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How to improve the human brucellosis surveillance system in Kurdistan Province, Iran: reduce the delay in the diagnosis time

Epidemiology and Health 2020년 42권 1호 p.58 ~ 58
Olfatifar Meysam, Hosseini Seyed Mehdi, Khodakarim Soheila, Khadembashi Naghmeh, Pordanjani Sajjad Rahimi,
소속 상세정보
 ( Olfatifar Meysam ) - Shahid Beheshti University of Medical Sciences Research Institute for Gastroenterology and Liver Diseases Gastroenterology and Liver Diseases Research Center
 ( Hosseini Seyed Mehdi ) - Kurdistan University of Medical Sciences Research Institute for Health Development Social Determinants of Health Research Center
 ( Khodakarim Soheila ) - Shahid Beheshti University of Medical Sciences School of Public Health and Safety Department of Epidemiology
 ( Khadembashi Naghmeh ) - Shahid Beheshti University of Medical Sciences School of Allied Medical Sciences English Language Department
 ( Pordanjani Sajjad Rahimi ) - Shahid Beheshti University of Medical Sciences School of Public Health and Safety Department of Epidemiology

Abstract


OBJECTIVES: Spatial information makes a crucial contribution to enhancing and monitoring the brucellosis surveillance system by facilitating the timely diagnosis and treatment of brucellosis.

METHODS: An exponential scan statistic model was used to formalize the spatial distribution of the adjusted delay in the diagnosis time of brucellosis (time between onset and diagnosis of the disease) in Kurdistan Province, Iran. Logistic regression analysis was used to compare variables of interest between the clustered and non-clustered areas.

RESULTS: The spatial distribution of clusters of human brucellosis cases with delayed diagnoses was not random in Kurdistan Province. The mean survival time (i.e., time between symptom onset and diagnosis) was 4.02 months for the short spatial cluster, which was centered around the city of Baneh, and was 4.21 months for spatiotemporal clusters centered around the cities of Baneh and Qorveh. Similarly, the mean survival time for the long spatial and spatiotemporal clusters was 6.56 months and 15.69 months, respectively. The spatial distribution of the cases inside and outside of clusters differed in terms of livestock vaccination, residence, sex, and occupational variables.

CONCLUSIONS: The cluster pattern of brucellosis cases with delayed diagnoses indicated poor performance of the surveillance system in Kurdistan Province. Accordingly, targeted and multi-faceted approaches should be implemented to improve the brucellosis surveillance system and to reduce the number of lost days caused by delays in the diagnosis of brucellosis, which can lead to long-term and serious complications in patients.

키워드

Spatial analysis; Brucellosis; Exponential scanning statistics; Iran

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