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Weather data is of great importance to the development of weather prediction models. However, the availability and quality of this data remains a significant challenge for most researchers around the world. In Uganda, obtaining observational weather data is very challenging due to the sparse distribution of weather stations and inconsistent data records. This has created critical gaps in data availability to run and develop efficient weather prediction models. To bridge this gap, we obtained country-specific time series hourly observational weather data. The data period is from 2020 to 2022 of 11 weather stations distributed in the four regions of Uganda. The data was accessed from the Ogimet data repository using the "climate" R-package. The automated procedures in the R-programming language environment allowed us to download user-defined data at a time resolution from an hourly to an annual basis. However, the raw data acquired cannot be used to learn rainfall patterns because it includes duplicates and non-uniform data. Therefore, this article presents a prepared and cleaned dataset that can be used for the prediction of short-term rainfall quantities in Uganda.
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Particulate matter exposure is a risk factor for lower respiratory tract infection in children. Here, we investigated the geospatial patterns of community-acquired pneumonia and the impact of PM2.5 (particulate matter with an aerodynamic diameter ≤2.5 µm) on geospatial variability of pneumonia in children. We performed a retrospective analysis of prospectively collected population-based surveillance study data of community-acquired pneumonia hospitalizations among children <18 years residing in the Memphis metropolitan area, who were enrolled in the Centers for Disease Control and Prevention sponsored Etiology of Pneumonia in the Community (EPIC) study from January 2010 to June 2012. The outcome measure, residence in high- and low-risk areas for community-acquired pneumonia, was determined by calculating pneumonia incidence rates and performing cluster analysis to identify areas with higher/lower than expected rates of community-acquired pneumonia for the population at risk. High PM2.5 was defined as exposure to PM2.5 concentrations greater than the mean value (>10.75 µg/m3), and low PM2.5 is defined as exposure to PM2.5 concentrations less than or equal to the mean value (≤10.75 µg/m3). We also assessed the effects of age, sex, race/ethnicity, history of wheezing, insurance type, tobacco smoke exposure, bacterial etiology, and viral etiology of infection. Of 810 (96.1%) subjects with radiographic community-acquired pneumonia, who resided in the Memphis metropolitan area and had addresses which were successfully geocoded (Supplementary Figure F2), 220 (27.2%) patients were identified to be from high- (n = 126) or low-risk (n = 94) community-acquired pneumonia areas. Community-acquired pneumonia in Memphis metropolitan area had a non-homogenous geospatial pattern. PM2.5 was associated with residence in high-risk areas for community-acquired pneumonia. In addition, children with private insurance and bacterial, as opposed to viral, etiology of infection had a decreased risk of residence in a high-risk area for community-acquired pneumonia. The results from this paper suggest that environmental exposures as well as social risk factors are associated with childhood pneumonia.
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Exposição Ambiental/efeitos adversos , Material Particulado/efeitos adversos , Pneumonia/epidemiologia , Pneumonia/etiologia , Adolescente , Criança , Criança Hospitalizada/estatística & dados numéricos , Pré-Escolar , Humanos , Incidência , Lactente , Masculino , Pneumonia/induzido quimicamente , Fatores de RiscoRESUMO
The effects of childhood exposure to ambient air pollution and their influences on healthcare utilization and respiratory outcomes in Memphis pediatric asthma cohort are still unknown. This study seeks to (1) investigate individual-level associations between asthma and exposure measures in high asthma rate and low asthma rate areas and (2) determine factors that influence asthma at first year of a child's life, first 2 years, first 5 years, and during their childhood. Datasets include physician-diagnosed asthma patients, on-road and individual PM2.5 emissions, and high-resolution spatiotemporal PM2.5 estimates. Spatial analytical and logistic regression models were used to analyze the effects of childhood exposure on outcomes. Increased risk was associated with African American (AA) (odds ratio (OR) = 3.09, 95% confidence interval (CI) 2.80-3.41), aged < 5 years old (OR = 1.31, 95% 1.17-1.47), public insurance (OR = 2.80, 95% CI 2.60-3.01), a 2.5-km radius from on-road emission sources (OR = 3.06, 95% CI 2.84-3.30), and a 400-m radius from individual PM2.5 sources (OR = 1.33, 95% CI 1.25-1.41) among the cohort with residence in high asthma rate areas compared to low asthma rates areas. A significant interaction was observed between race and insurance with the odds of AA being approximately five times (OR = 4.68, 95% CI 2.23-9.85), public insurance being about three times (OR = 2.65, 95% CI 1.68-4.17), and children in their first 5 years of life have more hospital visits than other age groups. Findings from this study can guide efforts to minimize emissions, manage risk, and design interventions to reduce disease burden.
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Poluentes Atmosféricos/análise , Asma/epidemiologia , Exposição por Inalação/estatística & dados numéricos , Material Particulado/análise , Adolescente , Criança , Pré-Escolar , Estudos de Coortes , Monitoramento Ambiental/estatística & dados numéricos , Feminino , Humanos , Lactente , Exposição por Inalação/análise , Modelos Logísticos , Masculino , Fatores de Risco , Tennessee/epidemiologiaRESUMO
Stable, bioreactive, radicals known as environmentally persistent free radicals (EPFRs) have been found to exist on the surface of airborne PM2.5. These EPFRs have been found to form during many combustion processes, are present in vehicular exhaust, and persist in the environment for weeks and biological systems for up to 12 h. To measure EPFRs in PM samples, high volume samplers are required and measurements are less representative of community exposure; therefore, we developed a novel spatial phytosampling methodology to study the spatial patterns of EPFR concentrations using plants. Leaf samples for laboratory PM analysis were collected from 188 randomly drawn sampling sites within a 500-m buffer zone of pollution sources across a sampling grid measuring 32.9 × 28.4 km in Memphis, Tennessee. PM was isolated from the intact leaves and size fractionated, and EPFRs on PM quantified by electron paramagnetic resonance spectroscopy. The radical concentration was found to positively correlate with the EPFR g-value, thus indicating cumulative content of oxygen centered radicals in PM with higher EPFR load. Our spatial phytosampling approach reveals spatial variations and potential "hotspots" risk due to EPFR exposure across Memphis and provides valuable insights for identifying exposure and demographic differences for health studies.
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Monitoramento Ambiental/métodos , Radicais Livres/análise , Folhas de Planta , Emissões de Veículos/análise , Poluentes Atmosféricos , Espectroscopia de Ressonância de Spin Eletrônica , Poluição Ambiental , Material Particulado , TennesseeRESUMO
OBJECTIVE: To identify the key risk factors and explain the spatiotemporal patterns of childhood asthma in the Memphis metropolitan area (MMA) over an 11-year period (2005-2015). We hypothesize that in the MMA region this burden is more prevalent among urban children living south, downtown, and north of Memphis than in other areas. METHODS: We used a large-scale longitudinal electronic health record database from an integrated healthcare system, Geographic information systems (GIS), and statistical and space-time models to study the spatiotemporal distributions of childhood asthma at census tract level. RESULTS: We found statistically significant spatiotemporal clusters of childhood asthma in the south, west, and north of Memphis city after adjusting for key covariates. The results further show a significant increase in temporal gradient in frequency of emergency department (ED) visits and inpatient hospitalizations from 2009 to 2013, and an upward trajectory from 4 per 1,000 children in 2005 to 16 per 1,000 children in 2015. The multivariate logistic regression identified age, race, insurance, admit source, encounter type, and frequency of visits as significant risk factors for childhood asthma (p < 0.05). We observed a greater asthma burden and healthcare utilization for African American (AA) patients living in a high-risk area than those living in a low-risk area in comparison to the white patients: AA vs. white [odds ratio (OR) = 3.03, 95% confidence interval (CI): 2.75-3.34]; and Hispanic vs. white (OR = 1.62, 95% CI: 1.21-2.17). CONCLUSIONS: These findings provide a strong basis for developing geographically tailored population health strategies at the neighborhood level for young children with chronic respiratory conditions.
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Asma/etnologia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Grupos Raciais/estatística & dados numéricos , Características de Residência/estatística & dados numéricos , Adolescente , Negro ou Afro-Americano/estatística & dados numéricos , Distribuição por Idade , Criança , Pré-Escolar , Feminino , Sistemas de Informação Geográfica , Hispânico ou Latino/estatística & dados numéricos , Humanos , Modelos Logísticos , Masculino , Estudos Retrospectivos , Fatores de Risco , Distribuição por Sexo , Fatores Socioeconômicos , Análise Espaço-Temporal , Tennessee/epidemiologia , População Urbana/estatística & dados numéricos , População Branca/estatística & dados numéricosRESUMO
Cancer is one of the leading causes of death among children in the United States. Previous research has examined geographic variation in cancer incidence and survival, but the geographic variation in mortality among children and adolescents is not as well understood. The purpose of this study was to investigate geographic variation by race in mortality among children and adolescents diagnosed with cancer in Tennessee. Using an innovative combination of spatial and nonspatial analysis techniques with data from the 2004-2011 Tennessee Cancer Registry, pediatric deaths were mapped and the effect of race on the proximity to rural areas and clusters of mortality were explored with multivariate regressions. The findings revealed that African American children and adolescents in Tennessee were more likely than their counterparts of other races to reside in rural areas with close proximity to mortality clusters of children and adolescents with a cancer. Findings have clinical implications for pediatric oncology nurses regarding the delivery of supportive care at end of life for rural African American children and adolescents.
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Neoplasias/etnologia , Neoplasias/mortalidade , Adolescente , Criança , Feminino , Geografia Médica , Humanos , Incidência , Masculino , Análise Multivariada , Grupos Raciais , Sistema de Registros/estatística & dados numéricos , População Rural , Tennessee/epidemiologia , Estados UnidosRESUMO
OBJECTIVE: We have conducted a study to assess the role of environment on the burden of maternal morbidities and mortalities among women using an external exposome approach for the purpose of developing targeted public health interventions to decrease disparities. METHODS: We identified counties in the 48 contiguous USA where observed low birthweight (LBW) rates were higher than expected during a five-year study period. The identification was conducted using a retrospective space-time analysis scan for statistically significant clusters with high or low rates by a Discrete Poisson Model. RESULTS: We observed statistically significant associations of LBW rate with a set of predictive variables. However, in one of the two spatiotemporal models we discovered LBW to be associated with five predictive variables (teen birth rate, adult obesity, uninsured adults, physically unhealthy days, and percent of adults who smoke) in two counties situated in Alabama after adjusting for location changes. Counties with higher than expected LBW rates were similarly associated with two environmental variables (ozone and fine particulate matter). CONCLUSIONS: The county-level predictive measures of LBW offer new insights into spatiotemporal patterns relative to key contributory factors. An external framework provides a promising place-based approach for identifying "hotspots" with implications for designing targeted interventions and control measures to reduce and eliminate health disparities.
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Disparidades em Assistência à Saúde/organização & administração , Mortalidade Infantil , Recém-Nascido de Baixo Peso , Recém-Nascido Prematuro , Complicações na Gravidez/epidemiologia , Complicações na Gravidez/mortalidade , Resultado da Gravidez/epidemiologia , Adolescente , Adulto , Alabama/epidemiologia , Feminino , Humanos , Lactente , Recém-Nascido , Morbidade , Gravidez , Gestantes , Nascimento Prematuro/epidemiologia , Prevalência , Características de Residência , Estudos Retrospectivos , Fatores de Risco , Fatores Socioeconômicos , Adulto JovemRESUMO
Recent advances in informatics technology has made it possible to integrate, manipulate, and analyze variables from a wide range of scientific disciplines allowing for the examination of complex social problems such as health disparities. This study used 589 county-level variables to identify and compare geographical variation of high and low preterm birth rates. Data were collected from a number of publically available sources, bringing together natality outcomes with attributes of the natural, built, social, and policy environments. Singleton early premature county birth rate, in counties with population size over 100,000 persons provided the dependent variable. Graph theoretical techniques were used to identify a wide range of predictor variables from various domains, including black proportion, obesity and diabetes, sexually transmitted infection rates, mother's age, income, marriage rates, pollution and temperature among others. Dense subgraphs (paracliques) representing groups of highly correlated variables were resolved into latent factors, which were then used to build a regression model explaining prematurity (R-squared = 76.7%). Two lists of counties with large positive and large negative residuals, indicating unusual prematurity rates given their circumstances, may serve as a starting point for ways to intervene and reduce health disparities for preterm births.
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Bases de Dados Factuais , Modelos Teóricos , Nascimento Prematuro/epidemiologia , Feminino , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Modelos Logísticos , Vigilância da População , Gravidez , Resultado da Gravidez , Administração em Saúde Pública , Fatores de Risco , Estados Unidos/epidemiologiaRESUMO
Despite staggering investments made in unraveling the human genome, current estimates suggest that as much as 90% of the variance in cancer and chronic diseases can be attributed to factors outside an individual's genetic endowment, particularly to environmental exposures experienced across his or her life course. New analytical approaches are clearly required as investigators turn to complicated systems theory and ecological, place-based and life-history perspectives in order to understand more clearly the relationships between social determinants, environmental exposures and health disparities. While traditional data analysis techniques remain foundational to health disparities research, they are easily overwhelmed by the ever-increasing size and heterogeneity of available data needed to illuminate latent gene x environment interactions. This has prompted the adaptation and application of scalable combinatorial methods, many from genome science research, to the study of population health. Most of these powerful tools are algorithmically sophisticated, highly automated and mathematically abstract. Their utility motivates the main theme of this paper, which is to describe real applications of innovative transdisciplinary models and analyses in an effort to help move the research community closer toward identifying the causal mechanisms and associated environmental contexts underlying health disparities. The public health exposome is used as a contemporary focus for addressing the complex nature of this subject.
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Disparidades nos Níveis de Saúde , Algoritmos , Exposição Ambiental/efeitos adversos , Interação Gene-Ambiente , Humanos , Saúde Pública , Projetos de Pesquisa , Fatores SocioeconômicosRESUMO
Although recent efforts taken have substantially contained human onchocerciasis in many African countries, published reports indicate a recrudescence of the disease. To understand this problem, biophysical factors that favor the establishment of human onchocerciasis in Ghana and Burundi-countries identified as threat locations of recrudescence for neighboring countries-were analyzed. Data pertaining to the prevalence of human onchocerciasis in both countries was obtained from published sources. Findings in this study suggest that there was a gradient in prevalence of onchocerciasis in geographic locations near the water streams. The predictive models suggest that rainfall, humidity, and elevation were statistically significant for Burundi data while in Ghana, only the effect of elevation was highly significant (p<0.0001). In 2010, the estimated at-risk population was 4,817,280 people (19.75% of the total population) and 522,773 people (6.23% of the total population) in Ghana and Burundi, respectively. Findings can help in the effective design of preventive control measures.
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Oncocercose/epidemiologia , Altitude , Burundi/epidemiologia , Sistemas de Informação Geográfica , Geografia Médica , Gana/epidemiologia , Humanos , Modelos Teóricos , Prevalência , Análise de Componente Principal , Chuva/parasitologia , Fatores de Risco , Rios/parasitologia , Clima TropicalRESUMO
The objective of this paper is to introduce an efficient algorithm, namely, the mathematically improved learning-self organizing map (MIL-SOM) algorithm, which speeds up the self-organizing map (SOM) training process. In the proposed MIL-SOM algorithm, the weights of Kohonen's SOM are based on the proportional-integral-derivative (PID) controller. Thus, in a typical SOM learning setting, this improvement translates to faster convergence. The basic idea is primarily motivated by the urgent need to develop algorithms with the competence to converge faster and more efficiently than conventional techniques. The MIL-SOM algorithm is tested on four training geographic datasets representing biomedical and disease informatics application domains. Experimental results show that the MIL-SOM algorithm provides a competitive, better updating procedure and performance, good robustness, and it runs faster than Kohonen's SOM.
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Algoritmos , Inteligência Artificial , Sistemas de Informação Geográfica , Adulto , Asma/epidemiologia , Chicago/epidemiologia , Criança , Humanos , Chumbo/sangue , Redes Neurais de Computação , Reconhecimento Automatizado de Padrão/métodos , PrevalênciaRESUMO
The central purpose of this study is to further evaluate the quality of the performance of a new algorithm. The study provides additional evidence on this algorithm that was designed to increase the overall efficiency of the original k-means clustering technique-the Fast, Efficient, and Scalable k-means algorithm (FES-k-means). The FES-k-means algorithm uses a hybrid approach that comprises the k-d tree data structure that enhances the nearest neighbor query, the original k-means algorithm, and an adaptation rate proposed by Mashor. This algorithm was tested using two real datasets and one synthetic dataset. It was employed twice on all three datasets: once on data trained by the innovative MIL-SOM method and then on the actual untrained data in order to evaluate its competence. This two-step approach of data training prior to clustering provides a solid foundation for knowledge discovery and data mining, otherwise unclaimed by clustering methods alone. The benefits of this method are that it produces clusters similar to the original k-means method at a much faster rate as shown by runtime comparison data; and it provides efficient analysis of large geospatial data with implications for disease mechanism discovery. From a disease mechanism discovery perspective, it is hypothesized that the linear-like pattern of elevated blood lead levels discovered in the city of Chicago may be spatially linked to the city's water service lines.
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OBJECTIVES: To assess previously determined geographic clusters of breast and lung cancer incidences among residents living near the Tittabawassee and Saginaw Rivers, Michigan, using a new set of environmental factors. MATERIALS AND METHODS: Breast and lung cancer data were acquired from the Michigan Department of Community Health, along with point source pollution data from the U.S. Environmental Protection Agency. The datasets were used to determine whether there is a spatial association between disease risk and environmental contamination. GIS and spatial techniques were combined with statistical analysis to investigate local risk of breast and lung cancer. RESULTS AND CONCLUSION: The study suggests that neighborhoods in close proximity to the river were associated with a high risk of breast cancer, while increased risk of lung cancer was detected among neighborhoods in close proximity to point source pollution and major highways. Statistically significant (P = .001) clusters of cancer incidences were observed among residents living near the rivers. These findings are useful to researchers and governmental agencies for risk assessment, regulation, and control of environmental contamination in the floodplains.
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Neoplasias da Mama/epidemiologia , Exposição Ambiental/efeitos adversos , Sistemas de Informação Geográfica , Neoplasias Pulmonares/epidemiologia , Rios , Adolescente , Adulto , Distribuição por Idade , Neoplasias da Mama/induzido quimicamente , Análise por Conglomerados , Análise Discriminante , Poluição Ambiental/efeitos adversos , Feminino , Humanos , Incidência , Indústrias , Neoplasias Pulmonares/induzido quimicamente , Masculino , Michigan/epidemiologia , Pessoa de Meia-Idade , Razão de Chances , Características de Residência , Estudos Retrospectivos , Fatores de Risco , Poluentes do Solo/intoxicação , Poluentes Químicos da Água/intoxicação , Adulto JovemRESUMO
BACKGROUND: High levels of dioxins in soil and higher-than-average body burdens of dioxins in local residents have been found in the city of Midland and the Tittabawassee River floodplain in Michigan. The objective of this study is threefold: (1) to evaluate dioxin levels in soils; (2) to evaluate the spatial variations in breast cancer incidence in Midland, Saginaw, and Bay Counties in Michigan; (3) to evaluate whether breast cancer rates are spatially associated with the dioxin contamination areas. METHODS: We acquired 532 published soil dioxin data samples collected from 1995 to 2003 and data pertaining to female breast cancer cases (n = 4,604) at ZIP code level in Midland, Saginaw, and Bay Counties for years 1985 through 2002. Descriptive statistics and self-organizing map algorithm were used to evaluate dioxin levels in soils. Geographic information systems techniques, the Kulldorff's spatial and space-time scan statistics, and genetic algorithms were used to explore the variation in the incidence of breast cancer in space and space-time. Odds ratio and their corresponding 95% confidence intervals, with adjustment for age, were used to investigate a spatial association between breast cancer incidence and soil dioxin contamination. RESULTS: High levels of dioxin in soils were observed in the city of Midland and the Tittabawassee River 100-year floodplain. After adjusting for age, we observed high breast cancer incidence rates and detected the presence of spatial clusters in the city of Midland, the confluence area of the Tittabawassee, and Saginaw Rivers. After accounting for spatiotemporal variations, we observed a spatial cluster of breast cancer incidence in Midland between 1985 and 1993. The odds ratio further suggests a statistically significant (alpha = 0.05) increased breast cancer rate as women get older, and a higher disease burden in Midland and the surrounding areas in close proximity to the dioxin contaminated areas. CONCLUSION: These findings suggest that increased breast cancer incidences are spatially associated with soil dioxin contamination. Aging is a substantial factor in the development of breast cancer. Findings can be used for heightened surveillance and education, as well as formulating new study hypotheses for further research.
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Neoplasias da Mama/induzido quimicamente , Neoplasias da Mama/epidemiologia , Dioxinas/toxicidade , Monitoramento Ambiental , Sedimentos Geológicos/análise , Poluentes do Solo/toxicidade , Adolescente , Distribuição por Idade , Idoso , Neoplasias da Mama/patologia , Bases de Dados Factuais , Dioxinas/análise , Monitoramento Epidemiológico , Feminino , Geografia , Humanos , Incidência , Michigan/epidemiologia , Pessoa de Meia-Idade , Método de Monte Carlo , Probabilidade , Sistema de Registros , Medição de Risco , Rios , Poluentes do Solo/análise , Taxa de SobrevidaRESUMO
In this retrospective study, the authors investigated pediatric blood lead levels (BLLs) at 2 threshold levels in neighborhoods across the US city of Chicago, examining geographic associations with demographic risk factors and housing characteristics, using data from large-scale childhood BLL screening records from 1997 through 2003. They used logistic regression and geostatistical methods to assess disease dynamics and probability of elevated BLLs. The results showed a significant decline of elevated BLLs, with levels measured at >or= 10 microg/dL decreasing by 74%, compared with a 40% decrease for the lower levels (6-9 microg/dL). The Westside and Southside neighborhoods, with a high concentration of minority populations, had the highest prevalence rates, which were significantly associated with living in pre-1950 housing units. The findings provided insights for lead prevention, implications for lowering the threshold limit, and suggestions for the urgent task of developing healthy neighborhoods.
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Exposição Ambiental/efeitos adversos , Saúde Ambiental , Promoção da Saúde , Intoxicação por Chumbo/epidemiologia , Chumbo/sangue , Características de Residência , Saúde da População Urbana , Chicago/epidemiologia , Criança , Proteção da Criança , Pré-Escolar , Demografia , Feminino , Sistemas de Informação Geográfica , Humanos , Illinois/epidemiologia , Lactente , Masculino , Prevalência , Estudos Retrospectivos , Medição de Risco , Fatores de RiscoRESUMO
OBJECTIVES: To examine socioeconomic characteristics associated with planned methadone maintenance treatment (MMT). METHODS: We performed multiple logistic regressions using data from the 1998 Treatment Episode Data Set, which tracks admissions for substance abuse treatment. RESULTS: MMT was more prevalent among heroin users than nonheroin users. Among heroin users, females, Hispanics, Southerners, the employed, and those who are not homeless or in jail are more likely to be planned to receive MMT. Among nonheroin users, females were less likely to be planned for MMT. CONCLUSIONS: Greater effort may be necessary to extend MMT to vulnerable populations.
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Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Metadona/uso terapêutico , Entorpecentes/uso terapêutico , Seleção de Pacientes , Transtornos Relacionados ao Uso de Substâncias/reabilitação , Populações Vulneráveis/estatística & dados numéricos , Fatores Etários , Feminino , Alocação de Recursos para a Atenção à Saúde/estatística & dados numéricos , Dependência de Heroína/economia , Dependência de Heroína/etnologia , Dependência de Heroína/reabilitação , Humanos , Modelos Logísticos , Masculino , Metadona/administração & dosagem , Metadona/economia , Entorpecentes/administração & dosagem , Entorpecentes/economia , Estudos Retrospectivos , Fatores Sexuais , Fatores Socioeconômicos , Transtornos Relacionados ao Uso de Substâncias/economia , Transtornos Relacionados ao Uso de Substâncias/etnologiaRESUMO
This study investigates spatiotemporal distributions of reported cases of the avian influenza H5N1 (bird flu) in Southern China in early 2004. Forty-nine cases of the avian influenza H5N1 covering a 6-week period (January 19, 2004, through March 9, 2004) were compiled from the Chinese Ministry of Agriculture and the World Health Organization. Geographic information systems (GIS) techniques combined with statistical techniques were used to analyze the spatiotemporal variation of reported cases of avian influenza. Using Oden's direction method, we also explored the spatiotemporal interaction of individual-level avian influenza cases during the study duration. The peak period (temporal clustering) for the epidemiological avian influenza outbreak occurred between the third and fourth weeks. Although we observed a major northeast-southwest distribution of the avian influenza H5N1 cases, there was no significant spatiotemporal association in average "direction of advance" of these cases. The directional finding is very consistent with the major migratory bird routes in East Asia, but owing to weak surveillance and reporting systems in the region, the study findings warrant further evaluation.
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Aves/virologia , Virus da Influenza A Subtipo H5N1/isolamento & purificação , Influenza Aviária/epidemiologia , Influenza Aviária/virologia , Animais , China/epidemiologia , Fatores de TempoRESUMO
Previous to this study various healthcare utilization studies and house-to-house surveys had shown that Buffalo's west side had a high utilization rate for asthma and high asthma prevalence in comparison with neighboring communities. The relative contributions of traffic-related pollution and personal and local ecological factors to the high asthma rates were still unknown. To investigate the potential roles of personal home environmental factors and local ecological factors in variations of asthma prevalence in Buffalo neighborhoods, we conducted a cross-sectional survey of a systematic random sample of 2000 households in the city of Buffalo, New York, with a response rate of 80.4%. We found that the odds of having at least one person with asthma per household on Buffalo's west side was 2.57 times [95% confidence interval (CI)=1.85-3.57] that of Buffalo's east side. There were no statistically significant differences in the odds of finding at least one person with asthma in households of other Buffalo neighborhoods. We further found no difference in the odds of having asthma on Buffalo's west side even after correcting for race/ethnicity, household triggers of asthma, and socioeconomic factors. Monitoring ultrafine particulates showed increased levels in communities downwind of the Peace Bridge Complex and major roadways supplying it. A multiple-regression model showed that asthma prevalence may be influenced by humidity and ultrafine particulate concentrations. These results suggest that increased asthma risk may be influenced by chronic exposure to personal and local ecological factors.
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Poluição do Ar em Ambientes Fechados , Asma/epidemiologia , Ecologia , Estudos Transversais , Demografia , Feminino , Humanos , Umidade , Masculino , New York/epidemiologia , Tamanho da Partícula , Prevalência , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Childhood asthma is a significant public health problem in the United States and evidence is accumulating regarding the contribution from traffic and ambient air pollution. This study is a companion piece of a related Buffalo asthma study in adults recently published in the July 2004 issue of American Journal of Public Health. This study focuses on children under 18 years of age diagnosed with asthma during a three-year period (2000-2002). In order to determine the effects of particulate air pollution on public health, we conducted an ecologic study of childhood asthma and point-source respirable particulate air pollution in patients diagnosed with asthma (n = 6,425). Patients diagnosed with gastroenteritis (n = 5,132) were used as controls. RESULTS: Although the results of this study show spatial patterns similar to the ones observed in the adult study, a multiple-comparison test shows that EPA-designated focus sites located in Buffalo's east side are statistically (p < 0.008) more linked to childhood asthma than sites located elsewhere. CONCLUSION: Findings of this study can be useful in geographic targeting and in the design of optimal and preventive measures.
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STUDY OBJECTIVE: The aim of this study is to identify risk factors for asthma prevalence and chronic respiratory illnesses in Buffalo's neighbourhoods after previous studies reported increased levels of asthma among residents on Buffalo's west side. DESIGN: Cross sectional surveys. SETTING: Buffalo neighbourhoods along a US-Canada border crossing point. SUBJECTS: A systematic random survey of 82% of the 2000 targeted households was conducted between January and August 2002. MAIN RESULTS: A multivariate logistic regression model shows that the risk of persons with asthma and chronic respiratory illnesses is significantly (p< or =0.05) high among children and young adults living in Buffalo's west side, newer housing units, and of Latino ethnicity. In a separate analysis of the nine risk factors, it was observed that location, gender, age, and race were significant risk factors even after adjusting for age of housing, pets, moulds, animal trigger, and smoking. CONCLUSIONS: These findings confirm the hypothesis that a considerable risk of asthma and chronic respiratory illnesses exists particularly among Buffalo's west side residents. Further evaluation of these risk factors is warranted to determine the severity of asthma and the reasons for such a significant disease burden.