Fernando Simón

Spatial pattern of legionellosis in Spain, 2003-2007

OBJECTIVES To analyze the spatial pattern of legionellosis in Spain for men and women during the period 2003-2007 and to identify spatial clustering of risk. METHODS We identified the spatial pattern of the distribution of legionellosis rates based on calculation of rates by municipality through the direct method. Smoothing of these rates was performed by the Empirical Bayes method for studying the spatial pattern of disease for both sexes. We used Morans index to analyze spatial autocorrelation rates globally. To calculate local rates, the Local Morans Index [known as local indicators of spatial association (LISA)], was used to analyze the clusters of municipalities with the highest risk. RESULTS After smoothing the risk, the highest rates (over 50 per 100,000 inhabitants) were grouped in the eastern Mediterranean coastal areas and the north of the mainland, as well as in the Mediterranean islands. Morans index smoothed rates were 0.15 for men and 0.23 for women. The spatial clusters of statistically significant higher rates calculated by the LISA index were distributed in the north and east for both sexes. CONCLUSIONS These methods of spatial analysis allow patterns of disease distribution to be identified. All the methods used yielded similar results. These techniques are a complementary tool for epidemiological surveillance of infectious diseases.

Patrón espacial de la legionelosis en España, 2003-2007

OBJECTIVES To analyze the spatial pattern of legionellosis in Spain for men and women during the period 2003-2007 and to identify spatial clustering of risk. METHODS We identified the spatial pattern of the distribution of legionellosis rates based on calculation of rates by municipality through the direct method. Smoothing of these rates was performed by the Empirical Bayes method for studying the spatial pattern of disease for both sexes. We used Morańs index to analyze spatial autocorrelation rates globally. To calculate local rates, the Local Morans Index [known as local indicators of spatial association (LISA)], was used to analyze the clusters of municipalities with the highest risk. RESULTS After smoothing the risk, the highest rates (over 50 per 100,000 inhabitants) were grouped in the eastern Mediterranean coastal areas and the north of the mainland, as well as in the Mediterranean islands. Morans index smoothed rates were 0.15 for men and 0.23 for women. The spatial clusters of statistically significant higher rates calculated by the LISA index were distributed in the north and east for both sexes. CONCLUSIONS These methods of spatial analysis allow patterns of disease distribution to be identified. All the methods used yielded similar results. These techniques are a complementary tool for epidemiological surveillance of infectious diseases.