Primena geografskog informacionog sistema u istraživanju prostornih aspekata obolevanja od raka grlića materice u Beogradu
Sažetak
Uvod/Cilj. Rak grlića materice je još uvek značajan javnozdravstveni problem u Beogradu. Ciljevi ove studije bili su istraživanje prostornih obrazaca raka grlića materice, obezbeđenosti i dostupnosti ginekološke zdravstvene zaštite na primarnom nivou u Beogradu, kao i sagledavanje potrebe za unapređenjem epidemiološkog nadzora i programa prevencije. Metode. U radu je primenjen deskriptivni epidemiološki metod i tehnologija geografskih informacionih sistema. Uključeni su svi slučajevi raka grlića materice utvrđeni kod stanovnica Beograda u toku 2006. i 2011. godine. Mape gustine slučajeva i mape distribucije ginekoloških ordinacija domova zdravlja u Beogradu su generisane procesom geokodiranja preciznih i kompletnih podataka adrese stanovanja obolelih u vreme utvrđene dijagnoze i adresa ginekoloških ordinacija. Rezultati. U toku 2006. i 2011. godine registrovano je ukupno 569 slučajeva raka grlića materice, bez statistički značajne razlike. Statistička značajna povezanost je utvrđena za opštinu stanovanja i godinu utvrđene dijagnoze (χ2 = 42,99 df = 16 p = 0,000), i godinu utvrđene dijagnoze i dobne grupe 30–34 (р = 0,038, f = 3,998, df = 11, ANOVA), 40–44 (р = 0,001, f = 7,545, df = 13, ANOVA) i 45–49 (р = 0,046, f = 2,679, df = 15, ANOVA). Procesom geokodiranja obuhvaćeno je ukupno 466 (81,8%) slučajeva obolevanja, među kojima 97,4% svih slučajeva utvrđenih u 2006. i 68,6% u 2011. godini. Generisane mape pokazuju slične prostorne obrasce obolevanja za obe posmatrane godine: veća gustina slučajeva među osobama sa adresom stanovanja u centralnim delovima opština gradskog i prigradskog područja, kao i u delovima sa većom gustinom naseljenosti u opštinama užeg gradskog jezgra. Nije uočena pravilnost grupisanja slučajeva obolevanja u odnosu na obezbeđenost ginekološke zdravstvene zaštite na primarnom nivou ili udaljenosti mesta stanovanja obolelih do najbliže ustanove koja pruža ovaj vid zdravstvene zaštite. Zaključak. Naši rezultati ukazuju na mogućnost potpunijeg sagledavanja prostornih obrazaca distribucije obolevanja od raka grlića materice i potreba za unapređenjem nadzora i programa prevencija na majim geografskim područjima.
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