Article
Detection and modelling of case clusters for urban leptospirosis.
Registro en:
TASSINARI, W. de S. et al. Detection and modelling of case clusters for urban leptospirosis. Tropical Medicine and International Health, v. 13, n. 4, p. 503-512, 2008.
1365-3156
10.1111/j.1365-3156.2008.02028.x
Autor
Tassinari, Wagner de Souza
Pellegrini, Debora da Cruz Payão
Sá, Claudio B. P
Reis, Renato Barbosa
Ko, Albert Icksang
Carvalho, Marilia Sá
Resumen
OBJECTIVE: To analyse the epidemiological profile of 488 cases of leptospirosis in Rio de Janeiro, Brazil between 1997 and 2002, using a variety of methods of spatial epidemiology, to establish alert guidelines in general hospitals, which might be a tool to improve diagnosis and treatment of leptospirosis to reduce lethality rates. METHODS: Scan statistics identified six space-time clusters, which comprised a range of 2 to 28 cases per cluster. Generalized linear mixed models were used to evaluate risk factors for a cluster case which incorporated individual characteristics and spatial information on environmental and climactic factors in a single model frame. RESULTS: Cluster case events were associated with heavy rainfall (OR 3.71; 95% CI 1.83-7.51). The model did not identify socioeconomic or environmental covariates that significantly influence the risk of developing a cluster rather than non-cluster case. CONCLUSION: Clustering of leptospirosis in this urban setting appears to be due to transmission during heavy rainfall.