背景:发展中国家霍乱疫情的持续存在需要关注并采取更有针对性的干预措施,以实现长期控制。这项研究对尼日利亚十七年的霍乱发病率进行了空间分析,以确定区域热点和预测因素的存在。
方法:本研究采用横断面研究设计。36个州和联邦首都领土(FCT)的霍乱数据是从联邦卫生部的尼日利亚疾病控制中心(NCDC)获得的,尼日利亚。社会经济数据,包括使用固体废物处理的家庭比例(未经批准的垃圾场,垃圾掩埋,垃圾焚烧,公共垃圾场,和垃圾收集者),水源(管道输送水,嗯,钻孔,雨水,地表水和水供应商),污水处理(抽水马桶,坑式厕所,桶/盘,公共厕所和附近的灌木丛/小溪),住在一个房间里,收入低于最低工资(18,000奈拉)是从国家人口委员会获得的。另一方面,文盲成年人(15岁及以上)和穷人的比例;人口密度从国家统计局获得。每个社会经济数据都是在州一级获得的。使用GlobalMoran'sI在州一级分析霍乱模式,而使用LocalMoran'sI确定霍乱集群的具体位置。使用逐步多元回归来确定霍乱发病率的社会经济预测因子。
结果:LocalMoran\'sI在1999年,2001年,2002年,2009年和2010年在Adamawa揭示了重要的集群模式,贡贝,Katsina,包奇,博尔诺,Yobe,和卡诺国家。使用地表水的家庭是观察到的霍乱发病率空间变化的重要预测因子(23%)。
结论:东北和西北一些州的霍乱疫情持续存在,需要更有针对性,长期和有效的干预措施,特别是政府和其他利益相关者提供安全的水源。
BACKGROUND: Persistence of cholera outbreaks in developing countries calls for concern and more targeted intervention measures for long-term control. This research undertook spatial analysis of cholera incidence in Nigeria over a seventeen-year period to determine the existence of regional hotspots and predictors.
METHODS: A cross-sectional study design was used for the research. Cholera data for each of the thirty-six states and the federal capital territory (FCT) were obtained from the Nigeria Centre for Disease Control (NCDC) of the Federal Ministry of Health, Nigeria. Socioeconomic data including proportion of households using solid waste disposal (unapproved dumpsite, refuse burying, refuse burning, public dumpsite, and refuse collectors), water sources (pipe borne water, well, borehole, rain water, surface waters and water vendors), sewage disposal (water closet, pit latrines, bucket/pan, public toilet and nearby bush/stream), living in a single room and earning less than minimum wage (18,000 naira) were obtained from National Population Commission. On the other hand, proportion of illiterate adults (15 years and above) and poor people; and population density were obtained from National Bureau of Statistics. Each socioeconomic data was obtained at state level. Cholera patterns were analysed at state level using Global Moran\'s I while specific locations of cholera clusters were determined using Local Moran\'s I. Stepwise multiple regression was used to determine socioeconomic predictors of cholera incidence.
RESULTS: Local Moran\'s I revealed significant cluster patterns in 1999, 2001, 2002, 2009 and 2010 in Adamawa, Gombe, Katsina, Bauchi, Borno, Yobe, and Kano states. Households using surface water was the significant predictor (23%) of the observed spatial variations in cholera incidence.
CONCLUSIONS: Persistence of cholera outbreaks in some north east and north western states calls for more targeted, long-term and effective intervention measures especially on provision of safe sources of water supply by government and other stakeholders.