Éditeur(s) : s.n. s.n. ( Gainesville )
Résumé : (Bibliography) Includes bibliographical references (p. 162-179).
(Statement of Responsibility) Gary Brana-Shute, Rosemary Brana-Shute.
"The research for this report was undertaken at the request of U.S.A.I.D. under contract number AID/LAC-C-1395."
Dominica
Barbados
Saint Vincent and the Grenadines
Saint Lucia
Caribbean Area
Caribbean Area
Caribbean Area

08066178

Éditeur(s) : HAL CCSD Public Library of Science
Résumé : International audience
Understanding the factors underlying the spatio-temporal distribution of infectious diseases provides useful information regarding their prevention and control. Dengue fever spatio-temporal patterns result from complex interactions between the virus, the host, and the vector. These interactions can be influenced by environmental conditions. Our objectives were to analyse dengue fever spatial distribution over New Caledonia during epidemic years, to identify some of the main underlying factors, and to predict the spatial evolution of dengue fever under changing climatic conditions, at the 2100 horizon. We used principal component analysis and support vector machines to analyse and model the influence of climate and socio-economic variables on the mean spatial distribution of 24,272 dengue cases reported from 1995 to 2012 in thirty-three communes of New Caledonia. We then modelled and estimated the future evolution of dengue incidence rates using a regional downscaling of future climate projections. The spatial distribution of dengue fever cases is highly heterogeneous. The variables most associated with this observed heterogeneity are the mean temperature, the mean number of people per premise, and the mean percentage of unemployed people, a variable highly correlated with people's way of life. Rainfall does not seem to play an important role in the spatial distribution of dengue cases during epidemics. By the end of the 21st century, if temperature increases by approximately 3°C, mean incidence rates during epidemics could double. In New Caledonia, a subtropical insular environment, both temperature and socio-economic conditions are influencing the spatial spread of dengue fever. Extension of this study to other countries worldwide should improve the knowledge about climate influence on dengue burden and about the complex interplay between different factors. This study presents a methodology that can be used as a step by step guide to model dengue spatial heterogeneity in other countries.
ISSN: 1935-2727

Droits : http://creativecommons.org/licenses/by/
pasteur-01247037
https://hal-riip.archives-ouvertes.fr/pasteur-01247037
https://hal-riip.archives-ouvertes.fr/pasteur-01247037/document
https://hal-riip.archives-ouvertes.fr/pasteur-01247037/file/journal.pntd.0004211.pdf
DOI : 10.1371/journal.pntd.0004211

Éditeur(s) : HAL CCSD Springer Verlag
Résumé : International audience
In France, reducing social health inequalities has become an explicit goal of health policies over the past few years, one of its objectives is specifically the reduction of the perinatal mortality rate. This study investigates the association between infant mortality and social deprivation categories at a small area level in the Lille metropolitan area, in the north of France, to identify census blocks where public authorities should prioritize appropriate preventive actions. We used census data to establish a neighbourhood deprivation index whose multiple dimensions encompass socioeconomic characteristics. Infant mortality data were obtained from the Lille metropolitan area municipalities to estimate a death rate at the census tract level. We used Bayesian hierarchical models in order to reduce the extra variability when computing relative risks (RR) and to assess the associations between infant mortality and deprivation. Between 2000 and 2009, 668 cases of infant death occurred in the Lille metropolitan area (4.2 per 1,000 live births). The socioeconomic status is associated with infant mortality, with a clear gradient of risk from the most privileged census blocks to the most deprived ones (RR = 2.62, 95 % confidence interval [1.87; 3.70]). The latter have 24.6 % of families who were single parents and 29.9 % of unemployed people in the labor force versus 8.5 % and 7.7 % in the former. Our study reveals socio-spatial disparities in infant mortality in the Lille metropolitan area and highlights the census blocks most affected by the inequalities. Fine spatial analysis may help inform the design of preventive policies tailored to the characteristics of the local communities.
ISSN: 1092-7875

hal-00876255
https://hal.archives-ouvertes.fr/hal-00876255
DOI : 10.1007/s10995-013-1251-8
PUBMED : 23479336

Éditeur(s) : HAL CCSD Elsevier Masson
Résumé : International audience
OBJECTIVE: To assess the relationship between hypertension and perceived material insecurity in a disadvantaged Caribbean population. PATIENTS AND METHODS: We used data from a cross-sectional study involving 2420 disadvantaged subjects aged 18-69 years, included consecutively at three Guadeloupian health centers. Hypertension was diagnosed over two consultations with a total of six blood pressure measurements. Perceived material insecurity was assessed using a closed-ended question. RESULTS: The prevalence of hypertension was estimated at 17.7% among subjects who believed their material situation would improve in the future, at 28.2% among those who believed it would remain the same, and at 43.3% among those who believed it would deteriorate. A multivariate logistic regression analysis showed that hypertension risk more than doubled (OR: 2.35 - P: 0.002) among subjects who believed that their material situation would deteriorate in the future compared to those who believed that their situation would improve, with no significant sex-related differences. This relationship was especially strong among subjects aged 40 years or more (OR: 3.30 - P<10(-3)), and among subjects with low education level (OR: 3.81 - P: 0.003), but was independent of the other tested variables. CONCLUSION: In this disadvantaged population, perceived material insecurity is a psychosocial factor strongly associated with hypertension, independently of subjects' risk behaviors. Subjects aged 40 years or more and subjects with a low education level seem the most vulnerable.
ISSN: 0003-3928

hal-00739792
https://hal.univ-antilles.fr/hal-00739792
https://hal.univ-antilles.fr/hal-00739792/document
https://hal.univ-antilles.fr/hal-00739792/file/HTA_et_precarite_percue_en_guadeloupe_-_Copie.pdf
DOI : 10.1016/j.ancard.2012.04.023