在社会决定因素的背景下,俄罗斯结核病的空间模式
Natalia Shartova1, Fedor Korennoy2, Svetlana Makhazova3
1Higher School of Economics, International Laboratory for Landscape Ecology, Myasnitskaya ulitsa 20, Moscow 101000, Russia.
Spatial and spatio-temporal epidemiology
|June 10, 2023
概括
结核病 (TB) 在俄罗斯的分布不均,欧洲地区呈现下降趋势,而东部地区则没有. 与收入和城市化相关的艾滋病毒-结核病共感染,显著影响了整个俄罗斯的结核病率.
科学领域:
- 流行病学 流行病学
- 公共卫生 公共卫生
- 社会科学 社会科学 社会科学
背景情况:
- 结核病 (TB) 仍然是一个重大的全球卫生挑战,不同地区的发病率和死亡率各不相同.
- 了解结核病的空间分布和社会决定因素对于有效的公共卫生干预至关重要.
- 俄罗斯表现出明显的结核病流行病学模式,需要进行本地化调查.
研究的目的:
- 调查2006年至2018年俄罗斯结核病的空间分布.
- 分析社会决定因素对结核病发病率的影响,特别是多抗药性结核病 (MDR-TB) 和艾滋病毒-结核病共感染.
- 确定欧洲和俄罗斯东部之间结核病负担的趋势和差异.
主要方法:
- 利用"时空立方体"方法分析结核病的地理分布.
- 使用通用线性逻辑回归来评估结核病与社会经济因素之间的关联.
- 分析了多药耐药结核病,艾滋病毒-结核病共感染和死亡率的区域发病率数据.
主要成果:
- 确定了结核病负担在俄罗斯的地理分布不均.
- 观察到欧洲俄罗斯的结核病发病率和死亡率有统计学意义的下降趋势,与俄罗斯东部形成鲜明对比.
- 即使在更富裕的欧洲地区,艾滋病毒-结核病同时感染的发病率也是一个重要因素,与收入和城市化密切相关.
- 较高的犯罪率与社会不利地区结核病传播的增加有关.
结论:
- 在欧洲和俄罗斯东部之间存在结核病负担的空间差异,流行病学趋势不同.
- 艾滋病毒-结核病共感染是结核病流行病的关键驱动因素,受收入和城市化等社会经济因素的影响.
- 包括犯罪在内的社会决定因素在结核病传播中发挥着作用,特别是在弱势群体中,这凸显了综合公共卫生和社会政策的需要.
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