title: Spatial modeling of cutaneous leishmaniasis in the Andean region of Colombia.
abstract: The objective of this research was to identify environmental risk factors for cutaneous leishmaniasis (CL) in Colombia and map high-risk municipalities. The study area was the Colombian Andean region, comprising 715 rural and urban municipalities. We used 10 years of CL surveillance: 2000-2009. We used spatial-temporal analysis - conditional autoregressive Poisson random effects modelling - in a Bayesian framework to model the dependence of municipality-level incidence on land use, climate, elevation and population density. Bivariable spatial analysis identified rainforests, forests and secondary vegetation, temperature, and annual precipitation as positively associated with CL incidence. By contrast, livestock agroecosystems and temperature seasonality were negatively associated. Multivariable analysis identified land use - rainforests and agro-livestock - and climate - temperature, rainfall and temperature seasonality - as best predictors of CL. We conclude that climate and land use can be used to identify areas at high risk of CL and that this approach is potentially applicable elsewhere in Latin America.
authors.affiliation: Centro Internacional de Entrenamiento e Investigaciones Médicas, Cali, Colombia.|Pontificia Universidad Javeriana, Cali, Colombia.
authors.forename: Mauricio
authors.initials: M
authors.lastname: Pérez-Flórez
authors.affiliation: Centro Internacional de Entrenamiento e Investigaciones Médicas, Cali, Colombia.
authors.forename: Clara Beatriz
authors.initials: CB
authors.lastname: Ocampo
authors.affiliation: Universidad Icesi, Departamento de Ciencias Biológicas, Cali, Colombia.
authors.forename: Carlos
authors.initials: C
authors.lastname: Valderrama-Ardila
authors.affiliation: Centro Internacional de Entrenamiento e Investigaciones Médicas, Cali, Colombia.
authors.forename: Neal
authors.initials: N
authors.lastname: Alexander
mesh_terms: D000531:Altitude; D001499:Bayes Theorem; D003105:Colombia / Q000453:epidemiology; D004812:Epidemiologic Methods; D065928:Forests; D040362:Geographic Information Systems; D062306:Geography, Medical; D006801:Humans; D016773:Leishmaniasis, Cutaneous / Q000453:epidemiology*; D011156:Population Density; D012307:Risk Factors; D012987:Soil
chemical_list: D012987:Soil