattern of MI incidence and to identify the associated factors in Iran by province. Materials and Methods: This study has two parts. One part is prospective and hospital-based, and the other part is an ecological study. In this study, the data of 20,750 new MI cases registered in Iranian Myocardial Infarction Registry in 2012 were used. For spatial analysis in global and local, spatial autocorrelation, Moran's I, Getis-Ord, and logistic regression models were used. Data were analyzed by Stata software and ArcGIS 9.3. Results: Based on autocorrelation coefficient, a specific pattern was observed in the distribution of MI incidence in different provinces (Moran's I: 0.75, P < 0.001). Spatial pattern of incidence was approximately the same in men and women. MI incidence was clustering in six provinces (North Khorasan, Yazd, Kerman, Semnan, Golestan, and Mazandaran). Out of the associated factors with clustered MI in six provinces, temperature, humidity, hypertension, smoking, and body mass index (BMI) could be mentioned. Hypertension, smoking, and BMI contributed to clustering with, respectively, 2.36, 1.31, and 1.31 odds ratio. Conclusion: Addressing the place-based pattern of incidence and clarifying their epidemiologic dimension, including spatial analysis, has not yet been implemented in Iran. Report on MI incidence rate by place and formal borders is useful and is used in the planning and prioritization in different levels of health system.
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Affiliation(s)
- Ali Ahmadi
- Department of Epidemiology and Biostatistics, School of Public Health, Modeling in Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Hamid Soori
- Department of Epidemiology, School of Public Health, Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Yadollah Mehrabi
- Department of Epidemiology, School of Public Health, Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Koorosh Etemad
- Department of Epidemiology, School of Public Health, Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Gracia E, López-Quílez A, Marco M, Lladosa S, Lila M. The Spatial Epidemiology of Intimate Partner Violence: Do Neighborhoods Matter? Am J Epidemiol 2015; 182:58-66. [PMID: 25980418 DOI: 10.1093/aje/kwv016] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2014] [Accepted: 01/15/2015] [Indexed: 11/14/2022] Open
Abstract
We examined whether neighborhood-level characteristics influence spatial variations in the risk of intimate partner violence (IPV). Geocoded data on IPV cases with associated protection orders (n = 1,623) in the city of Valencia, Spain (2011-2013), were used for the analyses. Neighborhood units were 552 census block groups. Drawing from social disorganization theory, we explored 3 types of contextual influences: concentrated disadvantage, concentration of immigrants, and residential instability. A Bayesian spatial random-effects modeling approach was used to analyze influences of neighborhood-level characteristics on small-area variations in IPV risk. Disease mapping methods were also used to visualize areas of excess IPV risk. Results indicated that IPV risk was higher in physically disordered and decaying neighborhoods and in neighborhoods with low educational and economic status levels, high levels of public disorder and crime, and high concentrations of immigrants. Results also revealed spatially structured remaining variability in IPV risk that was not explained by the covariates. In this study, neighborhood concentrated disadvantage and immigrant concentration emerged as significant ecological risk factors explaining IPV. Addressing neighborhood-level risk factors should be considered for better targeting of IPV prevention.
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Tomek S, Hooper LM, Church WT, Bolland KA, Bolland JM, Wilcox K. Relations Among Suicidality, Recent/Frequent Alcohol Use, and Gender in a Black American Adolescent Sample: A Longitudinal Investigation. J Clin Psychol 2015; 71:544-60. [DOI: 10.1002/jclp.22169] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Ngamini Ngui A, Apparicio P, Moltchanova E, Vasiliadis HM. Spatial analysis of suicide mortality in Québec: spatial clustering and area factor correlates. Psychiatry Res 2014; 220:20-30. [PMID: 25095757 DOI: 10.1016/j.psychres.2014.07.033] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2014] [Revised: 07/09/2014] [Accepted: 07/16/2014] [Indexed: 11/18/2022]
Abstract
Understanding the spatial distribution of suicide can inform the planning, implementation and evaluation of suicide prevention actions. No previous study has assessed spatial clustering of the different methods of suicide in Quebec. The aim of this study was to assess spatial clustering of suicide in Quebec between 2004 and 2007 and neighborhood level predictors of the clusters. Scan statistics was applied to detect clusters of suicides by method and by sex. Smoothed standardized mortality ratios (SMRs) for suicide for each neighborhood were also estimated and their association with neighborhood characteristics was investigated using the Bayesian hierarchical spatial model. The pattern of suicide rate was different among men and women; men showed higher standardized mortality rates. The most likely clusters of suicide were found in remote rural areas. However, some neighborhoods in urban areas also had noticeable suicide clusters. Firearms suicide was most likely found in remote rural areas while poisoning and hanging suicide methods clustered in urban areas. These findings suggest that it is important to take geographical variations into account in national policy and health services planning.
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Affiliation(s)
- André Ngamini Ngui
- Centre de réadaptation en dépendance de Montréal - Institut Universitaire, Canada; Hôpital Charles LeMoyne Research Centre Longueuil (QC), Canada.
| | - Philippe Apparicio
- Institut national de la recherche scientifique, Centre Urbanisation Culture Société, Montréal, Québec, Canada.
| | - Elena Moltchanova
- Department of Mathematics and Statistics, University of Canterbury, New Zealand.
| | - Helen-Maria Vasiliadis
- Hôpital Charles LeMoyne Research Centre Longueuil (QC), Canada; Department of Community Health Sciences, Université de Sherbrooke, Qc, Canada.
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Chang ET, Adami HO, Bailey WH, Boffetta P, Krieger RI, Moolgavkar SH, Mandel JS. Validity of geographically modeled environmental exposure estimates. Crit Rev Toxicol 2014; 44:450-66. [PMID: 24766059 DOI: 10.3109/10408444.2014.902029] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Geographic modeling is increasingly being used to estimate long-term environmental exposures in epidemiologic studies of chronic disease outcomes. However, without validation against measured environmental concentrations, personal exposure levels, or biologic doses, these models cannot be assumed a priori to be accurate. This article discusses three examples of epidemiologic associations involving exposures estimated using geographic modeling, and identifies important issues that affect geographically modeled exposure assessment in these areas. In air pollution epidemiology, geographic models of fine particulate matter levels have frequently been validated against measured environmental levels, but comparisons between ambient and personal exposure levels have shown only moderate correlations. Estimating exposure to magnetic fields by using geographically modeled distances is problematic because the error is larger at short distances, where field levels can vary substantially. Geographic models of environmental exposure to pesticides, including paraquat, have seldom been validated against environmental or personal levels, and validation studies have yielded inconsistent and typically modest results. In general, the exposure misclassification resulting from geographic models of environmental exposures can be differential and can result in bias away from the null even if non-differential. Therefore, geographic exposure models must be rigorously constructed and validated if they are to be relied upon to produce credible scientific results to inform epidemiologic research. To our knowledge, such models have not yet successfully predicted an association between an environmental exposure and a chronic disease outcome that has eventually been established as causal, and may not be capable of doing so in the absence of thorough validation.
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Affiliation(s)
- Ellen T Chang
- Health Sciences Practice, Exponent, Inc. , Menlo Park, CA, Bowie, MD, and Bellevue, WA , USA
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Rezaeian M. A call for revising the strengthening the reporting of observational studies in epidemiology statement to include ecologic studies. J Clin Epidemiol 2014; 67:836-7. [PMID: 24751175 DOI: 10.1016/j.jclinepi.2014.02.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Accepted: 02/24/2014] [Indexed: 11/25/2022]
Affiliation(s)
- Mohsen Rezaeian
- Social Medicine Department, Occupational Environmental Research Center, Rafsanjan Medical School, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
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Rashidi M, Ramesht MH, Zohary M, Poursafa P, Kelishadi R, Rashidi Z, Rouzbahani R. Relation of air pollution with epidemiology of respiratory diseases in isfahan, Iran from 2005 to 2009. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2013; 18:1074-9. [PMID: 24523799 PMCID: PMC3908529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Revised: 05/13/2013] [Accepted: 05/30/2013] [Indexed: 11/23/2022]
Abstract
BACKGROUND National Institute of Environmental Health Sciences (NIEHS) scientists shows that long-term exposure to air pollutants increases the risk of respiratory diseases such as allergies, asthma, chronic obstructive pulmonary disease, and lung cancer. Children and the elderly are particularly vulnerable to the health effects of ozone, fine particles, and other airborne toxicants. Air pollution factors are considered as one of the underlying causes of respiratory diseases. This study aimed to determine the association of respiratory diseases documented in medical records and air pollution (Map distribution) of accumulation in Isfahan province, Iran. By plotting the prevalence and spatial distribution maps, important differences from different points can be observed. MATERIALS AND METHODS The geographic information system (GIS), pollutant standards index (PSI) measurements, and remote Sensing (RS) technology were used after entering data in the mapping information table; spatial distribution was mapped and distribution of Geographical Epidemiology of Respiratory Diseases in Isfahan province (Iran) was determined in this case study from 2005 to 2009. RESULTS Space with tracing the distribution of respiratory diseases was scattered based on the distribution of air pollution in the points is an important part of this type of diseases in Isfahan province where air pollution was more abundant. CONCLUSION The findings of this study emphasis on the importance of preventing the exposure to air pollution, and to control air pollution product industries, to improve work environmental health, and to increase the health professionals and public knowledge in this regard.
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Affiliation(s)
- Maasoumeh Rashidi
- PhD Student, Department of Geography, University of Isfahan and Remote Sensing Researcher, Iranian Space Research Center, Tehran, Iran,Address for correspondence: Maasoumeh Rashidi, PhD Student, Department of Geography, University of Isfahan and Remote Sensing Researcher, Iranian Space Research Center, Tehran, Iran. E-mail:
| | | | - Moein Zohary
- Remote Sensing Researcher, University of Tehran and Iranian Space Research Center, Tehran, Iran
| | - Parinaz Poursafa
- Environmental Engineering, Environment Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Roya Kelishadi
- Preventive Pediatric Cardiology, Isfahan Cardiovascular Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zeinab Rashidi
- Sport Psychology, School of Physical Education, Islamic Azad University, Karaj Branch, Karaj, Iran
| | - Reza Rouzbahani
- Specialist in Community Medicine, Researcher, Isfahan University of Medical Sciences, Isfahan, Iran
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68
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Wimberly MC, Giacomo P, Kightlinger L, Hildreth MB. Spatio-temporal epidemiology of human West Nile virus disease in South Dakota. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 10:5584-602. [PMID: 24173141 PMCID: PMC3863861 DOI: 10.3390/ijerph10115584] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Revised: 10/08/2013] [Accepted: 10/15/2013] [Indexed: 11/16/2022]
Abstract
Despite a cold temperate climate and low human population density, the Northern Great Plains has become a persistent hot spot for human West Nile virus (WNV) disease in North America. Understanding the spatial and temporal patterns of WNV can provide insights into the epidemiological and ecological factors that influence disease emergence and persistence. We analyzed the 1,962 cases of human WNV disease that occurred in South Dakota from 2002-2012 to identify the geographic distribution, seasonal cycles, and interannual variability of disease risk. The geographic and seasonal patterns of WNV have changed since the invasion and initial epidemic in 2002-2003, with cases shifting toward the eastern portion of South Dakota and occurring earlier in the transmission season in more recent years. WNV cases were temporally autocorrelated at lags of up to six weeks and early season cumulative case numbers were correlated with seasonal totals, indicating the possibility of using these data for short-term early detection of outbreaks. Epidemiological data are likely to be most effective for early warning of WNV virus outbreaks if they are integrated with entomological surveillance and environmental monitoring to leverage the strengths and minimize the weaknesses of each information source.
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Affiliation(s)
- Michael C. Wimberly
- Geospatial Sciences Center of Excellence, South Dakota State University, Brookings, SD 57007, USA; E-Mail:
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +1-605-688-5350; Fax: +1-605-688-5227
| | - Paolla Giacomo
- Geospatial Sciences Center of Excellence, South Dakota State University, Brookings, SD 57007, USA; E-Mail:
| | - Lon Kightlinger
- South Dakota Department of Health, Pierre, SD 57501, USA; E-Mail:
| | - Michael B. Hildreth
- Departments of Biology & Microbiology and Veterinary & Biomedical Sciences, South Dakota State University, Brookings, SD 57007, USA; E-Mail:
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Sartorius B, Sartorius K. Identifying and targeting mortality disparities: a framework for sub-saharan Africa using adult mortality data from South Africa. PLoS One 2013; 8:e71437. [PMID: 23967209 PMCID: PMC3743803 DOI: 10.1371/journal.pone.0071437] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Accepted: 06/29/2013] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Health inequities in developing countries are difficult to eradicate because of limited resources. The neglect of adult mortality in Sub-Saharan Africa (SSA) is a particular concern. Advances in data availability, software and analytic methods have created opportunities to address this challenge and tailor interventions to small areas. This study demonstrates how a generic framework can be applied to guide policy interventions to reduce adult mortality in high risk areas. The framework, therefore, incorporates the spatial clustering of adult mortality, estimates the impact of a range of determinants and quantifies the impact of their removal to ensure optimal returns on scarce resources. METHODS Data from a national cross-sectional survey in 2007 were used to illustrate the use of the generic framework for SSA and elsewhere. Adult mortality proportions were analyzed at four administrative levels and spatial analyses were used to identify areas with significant excess mortality. An ecological approach was then used to assess the relationship between mortality "hotspots" and various determinants. Population attributable fractions were calculated to quantify the reduction in mortality as a result of targeted removal of high-impact determinants. RESULTS Overall adult mortality rate was 145 per 10,000. Spatial disaggregation identified a highly non-random pattern and 67 significant high risk local municipalities were identified. The most prominent determinants of adult mortality included HIV antenatal sero-prevalence, low SES and lack of formal marital union status. The removal of the most attributable factors, based on local area prevalence, suggest that overall adult mortality could be potentially reduced by ∼90 deaths per 10,000. CONCLUSIONS The innovative use of secondary data and advanced epidemiological techniques can be combined in a generic framework to identify and map mortality to the lowest administration level. The identification of high risk mortality determinants allows health authorities to tailor interventions at local level. This approach can be replicated elsewhere.
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Affiliation(s)
- Benn Sartorius
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
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Dijkstra A, Hak E, Janssen F. A systematic review of the application of spatial analysis in pharmacoepidemiologic research. Ann Epidemiol 2013; 23:504-14. [PMID: 23830932 DOI: 10.1016/j.annepidem.2013.05.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Revised: 05/23/2013] [Accepted: 05/23/2013] [Indexed: 11/18/2022]
Abstract
PURPOSE Although current reviews of the use of spatial analysis in general epidemiologic research illustrate an important and well-established role in exploring and predicting health, its application has not been reviewed in the subspecialty field of pharmacoepidemiology. METHODS We systematically reviewed the scientific literature to assess to what extent spatial analysis has been applied in pharmacoepidemiologic research and explored its potential added value. RESULTS A systematic search in PubMed and Embase/MEDLINE yielded 823 potentially relevant articles; 45 articles met our criteria for review. The studies were reviewed on study objective, applied spatial methods and units of analysis, and author-reported added value of the geographic approach used. Of the 45 included studies, 34 (76%) reported a geographic research objective. Comparative spatial methods were most often used (n = 25; 56%). Eleven studies used spatial statistics (32%); cluster analysis (n = 5) and aggregate data analysis (n = 4) being most common. Mapping was done in 15 studies (33%). The most common added value reported was to aid the planning of health policies and interventions (n = 24; 53%). A minority of pharmacoepidemiologic studies used a geographic approach and the applied methods were less advanced compared with the broader field of epidemiology. CONCLUSIONS Further advancements are needed to incorporate currently available spatial techniques to impact health care planning.
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Affiliation(s)
- Aletta Dijkstra
- Unit of PharmacoEpidemiology & PharmacoEconomics (PE(2)), Department of Pharmacy, University of Groningen, The Netherlands.
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Corner RJ, Dewan AM, Hashizume M. Modelling typhoid risk in Dhaka metropolitan area of Bangladesh: the role of socio-economic and environmental factors. Int J Health Geogr 2013; 12:13. [PMID: 23497202 PMCID: PMC3610306 DOI: 10.1186/1476-072x-12-13] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2012] [Accepted: 03/03/2013] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Developing countries in South Asia, such as Bangladesh, bear a disproportionate burden of diarrhoeal diseases such as cholera, typhoid and paratyphoid. These seem to be aggravated by a number of social and environmental factors such as lack of access to safe drinking water, overcrowdedness and poor hygiene brought about by poverty. Some socioeconomic data can be obtained from census data whilst others are more difficult to elucidate. This study considers a range of both census data and spatial data from other sources, including remote sensing, as potential predictors of typhoid risk. Typhoid data are aggregated from hospital admission records for the period from 2005 to 2009. The spatial and statistical structures of the data are analysed and principal axis factoring is used to reduce the degree of co-linearity in the data. The resulting factors are combined into a quality of life index, which in turn is used in a regression model of typhoid occurrence and risk. RESULTS The three principal factors used together explain 87% of the variance in the initial candidate predictors, which eminently qualifies them for use as a set of uncorrelated explanatory variables in a linear regression model. Initial regression result using ordinary least squares (OLS) were disappointing, this was explainable by analysis of the spatial autocorrelation inherent in the principal factors. The use of geographically weighted regression caused a considerable increase in the predictive power of regressions based on these factors. The best prediction, determined by analysis of the Akaike information criterion (AIC) was found when the three factors were combined into a quality of life index, using a method previously published by others, and had a coefficient of determination of 73%. CONCLUSIONS The typhoid occurrence/risk prediction equation was used to develop the first risk map showing areas of Dhaka metropolitan area whose inhabitants are at greater or lesser risk of typhoid infection. This, coupled with seasonal information on typhoid incidence also reported in this paper, has the potential to advise public health professionals on developing prevention strategies such as targeted vaccination.
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Affiliation(s)
- Robert J Corner
- Department of Spatial Sciences, Curtin University, GPO Box U1987, Perth, Western Australia, 6845, Australia
| | - Ashraf M Dewan
- Department of Spatial Sciences, Curtin University, GPO Box U1987, Perth, Western Australia, 6845, Australia
- Department of Geography & Environment, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Masahiro Hashizume
- Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan
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Dewan AM, Corner R, Hashizume M, Ongee ET. Typhoid Fever and its association with environmental factors in the Dhaka Metropolitan Area of Bangladesh: a spatial and time-series approach. PLoS Negl Trop Dis 2013; 7:e1998. [PMID: 23359825 PMCID: PMC3554574 DOI: 10.1371/journal.pntd.0001998] [Citation(s) in RCA: 119] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2012] [Accepted: 11/20/2012] [Indexed: 11/25/2022] Open
Abstract
Typhoid fever is a major cause of death worldwide with a major part of the disease burden in developing regions such as the Indian sub-continent. Bangladesh is part of this highly endemic region, yet little is known about the spatial and temporal distribution of the disease at a regional scale. This research used a Geographic Information System to explore, spatially and temporally, the prevalence of typhoid in Dhaka Metropolitan Area (DMA) of Bangladesh over the period 2005-9. This paper provides the first study of the spatio-temporal epidemiology of typhoid for this region. The aims of the study were: (i) to analyse the epidemiology of cases from 2005 to 2009; (ii) to identify spatial patterns of infection based on two spatial hypotheses; and (iii) to determine the hydro-climatological factors associated with typhoid prevalence. Case occurrences data were collected from 11 major hospitals in DMA, geocoded to census tract level, and used in a spatio-temporal analysis with a range of demographic, environmental and meteorological variables. Analyses revealed distinct seasonality as well as age and gender differences, with males and very young children being disproportionately infected. The male-female ratio of typhoid cases was found to be 1.36, and the median age of the cases was 14 years. Typhoid incidence was higher in male population than female (χ(2) = 5.88, p<0.05). The age-specific incidence rate was highest for the 0-4 years age group (277 cases), followed by the 60+ years age group (51 cases), then there were 45 cases for 15-17 years, 37 cases for 18-34 years, 34 cases for 35-39 years and 11 cases for 10-14 years per 100,000 people. Monsoon months had the highest disease occurrences (44.62%) followed by the pre-monsoon (30.54%) and post-monsoon (24.85%) season. The Student's t test revealed that there is no significant difference on the occurrence of typhoid between urban and rural environments (p>0.05). A statistically significant inverse association was found between typhoid incidence and distance to major waterbodies. Spatial pattern analysis showed that there was a significant clustering of typhoid distribution in the study area. Moran's I was highest (0.879; p<0.01) in 2008 and lowest (0.075; p<0.05) in 2009. Incidence rates were found to form three large, multi-centred, spatial clusters with no significant difference between urban and rural rates. Temporally, typhoid incidence was seen to increase with temperature, rainfall and river level at time lags ranging from three to five weeks. For example, for a 0.1 metre rise in river levels, the number of typhoid cases increased by 4.6% (95% CI: 2.4-2.8) above the threshold of 4.0 metres (95% CI: 2.4-4.3). On the other hand, with a 1 °C rise in temperature, the number of typhoid cases could increase by 14.2% (95% CI: 4.4-25.0).
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Affiliation(s)
- Ashraf M. Dewan
- Department of Spatial Sciences, Curtin University Western Australia, Bentley, Western Australia, Australia
| | - Robert Corner
- Department of Spatial Sciences, Curtin University Western Australia, Bentley, Western Australia, Australia
| | | | - Emmanuel T. Ongee
- Department of Spatial Sciences, Curtin University Western Australia, Bentley, Western Australia, Australia
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Sartorius B. Modelling determinants, impact, and space-time risk of age-specific mortality in rural South Africa: integrating methods to enhance policy relevance. Glob Health Action 2013; 6:19239. [PMID: 23364094 PMCID: PMC3556703 DOI: 10.3402/gha.v6i0.19239] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2012] [Revised: 10/19/2012] [Accepted: 10/20/2012] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND There is a lack of reliable data in developing countries to inform policy and optimise resource allocation. Health and socio-demographic surveillance sites (HDSS) have the potential to address this gap. Mortality levels and trends have previously been documented in rural South Africa. However, complex space-time clustering of mortality, determinants, and their impact has not been fully examined. OBJECTIVES To integrate advanced methods enhance the understanding of the dynamics of mortality in space-time, to identify mortality risk factors and population attributable impact, to relate disparities in risk factor distributions to spatial mortality risk, and thus, to improve policy planning and resource allocation. METHODS Agincourt HDSS supplied data for the period 1992-2008. Advanced spatial techniques were used to identify significant age-specific mortality 'hotspots' in space-time. Multivariable Bayesian models were used to assess the effects of the most significant covariates on mortality. Disparities in risk factor profiles in identified hotspots were assessed. RESULTS Increasing HIV-related mortality and a subsequent decrease possibly attributable to antiretroviral therapy introduction are evident in this rural population. Distinct space-time clustering and variation (even in a small geographic area) of mortality were observed. Several known and novel risk factors were identified, and population impact was quantified. Significant differences in the risk factor profiles of the identified 'hotspots' included ethnicity; maternal, partner, and household deaths; household head demographics; migrancy; education; and poverty. CONCLUSIONS A complex interaction of highly attributable multilevel factors continues to demonstrate differential space-time influences on mortality risk (especially for HIV). High-risk households and villages displayed differential risk factor profiles. This integrated approach could prove valuable to decision makers. Tailored interventions for specific child and adult high-risk mortality areas are needed, such as preventing vertical transmission, ensuring maternal survival, and improving water and sanitation infrastructure. This framework can be applied in other settings within the region.
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Affiliation(s)
- Benn Sartorius
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
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Cartabia M, Campi R, Clavenna A, Bortolotti A, Fortino I, Merlino L, Bonati M. Geographical epidemiology of antibacterials in the preschool age. Int J Health Geogr 2012; 11:52. [PMID: 23241437 PMCID: PMC3539941 DOI: 10.1186/1476-072x-11-52] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2012] [Accepted: 12/11/2012] [Indexed: 12/05/2022] Open
Abstract
Abstract Riassunto
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Affiliation(s)
- Massimo Cartabia
- Department of Public Health, Mario Negri Pharmacological Research Institute, Milan, Italy.
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Neighborhood Influences on Late Life Cognition in the ACTIVE Study. J Aging Res 2012; 2012:435826. [PMID: 22966458 PMCID: PMC3433144 DOI: 10.1155/2012/435826] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Revised: 06/10/2012] [Accepted: 06/30/2012] [Indexed: 11/23/2022] Open
Abstract
Low neighborhood-level socioeconomic status has been associated with poorer health, reduced physical activity, increased psychological stress, and less neighborhood-based social support. These outcomes are correlates of late life cognition, but few studies have specifically investigated the neighborhood as a unique source of explanatory variance in cognitive aging. This study supplemented baseline cognitive data from the ACTIVE (Advanced Cognitive Training for Independent and Vital Elderly) study with neighborhood-level data to investigate (1) whether neighborhood socioeconomic position (SEP) predicts cognitive level, and if so, whether it differentially predicts performance in general and specific domains of cognition and (2) whether neighborhood SEP predicts differences in response to short-term cognitive intervention for memory, reasoning, or processing speed. Neighborhood SEP positively predicted vocabulary, but did not predict other general or specific measures of cognitive level, and did not predict individual differences in response to cognitive intervention.
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Salinas-Pérez JA, García-Alonso CR, Molina-Parrilla C, Jordà-Sampietro E, Salvador-Carulla L. Identification and location of hot and cold spots of treated prevalence of depression in Catalonia (Spain). Int J Health Geogr 2012; 11:36. [PMID: 22917223 PMCID: PMC3460765 DOI: 10.1186/1476-072x-11-36] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2012] [Accepted: 08/10/2012] [Indexed: 12/04/2022] Open
Abstract
Background Spatial analysis is a relevant set of tools for studying the geographical distribution of diseases, although its methods and techniques for analysis may yield very different results. A new hybrid approach has been applied to the spatial analysis of treated prevalence of depression in Catalonia (Spain) according to the following descriptive hypotheses: 1) spatial clusters of treated prevalence of depression (hot and cold spots) exist and, 2) these clusters are related to the administrative divisions of mental health care (catchment areas) in this region. Methods In this ecological study, morbidity data per municipality have been extracted from the regional outpatient mental health database (CMBD-SMA) for the year 2009. The second level of analysis mapped small mental health catchment areas or groups of municipalities covered by a single mental health community centre. Spatial analysis has been performed using a Multi-Objective Evolutionary Algorithm (MOEA) which identified geographical clusters (hot spots and cold spots) of depression through the optimization of its treated prevalence. Catchment areas, where hot and cold spots are located, have been described by four domains: urbanicity, availability, accessibility and adequacy of provision of mental health care. Results MOEA has identified 6 hot spots and 4 cold spots of depression in Catalonia. Our results show a clear spatial pattern where one cold spot contributed to define the exact location, shape and borders of three hot spots. Analysing the corresponding domain values for the identified hot and cold spots no common pattern has been detected. Conclusions MOEA has effectively identified hot/cold spots of depression in Catalonia. However these hot/cold spots comprised municipalities from different catchment areas and we could not relate them to the administrative distribution of mental care in the region. By combining the analysis of hot/cold spots, a better statistical and operational-based visual representation of the geographical distribution is obtained. This technology may be incorporated into Decision Support Systems to enhance local evidence-informed policy in health system research.
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Affiliation(s)
- José A Salinas-Pérez
- Universidad Loyola Andalucía, Business Administration Faculty, Sevilla, Córdoba, Spain.
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Abstract
PURPOSE OF REVIEW Geographic variation in the occurrence and outcomes of chronic kidney disease (CKD) is major area of study in epidemiology and health services and outcomes research. Geographic attributes may be as diverse as the physical, socioeconomic, and medical care characteristics of an environment. This review summarizes the recent literature pertaining to geographic risk factors and CKD. RECENT FINDINGS Studies have reported on the association between CKD and physical attributes of place (ambient temperature and altitude), the impact of disasters on CKD populations, new diseases characterized by regional localization, national variations in CKD incidence and prevalence, regional variation in end-stage renal disease incidence, residential mobility and CKD risk factors, and geographic variations in CKD care. The emerging role of tools for geospatial studies - including multilevel analytical designs, which reduce the likelihood of an ecologically biased inference, and geographic information systems, which allow the simultaneous linkage, analysis, and mapping of geospatial data - is illustrated by these studies. SUMMARY Our understanding of the occurrence and outcomes of CKD will continue to be expanded and deepened by the explicit study of attributes associated with place as a potential risk factor. Many of the studies reviewed are largely hypothesis generating, and a better understanding of the role of geography in the study of CKD awaits investigations that probe the mechanisms that link attributes of place to disease processes.
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Abstract
Understanding the impact of place on health is a key element of epidemiologic investigation, and numerous tools are being employed for analysis of spatial health-related data. This review documents the huge growth in spatial epidemiology, summarizes the tools that have been employed, and provides in-depth discussion of several methods. Relevant research articles for 2000-2010 from seven epidemiology journals were included if the study utilized a spatial analysis method in primary analysis (n = 207). Results summarized frequency of spatial methods and substantive focus; graphs explored trends over time. The most common spatial methods were distance calculations, spatial aggregation, clustering, spatial smoothing and interpolation, and spatial regression. Proximity measures were predominant and were applied primarily to air quality and climate science and resource access studies. The review concludes by noting emerging areas that are likely to be important to future spatial analysis in public health.
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Affiliation(s)
- Amy H. Auchincloss
- Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, Pennsylvania 19102;
| | - Samson Y. Gebreab
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan 48109; ,
| | - Christina Mair
- Prevention Research Center, University of California, Berkeley, California 94704;
| | - Ana V. Diez Roux
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan 48109; ,
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Rezaeian M. Suicide clusters: introducing a novel type of categorization. VIOLENCE AND VICTIMS 2012; 27:125-132. [PMID: 22455189 DOI: 10.1891/0886-6708.27.1.125] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
A suicide cluster within a given community may be defined as a group of suicides or suicide attempts, or both, that happen closer together in time and space than would generally be expected. However, since the perception of clustering may itself be a risk factor for suicide, suicide clusters differ almost from all other event clusters. The aim of this article, therefore, is to discuss the unique pattern of suicide cluster and introduce a novel type of categorization taking into account varieties of studies, which investigate suicide clusters within diverse settings. This article concludes with challenging areas in suicide cluster studies and emphasizing that each community must deal rapidly and appropriately with any perceived suicide clusters.
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Affiliation(s)
- Mohsen Rezaeian
- Social Medicine Department, Rafsanjan Medical School, Rafsanjan University of Medical Sciences, Iran.
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Ducey TF, Miller JO, Busscher WJ, Lackland DT, Hunt PG. An analysis of the link between strokes and soils in the South Carolina coastal plains. JOURNAL OF ENVIRONMENTAL SCIENCE AND HEALTH. PART A, TOXIC/HAZARDOUS SUBSTANCES & ENVIRONMENTAL ENGINEERING 2012; 47:1104-1112. [PMID: 22506703 DOI: 10.1080/10934529.2012.668064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The Stroke Belt is a geographical region of the Southeastern United States where resident individuals suffer a disproportionately higher rate of strokes than the rest of the population. While the "buckle" of this Stroke Belt coincides with the Southeastern Coastal Plain region of North and South Carolina and Georgia, there is a paucity of information pinpointing specific causes for this phenomenon. A number of studies posit that an exposure event-potentially microbial in nature-early in life, could be a risk factor. The most likely vector for such an exposure event would be the soils of the Southeastern Coastal Plain region. These soils may have chemical and physical properties which are conducive to the growth and survival of microorganisms which may predispose individuals to stroke. To this aim, we correlated SC stroke mortality data to soil characteristics found in the NRCS SSURGO database. In statewide comparisons, depth to water table (50 to 100 cm, R = 0.62) and soil drainage class (poorly drained, R = 0.59; well drained, R = -0.54) both showed statistically significant relationships with stroke rate. In a 20 county comparison, depth to water table, drainage class, hydric rating (hydric soils, R = 0.56), and pH (very strongly acid, R = 0.66) all showed statistically significant relationships with stroke rate. These data should help direct future research and epidemiology efforts to pinpoint the exact exposure events which predispose individuals to an increased stroke rate.
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Affiliation(s)
- Thomas F Ducey
- Coastal Plains Soil, Water, and Plant Research Center, Agricultural Research Service, USDA, Florence, South Carolina, USA.
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81
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Dominkovics P, Granell C, Pérez-Navarro A, Casals M, Orcau A, Caylà JA. Development of spatial density maps based on geoprocessing web services: application to tuberculosis incidence in Barcelona, Spain. Int J Health Geogr 2011; 10:62. [PMID: 22126392 PMCID: PMC3251534 DOI: 10.1186/1476-072x-10-62] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2011] [Accepted: 11/29/2011] [Indexed: 11/18/2022] Open
Abstract
Background Health professionals and authorities strive to cope with heterogeneous data, services, and statistical models to support decision making on public health. Sophisticated analysis and distributed processing capabilities over geocoded epidemiological data are seen as driving factors to speed up control and decision making in these health risk situations. In this context, recent Web technologies and standards-based web services deployed on geospatial information infrastructures have rapidly become an efficient way to access, share, process, and visualize geocoded health-related information. Methods Data used on this study is based on Tuberculosis (TB) cases registered in Barcelona city during 2009. Residential addresses are geocoded and loaded into a spatial database that acts as a backend database. The web-based application architecture and geoprocessing web services are designed according to the Representational State Transfer (REST) principles. These web processing services produce spatial density maps against the backend database. Results The results are focused on the use of the proposed web-based application to the analysis of TB cases in Barcelona. The application produces spatial density maps to ease the monitoring and decision making process by health professionals. We also include a discussion of how spatial density maps may be useful for health practitioners in such contexts. Conclusions In this paper, we developed web-based client application and a set of geoprocessing web services to support specific health-spatial requirements. Spatial density maps of TB incidence were generated to help health professionals in analysis and decision-making tasks. The combined use of geographic information tools, map viewers, and geoprocessing services leads to interesting possibilities in handling health data in a spatial manner. In particular, the use of spatial density maps has been effective to identify the most affected areas and its spatial impact. This study is an attempt to demonstrate how web processing services together with web-based mapping capabilities suit the needs of health practitioners in epidemiological analysis scenarios.
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Affiliation(s)
- Pau Dominkovics
- Estudis d'Informàtica, Multimèdia i Telecomunicació, Universitat Oberta de Catalunya (UOC), Rambla del Poblenou, 156, 08018, Barcelona, Spain
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Spatio-temporal patterns of Barmah Forest virus disease in Queensland, Australia. PLoS One 2011; 6:e25688. [PMID: 22022430 PMCID: PMC3192738 DOI: 10.1371/journal.pone.0025688] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2011] [Accepted: 09/08/2011] [Indexed: 02/06/2023] Open
Abstract
Background Barmah Forest virus (BFV) disease is a common and wide-spread mosquito-borne disease in Australia. This study investigated the spatio-temporal patterns of BFV disease in Queensland, Australia using geographical information system (GIS) tools and geostatistical analysis. Methods/Principal Findings We calculated the incidence rates and standardised incidence rates of BFV disease. Moran's I statistic was used to assess the spatial autocorrelation of BFV incidences. Spatial dynamics of BFV disease was examined using semi-variogram analysis. Interpolation techniques were applied to visualise and display the spatial distribution of BFV disease in statistical local areas (SLAs) throughout Queensland. Mapping of BFV disease by SLAs reveals the presence of substantial spatio-temporal variation over time. Statistically significant differences in BFV incidence rates were identified among age groups (χ2 = 7587, df = 7327,p<0.01). There was a significant positive spatial autocorrelation of BFV incidence for all four periods, with the Moran's I statistic ranging from 0.1506 to 0.2901 (p<0.01). Semi-variogram analysis and smoothed maps created from interpolation techniques indicate that the pattern of spatial autocorrelation was not homogeneous across the state. Conclusions/Significance This is the first study to examine spatial and temporal variation in the incidence rates of BFV disease across Queensland using GIS and geostatistics. The BFV transmission varied with age and gender, which may be due to exposure rates or behavioural risk factors. There are differences in the spatio-temporal patterns of BFV disease which may be related to local socio-ecological and environmental factors. These research findings may have implications in the BFV disease control and prevention programs in Queensland.
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83
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Rezaeian M, Dunn G, St Leger S, Appleby L. Mapping suicide in London: a brief methodological case study on the application of the smoothing technique. CRISIS 2011; 32:225-30. [PMID: 21940247 DOI: 10.1027/0227-5910/a000085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND When one intends to globally smooth unstable rates, e.g., suicide rates in a region, one needs to consider whether it is better to smooth the rates toward the global mean of the country or toward the global mean of the same region. AIMS The present study aims to provide a methodological framework to answer this question by smoothing suicide rates within London boroughs. METHODS Based on the results of the spatial autocorrelation statistics, the noniterative empirical Bayes method of moments was chosen to globally smooth the suicide rate of each borough, first toward the global mean of England and Wales, and second toward the mean of the London region. RESULTS The results revealed that smoothing the suicide rates of the boroughs toward the global mean of England and Wales had a stronger influence in reducing the variability of suicide rates than smoothing toward the global mean of the London region. CONCLUSIONS Smoothing the rates toward the mean of a region within a country acts somewhat between global and local smoothing.
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Affiliation(s)
- Mohsen Rezaeian
- Social Medicine Department, Rafsanjan Medical School, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
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Cheng CL, Chen YC, Liu TM, Yang YHK. Using spatial analysis to demonstrate the heterogeneity of the cardiovascular drug-prescribing pattern in Taiwan. BMC Public Health 2011; 11:380. [PMID: 21609462 PMCID: PMC3125367 DOI: 10.1186/1471-2458-11-380] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2010] [Accepted: 05/24/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Geographic Information Systems (GIS) combined with spatial analytical methods could be helpful in examining patterns of drug use. Little attention has been paid to geographic variation of cardiovascular prescription use in Taiwan. The main objective was to use local spatial association statistics to test whether or not the cardiovascular medication-prescribing pattern is homogenous across 352 townships in Taiwan. METHODS The statistical methods used were the global measures of Moran's I and Local Indicators of Spatial Association (LISA). While Moran's I provides information on the overall spatial distribution of the data, LISA provides information on types of spatial association at the local level. LISA statistics can also be used to identify influential locations in spatial association analysis. The major classes of prescription cardiovascular drugs were taken from Taiwan's National Health Insurance Research Database (NHIRD), which has a coverage rate of over 97%. The dosage of each prescription was converted into defined daily doses to measure the consumption of each class of drugs. Data were analyzed with ArcGIS and GeoDa at the township level. RESULTS The LISA statistics showed an unusual use of cardiovascular medications in the southern townships with high local variation. Patterns of drug use also showed more low-low spatial clusters (cold spots) than high-high spatial clusters (hot spots), and those low-low associations were clustered in the rural areas. CONCLUSIONS The cardiovascular drug prescribing patterns were heterogeneous across Taiwan. In particular, a clear pattern of north-south disparity exists. Such spatial clustering helps prioritize the target areas that require better education concerning drug use.
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Affiliation(s)
- Ching-Lan Cheng
- Institute of Biopharmaceutical Science, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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85
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Rezaeian M, Dunn G, St Leger S, Appleby L. Application of commercial software to the classification of suicide cases: a brief report. VIOLENCE AND VICTIMS 2011; 26:533-540. [PMID: 21882673 DOI: 10.1891/0886-6708.26.4.533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Mosaic Profiler software was used to classify suicide and open verdict cases during 1996 to 1998 in England and within England, for the London and the North West regions. The classification system was based on the socioeconomic characteristics of the last place of residence of the cases at the level of postcode. The results highlighted that deprived areas and areas that contain elderly population or those areas that suffer from lack of social cohesion are overrepresented, whereas affluent areas are underrepresented. All of these, although in the larger scale, seem to support the results of other studies. Nevertheless, more studies would be required before one can fully evaluate the application of the Mosaic Profiler in the field of spatial epidemiology.
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Affiliation(s)
- Mohsen Rezaeian
- School of Medicine, Rafsanjan University of Medical Sciences, Iran.
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Geographical Variations in the Prevalence of COPD in Spain: Relationship to Smoking, Death Rates and other Determining Factors. ACTA ACUST UNITED AC 2010. [DOI: 10.1016/s1579-2129(11)60005-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Soriano JB, Miravitlles M, Borderías L, Duran-Tauleria E, García Río F, Martínez J, Montemayor T, Muñoz L, Piñeiro L, Sánchez G, Serra J, Soler-Cataluña JJ, Torres A, Luis Viejo J, Sobradillo-Peña V, Ancochea J. [Geographical variations in the prevalence of COPD in Spain: relationship to smoking, death rates and other determining factors]. Arch Bronconeumol 2010; 46:522-30. [PMID: 20832926 DOI: 10.1016/j.arbres.2010.06.008] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2010] [Revised: 06/11/2010] [Accepted: 06/16/2010] [Indexed: 11/30/2022]
Abstract
BACKGROUND The EPI-SCAN study (Epidemiologic Study of COPD in Spain), conducted from May 2006 to July 2007, determined that the prevalence of COPD in Spain according to the GOLD criteria was 10.2% of the 40 to 80 years population. Little is known about the current geographical variation of COPD in Spain. OBJECTIVES We studied the prevalence of COPD, its under-diagnosis and under-treatment, smoking and mortality in the eleven areas participating in EPI-SCAN. COPD was defined as a post-bronchodilator FEV₁/FVC ratio <0.70 or as the lower limit of normal (LLN). RESULTS The ratio of prevalences of COPD among the EPI-SCAN areas was 2.7-fold, with a peak in Asturias (16.9%) and a minimum in Burgos (6.2 %) (P<0.05). The prevalence of COPD according to LLN was 5.6% (95% CI 4.9-6.4) and the ratio of COPD prevalence using LLN was 3.1-fold, but with a peak in Madrid-La Princesa (10.1%) and a minimum in Burgos (3.2%) (P<0.05). The ranking of prevalences of COPD was not maintained in both sexes or age groups in each area. Variations in under-diagnosis (58.6% to 72.8%) and under-treatment by areas (24.1% to 72.5%) were substantial (P<0.05). The prevalence of smokers and former smokers, and cumulative exposure as measured by pack-years, and the age structure of each of the areas did not explain much of the variability by geographic areas. Nor is there any relation with mortality rates published by Autonomous Communities. CONCLUSION There are significant variations in the distribution of COPD in Spain, either in prevalence or in under-diagnosis and under-treatment.
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Strebel K, Rolle-Kampczyk U, Richter M, Kindler A, Richter T, Schlink U. A rigorous small area modelling-study for the Helicobacter pylori epidemiology. THE SCIENCE OF THE TOTAL ENVIRONMENT 2010; 408:3931-3942. [PMID: 20444496 DOI: 10.1016/j.scitotenv.2010.03.045] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2009] [Revised: 03/22/2010] [Accepted: 03/24/2010] [Indexed: 05/29/2023]
Abstract
This paper presents an investigation into spatial risk differences over small distances for the Helicobacter pylori infection in the city of Leipzig, Germany and two rural districts. A model, using Bayesian inference, was developed that adjusts the risk for individual-specific factors, and for spatial or individual over-dispersion, respectively. Additionally, the model takes into account conditional spatial autocorrelation. We found a significant positive association to the H. pylori infection risk for: "more than three children live in the household" (OR=2.4, p=0.001), "more persons live per sq.m than average" (OR=1.4, p=0.03), "home situated at main road" (OR=1.4, p=0.04) and "using well water" (OR=2.3, p=0.05). A protective effect was identified for "travelled to low prevalence region" (OR=0.4, p<0.0001) and "born in Germany" (OR=0.2, p<0.0001). Three administrative areas with significantly increased spatial risk were identified: one in the rural district and two in the city of Leipzig. The model explained 24.9% of the total deviance. Contrary to expectations, the largest part of deviance of the data was not explained by the identified significant risk factors, but by individual-specific heterogeneities. We conclude that further - so far not discussed - factors influence the risk and the spatial variation of the H.pylori infection. Furthermore, from the results we speculate about a possible impact of long-time air pollution and surface water.
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Affiliation(s)
- Kathrin Strebel
- Helmholtz Centre for Environmental Research-UFZ, Permoserstrasse 15, 04318 Leipzig, Germany.
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Szonyi B, Wade SE, Mohammed HO. Temporal and spatial dynamics of Cryptosporidium parvum infection on dairy farms in the New York City Watershed: a cluster analysis based on crude and Bayesian risk estimates. Int J Health Geogr 2010; 9:31. [PMID: 20565805 PMCID: PMC2902428 DOI: 10.1186/1476-072x-9-31] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2010] [Accepted: 06/17/2010] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Cryptosporidium parvum is one of the most important biological contaminants in drinking water that produces life threatening infection in people with compromised immune systems. Dairy calves are thought to be the primary source of C. parvum contamination in watersheds. Understanding the spatial and temporal variation in the risk of C. parvum infection in dairy cattle is essential for designing cost-effective watershed management strategies to protect drinking water sources. Crude and Bayesian seasonal risk estimates for Cryptosporidium in dairy calves were used to investigate the spatio-temporal dynamics of C. parvum infection on dairy farms in the New York City watershed. RESULTS Both global (Global Moran's I) and specific (SaTScan) cluster analysis methods revealed a significant (p < 0.05) elliptical spatial cluster in the winter with a relative risk of 5.8, but not in other seasons. There was a two-fold increase in the risk of C. parvum infection in all herds in the summer (p = 0.002), compared to the rest of the year. Bayesian estimates did not show significant spatial autocorrelation in any season. CONCLUSIONS Although we were not able to identify seasonal clusters using Bayesian approach, crude estimates highlighted both temporal and spatial clusters of C. parvum infection in dairy herds in a major watershed. We recommend that further studies focus on the factors that may lead to the presence of C. parvum clusters within the watershed, so that monitoring and prevention practices such as stream monitoring, riparian buffers, fencing and manure management can be prioritized and improved, to protect drinking water supplies and public health.
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Affiliation(s)
- Barbara Szonyi
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, 14853, USA
| | - Susan E Wade
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, 14853, USA
| | - Hussni O Mohammed
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, 14853, USA
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Congdon P. Estimating prevalence of coronary heart disease for small areas using collateral indicators of morbidity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2010; 7:164-77. [PMID: 20195439 PMCID: PMC2819782 DOI: 10.3390/ijerph7010164] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2009] [Accepted: 01/14/2010] [Indexed: 11/16/2022]
Abstract
Different indicators of morbidity for chronic disease may not necessarily be available at a disaggregated spatial scale (e.g., for small areas with populations under 10 thousand). Instead certain indicators may only be available at a more highly aggregated spatial scale; for example, deaths may be recorded for small areas, but disease prevalence only at a considerably higher spatial scale. Nevertheless prevalence estimates at small area level are important for assessing health need. An instance is provided by England where deaths and hospital admissions for coronary heart disease are available for small areas known as wards, but prevalence is only available for relatively large health authority areas. To estimate CHD prevalence at small area level in such a situation, a shared random effect method is proposed that pools information regarding spatial morbidity contrasts over different indicators (deaths, hospitalizations, prevalence). The shared random effect approach also incorporates differences between small areas in known risk factors (e.g., income, ethnic structure). A Poisson-multinomial equivalence may be used to ensure small area prevalence estimates sum to the known higher area total. An illustration is provided by data for London using hospital admissions and CHD deaths at ward level, together with CHD prevalence totals for considerably larger local health authority areas. The shared random effect involved a spatially correlated common factor, that accounts for clustering in latent risk factors, and also provides a summary measure of small area CHD morbidity.
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Affiliation(s)
- Peter Congdon
- Department of Geography and Centre for Statistics, Queen Mary University of London, Mile End Rd, London E1 4NS, UK.
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91
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Werneck GL. Georeferenced data in epidemiologic research. CIENCIA & SAUDE COLETIVA 2009; 13:1753-66. [PMID: 18833352 DOI: 10.1590/s1413-81232008000600010] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2008] [Accepted: 06/20/2008] [Indexed: 01/01/2023] Open
Abstract
This paper reviews some conceptual and practical issues regarding the application of georeferenced data in epidemiologic research. Starting with the disease mapping tradition of geographical medicine, topics such as types of georeferenced data, implications for data analysis, spatial autocorrelation and main analytical approaches are heuristically discussed, relying on examples from the epidemiologic literature, most of them concerning mapping disease distribution, detection of disease spatial clustering, evaluation of exposure in environmental health investigation and ecological correlation studies. As for concluding remarks, special topics that deserve further development, including the misuses of the concept of space in epidemiologic research, issues related to data quality and confidentiality, the role of epidemiologic designs for spatial research, sensitivity analysis and spatiotemporal modeling, are presented.
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Affiliation(s)
- Guilherme Loureiro Werneck
- Departamento de Endemias Samuel Pessoa, Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro, RJ.
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92
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Basara HG, Yuan M. Community health assessment using self-organizing maps and geographic information systems. Int J Health Geogr 2008; 7:67. [PMID: 19116020 PMCID: PMC2632622 DOI: 10.1186/1476-072x-7-67] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2008] [Accepted: 12/30/2008] [Indexed: 11/23/2022] Open
Abstract
Background From a public health perspective, a healthier community environment correlates with fewer occurrences of chronic or infectious diseases. Our premise is that community health is a non-linear function of environmental and socioeconomic effects that are not normally distributed among communities. The objective was to integrate multivariate data sets representing social, economic, and physical environmental factors to evaluate the hypothesis that communities with similar environmental characteristics exhibit similar distributions of disease. Results The SOM algorithm used the intrinsic distributions of 92 environmental variables to classify 511 communities into five clusters. SOM determined clusters were reprojected to geographic space and compared with the distributions of several health outcomes. ANOVA results indicated that the variability between community clusters was significant with respect to the spatial distribution of disease occurrence. Conclusion Our study demonstrated a positive relationship between environmental conditions and health outcomes in communities using the SOM-GIS method to overcome data and methodological challenges traditionally encountered in public health research. Results demonstrated that community health can be classified using environmental variables and that the SOM-GIS method may be applied to multivariate environmental health studies.
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Affiliation(s)
- Heather G Basara
- Center for Applied Social Research, University of Oklahoma, 101 David L, Boren Blvd,, Norman, OK, USA.
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93
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Loughnan ME, Nicholls N, Tapper NJ. Demographic, seasonal, and spatial differences in acute myocardial infarction admissions to hospital in Melbourne Australia. Int J Health Geogr 2008; 7:42. [PMID: 18664293 PMCID: PMC2517067 DOI: 10.1186/1476-072x-7-42] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2008] [Accepted: 07/30/2008] [Indexed: 11/10/2022] Open
Abstract
Background Seasonal patterns in cardiac disease in the northern hemisphere are well described in the literature. More recently age and gender differences in cardiac mortality and to a lesser extent morbidity have been presented. To date spatial differences between the seasonal patterns of cardiac disease has not been presented. Literature relating to seasonal patterns in cardiac disease in the southern hemisphere and in Australia in particular is scarce. The aim of this paper is to describe the seasonal, age, gender, and spatial patterns of cardiac disease in Melbourne Australia by using acute myocardial infarction admissions to hospital as a marker of cardiac disease. Results There were 33,165 Acute Myocardial Infarction (AMI) admissions over 2186 consecutive days. There is a seasonal pattern in AMI admissions with increased rates during the colder months. The peak month is July. The admissions rate is greater for males than for females, although this difference decreases with advancing age. The maximal AMI season for males extends from April to November. The difference between months of peak and minimum admissions was 33.7%. Increased female AMI admissions occur from May to November, with a variation between peak and minimum of 23.1%. Maps of seasonal AMI admissions demonstrate spatial differences. Analysis using Global and Local Moran's I showed increased spatial clustering during the warmer months. The Bivariate Moran's I statistic indicated a weaker relationship between AMI and age during the warmer months. Conclusion There are two distinct seasons with increased admissions during the colder part of the year. Males present a stronger seasonal pattern than females. There are spatial differences in AMI admissions throughout the year that cannot be explained by the age structure of the population. The seasonal difference in AMI admissions warrants further investigation. This includes detailing the prevalence of cardiac disease in the community and examining issues of social and environmental justice.
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Affiliation(s)
- Margaret E Loughnan
- School of Geography and Environmental Science Monash University, Wellington Road Clayton, Australia.
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Haas SW, Travers D, Tintinalli JE, Pollock D, Waller A, Barthell E, Burt C, Chapman W, Coonan K, Kamens D, McClay J. Toward vocabulary control for chief complaint. Acad Emerg Med 2008; 15:476-82. [PMID: 18439204 DOI: 10.1111/j.1553-2712.2008.00104.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The chief complaint (CC) is the data element that documents the patient's reason for visiting the emergency department (ED). The need for a CC vocabulary has been acknowledged at national meetings and in multiple publications, but to our knowledge no groups have specifically focused on the requirements and development plans for a CC vocabulary. The national consensus meeting "Towards Vocabulary Control for Chief Complaint" was convened to identify the potential uses for ED CC and to develop the framework for CC vocabulary control. The 10-point consensus recommendations for action were 1) begin to develop a controlled vocabulary for CC, 2) obtain funding, 3) establish an infrastructure, 4) work with standards organizations, 5) address CC vocabulary characteristics for all user communities, 6) create a collection of CC for research, 7) identify the best candidate vocabulary for ED CCs, 8) conduct vocabulary validation studies, 9) establish beta test sites, and 10) plan publicity and marketing for the vocabulary.
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Affiliation(s)
- Stephanie W Haas
- School of Information and Library Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Borrell C. Methods in Social Epidemiology. J Michael Oakes and Jay S Kaufman. Int J Epidemiol 2007. [DOI: 10.1093/ije/dym183] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Piro FN, Næss Ø, Claussen B. Area deprivation and its association with health in a cross-sectional study: are the results biased by recent migration? Int J Equity Health 2007; 6:10. [PMID: 17883855 PMCID: PMC2072941 DOI: 10.1186/1475-9276-6-10] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2006] [Accepted: 09/20/2007] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The association between area deprivation and health has mostly been examined in cross-sectional studies or prospective studies with short follow-up. These studies have rarely taken migration into account. This is a possible source of misclassification of exposure, i.e. an unknown number of study participants are attributed an exposure of area deprivation that they may have experienced too short for it to have any influence. The aim of this article was to examine to what extent associations between area deprivation and health outcomes were biased by recent migration. METHODS Based on data from the Oslo Health Study, a cross-sectional study conducted in 2000 in Oslo, Norway, we used six health outcomes (self rated health, mental health, coronary heart disease, chronic obstructive pulmonary disease, smoking and exercise) and considered migration nine years prior to the study conduct. Migration into Oslo, between the areas of Oslo, and the changes in area deprivation during the period were taken into account. Associations were investigated by multilevel logistic regression analyses. RESULTS After adjustment for individual socio-demographic variables we found significant associations between area deprivation and all health outcomes. Accounting for migration into Oslo and between areas of Oslo did not change these associations much. However, the people who migrated into Oslo were younger and had lower prevalences of unfavourable health outcomes than those who were already living in Oslo. But since they were evenly distributed across the area deprivation quintiles, they had little influence on the associations between area deprivation and health. Evidence of selective migration within Oslo was weak, as both moving up and down in the deprivation hierarchy was associated with significantly worse health than not moving. CONCLUSION We have documented significant associations between area deprivation and health outcomes in Oslo after adjustment for socio-demographic variables in a cross-sectional study. These associations were weakly biased by recent migration. From our results it still appears that migration prior to study conduct may be relevant to investigate even within a relatively short period of time, whereas changes in area deprivation during such a period is of limited interest.
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Affiliation(s)
- Fredrik Niclas Piro
- Institute of General Practice and Community Medicine, University of Oslo, Norway
| | - Øyvind Næss
- Institute of General Practice and Community Medicine, University of Oslo, Norway
| | - Bjørgulf Claussen
- Institute of General Practice and Community Medicine, University of Oslo, Norway
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Rezaeian M, Dunn G, St Leger S, Appleby L. Do hot spots of deprivation predict the rates of suicide within London boroughs? Health Place 2007; 13:886-93. [PMID: 17468030 DOI: 10.1016/j.healthplace.2007.02.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2006] [Revised: 02/24/2007] [Accepted: 02/27/2007] [Indexed: 01/18/2023]
Abstract
INTRODUCTION The ecological associations between suicide rates and different indices of deprivation within London have been investigated at least for half a century. In the present study, the association between rates of suicide with newly developed hot spots of deprivation index within London boroughs have been studied taking into account the results of the spatial dependency between suicide rates in nearby boroughs. METHODS Suicide data were provided by the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness. The hot spots index of deprivation and the population counts were provided by the Department of the Environment, Transport and the Region (DETR) and Office for the National Statistics (ONS), respectively. RESULTS The results show that there is no strong spatial dependency between suicide rates in the London boroughs, the 'hot spots' index of deprivation predicts the rates of suicide in males 30-49, better than other age and sex groups. The rate of suicide decreases with decreasing deprivation as indicated by the 'hot spots' index. CONCLUSION These findings suggest that at the London boroughs the 'hot spots' index of deprivation (together with other socio-economic and social fragmentation indices) should be considered as a potential explanatory variable to explain the effects of age on rates of suicide in men and women.
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Affiliation(s)
- Mohsen Rezaeian
- Biostatistics Group, Division of Epidemiology and Health Sciences, The University of Manchester, UK.
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