title: Visceral leishmaniasis in Tunisia: spatial distribution and association with climatic factors.
abstract: 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.
authors: Laboratoire de Recherche 05SP03, Institut Pasteur de Tunis, Tunis, Tunisia.
authors: Kais
authors: K
authors: Ben-Ahmed
authors: Karim
authors: K
authors: Aoun
authors: Fakhri
authors: F
authors: Jeddi
authors: Jamila
authors: J
authors: Ghrab
authors: Mhamed-Ali
authors: MA
authors: El-Aroui
authors: Aïda
authors: A
authors: Bouratbine
mesh_terms: D002980:Climate; D006801:Humans; D015994:Incidence; D007898:Leishmaniasis, Visceral / Q000453:epidemiology* / Q000209:etiology; D016012:Poisson Distribution; D011891:Rain; D013997:Time Factors; D014416:Tunisia / Q000453:epidemiology