Changing spatial patterns and increasing rurality of HIV prevalence in the Democratic Republic of the Congo between 2007 and 2013
Identifieur interne : 001146 ( Main/Exploration ); précédent : 001145; suivant : 001147Changing spatial patterns and increasing rurality of HIV prevalence in the Democratic Republic of the Congo between 2007 and 2013
Auteurs : Margaret Carrel [États-Unis] ; Mark Janko [États-Unis] ; Melchior Kashamuka Mwandagalirwa [États-Unis] ; Camille Morgan [États-Unis] ; Franck Fwamba ; Jérémie Muwonga ; Antoinette K. Tshefu ; Steven Meshnick [États-Unis] ; Michael Emch [États-Unis]Source :
- Health & place [ 1353-8292 ] ; 2016.
Abstract
The Democratic Republic of the Congo (DRC) has one of the lowest HIV prevalence in sub-Saharan Africa, estimated at 1.1% [0.9-1.3] of adults aged 15-49 in 2013 (UNAIDS). Within the 2 million km2 country, however, there exists spatial variation in HIV prevalence, with the highest HIV prevalence observed in the large cities of Kinshasa and Lubumbashi. Globally, HIV is an increasingly rural disease, diffusing outwards from urban centers of high HIV prevalence to places where HIV was previously absent or present at very low levels. Utilizing data collected during Demographic and Health Surveillance (DHS) in 2007 and 2013 in the DRC, we sought to update the map of HIV prevalence in the DRC as well as to explore whether HIV in the DRC is an increasingly rural disease or remains confined to urban areas. Bayesian kriging and regression indicate that HIV prevalence in rural areas of the DRC is higher in 2013 than in 2007 and that increased distance to an urban area is no longer protective against HIV as it was in 2007. These findings suggest that HIV education, testing and prevention efforts need to diffuse from urban to rural areas just as HIV is doing.
Url:
DOI: 10.1016/j.healthplace.2016.02.009
PubMed: 26974234
PubMed Central: 4874876
Affiliations:
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l'Iowa</orgName></affiliation></author><author><name sortKey="Janko, Mark" sort="Janko, Mark" uniqKey="Janko M" first="Mark" last="Janko">Mark Janko</name><affiliation wicri:level="2"><nlm:aff id="A3">Department of Geography, CB3220, Carolina Hall, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Geography, CB3220, Carolina Hall, University of North Carolina-Chapel Hill, Chapel Hill, NC</wicri:regionArea><placeName><region type="state">Caroline du Nord</region></placeName></affiliation><affiliation wicri:level="2"><nlm:aff id="A4">Department of Biostatistics, CB7420, McGavran-Greenberg Hall, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Biostatistics, CB7420, McGavran-Greenberg Hall, University of North Carolina-Chapel Hill, Chapel Hill, NC</wicri:regionArea><placeName><region 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University of North Carolina-Chapel Hill, Chapel Hill, NC, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Biostatistics, CB7420, McGavran-Greenberg Hall, University of North Carolina-Chapel Hill, Chapel Hill, NC</wicri:regionArea><placeName><region type="state">Caroline du Nord</region></placeName></affiliation></author><author><name sortKey="Fwamba, Franck" sort="Fwamba, Franck" uniqKey="Fwamba F" first="Franck" last="Fwamba">Franck Fwamba</name><affiliation><nlm:aff id="A6">National AIDS Control Program (PNLS), Kinshasa, Democratic Republic of the Congo</nlm:aff><wicri:noCountry code="subfield">Democratic Republic of the Congo</wicri:noCountry></affiliation></author><author><name sortKey="Muwonga, Jeremie" sort="Muwonga, Jeremie" uniqKey="Muwonga J" first="Jérémie" last="Muwonga">Jérémie Muwonga</name><affiliation><nlm:aff id="A6">National AIDS Control Program (PNLS), Kinshasa, Democratic Republic of the Congo</nlm:aff><wicri:noCountry code="subfield">Democratic Republic of the Congo</wicri:noCountry></affiliation></author><author><name sortKey="Tshefu, Antoinette K" sort="Tshefu, Antoinette K" uniqKey="Tshefu A" first="Antoinette K." last="Tshefu">Antoinette K. Tshefu</name><affiliation><nlm:aff id="A7">Ecole de Sante Publique, Faculte de Medecine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo</nlm:aff><wicri:noCountry code="subfield">Democratic Republic of the Congo</wicri:noCountry></affiliation></author><author><name sortKey="Meshnick, Steven" sort="Meshnick, Steven" uniqKey="Meshnick S" first="Steven" last="Meshnick">Steven Meshnick</name><affiliation wicri:level="2"><nlm:aff id="A5">Department of Epidemiology, CB7435, McGavran-Greenberg Hall, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Epidemiology, CB7435, McGavran-Greenberg Hall, University of North Carolina-Chapel Hill, Chapel Hill, NC</wicri:regionArea><placeName><region type="state">Caroline du Nord</region></placeName></affiliation></author><author><name sortKey="Emch, Michael" sort="Emch, Michael" uniqKey="Emch M" first="Michael" last="Emch">Michael Emch</name><affiliation wicri:level="2"><nlm:aff id="A3">Department of Geography, CB3220, Carolina Hall, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Geography, CB3220, Carolina Hall, University of North Carolina-Chapel Hill, Chapel Hill, NC</wicri:regionArea><placeName><region type="state">Caroline du Nord</region></placeName></affiliation><affiliation wicri:level="2"><nlm:aff id="A5">Department of Epidemiology, CB7435, McGavran-Greenberg Hall, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Epidemiology, CB7435, McGavran-Greenberg Hall, University of North Carolina-Chapel Hill, Chapel Hill, NC</wicri:regionArea><placeName><region type="state">Caroline du Nord</region></placeName></affiliation></author></analytic><series><title level="j">Health & place</title><idno type="ISSN">1353-8292</idno><idno type="eISSN">1873-2054</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p id="P1">The Democratic Republic of the Congo (DRC) has one of the lowest HIV prevalence in sub-Saharan Africa, estimated at 1.1% [0.9-1.3] of adults aged 15-49 in 2013 (UNAIDS). Within the 2 million km<sup>2</sup> country, however, there exists spatial variation in HIV prevalence, with the highest HIV prevalence observed in the large cities of Kinshasa and Lubumbashi. Globally, HIV is an increasingly rural disease, diffusing outwards from urban centers of high HIV prevalence to places where HIV was previously absent or present at very low levels. Utilizing data collected during Demographic and Health Surveillance (DHS) in 2007 and 2013 in the DRC, we sought to update the map of HIV prevalence in the DRC as well as to explore whether HIV in the DRC is an increasingly rural disease or remains confined to urban areas. Bayesian kriging and regression indicate that HIV prevalence in rural areas of the DRC is higher in 2013 than in 2007 and that increased distance to an urban area is no longer protective against HIV as it was in 2007. These findings suggest that HIV education, testing and prevention efforts need to diffuse from urban to rural areas just as HIV is doing.</p></div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Caroline du Nord</li><li>Iowa</li></region><settlement><li>Iowa City</li></settlement><orgName><li>Université de l'Iowa</li></orgName></list><tree><noCountry><name sortKey="Fwamba, Franck" sort="Fwamba, Franck" uniqKey="Fwamba F" first="Franck" last="Fwamba">Franck Fwamba</name><name sortKey="Muwonga, Jeremie" sort="Muwonga, Jeremie" uniqKey="Muwonga J" first="Jérémie" last="Muwonga">Jérémie Muwonga</name><name sortKey="Tshefu, Antoinette K" sort="Tshefu, Antoinette K" uniqKey="Tshefu A" first="Antoinette K." last="Tshefu">Antoinette K. Tshefu</name></noCountry><country name="États-Unis"><region name="Iowa"><name sortKey="Carrel, Margaret" sort="Carrel, Margaret" uniqKey="Carrel M" first="Margaret" last="Carrel">Margaret Carrel</name></region><name sortKey="Emch, Michael" sort="Emch, Michael" uniqKey="Emch M" first="Michael" last="Emch">Michael Emch</name><name sortKey="Emch, Michael" sort="Emch, Michael" uniqKey="Emch M" first="Michael" last="Emch">Michael Emch</name><name sortKey="Janko, Mark" sort="Janko, Mark" uniqKey="Janko M" first="Mark" last="Janko">Mark Janko</name><name sortKey="Janko, Mark" sort="Janko, Mark" uniqKey="Janko M" first="Mark" last="Janko">Mark Janko</name><name sortKey="Meshnick, Steven" sort="Meshnick, Steven" uniqKey="Meshnick S" first="Steven" last="Meshnick">Steven Meshnick</name><name sortKey="Morgan, Camille" sort="Morgan, Camille" uniqKey="Morgan C" first="Camille" last="Morgan">Camille Morgan</name><name sortKey="Mwandagalirwa, Melchior Kashamuka" sort="Mwandagalirwa, Melchior Kashamuka" uniqKey="Mwandagalirwa M" first="Melchior Kashamuka" last="Mwandagalirwa">Melchior Kashamuka Mwandagalirwa</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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