Abstract
The present study was conducted to geographically evaluate the epidemiology of respiratory diseases in the regions of Tehran. The research method is descriptive-analytical and the statistical population of the research is 1918 respiratory patients in Tehran metropolis. Data analysis was done in ArcGIS software. To show the distribution of patients in the period of 2018-2021, the point density method was used, and then the spatial distribution of patients was checked by using Moran's coefficient, and also by using spatial autocorrelation, the spread of respiratory diseases was analyzed among the regions of Tehran. Finally, by using the local Moran's coefficient of the single-variable Moran's spatial linkage, the spatial clustering of 22 districts of Tehran was formed based on respiratory disease sufferers. The findings show that the spread of respiratory diseases in Tehran in the years 2020, 2019, and 2018 is towards the semi-eastern regions, and the highest spatial spread has occurred in regions 13 and 14 as the center of the disease, and in 2021 Most areas, especially the north of the city, have been affected by the disease. In the years 2020, 2019, and 2018, the spread of the disease has an upward trend up to a distance of 2.75 km between the city areas, and from then on, due to the increase in distance and decrease in population density, its spread has decreased. The spatial pattern of respiratory diseases in Tehran is of a cluster type, with areas 13 and 14 in the HH part of the Moran scatter diagram with positive spatial autocorrelation as the main focus of disease spread, areas 9, 10, 11, 15, 21 and 22 in The HL part of the Moran scatter diagram with negative spatial autocorrelation and the existence of spatial heterogeneity in the number of patients and in the LL cluster of region 17 and the LH cluster of regions 1, 3, 6, 7, 18, 19 and 20 are located with negative spatial autocorrelation.
Introduction
Nowadays, with the advancement of technology and the increase of environmental pollution, and with the changes in people's lifestyle from rural to urban, re-emerging and re-emerging diseases are spreading among human societies with great intensity. Respiratory diseases are one of the most important diseases that have involved the world community (Kermani et al., 2015). According to the statistics of the World Health Organization (WHO), one-fifth of people in the world are suffering from these diseases, in 2005, the ranking of chronic respiratory diseases was 13, and in 2016, the ranking of this disease reached 5. Also, chronic respiratory diseases ranked 11th in terms of occurrence of physical disabilities in 2020 (World Health Center website, 2021). Iran's respiratory diseases are always a major challenge. Iran's respiratory diseases are always a major challenge. According to a four-year study, the rate of asthma in the adult population of the country is 9% and in the child and adolescent population, it is 11%. In Iran, chronic respiratory diseases are the third cause of death after cardiovascular diseases and road accidents (Ethmarian et al., 2012). The air of the Tehran metropolis is polluted most days of the year, according to the statistics of the Tehran Environmental Monitoring Center, carbon monoxide and nitrogen dioxide cause the highest pollution in the city of Tehran, and in some high-traffic hours of the day, such as noon and the beginning of the night, the most pollution After that, sulfur dioxide and suspended particles in the air are in the next rank of air pollution in Tehran metropolis (Tehran Environmental Pollutants Monitoring Center website report, 1400). On average, 200 people die in Kalansehr, Tehran, due to respiratory diseases (Kermani et al., 2015). Therefore, it is necessary to identify and plan for the reduction and prevention of these diseases in the city of Tehran. To make correct preventive plans, we must know how the diseases are distributed in the place, so that the influence of environmental factors on the increase or decrease of the affected people is necessary. to be able to measure the specific disease (Ghadami et al., 2012). On average, 200 people die in Kalansehr of Tehran every year due to respiratory diseases (Kermani et al., 2015). Geographical epidemiology is a part of descriptive epidemiology in the style of spatial analysis that examines the geographical distribution of morbidity and mortality rates (Rivero et al., 2015). The first step in the analysis of geographic data is to depict them, especially in the form of geographic maps in the geographic information system (GIS) (2009 Kandwa & et al). Based on this, the geographic information system will be used in this study. The research aims to evaluate the geographical epidemiology of respiratory diseases in Tehran. Analysis methods are spatial analysis using point density and Moran coefficient. The findings show that the spread of respiratory diseases in Tehran in the years 1999, 1998, and 2021 is towards the semi-eastern regions, and the highest spatial spread has occurred in regions 13 and 14 as the center of the disease, and in 1400 Most areas, especially the north of the city, have been affected by the disease.
Methodology
This research is in the category of applied research, which was carried out in a descriptive-analytical way. The statistical population of the research includes respiratory patients of Tehran city in the period of 2018-2021, which is the peak of the prevalence of respiratory diseases, which was examined in the number of 1918 people. The data analysis was done by spatial analysis method in GIS software, which was entered into the software by specifying the regions. Point density has been used to show the spatial distribution of people suffering from respiratory diseases in the areas of Tehran in the mentioned period. Then, its spatial distribution was analyzed using Moran's coefficient, and also using spatial autocorrelation, the spread of respiratory diseases was analyzed at the level of each Tehran. Finally, the spatial autocorrelation of respiratory diseases has been investigated by using the local index of Moran's univariate spatial correlation.
Conclusion
The geographical analysis of the epidemiology of respiratory diseases in the years 2018, 2019, 2020, and 2021 in Tehran showed that the spread of respiratory diseases in Tehran in the years 2018, 2019, and 2020 towards the eastern half of Tehran, including the south, southeast, North-east, and south-west of Tehran city, and the most spatial spread of respiratory diseases has taken place in areas 13 and 14 as the center of diseases, and in 2021, most areas, especially in the north of Tehran city, have been affected by respiratory diseases. Geographical and spatial surveys show that the most important factors in the spread of respiratory diseases in Tehran are population concentration and distance, which have accelerated the spread of this disease. In other words, in the years 2018, 2019, and 2018, the spread of respiratory diseases has an upward trend up to a distance of 2.75 km between the city areas, and from then on, due to the increase in distance and the decrease in population density, the spread of the disease decreases. Examining the distribution pattern of respiratory diseases in Tehran showed that the spatial pattern of this disease in Tehran is cluster type. The cluster pattern is the worst spatial distribution pattern for the disease variable, which indicates the occurrence of a serious problem in the mentioned fields and indicates the acuteness of that problem in society. For this reason, it can be said that the trend of respiratory diseases in the mentioned years 2018, 2019, 2020, and 2021 is extremely acute, which is achieved by the participation and cooperation of citizens, air pollution control, population concentration policies, prevention strategies, and equipping centers. Health, as well as treatment, etc., should prevent the increasing spread of this disease in the Tehran metropolis.