PDF(Pubmed)
Abstract：
Leptospirosis is a global zoonotic disease caused by spirochete bacteria of the genus Leptospira. The disease exhibits a notable incidence in tropical and developing countries, and in Colombia, environmental, economic, social, and cultural conditions favor disease transmission, directly impacting both mortality and morbidity rates. Our objective was to establish the pooled lagged effect of runoff on leptospirosis cases in Colombia. For our study, we included the top 20 Colombian municipalities with the highest number of leptospirosis cases. Monthly cases of leptospirosis, confirmed by laboratory tests and spanning from 2007 to 2022, were obtained from the National Public Health Surveillance System. Additionally, we collected monthly runoff and atmospheric and oceanic data from remote sensors. Multidimensional poverty index values for each municipality were sourced from the Terridata repository. We employed causal inference and distributed lag nonlinear models to estimate the lagged effect of runoff on leptospirosis cases. Municipality-specific estimates were combined through meta-analysis to derive a single estimate for all municipalities under study. The pooled results for the 20 municipalities suggest a lagged effect for the 0 to 2, and 0-3 months of runoff on leptospirosis when the runoff is < 120 g/m2. No effect was identified for longer lagged periods (0-1, 0 to 4, 0 to 5, and 0-6 months) or higher runoff values. Incorporation of the multidimensional poverty index into the meta-analysis of runoff contributed to the models for the lagged periods of 0-3, and 0-4 months.
摘要：
钩端螺旋体病是由钩端螺旋体属细菌引起的全球性人畜共患疾病。这种疾病在热带和发展中国家的发病率很高，在哥伦比亚，环境,经济,社会,文化条件有利于疾病传播，直接影响死亡率和发病率。我们的目标是确定径流对哥伦比亚钩端螺旋体病病例的汇总滞后影响。对于我们的研究，我们纳入了钩端螺旋体病病例最多的前20个哥伦比亚城市.每月钩端螺旋体病病例，通过实验室测试确认，从2007年到2022年，是从国家公共卫生监测系统获得的。此外,我们从遥感器收集了每月的径流以及大气和海洋数据。每个城市的多维贫困指数值来自Terridata存储库。我们采用因果推断和分布滞后非线性模型来估计径流对钩端螺旋体病病例的滞后效应。通过荟萃分析将特定城市的估算值合并起来，以得出所有研究城市的单个估算值。20个城市的汇总结果表明，当径流<120g/m2时，径流对钩端螺旋体病的0至2和0-3个月的影响滞后。对于更长的滞后期（0-1、0至4、0至5和0-6个月）或更高的径流值，未发现影响。将多维贫困指数纳入径流的荟萃分析有助于建立0-3和0-4个月滞后期的模型。
