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1.
Front Public Health ; 12: 1418526, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38983249

RESUMEN

Background: HPV is responsible for most cervical, oropharyngeal, anal, vaginal, and vulvar cancers. The HPV vaccine has decreased cervical cancer incidence, but only 49% of Texas adolescents have initiated the vaccine. Texas shows great variation in HPV vaccination rates. We used geospatial analysis to identify areas with high and low vaccination rates and explored differences in neighborhood characteristics. Methods: Using Anselin's Local Moran's I statistic, we conducted an ecological analysis of hot and cold spots of adolescent HPV vaccination coverage in Texas from 2017 to 2021. Next, we utilized a Mann-Whitney U test to compare neighborhood characteristics of vaccination coverage in hot spots versus cold spots, leveraging data from the Child Opportunity Index (COI) and American Community Survey. Results: In Texas, there are 64 persistent vaccination coverage hotspots and 55 persistent vaccination coverage cold spots. The persistent vaccination coverage hot spots are characterized by ZIP codes with lower COI scores, higher percentages of Hispanic residents, higher poverty rates, and smaller populations per square mile compared to vaccine coverage cold spots. We found a more pronounced spatial clustering pattern for male adolescent vaccine coverage than we did for female adolescent vaccine coverage. Conclusion: In Texas, HPV vaccination coverage rates differ depending on the community's income level, with lower-income areas achieving higher success rates. Notably, there are also gender-based discrepancies in vaccination coverage rates, particularly among male adolescents. This knowledge can aid advocates in customizing their outreach initiatives to address these disparities.


Asunto(s)
Infecciones por Papillomavirus , Vacunas contra Papillomavirus , Características de la Residencia , Análisis Espacio-Temporal , Humanos , Texas , Vacunas contra Papillomavirus/administración & dosificación , Femenino , Adolescente , Masculino , Características de la Residencia/estadística & datos numéricos , Infecciones por Papillomavirus/prevención & control , Vacunación/estadística & datos numéricos , Cobertura de Vacunación/estadística & datos numéricos , Disparidades en Atención de Salud/estadística & datos numéricos , Neoplasias del Cuello Uterino/prevención & control
2.
Ann Glob Health ; 90(1): 37, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38947310

RESUMEN

Introduction: Minimum meal frequency is the number of times children eat in a day. Without adequate meal frequency, infants and young children are prone to malnutrition. There is little information on the spatial distribution and determinants of inadequate meal frequency at the national level. Therefore, we aimed to investigate the spatial distribution and determinants of inadequate meal frequency among young children in Ethiopia. Methods: The most recent Ethiopian demographic and health survey data was used. The analysis was conducted using a weighted sample of 1,610 children aged 6-23 months old. The Global Moran's I was estimated to assess the regional variation in minimum meal frequency. Further, a multivariable multilevel logistic regression model was fitted to identify factors associated with inadequate meal frequency. The AOR (adjusted odds ratio) at 95% CI (confidence interval) was computed to assess the strength and significance of the relationship between explanatory variables and the outcome variable. Factors with a p-value of <0.05 are declared statistically significant. Results: This study revealed that the prevalence of inadequate meal frequency was found to be 30.56% (95% CI: 28.33-32.88). We identified statistically significant clusters of high inadequate meal frequency, notably observed in Somalia, northern Amhara, the eastern part of southern nations and nationalities, and the southwestern Oromia regions. Child age, antenatal care (ANC) visit, marital status, and community level illiteracy were significant factors that were associated with inadequate meal frequency. Conclusion: According to the study findings, the proportion of inadequate meal frequency among young children in Ethiopia was higher and also distributed non-randomly across Ethiopian regions. As a result, policymakers and other concerned bodies should prioritize risky areas in designing intervention. Thus, special attention should be given to the Somalia region, the northern part of Amhara, the eastern part of Southern nations and nationalities, and southwestern Oromia.


Asunto(s)
Encuestas Epidemiológicas , Comidas , Análisis Multinivel , Humanos , Etiopía/epidemiología , Lactante , Femenino , Masculino , Análisis Espacial , Conducta Alimentaria , Modelos Logísticos , Escolaridad , Adulto , Adulto Joven , Factores Socioeconómicos
3.
Health Place ; 89: 103318, 2024 Jul 12.
Artículo en Inglés | MEDLINE | ID: mdl-39002227

RESUMEN

The HealthGap study aimed to understand cardiovascular risk among Indigenous Australians in Victoria using linked administrative data. A key challenge was differing spatial coverages of sources: state-level data for risk factors but cardiovascular outcomes for three hospitals. Catchments were defined based on hospital postcodes to estimate denominator populations for risk modelling: first- and second-order neighbours, and spatial distribution of outcomes ('spatial event distribution'). Catchment coverage was assessed through proportions of patients presenting to study hospitals from catchment postcodes. The spatial event distribution performed best, capturing 82% events overall (first-order:40%; second-order:64%) and 65% Indigenous (27% and 45%). No approach excluded proximal non-study hospitals. Spatial event distributions could help define denominator populations when geographic information on outcome data is available but may not avoid potential misclassification.

4.
bioRxiv ; 2024 Jun 25.
Artículo en Inglés | MEDLINE | ID: mdl-38979183

RESUMEN

Background: MHC class I (MHC-I) loss is frequent in non-small cell lung cancer (NSCLC) rendering tumor cells resistant to T cell lysis. NK cells kill MHC-I-deficient tumor cells, and although previous work indicated their presence at NSCLC margins, they were functionally impaired. Within, we evaluated whether NK cell and CD8 T cell infiltration and activation vary with MHC-I expression. Methods: We used single-stain immunohistochemistry (IHC) and Kaplan-Meier analysis to test the effect of NK cell and CD8 T cell infiltration on overall and disease-free survival. To delineate immune covariates of MHC-I-disparate lung cancers, we used multiplexed immunofluorescence (mIF) imaging followed by multivariate statistical modeling. To identify differences in infiltration and intercellular communication between IFNγ-activated and non-activated lymphocytes, we developed a computational pipeline to enumerate single cell neighborhoods from mIF images followed by multivariate discriminant analysis. Results: Spatial quantitation of tumor cell MHC-I expression revealed intra- and inter-tumoral heterogeneity, which was associated with the local lymphocyte landscape. IHC analysis revealed that high CD56+ cell numbers in patient tumors were positively associated with disease-free survival (DFS) (HR=0.58, p=0.064) and overall survival (OS) (HR=0.496, p=0.041). The OS association strengthened with high counts of both CD56+ and CD8+ cells (HR=0.199, p<1×10-3). mIF imaging and multivariate discriminant analysis revealed enrichment of both CD3+CD8+ T cells and CD3-CD56+ NK cells in MHC-I-bearing tumors (p<0.05). To infer associations of functional cell states and local cell-cell communication, we analyzed spatial single cell neighborhood profiles to delineate the cellular environments of IFNγ+/- NK cells and T cells. We discovered that both IFNγ+ NK and CD8 T cells were more frequently associated with other IFNγ+ lymphocytes in comparison to IFNγ- NK cells and CD8 T cells (p<1×10-30). Moreover, IFNγ+ lymphocytes were most often found clustered near MHC-I+ tumor cells. Conclusions: Tumor-infiltrating NK cells and CD8 T cells jointly affected control of NSCLC tumor progression. Co-association of NK and CD8 T cells was most evident in MHC-I-bearing tumors, especially in the presence of IFNγ. Frequent co-localization of IFNγ+ NK cells with other IFNγ+ lymphocytes in near-neighbor analysis suggests NSCLC lymphocyte activation is coordinately regulated.

5.
Mar Environ Res ; 200: 106632, 2024 Jul 06.
Artículo en Inglés | MEDLINE | ID: mdl-39018817

RESUMEN

Trace metals are one of the most serious pollutants in tropical seagrass meadows given their persistence and toxicity. Whereas quantity is frequently measured, there is no information on the spatial extent of metal pollution in these systems. Here, we use an island in Indonesia (Barang Lompo) as a model system to study the impact radius of two major and eight trace metals in sediment and seagrass leaves. We provide evidence for exponential decay in both the metal pollution index and concentrations of most metals with increasing distance from the island (k = -0.01 to -0.08 m-1). Consequently, there is an impact radius of approximately 100 m around the island. The comparative analysis of both seagrass species further revealed interspecific differences in metal loads. This study highlights the importance of assessing the spatial extent of metal pollution in addition to its quantity.

6.
Infect Dis Model ; 9(4): 1045-1056, 2024 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-38974897

RESUMEN

In Canada, Gonorrhea infection ranks as the second most prevalent sexually transmitted infection. In 2018, Manitoba reported an incidence rate three times greater than the national average. This study aims to investigate the spatial, temporal, and spatio-temporal patterns of Gonorrhea infection in Manitoba, using individual-level laboratory-confirmed administrative data provided by Manitoba Health from 2000 to 2016. Age and sex patterns indicate that females are affected by infections at younger ages compared to males. Moreover, there is an increase in repeated infections in 2016, accounting for 16% of the total infections. Spatial analysis at the 96 Manitoba regional health authority districts highlights significant positive spatial autocorrelation, demonstrating a clustered distribution of the infection. Northern districts of Manitoba and central Winnipeg were identified as significant clusters. Temporal analysis shows seasonal patterns, with higher infections in late summer and fall. Additionally, spatio-temporal analysis reveals clusters during high-risk periods, with the most likely cluster in the northern districts of Manitoba from January 2006 to June 2014, and a secondary cluster in central Winnipeg from June 2004 to November 2012. This study identifies that Gonorrhea infection transmission in Manitoba has temporal, spatial, and spatio-temporal variations. The findings provide vital insights for public health and Manitoba Health by revealing high-risk clusters and emphasizing the need for focused and localized prevention, control measures, and resource allocation.

7.
Euro Surveill ; 29(27)2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38967015

RESUMEN

BackgroundQ fever is a bacterial zoonosis caused by Coxiella burnetii. Spain has the highest number of notified human cases in Europe. Small ruminants are a key reservoir for the pathogen, transmission from animals to humans is usually airborne.AimWe aimed at exploring temporal and spatial epidemiological patterns of sporadic and outbreak cases of Q fever in four Spanish regions with the highest number of notified cases.MethodsWe extracted data on Q fever cases in the Canary Islands, Basque Country, La Rioja and Navarre between 2016 and 2022 from the Spanish National Epidemiological Surveillance Network. We calculated standardised incidence ratios (SIR), spatial relative risks (sRR) and posterior probabilities (PP) utilising Besag-York-Mollié models.ResultsThere were 1,059 notifications, with a predominance of males aged 30-60 years. In Basque Country, La Rioja and Navarre area, 11 outbreaks were reported, while no in the Canary Islands. A seasonal increase in incidence rates was observed between March and June. In the Canary Islands, elevated sRR was seen in La Palma, Gran Canaria, Lanzarote and Fuerteventura. In Basque Country, La Rioja and Navarre area, the highest sRR was identified in the south of Biscay province.ConclusionGoats were the main source for humans in outbreaks reported in the literature. Seasonal increase may be related to the parturition season of small ruminants and specific environmental conditions. Local variations in sRR within these regions likely result from diverse environmental factors. Future One Health-oriented studies are essential to deepen our understanding of Q fever epidemiology.


Asunto(s)
Coxiella burnetii , Brotes de Enfermedades , Fiebre Q , Fiebre Q/epidemiología , Fiebre Q/transmisión , Humanos , España/epidemiología , Coxiella burnetii/aislamiento & purificación , Masculino , Incidencia , Persona de Mediana Edad , Animales , Adulto , Femenino , Anciano , Adolescente , Zoonosis/epidemiología , Adulto Joven , Niño , Vigilancia de la Población , Estaciones del Año , Distribución por Edad , Preescolar , Cabras , Distribución por Sexo
8.
Sustain Sci ; 19(4): 1221-1242, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39006533

RESUMEN

European agri-food systems must overcome structural lock-ins to achieve more sustainable modes of production and consumption. Yet European regions are highly diverse, and we lack understanding of how different regional characteristics may enable or inhibit sustainability transitions. This hinders the development of context-tailored governance strategies. In this paper, we identify and apply sets of spatial indicators to map the regional potentials for agri-food transitions. We first analyse the strength of lock-in to the incumbent agro-industrial paradigm. We then map the enabling environments for two alternative agri-food networks-multifunctional value chains and civic food networks-that each embed distinct social-ecological qualities of agriculture and food. Results demonstrate a large spatial diversity in transition potential, with stronger lock-ins throughout North and Western Europe and stronger enabling environments for agri-food transitions in Italy, France, Switzerland, and Southwest Germany. We find that lock-ins are strongest in livestock-dominated regions and are associated with higher GHG emissions and excess nitrogen levels. Our study demonstrates the need for coordinated public policies that (1) leverage region-specific transition potentials and (2) enable complementary innovations in market-based and community-led networks. Supplementary Information: The online version contains supplementary material available at 10.1007/s11625-024-01480-y.

9.
Child Abuse Negl ; 154: 106923, 2024 Jul 13.
Artículo en Inglés | MEDLINE | ID: mdl-39004054

RESUMEN

BACKGROUND: North American studies find that geographic indicators of disadvantage, such as concentrated poverty, significantly increase the risk of child protection involvement. Despite having one of the most extensive family support systems and progressive income redistribution policies in North America, the Canadian province of Québec still faces geographic variations in socioeconomic conditions that remain a major risk factor for child protection involvement. OBJECTIVE: This study asks how child protection involvement is distributed across socioeconomically distinct geographic areas of the province. Drawing from prior literature, we hypothesize that the highest level of child protection involvement across childhood (age 0-17) is found in the lowest socioeconomic areas. PARTICIPANTS & SETTING: This is a population-based prevalence study using administrative child protection data spanning the years 2000 to 2017 across Québec. METHODS: We constructed cumulative risk life tables of first instances of child protection events (report confirmation, compromised security or development, and out-of-home placement). Prevalence rates were mapped onto 10,650 Census dissemination areas divided into three tiers according to a validated socioeconomic status (SES) index. RESULTS: The highest childhood prevalence of confirmed child protection reports, finding of compromised security or development, and out-of-home placement was found in the lowest SES areas. Rates in low SES areas can be over twice the rates in high SES areas. CONCLUSIONS: Area-level socioeconomic vulnerability remains a robust predictor of child protection involvement even in a socially progressive context. Our findings underscore that without targeted pediatric and family services, as well as poverty-alleviation programs for high-need families in high-need areas, even well-intentioned systems may fall short of reaching the families most in need.

10.
J Safety Res ; 89: 251-261, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38858048

RESUMEN

INTRODUCTION: There is regional diversity inside countries regarding road safety indices (RSIs), and countries rarely have been compared based on these indicators. Thus, regional RSIs of England, the United States, Egypt, and Turkey were evaluated. Regional data were collected from the statistical center of each country. The adopted regional RSIs include road fatalities, health risk (HR) or fatalities per population, and traffic risk (TR) or fatalities per number of vehicles. The associations between variables were examined using correlation and regression analysis. The spatial distributions of subdivisions were evaluated using Moran's I, the local Moran index. RESULTS: Considerable differences between the countries were observed, including differences in the spatial distribution of regions and associations between RSIs. Significant relationships were detected between road fatality, population, and the number of motor vehicles. Higher exposure rates mean higher fatalities in regions. A robust linear relationship between the HR and TR indices was identified in developed countries. There is a nonlinear and significant association between motorization rates and TR indices of regions, and fatality risk decreases as the motorization rate increases. There is a considerable gap between developed and developing countries regarding regional RSIs, and the transferability of road safety models from one country to another is challenging. Huge hotspots regarding RSIs were observed in Turkey and the United States. The locations of hot spots in terms of the risk indices were identical in the developed countries.


Asunto(s)
Accidentes de Tránsito , Accidentes de Tránsito/mortalidad , Accidentes de Tránsito/estadística & datos numéricos , Humanos , Turquía/epidemiología , Estados Unidos/epidemiología , Egipto/epidemiología , Inglaterra/epidemiología , Seguridad/estadística & datos numéricos , Medición de Riesgo
11.
Spat Spatiotemporal Epidemiol ; 49: 100656, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38876567

RESUMEN

Disparities in care access for health conditions where physiotherapy can play a major role are abetting health inequities. Spatial analyses can contribute to illuminating inequities in health yet the geographic accessibility to physiotherapy care across New Zealand has not been examined. This population-based study evaluated the accessibility of the New Zealand physiotherapy workforce relative to the population at a local scale. The locations of 5,582 physiotherapists were geocoded and integrated with 2018 Census data to generate 'accessibility scores' for each Statistical Area 2 using the newer 3-step floating catchment area method. For examining the spatial distribution and mapping, accessibility scores were categorized into seven levels, centered around 0.5 SD above and below the mean. New Zealand has an above-average physiotherapy-to-population ratio compared with other OECD countries; however, this workforce is maldistributed. This study identified areas (and locations) where geographic accessibility to physiotherapy care is relatively low.


Asunto(s)
Accesibilidad a los Servicios de Salud , Modalidades de Fisioterapia , Nueva Zelanda , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Humanos , Modalidades de Fisioterapia/estadística & datos numéricos , Masculino , Femenino , Análisis Espacial , Disparidades en Atención de Salud/estadística & datos numéricos
12.
Spat Spatiotemporal Epidemiol ; 49: 100655, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38876566

RESUMEN

Nigeria grapples with a formidable public health concern, as approximately 14 million individuals partake in illicit drug use (IDU). This predicament significantly impacts psychiatric disorders, suicides, disability, and mortality rates. Despite previous investigations into predictors and remedies, the role of financial inclusion (FI) remains inadequately explored. Leveraging existing literature on FI and population health, this study asserts that bolstering FI could be instrumental in mitigating IDU prevalence in Nigeria. We employ spatial analysis to scrutinize the influence of FI and other social factors on IDU, revealing a 14.4 % national prevalence with spatial variations ranging from 7 % in Jigawa state to 33 % in Lagos state. Significant IDU hotspots were identified in the southwest states, while cold spots were observed in the Federal Capital Territory and Nassarawa. Multivariate spatial analysis indicates that FI, income, unemployment, and the proportion of the young population are pivotal predictors of IDU nationwide, explaining approximately 67 % of the spatial variance. Given these findings, the study advocates heightened levels of FI and underscores the need for intensified government initiatives to prevent and address illicit drug use.


Asunto(s)
Drogas Ilícitas , Trastornos Relacionados con Sustancias , Nigeria/epidemiología , Humanos , Trastornos Relacionados con Sustancias/epidemiología , Masculino , Femenino , Adulto , Drogas Ilícitas/economía , Prevalencia , Factores Socioeconómicos , Análisis Espacial , Adulto Joven , Adolescente , Persona de Mediana Edad
14.
Front Cardiovasc Med ; 11: 1316192, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38887453

RESUMEN

Background: COVID-19 has led to significant global mortality, with Peru being among the countries most affected. While pre-existing comorbidities have been linked to most cases, the exact distribution of fatalities within the country remains unclear. We aimed to assess deaths attributed to cardiovascular diseases (CVD) before and during the COVID-19 pandemic across various regions and provinces in Peru. Methods: An observational georeferencing study was designed. Peru faced four waves of COVID-19 over three years, with variable impacts across its three regions (Coast, Highlands, and Jungle). Deaths related to cardiovascular diseases, such as heart failure (HF), arrhythmia, acute myocardial infarction (AMI), strokes, and acute coronary syndrome, were examined as primary variables. The study period spanned pre-pandemic years (2017-2019) and pandemic years (2020-2021), utilizing death data from the National Death Information System (SINADEF). The georeferencing analysis was conducted using ArcGIS v10.3. Results: A total of 28,197 deaths were recorded during the study period, with significant increases during the pandemic (2020-2021). Cardiovascular deaths were disproportionately higher during the pandemic, totaling 19,376 compared to 8,821 in the pre-pandemic period (p < 0.001). AMI and HF were the leading causes of mortality, showing significant increases from the pre-pandemic (5,573 and 2,584 deaths) to the pandemic period (12,579 and 5,628 deaths), respectively. Deaths due to CVD predominantly affected individuals aged over 60, with significant increases between the two study periods (7,245 vs. 16,497 deaths, p = 0.002). Geospatial analysis revealed regional disparities in CVD mortality, highlighting provinces like Lima and Callao as COVID-19 critical areas. The substantial increase in cardiovascular deaths during the COVID-19 pandemic in Peru showed distinctive patterns across regions and provinces. Conclusions: Geospatial analysis identified higher-risk areas and can guide specific interventions to mitigate the impact of future health crises. Understanding the dynamic relationship between pandemics and cardiovascular health is crucial for effective public health strategies.

15.
J Maps ; 20(1)2024.
Artículo en Inglés | MEDLINE | ID: mdl-38881703

RESUMEN

The health and societal impacts of COVID-19 have created tremendous interest in the scientific community, resulting in interdisciplinary research teams that combine their expertise to provide new insights into the epidemic. However, spatial computation, exploratory data analysis, and spatial data exploration tools have yet to be integrated into these dashboards. Despite the availability of these tools, many of the existing COVID-19 dashboards have provided a limited set of data (i.e., last week's total cases), which limits the user's ability to interact with or customize the data visualization. We present a Spatial Online Analytical Platform that integrates spatial analysis tools that enable users to explore and learn more about spatial patterns of COVID-19. We present three interaction classes designed to support users' needs for knowledge about COVID-19 data trends. Our first interaction class allows users to apply user-defined data classifications (i.e., quantile, equal interval, user-defined) and map color choices. The second interaction class applies a risk index across the time series, informing users of the recent temporal trends. The third interaction class allows users to hypothesize about the presence of spatial clusters and receive results on demand. Our SOLAP platform supports the data analysis and exploration needs of big spatial-temporal data.

16.
JMIR Public Health Surveill ; 10: e57209, 2024 Jun 14.
Artículo en Inglés | MEDLINE | ID: mdl-38875687

RESUMEN

BACKGROUND: Pulmonary tuberculosis (PTB) is a chronic communicable disease of major public health and social concern. Although spatial-temporal analysis has been widely used to describe distribution characteristics and transmission patterns, few studies have revealed the changes in the small-scale clustering of PTB at the street level. OBJECTIVE: The aim of this study was to analyze the temporal and spatial distribution characteristics and clusters of PTB at the street level in the Shenzhen municipality of China to provide a reference for PTB prevention and control. METHODS: Data of reported PTB cases in Shenzhen from January 2010 to December 2019 were extracted from the China Information System for Disease Control and Prevention to describe the epidemiological characteristics. Time-series, spatial-autocorrelation, and spatial-temporal scanning analyses were performed to identify the spatial and temporal patterns and high-risk areas at the street level. RESULTS: A total of 58,122 PTB cases from 2010 to 2019 were notified in Shenzhen. The annual notification rate of PTB decreased significantly from 64.97 per 100,000 population in 2010 to 43.43 per 100,000 population in 2019. PTB cases exhibited seasonal variations with peaks in late spring and summer each year. The PTB notification rate was nonrandomly distributed and spatially clustered with a Moran I value of 0.134 (P=.02). One most-likely cluster and 10 secondary clusters were detected, and the most-likely clustering area was centered at Nanshan Street of Nanshan District covering 6 streets, with the clustering time spanning from January 2010 to November 2012. CONCLUSIONS: This study identified seasonal patterns and spatial-temporal clusters of PTB cases at the street level in the Shenzhen municipality of China. Resources should be prioritized to the identified high-risk areas for PTB prevention and control.


Asunto(s)
Análisis Espacio-Temporal , Tuberculosis Pulmonar , Humanos , China/epidemiología , Tuberculosis Pulmonar/epidemiología , Masculino , Adulto , Femenino , Persona de Mediana Edad , Notificación de Enfermedades/estadística & datos numéricos , Adolescente , Anciano , Adulto Joven , Niño , Preescolar , Lactante
17.
Public Health Pract (Oxf) ; 7: 100459, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38895027

RESUMEN

Background: Vaccination against SARS-CoV-2 has been deployed in France since January 2021. Without specific action for different population subgroups, the inverse equity hypothesis postulates that people in the most deprived neighbourhoods will be the last to benefit. The article aims to study whether the inverse care law has been verified in the context of vaccination against SARS-CoV-2 from a vaccination centre of a hospital in the Paris region. Methods: We performed a spatial analysis using primary data from the vaccination centre of the Avicenne Hospital in Bobigny from January 8th to September 30th, 2021. Primary data variables include the vaccinated person's date, age, and postal address. Secondary data calculates access times between residential neighbourhoods and the vaccination centre and social deprivation index. We performed flow analysis, k-means aggregation, and mapping. Results: 32,712 people were vaccinated at the study centre. Vaccination flow to the hospital shows that people living in the most disadvantaged areas were the last to be vaccinated. The number of people immunized according to the level of social deprivation then scales out with slightly more access to the vaccination centre for the most advantaged. The furthest have travelled more than 100 km, and more than 1h45 of transport time to get to this vaccination centre. Conclusion: The study confirms the inverse equity hypothesis and shows that vaccination preparedness strategies must consider equity issues. Public health interventions should be implemented according to proportionate universalism and use community health, health mediation, and outreach activities for more equity.

18.
Public Health ; 233: 149-156, 2024 Jun 18.
Artículo en Inglés | MEDLINE | ID: mdl-38897067

RESUMEN

OBJECTIVES: The aim of this study was to analyse the spatial patterns and factors associated with the incidence of tuberculosis-diabetes (TB-DM) in Brazil, from 2001 to 2019. STUDY DESIGN: Ecological study. METHODS: Brazilian municipalities were used as the units of analysis. The local empirical Bayesian rate and the spatial autocorrelation test were calculated. Moran and Getis-Ord Gi∗ were used to identify spatial clusters, and spatially weighted regression was conducted. RESULTS: In total, 75,021 new cases of TB associated with DM were reported in Brazil during the study period. Most Brazilian municipalities had an average TB-DM incidence of 1.0-2.0/100,000 inhabitants. The regression showed that the Gini index (ß = 0.85) and family health strategy coverage (ß = -0.26) were the two indicators that had the most influence on TB-DM incidence in Brazil. CONCLUSIONS: This study identified spatial clusters of TB-DM in Brazil. The results also indicated that social inequalities played a key role in the incidence of TB.

19.
Pathog Glob Health ; : 1-11, 2024 Jun 21.
Artículo en Inglés | MEDLINE | ID: mdl-38904099

RESUMEN

Understanding the distribution of tegumentary leishmaniasis (TL) in different periods enables the adequate conduction of actions at the public health level. The present study analyzes the spatiotemporal evolution of TL incidence rates in the municipalities of Brazil and identifies priority areas from 2001 to 2020. Notifications of new cases were analyzed employing space-time scan statistics and Local Indicators of Spatial Association. As TL incidence rates presented a downward trend in most Brazilian municipalities, spatiotemporal clusters of high relative risks (RR) were more frequent in the first decade of the series. There was a concentration of those clusters in the North and Northeast regions, mainly in the Legal Amazon area. More recent high-RR areas were identified in municipalities of different regions. The number of priority municipalities showed a stable trend in Brazil. There was a great concentration of such municipalities in the states of Acre, Mato Grosso, Rondônia, Pará, and Amapá, as well as large areas in Roraima, Amazonas, Maranhão, and Tocantins, and smaller areas in the states of Goiás, Ceará, Bahia, Minas Gerais, São Paulo, and Paraná. The present study contributes to the understanding of the historical evolution of TL in Brazil and subsidizes actions to combat the disease.

20.
Artículo en Inglés | MEDLINE | ID: mdl-38899318

RESUMEN

Background: Lung cancer is the leading cause of cancer related deaths. In Kansas, where coal-fired power plants account for 34% of power, we investigated whether hosting counties had higher age-adjusted lung cancer incidence rates. We also examined demographics, poverty levels, percentage of smokers, and environmental conditions using spatial analysis. Methods: Data from the Kansas Health Matters, and the Behavioral Risk Factor Surveillance System (2010-2014) for 105 counties in Kansas were analyzed. Multiple Linear Regression (MLR) assessed associations between potential risk factors and age-adjusted lung cancer incidence rates while Geographically Weighted Regression (GWR) examined regional risk factors. Results: Moran's I test confirmed spatial autocorrelation in age-adjusted lung cancer incidence rates (p<0.0003). MLR identified percentage of smokers, population size, and proportion of elderly population as significant predictors of age-adjusted lung cancer incidence rates (p<0.05). GWR showed positive associations between percentage of smokers and age-adjusted lung cancer incidence rates in over 50% of counties. Conclusion: Contrary to our hypothesis, proximity to a coal-fired power plant was not a significant predictor of age-adjusted lung cancer incidence rates. Instead, percentage of smokers emerged as a consistent global and regional risk factor. Regional lung cancer outcomes in Kansas are influenced by wind patterns and elderly population.

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