Changing spatial patterns and increasing rurality of HIV prevalence in the Democratic Republic of the Congo between 2007 and 2013
Identifieur interne : 000814 ( Pmc/Checkpoint ); précédent : 000813; suivant : 000815Changing 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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first="Margaret" last="Carrel">Margaret Carrel</name><affiliation wicri:level="4"><nlm:aff id="A1">Department of Geographical & Sustainability Sciences, 303 Jessup Hall, University of Iowa, Iowa City, IA 52245, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Geographical & Sustainability Sciences, 303 Jessup Hall, University of Iowa, Iowa City, IA 52245</wicri:regionArea><placeName><region type="state">Iowa</region><settlement type="city">Iowa City</settlement></placeName><orgName type="university">Université de 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 type="state">Caroline du Nord</region></placeName></affiliation></author><author><name sortKey="Mwandagalirwa, Melchior Kashamuka" sort="Mwandagalirwa, Melchior Kashamuka" uniqKey="Mwandagalirwa M" first="Melchior Kashamuka" last="Mwandagalirwa">Melchior Kashamuka Mwandagalirwa</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="Morgan, Camille" sort="Morgan, Camille" uniqKey="Morgan C" first="Camille" last="Morgan">Camille Morgan</name><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 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><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">9510067</journal-id><journal-id journal-id-type="pubmed-jr-id">21632</journal-id><journal-id journal-id-type="nlm-ta">Health Place</journal-id><journal-id journal-id-type="iso-abbrev">Health Place</journal-id><journal-title-group><journal-title>Health & place</journal-title></journal-title-group><issn pub-type="ppub">1353-8292</issn><issn pub-type="epub">1873-2054</issn></journal-meta><article-meta><article-id pub-id-type="pmid">26974234</article-id><article-id pub-id-type="pmc">4874876</article-id><article-id pub-id-type="doi">10.1016/j.healthplace.2016.02.009</article-id><article-id pub-id-type="manuscript">NIHMS768306</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Changing spatial patterns and increasing rurality of HIV prevalence in the Democratic Republic of the Congo between 2007 and 2013</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Carrel</surname><given-names>Margaret</given-names></name><xref ref-type="aff" rid="A1">a</xref><xref rid="FN1" ref-type="author-notes">*</xref></contrib><contrib contrib-type="author"><name><surname>Janko</surname><given-names>Mark</given-names></name><xref ref-type="aff" rid="A3">c</xref><xref ref-type="aff" rid="A4">d</xref></contrib><contrib contrib-type="author"><name><surname>Mwandagalirwa</surname><given-names>Melchior Kashamuka</given-names></name><xref ref-type="aff" rid="A5">e</xref></contrib><contrib contrib-type="author"><name><surname>Morgan</surname><given-names>Camille</given-names></name><xref ref-type="aff" rid="A4">d</xref></contrib><contrib contrib-type="author"><name><surname>Fwamba</surname><given-names>Franck</given-names></name><xref ref-type="aff" rid="A6">f</xref></contrib><contrib contrib-type="author"><name><surname>Muwonga</surname><given-names>Jérémie</given-names></name><xref ref-type="aff" rid="A6">f</xref></contrib><contrib contrib-type="author"><name><surname>Tshefu</surname><given-names>Antoinette K.</given-names></name><xref ref-type="aff" rid="A7">g</xref></contrib><contrib contrib-type="author"><name><surname>Meshnick</surname><given-names>Steven</given-names></name><xref ref-type="aff" rid="A5">e</xref></contrib><contrib contrib-type="author"><name><surname>Emch</surname><given-names>Michael</given-names></name><xref ref-type="aff" rid="A3">c</xref><xref ref-type="aff" rid="A5">e</xref></contrib></contrib-group><aff id="A1"><label>a</label>Department of Geographical & Sustainability Sciences, 303 Jessup Hall, University of Iowa, Iowa City, IA 52245, USA</aff><aff id="A2"><label>b</label>Department of Epidemiology, University of Iowa, Iowa City IA, USA</aff><aff id="A3"><label>c</label>Department of Geography, CB3220, Carolina Hall, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA</aff><aff id="A4"><label>d</label>Department of Biostatistics, CB7420, McGavran-Greenberg Hall, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA</aff><aff id="A5"><label>e</label>Department of Epidemiology, CB7435, McGavran-Greenberg Hall, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA</aff><aff id="A6"><label>f</label>National AIDS Control Program (PNLS), Kinshasa, Democratic Republic of the Congo</aff><aff id="A7"><label>g</label>Ecole de Sante Publique, Faculte de Medecine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo</aff><author-notes><corresp id="FN1"><label>*</label>Corresponding Author. Tel.: +319-335-0154, F:, <email>margaret-carrel@uiowa.edu</email></corresp></author-notes><pub-date pub-type="nihms-submitted"><day>30</day><month>3</month><year>2016</year></pub-date><pub-date pub-type="epub"><day>11</day><month>3</month><year>2016</year></pub-date><pub-date pub-type="ppub"><month>5</month><year>2016</year></pub-date><pub-date pub-type="pmc-release"><day>01</day><month>5</month><year>2017</year></pub-date><volume>39</volume><fpage>79</fpage><lpage>85</lpage><pmc-comment>elocation-id from pubmed: 10.1016/j.healthplace.2016.02.009</pmc-comment>
<abstract><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></abstract><kwd-group><kwd>HIV</kwd><kwd>Democratic Republic of the Congo</kwd><kwd>rural</kwd><kwd>urban</kwd><kwd>protective</kwd><kwd>Bayesian kriging</kwd></kwd-group></article-meta></front></pmc><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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