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背景:Cape Town市Ravensmead和Uitsig郊区的结核病流行严重,1996年的肺结核报告率为1340/10万。这些市郊的特点是人口稠密、失业率高、贫穷严重。传统认为结核病传播主要发生在与传染源有密切接触的家庭内。但近年来的研究则将结核病传播与家庭外的某些场所联系起来,而这些场所与高危生活方式有关。在CaPe Town市郊区进行的人类学研究确认了大量的饮酒场所(酒吧)(17/平方公里),这提示群体性饮酒已经成为一种特殊生活方式的一部分。 目的:应用地理信息系统(GIS)研究结核病传播的场所及影响因素。结果和结论:应用探索性疾病地图的空间流行病学技术,对1993—1998年间经细菌学确诊的1128例肺结核进行了研究。点分布模式分析结果和空间聚集性统计量都提示高发地区的肺结核存在聚集性。结核病报告率与失业、人口稠密以及研究地区的酒吧密度存在显著的相关性。其中,高肺结核病报告率与失业及其导致的贫穷之间的联系最为显著。
Background: The prevalence of tuberculosis in the suburbs of Ravensmead and Uitsig in Cape Town is severe, with a reported rate of 1340/10 million tuberculosis in 1996. These suburbs are characterized by dense population, high unemployment and severe poverty. Traditionally, the spread of tuberculosis mainly occurs in families with close contact with sources of infection. In recent years, however, research has linked TB transmission to certain settings outside the home, linked to high-risk lifestyles. Anthropological studies in the suburb of CaPe Town confirm a large number of drinking establishments (bars) (17 / sq km), suggesting that group drinking has become part of a special lifestyle. Objective: To study the place and influencing factors of tuberculosis transmission by using geographic information system (GIS). RESULTS AND CONCLUSIONS: Using epidemiological techniques of spatial maps of exploratory disease maps, 1128 tuberculosis confirmed bacteriologically between 1993 and 1998 were studied. Point distribution pattern analysis results and spatial aggregation statistics suggest that tuberculosis in high incidence areas are clustered. Tuberculosis reporting rates are significantly associated with unemployment, dense population and bar density in the study area. Of these, the link between reporting rates of high tuberculosis and unemployment and the resulting poverty is the most significant.