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The urban spread of visceral leishmaniasis: clues from spatial analysis
Guilherme L Werneck1, Carlos H N Costa, Alexander M Walker
1Department of Immunology and Infectious Disease, Harvard School of Public Health, Boston, MA, USA.
Background:
The pattern of spread of visceral leishmaniasis in Brazilian cities is poorly understood.
Methods:
We used geographic information systems and spatial statistics to evaluate the distribution of 1061 cases of visceral leishmaniasis in Teresina, Brazil, in 1993 through 1996.
Results:
A locally weighted (LOESS) regression model, which was fit as a smoothed function of spatial coordinates, demonstrated large-scale variation, with high incidence rates in peripheral neighborhoods that bordered forest land and pastures. Moran's I indicated small-scale variation and clustering up to 300 m, roughly the flight range of the sand fly vector.
Conclusions:
Spatial analytical techniques can identify high-risk areas for targeting control interventions.