Epidemiologia espacial da dengue em Araraquara, São Paulo, 2008 a 2015
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Data
2017-02-24
Autores
Ferreira, Aline Chimello
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
A dengue é uma doença viral febril transmitida por culicídeos, que atinge milhões de pessoas todos os anos e é considerada um grande problema de saúde pública. A cidade de Araraquara – São Paulo vem apresentando um aumento no número de casos notificados da doença. Programas como Sistemas de Informações Geográficas, análise espacial e regressão espacial têm permitido aos pesquisadores entender a distribuição espacial do vetor e da doença, além de levantar possíveis fatores de risco. O objetivo deste trabalho foi conhecer o histórico da dengue na cidade, descrevendo padrões epidemiológicos e espaciais entre os anos de 2008 e 2015. A associação dos casos com variáveis climáticas e positividade para Aedes aegypti em pontos estratégicos foi estudada. Também foi verificada a ocorrência de aglomerados de casos ao longo dos anos e investigadas as possíveis variáveis explicativas (dentre elas, as varáveis socioeconômicas, demográficas, ambientais) para a incidência de dengue no ano de 2015, a maior epidemia registrada na história da cidade no período estudado. A primeira epidemia registrada foi em 2008 e a partir deste ano a dengue se tornou endêmica na cidade, com casos autóctones ocorrendo em todos os meses do ano. As maiores incidências foram observadas entre os meses de março a maio, um ou dois meses após o aumento da chuva. Dos 15.729 casos notificados entre 2008 e 2015, 46% acometeram pessoas do sexo masculino e 54% do sexo feminino. Pessoas entre 20 e 59 anos foram as mais acometidas. Foram utilizadas diferentes técnicas de análise espacial para detectar dependência espacial e aglomerados de casos de dengue. Foi possível identificar visualmente áreas com maior e menor concentração de eventos, padrões que podem servir de pistas para a identificação de vias para conter a propagação da doença e que possam ser úteis na previsão da ocorrência de dengue. A análise das variáveis associadas à incidência de dengue apontou que áreas com baixo número de responsáveis alfabetizados e maior proporção de crianças nos domicílios estiveram associados com a dengue no ano de 2015. Os resultados mostraram-se adequados para a identificação de áreas de risco e do melhor momento para direcionamento de ações e recursos dos órgãos de saúde responsáveis.
Dengue fever is a febrile vector borne disease transmitted by Culicidae that affects millions of people every year and is considered a major public health problem. Araraquara (São Paulo/Brazil) has been presenting an increase in the number of reported cases of the disease. Tools such as Geographic Information Systems, spatial analysis and spatial regression have allowed researchers to understand the spatial distribution of the vector and the disease, in addition looking for risk factors. This study was to know the history of dengue in Araraquara by describing epidemiological and spatial patterns of dengue cases from 2008 to 2015. It was investigated the association between cases, climate and positivity for Aedes aegypti at strategic points. It was also searched for explanatory variables (which included socioeconomic, demographic and environmental) for dengue incidence in 2015, the highest epidemic recorded in the period. The first recorded outbreak was in 2008 and from this year dengue has become endemic in the city, with the cases occurring every month. The highest incidences were seen between the months of March and May following months of high rainfall. Of the 15729 cases reported between 2008 and 2015, 46% affected male and 54% female. People between 20 and 59 years old were more affected. To detect spatial dependence and clusters of dengue cases was performed several techniques of spatial analysis. It was possible to identify areas with highest and lowest concentration of dengue cases, patterns that can serve as clues to stop the spread of the disease and to predict the occurrence of dengue. It was found two variables associated with dengue, areas with low responsible literate and high proportion of children in the households were associated with dengue in 2015. The results were adequate to identify areas of risk and the best moment for directing actions and resources for the public health services.
Dengue fever is a febrile vector borne disease transmitted by Culicidae that affects millions of people every year and is considered a major public health problem. Araraquara (São Paulo/Brazil) has been presenting an increase in the number of reported cases of the disease. Tools such as Geographic Information Systems, spatial analysis and spatial regression have allowed researchers to understand the spatial distribution of the vector and the disease, in addition looking for risk factors. This study was to know the history of dengue in Araraquara by describing epidemiological and spatial patterns of dengue cases from 2008 to 2015. It was investigated the association between cases, climate and positivity for Aedes aegypti at strategic points. It was also searched for explanatory variables (which included socioeconomic, demographic and environmental) for dengue incidence in 2015, the highest epidemic recorded in the period. The first recorded outbreak was in 2008 and from this year dengue has become endemic in the city, with the cases occurring every month. The highest incidences were seen between the months of March and May following months of high rainfall. Of the 15729 cases reported between 2008 and 2015, 46% affected male and 54% female. People between 20 and 59 years old were more affected. To detect spatial dependence and clusters of dengue cases was performed several techniques of spatial analysis. It was possible to identify areas with highest and lowest concentration of dengue cases, patterns that can serve as clues to stop the spread of the disease and to predict the occurrence of dengue. It was found two variables associated with dengue, areas with low responsible literate and high proportion of children in the households were associated with dengue in 2015. The results were adequate to identify areas of risk and the best moment for directing actions and resources for the public health services.
Descrição
Palavras-chave
Dengue, Epidemiologia descritiva, Clima, Sistemas de informação geográfica, Análise espacial, Vigilância epidemiológica, Epidemiology, descriptive, Climate, Geographic information system, Spatial analysis, Epidemiological surveillance