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Childhood visceral leishmaniasis in Tunisia: A cross-sectional study in local spatial analysis
1Department of Finance, College of Business, University of Jeddah, Saudi Arabia; Higher Institute of Management, ISG, University of Sousse, Tunisia.
Insights
Visceral Leishmaniasis (VL) incidence in Tunisia correlates with climate. High precipitation, low continentality, and low pluviometric coefficient indicate increased VL risk in children.
Area of Science:
- Epidemiology
- Environmental Health
- Spatial Analysis
Background:
- Visceral Leishmaniasis (VL) is a significant public health concern in endemic regions.
- Understanding the spatial distribution of VL is crucial for effective control strategies.
- Climate factors are known to influence the transmission dynamics of vector-borne diseases like VL.
Purpose of the Study:
- To describe the spatial distribution of Visceral Leishmaniasis (VL) in northern and central Tunisia.
- To determine the correlation between VL cases in children and key climatic factors.
- To model the geographical distribution of VL using climatic predictors.
Main Methods:
- Data on VL cases in children under five were collected from Tunisian Pediatric Departments (2006-2016).
- Climatic variables included precipitation, continentality index, and Emberger's pluviometric coefficient.
- Bayesian local spatial models were employed using R and Arcview GIS software.
Main Results:
- VL incidence rates progressively increased in areas with high precipitation.
- Low values of continentality index and pluviometric coefficient were associated with higher VL incidence.
- Local effects of climatic factors can counteract each other when averaged across a large area.
Conclusions:
- Non-local spatial analysis can lead to misleading epidemiological interpretations of VL distribution.
- Accurate spatial analysis is vital for efficient resource allocation in VL control programs.
- Findings are relevant for managing VL spread in Tunisia and other endemic regions.
Abstract:
This paper describes spatial distribution of Visceral Leishmaniasis (VL) and determines its correlation with climatic factors in an endemic focus in northern and central Tunisia. Data on VL cases in children under five years of age were obtained by consulting medical reports from all Tunisian Pediatric Departments (TPD) during 2006-2016. Three key climatic factors, namely precipitation, continentality index and pluviometric coefficient of Emberger were used as predictor variables to model the VL geographical distribution. Data handling and statistical analysis were performed using R and Arcview GIS software systems. Bayesian local spatial model was employed to analyse the data. The results show a progressive increase in the VL incidence rates in regions with high levels of precipitation, but with low values of both continentality index and pluviometric coefficient of Emberger. A likely explanation of these findings arises from the opposite local effects of climatic factors which tend to cancel each other out in the calculation of the mean parameter estimate over the whole study area. We conclude that using non-local spatial analysis approach leads to misleading epidemiological interpretations, which in turn are of relevance for more efficient and cost-effective resource allocation for control and well manage the spread of VL in the study region and elsewhere in Tunisia.
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