Background: Tuberculosis (TB) is the leading cause of death for individuals infected with Human immunodeficiency virus (HIV). Conversely, HIV is the most important risk factor in the progression of TB from the latent to the active status. In order to manage this double epidemic situation, an integrated approach that includes HIV management in TB patients was proposed by the World Health Organization and was implemented in Uganda (one of the countries endemic with both diseases). To enable targeted intervention using the integrated approach, areas with high disease prevalence rates for TB and HIV need to be identified first. However, there is no such study in Uganda, addressing the joint spatial patterns of these two diseases. Methods: This study uses global Moran's index, spatial scan statistics and bivariate global and local Moran's indices to investigate the geographical clustering patterns of both diseases, as individuals and as combined. The data used are TB and HIV case data for 2015, 2016 and 2017 obtained from the District Health Information Software 2 system, housed and maintained by the Ministry of Health, Uganda. Results: Results from this analysis show that while TB and HIV diseases are highly correlated (55-76%), they exhibit relatively different spatial clustering patterns across Uganda. The joint TB/HIV prevalence shows consistent hotspot clusters around districts surrounding Lake Victoria as well as northern Uganda. These two clusters could be linked to the presence of high HIV prevalence among the fishing communities of Lake Victoria and the presence of refugees and internally displaced people camps, respectively. The consistent cold spot observed in eastern Uganda and around Kasese could be explained by low HIV prevalence in communities with circumcision tradition. Conclusions: This study makes a significant contribution to TB/HIV public health bodies around Uganda by identifying areas with high joint disease burden, in the light of TB/HIV co-infection. It, thus, provides a valuable starting point for an informed and targeted intervention, as a positive step towards a TB and HIV-AIDS free community.
Background Mesoamerica is severely affected by an epidemic of Chronic Kidney Disease of non-traditional origin (CKDnt), an epidemic with a marked variation within countries. We sought to describe the spatial distribution of CKDnt in Mesoamerica and examine area-level crop and climate risk factors. Methods CKD mortality or hospital admissions data was available for five countries: Mexico, Guatemala, El Salvador, Nicaragua and Costa Rica and linked to demographic, crop and climate data. Maps were developed using Bayesian spatial regression models. Regression models were used to analyze the association between area-level CKD burden and heat and cultivation of four crops: sugarcane, banana, rice and coffee. Results There are regions within each of the five countries with elevated CKD burden. Municipalities in hot areas and much sugarcane cultivation had higher CKD burden, both compared to equally hot municipalities with lower intensity of sugarcane cultivation and to less hot areas with equally intense sugarcane cultivation, but associations with other crops at different intensity and heat levels were not consistent across countries. Conclusion Mapping routinely collected, already available data could be a first step to identify areas with high CKD burden. The finding of higher CKD burden in hot regions with intense sugarcane cultivation which was repeated in all five countries agree with individual-level studies identifying heavy physical labor in heat as a key CKDnt risk factor. In contrast, no associations between CKD burden and other crops were observed.
Due to critical impacts of air pollution, prediction and monitoring of air quality in urban areas are important tasks. However, because of the dynamic nature and high spatio-temporal variability, prediction of the air pollutant concentrations is a complex spatio-temporal problem. Distribution of pollutant concentration is influenced by various factors such as the historical pollution data and weather conditions. Conventional methods such as the support vector machine (SVM) or artificial neural networks (ANN) show some deficiencies when huge amount of streaming data have to be analyzed for urban air pollution prediction. In order to overcome the limitations of the conventional methods and improve the performance of urban air pollution prediction in Tehran, a spatio-temporal system is designed using a LaSVM-based online algorithm. Pollutant concentration and meteorological data along with geographical parameters are continually fed to the developed online forecasting system. Performance of the system is evaluated by comparing the prediction results of the Air Quality Index (AQI) with those of a traditional SVM algorithm. Results show an outstanding increase of speed by the online algorithm while preserving the accuracy of the SVM classifier. Comparison of the hourly predictions for next coming 24 h, with those of the measured pollution data in Tehran pollution monitoring stations shows an overall accuracy of 0.71, root mean square error of 0.54 and coefficient of determination of 0.81. These results are indicators of the practical usefulness of the online algorithm for real-time spatial and temporal prediction of the urban air quality.
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