HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Ben-Ahmed, K. Articles by Bouratbine, A. PubMed PubMed Citation Articles by Ben-Ahmed, K. Articles by Bouratbine, A.

Visceral Leishmaniasis in Tunisia: Spatial Distribution and Association with Climatic Factors

Visceral leishmaniasis (VL) cases in children less than five years of age were recorded from 1996 through 2006 from Tunisian pediatric departments. Mean incidence rates were calculated for each of the 215 districts in the study area. Averages of annual rainfall and extreme values of low temperatures in winter and high temperatures in summer were used to characterize the climate of each district according to its continentality index and bioclimatic zone. A geographic information system and a local indicator of spatial association were used to summarize the spatial properties of VL distribution. Poisson spatial regression was performed to study the relationship between VL incidence rates and climatic parameters. We identified one hot-spot region of 35 inland districts located mostly in the semi-arid bioclimatic zone and two cold-spots located in coastal regions of the northeastern sub-humid zone and the southeastern arid zone. The incidence rate of VL was positively correlated with mean yearly rainfall and continentality index.

Received November 4, 2008. Accepted for publication March 22, 2009.

Acknowledgments: We thank all collaborators from pediatric departments and from the Regional Public Health Services who enabled and facilitated MVL data collection (Fethi Amri, Hôpital Regional de Kairouan; Sihem Barsaoui, Hôpital d’Enfants, Tunis; Mondher Bjaoui, Direction de Soins de Santé de Base, Tunis; Saïda Ben Bechr, Hôpital d’Enfants, Tunis; Marie-Françoise Ben Dridi, Hôpital la Rabta, Tunis; Asma Bouaziz, Hôpital Regional de Nabeul; Souad Bousnina, Hôpital d’Enfants, Tunis; Moncef Chibani, Hôpital Regional de Zagouan; Essia Dhahbi, Hôpital Regional du Kef; Abdel-Hamid Gnaoui, Hôpital Regional de Jendouba; Monia Hachicha, Hôpital H. Bourguiba, Sfax; Adel Hichri, Hôpital Regional de Béja; Mohamed-Rchid Lakhoua, Hôpital Ch. Nicolle, Tunis; Belgacem Mahmoudi, Hôpital Regional de Kasserine; Ahmed Meherzi, Hôpital Mongi Slim, la Marsa; Ahmed Ourari, Hôpital Regional de Menzel Bourguiba; Azza Sammoud, Hôpital d’Enfants, Tunis).

Financial support: This study was supported by the Ministry of Higher Education, Research and Technology in Tunisia and carried out within the framework of the Research Laboratory Parasitoses Emergentes LR 05SP03.

^* Address correspondence to Aïda Bouratbine, Laboratoire de Parasitologie, Institut Pasteur de Tunis, 13 Place Pasteur, BP 74, 1002 Tunis Belvedère, Tunisia. E-mail: aida.bouratbine{at}pasteur.rns.tn

Authors’ addresses: Kais Ben-Ahmed and Mhamed-Ali El-Aroui, Institut Superieur de Gestion de Tunis, 41 Rue de la Liberté, Bardo 2000, Tunisia. Karim Aoun, Fakhri Jeddi, Jamila Ghrab, and Aïda Bouratbine, LR Parasitoses Emergentes, Laboratoire de Parasitologie, Institut Pasteur de Tunis, 13 Place Pasteur, BP 74, 1002 Tunis Belvedère, Tunisia.

Reprint requests: Aïda Bouratbine, Laboratoire de Parasitologie, Institut Pasteur de Tunis, 13 Place Pasteur, BP 74, 1002 Tunis Belvedère, Tunisia, E-mail: aida.bouratbine{at}pasteur.rns.tn.