Spatiotemporal dynamics, risk areas and social determinants of dengue in Northeastern Brazil, 2014–2017: an ecological study

Abstract

Background Dengue fever is an arthropod-borne viral disease caused by dengue virus (DENV) and transmitted by Aedes mosquitoes. The Northeast region of Brazil is characterized by having one of the highest dengue rates in the country, in addition to being considered the poorest region. Here, we aimed to identify spatial clusters with the highest dengue risk, as well as to analyze the temporal behavior of the incidence rate and the effects of social determinants on the disease transmission dynamic in Northeastern Brazil. Methods This is an ecological study carried out with all confirmed cases of dengue in the Northeast Brazil between 2014 and 2017. Data were extracted from the National Notifiable Diseases Information System (SINAN) and the Brazilian Institute of Geography and Statistics (IBGE). Local empirical Bayesian model, Moran statistics and spatial scan statistics were applied. The association between dengue incidence rate and social determinants was tested using Moran’s bivariate correlation. Results A total of 509 261 cases of dengue were confirmed in the Northeast during the study period, 53.41% of them were concentrated in Pernambuco and Ceará states. Spatial analysis showed a heterogeneous distribution of dengue cases in the region, with the highest rates in the east coast. Four risk clusters were observed, involving 815 municipalities (45.45%). Moreover, social indicators related to population density, education, income, housing, and social vulnerability showed a spatial correlation with the dengue incidence rate. Conclusions This study provides information on the spatial dynamics of dengue in northeastern Brazil and its relationship with social determinants and can be used in the formulation of public health policies to reduce the impact of the disease in vulnerable populations.

Dengue, Zika, and Chikungunya viral circulation and hospitalization rates in Brazil from 2014 to 2019: An ecological study

“…With almost 85% of its population residing in high-density urbanized settings, stark social inequalities including disparities in housing and sanitation infrastructure [ 4 ], and climatic conditions and environmental features (e.g., open water reservoirs) that support year-round breeding of Aedes spp . mosquitoes in much of the country [ 5 ], Brazil is uniquely susceptible to arbovirus transmission [ 6 , 7 ]. In 2020 alone, Brazil reported almost 1 million notifications of suspected dengue, 82,419 of suspected chikungunya, and 7,387 of suspected Zika [ 8 ].…”

Influences of Differentiated Residence and Workplace Location on the Identification of Spatiotemporal Patterns of Dengue Epidemics: A Case Study in Guangzhou, China

“…Characterization and understanding of the spatiotemporal distribution and transmission patterns will provide theoretical support for DF prevention and control [ 18 , 19 , 20 , 21 ]. Previous studies have raised our understanding of its epidemiological characteristics and spatiotemporal patterns, by which high epidemic areas were identified for making timely interventions on this disease [ 22 , 23 ]. Fan et al [ 24 ] explored the spatial distribution patterns of DF in Guangdong Province based on incidence rates at the district and county scales, and pointed out the high epidemic areas; Khormi et al [ 25 ] mapped DF risk based on the Getis–Ord Gi* method and frequency index to explore the changes in DF incidence hotspots from a long-term perspective.…”

Identification of risk areas as a method of surveillance of dengue cases

“…Dengue is an acute viral infection transmitted by arthropods, mainly by the Aedes aegypti mosquito. It is the most frequent arboviral disease worldwide, occurring mainly in the tropics and subtropics, with an estimated burden of 390 million cases per year, of which 96 million cases manifest symptomatically, 2 million cases develop severe disease, and 21,000 deaths [do Carmo et al 2020].…”

“…The worldwide spread of dengue is a complex problem, which can be accelerated by several factors, such as climate change, population growth, rapid and unplanned urbanization, movement of people for commerce, tourism or forced by natural disasters, weaknesses in public health and vector control programs. From 2010 to 2019, more than 16 million dengue cases were reported across the American continent, and about 10 million cases ( 62%) were reported in Brazil alone [Canal et al 2018, do Carmo et al 2020].…”