The AIDS epidemic in the Amazon region: a spatial case-control study in Rondonia, Brazil

Revista de Saúde Pública

Maria Rita Donalisio¹  Ricardo Cordeiro¹  Roberto Wagner Lourenço¹  J Christopher Brown¹ 

关键词: Acquired Immunodeficiency Syndrome;    epidemiology;    Socioeconomic Factors;    Spatial Analysis;    Urbanization;    Case-Control Studies;    Síndrome de Inmunodeficiencia Adquirida;    epidemiología;    Factores Socioeconómicos;    Análisis Espacial;    Urbanización;    Estudios de Casos y Controles;    Síndrome de Imunodeficiência Adquirida;    epidemiologia;    Fatores Socioeconômicos;    Análise Espacial;    Urbanização;    Estudos de Casos e Controles;   

DOI  :  10.1590/S0034-8910.2013047004539

来源: SciELO

【 摘 要 】

OBJECTIVE To analyze spatial changes in the risk of AIDS and the relationship between AIDS incidence and socioeconomic variables in the state of Rondonia, Amazon region. METHODS A spatial, population case-control study in Rondonia, Brazil, based on 1,780 cases reported to the Epidemiological Surveillance System and controls based on demographic data from 1987 to 2006. The cases were grouped into five consecutive four-year periods. A generalized additive model was adjusted to the data; the dependent variable was the status of the individuals (case or control), and the independent variables were a bi-dimensional spline of the geographic coordinates and some municipality-level socioeconomic variables. The observed values of the Moran’s I test were compared to a reference distribution of values generated under conditions of spatial randomness. RESULTS AIDS risk shows a marked spatial and temporal pattern. The disease incidence is related to socioeconomic variables at the municipal level in Rondônia, such as urbanization and human capital. The highest incidence rates of AIDS are in municipalities along the BR-364 highway and calculations of the Moran’s I test show positive spatial correlation associated with proximity of the municipality to the highway in the third and fourth periods (p = 0.05). CONCLUSIONS Incidence of the disease is higher in municipalities of greater economic wealth and urbanization, and in those municipalities bisected by Rondônia’s main roads. The rapid development associated with the opening up of once remote regions may be accompanied by an increase in these risks to health.

【 授权许可】

CC BY   
 All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License