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Space–Time Clustering and Socioeconomic Factors Associated with Mortality from Diarrhea in Alagoas, Northeastern Brazil

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Resumo:Acute diarrhea is the second leading cause of death among children in developing countries and is strongly related with the socioeconomic conditions of the population. In Brazil, data show a drop in the diarrhea mortality rate. Nevertheless, the northeastern region still has the most deaths. Considering this, we analyze high-risk areas for diarrhea- and gastroenteritis-related deaths, and their association with social determinants of health (SDH) in the state with one of the worst human development indicators in Brazil (Alagoas) between 2000 and 2019. We applied temporal, spatial, and space–time risk modelling. We used a log-linear regression model to assess temporal trends and the local empirical Bayesian estimator, the global and local Moran indices for spatial analysis. Spearman’s correlation was used to correlate mortality rates with SDH. A total of 3472 diarrhea-related deaths were reported during this period in Alagoas. We observed a decreasing time trend of deaths in the state (9.41/100,000 in 2000 to 2.21 in 2019; APC = −6.7; p-value < 0.001), especially in children under one year of age. However, there was stability among adults and the elderly. We identified two high-risk spatiotemporal clusters of mortality in inland municipalities. Lastly, mortality rates correlated significantly with 90% of SDH. Taken together, these findings indicate that diarrhea diseases remain a serious public health concern in Alagoas, mainly in the poorest and inland municipalities. Thereby, it is urgently necessary to invest in measures to control and prevent cases, and improve the living conditions of the poorest populations and those with the highest social vulnerability index.
Autores principais:Lima, Deanna dos Santos
Outros Autores:da Paz, Wandklebson Silva; Lopes de Sousa, Álvaro Francisco; de Andrade, Denise; Conacci, Beatriz Juliana; Damasceno, Flávia Silva; Bezerra-Santos, Márcio
Assunto:Brazil diarrhea gastroenteritis public health spatial analysis RA0421 Public health. Hygiene. Preventive Medicine RC Internal medicine HV Social pathology. Social and public welfare General Immunology and Microbiology Public Health, Environmental and Occupational Health Infectious Diseases SDG 3 - Good Health and Well-being SDG 10 - Reduced Inequalities SDG 1 - No Poverty
Ano:2022
País:Portugal
Tipo de documento:artigo
Tipo de acesso:acesso aberto
Instituição associada:Universidade Nova de Lisboa
Idioma:inglês
Origem:Repositório Institucional da UNL
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author Lima, Deanna dos Santos
author2 da Paz, Wandklebson Silva
Lopes de Sousa, Álvaro Francisco
de Andrade, Denise
Conacci, Beatriz Juliana
Damasceno, Flávia Silva
Bezerra-Santos, Márcio
author2_role author
author
author
author
author
author
author_facet Lima, Deanna dos Santos
Lima, Deanna dos Santos
da Paz, Wandklebson Silva
Lopes de Sousa, Álvaro Francisco
de Andrade, Denise
Conacci, Beatriz Juliana
Damasceno, Flávia Silva
Bezerra-Santos, Márcio
da Paz, Wandklebson Silva
Lopes de Sousa, Álvaro Francisco
de Andrade, Denise
Conacci, Beatriz Juliana
Damasceno, Flávia Silva
Bezerra-Santos, Márcio
author_role author
contributor_name_str_mv Population health, policies and services (PPS)
Global Health and Tropical Medicine (GHTM)
Instituto de Higiene e Medicina Tropical (IHMT)
Universidade NOVA de Lisboa
MDPI - Multidisciplinary Digital Publishing Institute
RUN
country_str PT
creators_json_str [{\"Person.name\":\"Lima, Deanna dos Santos\"},{\"Person.name\":\"da Paz, Wandklebson Silva\"},{\"Person.name\":\"Lopes de Sousa, Álvaro Francisco\"},{\"Person.name\":\"de Andrade, Denise\"},{\"Person.name\":\"Conacci, Beatriz Juliana\"},{\"Person.name\":\"Damasceno, Flávia Silva\"},{\"Person.name\":\"Bezerra-Santos, Márcio\"}]
datacite.contributors.contributor.contributorName.fl_str_mv Population health, policies and services (PPS)
Global Health and Tropical Medicine (GHTM)
Instituto de Higiene e Medicina Tropical (IHMT)
Universidade NOVA de Lisboa
MDPI - Multidisciplinary Digital Publishing Institute
RUN
datacite.creators.creator.creatorName.fl_str_mv Lima, Deanna dos Santos
da Paz, Wandklebson Silva
Lopes de Sousa, Álvaro Francisco
de Andrade, Denise
Conacci, Beatriz Juliana
Damasceno, Flávia Silva
Bezerra-Santos, Márcio
datacite.date.Accepted.fl_str_mv 2022-10-01T00:00:00Z
datacite.date.available.fl_str_mv 2023-01-25T22:16:55Z
datacite.date.embargoed.fl_str_mv 2023-01-25T22:16:55Z
datacite.rights.fl_str_mv http://purl.org/coar/access_right/c_abf2
datacite.subjects.subject.fl_str_mv Brazil
diarrhea
gastroenteritis
public health
spatial analysis
RA0421 Public health. Hygiene. Preventive Medicine
RC Internal medicine
HV Social pathology. Social and public welfare
General Immunology and Microbiology
Public Health, Environmental and Occupational Health
Infectious Diseases
SDG 3 - Good Health and Well-being
SDG 10 - Reduced Inequalities
SDG 1 - No Poverty
datacite.titles.title.fl_str_mv Space–Time Clustering and Socioeconomic Factors Associated with Mortality from Diarrhea in Alagoas, Northeastern Brazil
A 20-Year Population-Based Study
dc.contributor.none.fl_str_mv Population health, policies and services (PPS)
Global Health and Tropical Medicine (GHTM)
Instituto de Higiene e Medicina Tropical (IHMT)
Universidade NOVA de Lisboa
MDPI - Multidisciplinary Digital Publishing Institute
RUN
dc.creator.none.fl_str_mv Lima, Deanna dos Santos
da Paz, Wandklebson Silva
Lopes de Sousa, Álvaro Francisco
de Andrade, Denise
Conacci, Beatriz Juliana
Damasceno, Flávia Silva
Bezerra-Santos, Márcio
dc.date.Accepted.fl_str_mv 2022-10-01T00:00:00Z
dc.date.available.fl_str_mv 2023-01-25T22:16:55Z
dc.date.embargoed.fl_str_mv 2023-01-25T22:16:55Z
dc.format.none.fl_str_mv application/pdf
dc.identifier.none.fl_str_mv http://hdl.handle.net/10362/148173
dc.language.none.fl_str_mv eng
dc.rights.none.fl_str_mv http://purl.org/coar/access_right/c_abf2
dc.subject.none.fl_str_mv Brazil
diarrhea
gastroenteritis
public health
spatial analysis
RA0421 Public health. Hygiene. Preventive Medicine
RC Internal medicine
HV Social pathology. Social and public welfare
General Immunology and Microbiology
Public Health, Environmental and Occupational Health
Infectious Diseases
SDG 3 - Good Health and Well-being
SDG 10 - Reduced Inequalities
SDG 1 - No Poverty
dc.title.fl_str_mv Space–Time Clustering and Socioeconomic Factors Associated with Mortality from Diarrhea in Alagoas, Northeastern Brazil
A 20-Year Population-Based Study
dc.type.none.fl_str_mv http://purl.org/coar/resource_type/c_6501
description Acute diarrhea is the second leading cause of death among children in developing countries and is strongly related with the socioeconomic conditions of the population. In Brazil, data show a drop in the diarrhea mortality rate. Nevertheless, the northeastern region still has the most deaths. Considering this, we analyze high-risk areas for diarrhea- and gastroenteritis-related deaths, and their association with social determinants of health (SDH) in the state with one of the worst human development indicators in Brazil (Alagoas) between 2000 and 2019. We applied temporal, spatial, and space–time risk modelling. We used a log-linear regression model to assess temporal trends and the local empirical Bayesian estimator, the global and local Moran indices for spatial analysis. Spearman’s correlation was used to correlate mortality rates with SDH. A total of 3472 diarrhea-related deaths were reported during this period in Alagoas. We observed a decreasing time trend of deaths in the state (9.41/100,000 in 2000 to 2.21 in 2019; APC = −6.7; p-value < 0.001), especially in children under one year of age. However, there was stability among adults and the elderly. We identified two high-risk spatiotemporal clusters of mortality in inland municipalities. Lastly, mortality rates correlated significantly with 90% of SDH. Taken together, these findings indicate that diarrhea diseases remain a serious public health concern in Alagoas, mainly in the poorest and inland municipalities. Thereby, it is urgently necessary to invest in measures to control and prevent cases, and improve the living conditions of the poorest populations and those with the highest social vulnerability index.
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eu_rights_str_mv openAccess
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institution Universidade Nova de Lisboa
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language eng
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person_str_mv Lima, Deanna dos Santos
da Paz, Wandklebson Silva
Lopes de Sousa, Álvaro Francisco
de Andrade, Denise
Conacci, Beatriz Juliana
Damasceno, Flávia Silva
Bezerra-Santos, Márcio
publishDate 2022
reponame_str Repositório Institucional da UNL
repository_id_str urn:repositoryAcronym:run
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spelling engenAcute diarrhea is the second leading cause of death among children in developing countries and is strongly related with the socioeconomic conditions of the population. In Brazil, data show a drop in the diarrhea mortality rate. Nevertheless, the northeastern region still has the most deaths. Considering this, we analyze high-risk areas for diarrhea- and gastroenteritis-related deaths, and their association with social determinants of health (SDH) in the state with one of the worst human development indicators in Brazil (Alagoas) between 2000 and 2019. We applied temporal, spatial, and space–time risk modelling. We used a log-linear regression model to assess temporal trends and the local empirical Bayesian estimator, the global and local Moran indices for spatial analysis. Spearman’s correlation was used to correlate mortality rates with SDH. A total of 3472 diarrhea-related deaths were reported during this period in Alagoas. We observed a decreasing time trend of deaths in the state (9.41/100,000 in 2000 to 2.21 in 2019; APC = −6.7; p-value < 0.001), especially in children under one year of age. However, there was stability among adults and the elderly. We identified two high-risk spatiotemporal clusters of mortality in inland municipalities. Lastly, mortality rates correlated significantly with 90% of SDH. Taken together, these findings indicate that diarrhea diseases remain a serious public health concern in Alagoas, mainly in the poorest and inland municipalities. Thereby, it is urgently necessary to invest in measures to control and prevent cases, and improve the living conditions of the poorest populations and those with the highest social vulnerability index.application/pdfenSpace–Time Clustering and Socioeconomic Factors Associated with Mortality from Diarrhea in Alagoas, Northeastern BrazilSubtitleenA 20-Year Population-Based StudyLima, Deanna dos Santosda Paz, Wandklebson SilvaLopes de Sousa, Álvaro Franciscode Andrade, DeniseConacci, Beatriz JulianaDamasceno, Flávia SilvaBezerra-Santos, MárcioPopulation health, policies and services (PPS)Global Health and Tropical Medicine (GHTM)Instituto de Higiene e Medicina Tropical (IHMT)Universidade NOVA de LisboaMDPI - Multidisciplinary Digital Publishing InstituteHostingInstitutionOrganizationalRUNe-mailmailto:run@unl.ptrun@unl.ptISSNIsPartOf2414-6366URNIsPartOfPURE: 50665250URNIsPartOfPURE UUID: 0e853315-4a4b-4856-831b-dfdcf49c8f0aURNIsPartOfScopus: 85140592000URNIsPartOfPubMedCentral: PMC9610189URNIsPartOfPubMed: 36288053DOIIsPartOf10.3390/tropicalmed71003122023-01-25T22:16:55Z2022-102022-10-01T00:00:00ZHandlehttp://hdl.handle.net/10362/148173http://purl.org/coar/access_right/c_abf2open accessBrazildiarrheagastroenteritispublic healthspatial analysisRA0421 Public health. Hygiene. Preventive MedicineRC Internal medicineHV Social pathology. Social and public welfareGeneral Immunology and MicrobiologyPublic Health, Environmental and Occupational HealthInfectious DiseasesSDG 3 - Good Health and Well-beingSDG 10 - Reduced InequalitiesSDG 1 - No Poverty1405629 bytesliteraturehttp://purl.org/coar/resource_type/c_6501journal articlehttp://purl.org/coar/access_right/c_abf2application/pdffulltexthttps://run.unl.pt/bitstreams/5fb5e522-db0f-4ee0-a9d5-85f83284034e/download
spellingShingle Space–Time Clustering and Socioeconomic Factors Associated with Mortality from Diarrhea in Alagoas, Northeastern Brazil
Space–Time Clustering and Socioeconomic Factors Associated with Mortality from Diarrhea in Alagoas, Northeastern Brazil
Lima, Deanna dos Santos
Brazil
diarrhea
gastroenteritis
public health
spatial analysis
RA0421 Public health. Hygiene. Preventive Medicine
RC Internal medicine
HV Social pathology. Social and public welfare
General Immunology and Microbiology
Public Health, Environmental and Occupational Health
Infectious Diseases
SDG 3 - Good Health and Well-being
SDG 10 - Reduced Inequalities
SDG 1 - No Poverty
Lima, Deanna dos Santos
Brazil
diarrhea
gastroenteritis
public health
spatial analysis
RA0421 Public health. Hygiene. Preventive Medicine
RC Internal medicine
HV Social pathology. Social and public welfare
General Immunology and Microbiology
Public Health, Environmental and Occupational Health
Infectious Diseases
SDG 3 - Good Health and Well-being
SDG 10 - Reduced Inequalities
SDG 1 - No Poverty
status NEW
subject.fl_str_mv Brazil
diarrhea
gastroenteritis
public health
spatial analysis
RA0421 Public health. Hygiene. Preventive Medicine
RC Internal medicine
HV Social pathology. Social and public welfare
General Immunology and Microbiology
Public Health, Environmental and Occupational Health
Infectious Diseases
SDG 3 - Good Health and Well-being
SDG 10 - Reduced Inequalities
SDG 1 - No Poverty
title Space–Time Clustering and Socioeconomic Factors Associated with Mortality from Diarrhea in Alagoas, Northeastern Brazil
title_full Space–Time Clustering and Socioeconomic Factors Associated with Mortality from Diarrhea in Alagoas, Northeastern Brazil
title_fullStr Space–Time Clustering and Socioeconomic Factors Associated with Mortality from Diarrhea in Alagoas, Northeastern Brazil
Space–Time Clustering and Socioeconomic Factors Associated with Mortality from Diarrhea in Alagoas, Northeastern Brazil
title_full_unstemmed Space–Time Clustering and Socioeconomic Factors Associated with Mortality from Diarrhea in Alagoas, Northeastern Brazil
Space–Time Clustering and Socioeconomic Factors Associated with Mortality from Diarrhea in Alagoas, Northeastern Brazil
title_short Space–Time Clustering and Socioeconomic Factors Associated with Mortality from Diarrhea in Alagoas, Northeastern Brazil
title_sort Space–Time Clustering and Socioeconomic Factors Associated with Mortality from Diarrhea in Alagoas, Northeastern Brazil
topic Brazil
diarrhea
gastroenteritis
public health
spatial analysis
RA0421 Public health. Hygiene. Preventive Medicine
RC Internal medicine
HV Social pathology. Social and public welfare
General Immunology and Microbiology
Public Health, Environmental and Occupational Health
Infectious Diseases
SDG 3 - Good Health and Well-being
SDG 10 - Reduced Inequalities
SDG 1 - No Poverty
topic_facet Brazil
diarrhea
gastroenteritis
public health
spatial analysis
RA0421 Public health. Hygiene. Preventive Medicine
RC Internal medicine
HV Social pathology. Social and public welfare
General Immunology and Microbiology
Public Health, Environmental and Occupational Health
Infectious Diseases
SDG 3 - Good Health and Well-being
SDG 10 - Reduced Inequalities
SDG 1 - No Poverty
url http://hdl.handle.net/10362/148173
visible 1