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Spatial and temporal analyses of sleeping sickness reemergence in south-eastern Uganda, 1970--2003.

机译：1970--2003年乌干达东南部睡眠病重现的时空分析。

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摘要

Sleeping sickness re-emerged in south-eastern Uganda in the 1970s, and remains a significant public health burden. Sleeping sickness has continued to spread northwards into new districts, and gaps remain in the understanding of the causes of its spread and distributions. This thesis presents a characterization and assessment of the historical patterns, processes, and predictors of sleeping sickness variation over space and time in south-eastern Uganda from 1970-2003 with the aim of improving the understanding of sleeping sickness transmission and guiding targeted prevention and control initiatives. Historical data and literature are used to characterize the multiple factors and processes affecting sleeping sickness over space and time in south-eastern Uganda. Sleeping sickness data were collected from records at the Ugandan Ministry of Health, individual sleeping sickness treatment centres, and through interviews with key informants to reconstruct an historical database of disease distributions and magnitude for 1970-2003. Remotely sensed imagery and Geographic Information Systems were used to extract a vegetation cover time-series for the region for four dates spanning the epidemic cycle. Data are used to conduct spatial and temporal analyses of sleeping sickness risk in south-eastern Uganda. Results show rapid propagation of sleeping sickness from its epicentre in southern Iganga District, followed by radial diffusion, and continued northwards spread into new districts and foci. Observed trends are consistent with the hypothesis of disease propagation due to changes in human-vector exposure and transport of the parasite to new areas via cattle reservoirs. Results indicate that rural areas with moderate-high vegetation cover, minimal tsetse habitat loss, high cattle infection, and civil conflict are at highest risk. Results support the probability of continued spread of sleeping sickness northwards into new regions in central Uganda. The central region is currently affected by high levels of civil conflict, which may accelerate disease spread. Central Uganda should be considered a high-priority area for emerging infection and targeted prevention and control initiatives.
机译：1970年代，乌干达东南部再次出现昏睡病，并且仍然是沉重的公共卫生负担。昏睡病继续向北蔓延到新的地区，在了解其传播和分布原因方面仍存在差距。本文对1970-2003年乌干达东南部随时间变化的昏睡病的历史规律，过程和预测因子进行了表征和评估，目的是增进对昏睡病传播的了解并指导有针对性的预防和控制倡议。历史数据和文献被用来描述影响乌干达东南部在空间和时间上的昏睡病的多种因素和过程。睡眠病数据是从乌干达卫生部，各个睡眠病治疗中心的记录中收集的，并通过与关键信息提供者的访谈来重建1970-2003年疾病分布和严重程度的历史数据库。利用遥感图像和地理信息系统提取了该区域整个流行周期中四个日期的植被覆盖时间序列。数据用于对乌干达东南部的昏睡风险进行时空分析。结果表明，昏睡病从其中心开始在伊甘加南部迅速传播，随后呈放射状扩散，并继续向北扩散到新的地区和疫源地。观察到的趋势与疾病传播假说相符，该假说是由于人类媒介暴露量的变化以及寄生虫通过牛库转移到新区域而引起的。结果表明，植被覆盖度较高，采采蝇栖息地损失最少，牛感染率高和内乱的农村地区处于最高风险。结果证明了昏睡病继续向北传播到乌干达中部新地区的可能性。目前，中部地区受到高度内战的影响，这可能会加速疾病的传播。乌干达中部应被视为新发感染和有针对性的预防和控制举措的重点地区。

著录项

  • 作者

    Berrang Ford, Lea.;

  • 作者单位

    University of Guelph (Canada).;

  • 授予单位 University of Guelph (Canada).;
  • 学科 Biology Parasitology.; Health Sciences Epidemiology.
  • 学位 Ph.D.
  • 年度 2006
  • 页码 195 p.
  • 总页数 195
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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