Medical geography in the study of hepatitis A, in the Coffee-triangle region, Colombia, 2007-2011

Objectives: There are few studies of geographical characterization of viral hepatitis. For this reason, we after estimating the incidence rates for Hepatitis A (HAV), we developed epidemiological GIS-based maps for this viral disease, within a well-defined geographic region (the coffee triangle) in Colombia. Study design: A retrospective cross-sectional analysis of surveillance data and GIS-based developing of epidemiological maps. Methods: Surveillance cases data (2007-2011) were used to estimate annual incidence rates using reference population data, on hepatitis, to develop the first maps of HAV in the 53 municipalities of the coffee-triangle region of Colombia (departments Caldas, Quindio, Risaralda). GIS used was Kosmo® 3.1. To summarize and compare the data among municipalities and departments (as units of analysis) we generate indicators such as accumulated incidence rates (AIR) and incidence rates ratios. Results: 1518 HAV cases were reported, 47% from Quindío, 30% Caldas and 22% Risaralda. Quindio presented with the highest AIR (131.54) among all the administrative units under study (Caldas, AIR: 46.39; Risaralda, AIR: 37.62). Interestingly, the highest rates in Quindio, during the period, could be related to the increased number of cases reported in two municipalities from 2008 (Quimbaya, AIR ratio: 4.0 and Montenegro: 3.61). The causes that underlie this augmentation will be subject to further research. Conclusions: Incidence rates for HAV is still high in the region. Showing epidemiological data, particularly in maps would allow planning actions oriented to interventions at the different forms of transmission that this disease has, which is highly important for decisions in public health policies