Spatial patterns and secular trends in human leishmaniasis incidence in Morocco between 2003 and 2013

作     者：Mina Sadeq 

作者机构：Environmental Epidemiology UnitNational Institute of HygieneMinistry of Health27 Avenue Ibn BattutaBP 769 RabatMorocco 

出 版 物：《Infectious Diseases of Poverty》 (贫困所致传染病（英文）)

年 卷 期：2016年第5卷第1期

页      面：404-416页

核心收录：

学科分类：0202[经济学-应用经济学] 02[经济学] 020205[经济学-产业经济学] 

主　　题：Human leishmaniasis Epidemiology Incidence rates Spatial patterns Secular trends Morocco 

摘      要：Background:Few studies on spatial patterns or secular trends in human leishmanias have been conducted in *** study aimed to examine spatial patterns and trends associated with the human leishmaniasis incidence rate(HLIR)at the province/prefecture level between 2003 and 2013 in ***:Only the available published country data on the HLIR between 2003 and 2013,from the open access files of the Ministry of Health,were *** trends were examined using Kendall’s rank *** exploratory spatial data analysis was also conducted to examine the spatial autocorrelation(Global Moran’s I and local indicator of spatial association[LISA]),and spatial diffusion at the province/prefecture *** influence of various covariates(poverty rate,vulnerability rate,population density,and urbanization)on the HLIR was tested via spatial regression(ordinary least squares regression).Results:At the country level,no secular variation was *** annual incidence rate estimates were 13 per 100000 population(95%CI=12.9–13.1)for cutaneous leishmaniasis(CL)and 0.4 per 100000 population(95%CI=0.4–0.5)for visceral leishmaniasis(VL).The available data on HLIR were based on combined CL and VL cases,however,as the CL cases totally outnumbered the VL ones,HLIR may be considered as CL incidence *** the provincial level,a secular increase in the incidence rate was observed in Al Hoceima(P=0.008),Taounate(P=0.04),Larache(P=0.002),Tétouan(P=0.0003),Khenifra(P=0.008),Meknes(P=0.03),and El Kelaa(P=0.0007),whereas a secular decrease was observed only in the Chichaoua province(P=0.006).Even though increased or decreased rate was evident in these provinces,none of them showed clustering of leishmaniasis *** spatial clusters of high leishmaniasis incidence were located in the northeastern part of Morocco,while spatial clusters of low leishmaniasis incidence were seen in some northwestern and southern parts of Morocco;there was spatial randomness i