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Spatial distribution and socioeconomic context of tuberculosis in Rio de Janeiro, Brazil.

Pereira AG, Medronho Rde A, Escosteguy CC, Valencia LI, Magalhães Mde A - Rev Saude Publica (2015)

Bottom Line: RESULTS We observed a higher risk of the disease in some neighborhoods of the port and north regions, as well as a high incidence in the slums of Rocinha and Vidigal, in the south region, and Cidade de Deus, in the west.The final model identified a positive association for the variables: percentage of permanent private households in which the head of the house earns three to five minimum wages; percentage of individual residents in the neighborhood; and percentage of people living in homes with more than two people per bedroom.However, the inclusion of the space component in the final model was not required during the modeling process.

View Article: PubMed Central - PubMed

Affiliation: Hospital Federal dos Servidores do Estado, Ministério da Saúde, Rio de Janeiro, RJ, Brasil.

ABSTRACT
OBJECTIVE To analyze the spatial distribution of risk for tuberculosis and its socioeconomic determinants in the city of Rio de Janeiro, Brazil. METHODS An ecological study on the association between the mean incidence rate of tuberculosis from 2004 to 2006 and socioeconomic indicators of the Censo Demográfico (Demographic Census) of 2000. The unit of analysis was the home district registered in the Sistema de Informação de Agravos de Notificação (Notifiable Diseases Information System) of Rio de Janeiro, Southeastern Brazil. The rates were standardized by sex and age group, and smoothed by the empirical Bayes method. Spatial autocorrelation was evaluated by Moran's I. Multiple linear regression models were studied and the appropriateness of incorporating the spatial component in modeling was evaluated. RESULTS We observed a higher risk of the disease in some neighborhoods of the port and north regions, as well as a high incidence in the slums of Rocinha and Vidigal, in the south region, and Cidade de Deus, in the west. The final model identified a positive association for the variables: percentage of permanent private households in which the head of the house earns three to five minimum wages; percentage of individual residents in the neighborhood; and percentage of people living in homes with more than two people per bedroom. CONCLUSIONS The spatial analysis identified areas of risk of tuberculosis incidence in the neighborhoods of the city of Rio de Janeiro and also found spatial dependence for the incidence of tuberculosis and some socioeconomic variables. However, the inclusion of the space component in the final model was not required during the modeling process.

No MeSH data available.


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Graphs for diagnosis of model adjustment.
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f02: Graphs for diagnosis of model adjustment.

Mentions: The variance inflation factor and the tolerance test suggested a low level of collinearity among the variables included in the final model. The variance inflation factor was < 10, the greatest being 2,039, and the tolerance test was > 0.1 for all variables. The existence of possible outliers was assessed by estimating Cook’s distance, which satisfactorily ranged from 0 to 0.065 in the observed units. The residual independence assumption was fulfilled, given that the Durbin-Watson test result was 2.275. Figure 2 summarizes the residual analysis. The histogram and Q-Q plot exhibit normal residual patterns. The random pattern of the scatterplot of the predicted values and standardized residuals strengthens the hypothesis of constant variance. Thus, we may assume that the model is homoscedastic. The last graph, a scatterplot between the dependent variable and the predicted values, although not perfectly adjusted, points to a reasonable adjustment of the final model.


Spatial distribution and socioeconomic context of tuberculosis in Rio de Janeiro, Brazil.

Pereira AG, Medronho Rde A, Escosteguy CC, Valencia LI, Magalhães Mde A - Rev Saude Publica (2015)

Graphs for diagnosis of model adjustment.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4544397&req=5

f02: Graphs for diagnosis of model adjustment.
Mentions: The variance inflation factor and the tolerance test suggested a low level of collinearity among the variables included in the final model. The variance inflation factor was < 10, the greatest being 2,039, and the tolerance test was > 0.1 for all variables. The existence of possible outliers was assessed by estimating Cook’s distance, which satisfactorily ranged from 0 to 0.065 in the observed units. The residual independence assumption was fulfilled, given that the Durbin-Watson test result was 2.275. Figure 2 summarizes the residual analysis. The histogram and Q-Q plot exhibit normal residual patterns. The random pattern of the scatterplot of the predicted values and standardized residuals strengthens the hypothesis of constant variance. Thus, we may assume that the model is homoscedastic. The last graph, a scatterplot between the dependent variable and the predicted values, although not perfectly adjusted, points to a reasonable adjustment of the final model.

Bottom Line: RESULTS We observed a higher risk of the disease in some neighborhoods of the port and north regions, as well as a high incidence in the slums of Rocinha and Vidigal, in the south region, and Cidade de Deus, in the west.The final model identified a positive association for the variables: percentage of permanent private households in which the head of the house earns three to five minimum wages; percentage of individual residents in the neighborhood; and percentage of people living in homes with more than two people per bedroom.However, the inclusion of the space component in the final model was not required during the modeling process.

View Article: PubMed Central - PubMed

Affiliation: Hospital Federal dos Servidores do Estado, Ministério da Saúde, Rio de Janeiro, RJ, Brasil.

ABSTRACT
OBJECTIVE To analyze the spatial distribution of risk for tuberculosis and its socioeconomic determinants in the city of Rio de Janeiro, Brazil. METHODS An ecological study on the association between the mean incidence rate of tuberculosis from 2004 to 2006 and socioeconomic indicators of the Censo Demográfico (Demographic Census) of 2000. The unit of analysis was the home district registered in the Sistema de Informação de Agravos de Notificação (Notifiable Diseases Information System) of Rio de Janeiro, Southeastern Brazil. The rates were standardized by sex and age group, and smoothed by the empirical Bayes method. Spatial autocorrelation was evaluated by Moran's I. Multiple linear regression models were studied and the appropriateness of incorporating the spatial component in modeling was evaluated. RESULTS We observed a higher risk of the disease in some neighborhoods of the port and north regions, as well as a high incidence in the slums of Rocinha and Vidigal, in the south region, and Cidade de Deus, in the west. The final model identified a positive association for the variables: percentage of permanent private households in which the head of the house earns three to five minimum wages; percentage of individual residents in the neighborhood; and percentage of people living in homes with more than two people per bedroom. CONCLUSIONS The spatial analysis identified areas of risk of tuberculosis incidence in the neighborhoods of the city of Rio de Janeiro and also found spatial dependence for the incidence of tuberculosis and some socioeconomic variables. However, the inclusion of the space component in the final model was not required during the modeling process.

No MeSH data available.


Related in: MedlinePlus