Using geo-spatial analysis for assessing the risk of hospital admissions due to community-acquired pneumonia in under-5 children and its association with socially vulnerable areas (Brazil)

Abstract Background The concentration of under-5 child morbidity and mortality due to pneumonia in developing countries reflects the social inequities. This study aimed to map and assess the spatial risk for hospitalization due to Community-Acquired Pneumonia in children under 5 years of age and its...

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Main Authors: Juliana Coelho Pina, Luana Seles Alves, Luiz Henrique Arroyo, Ricardo Alexandre Arcêncio, Ellen Cristina Gondim, Maria Cândida de Carvalho Furtado, Débora Falleiros de Mello
Format: Article
Language:English
Published: BMC 2020-11-01
Series:BMC Pediatrics
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12887-020-02398-x
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author Juliana Coelho Pina
Luana Seles Alves
Luiz Henrique Arroyo
Ricardo Alexandre Arcêncio
Ellen Cristina Gondim
Maria Cândida de Carvalho Furtado
Débora Falleiros de Mello
author_facet Juliana Coelho Pina
Luana Seles Alves
Luiz Henrique Arroyo
Ricardo Alexandre Arcêncio
Ellen Cristina Gondim
Maria Cândida de Carvalho Furtado
Débora Falleiros de Mello
author_sort Juliana Coelho Pina
collection DOAJ
description Abstract Background The concentration of under-5 child morbidity and mortality due to pneumonia in developing countries reflects the social inequities. This study aimed to map and assess the spatial risk for hospitalization due to Community-Acquired Pneumonia in children under 5 years of age and its association with vulnerable areas. Methods Ecological study in the city of Ribeirão Preto, state of São Paulo, Brazil. The study population consisted of hospitalized under-5 children, diagnosed with community-acquired pneumonia, in Ribeirão Preto-São Paulo-Brazil, from 2012 to 2013. Data were collected in different databases, by a trained team, between March 2012 and August 2013 and from the 2010 Demographic Census of the Brazilian Institute of Geography and Statistics. The 956 urban census tracts were considered as the units of analysis. The incidence of cases per 10,000 inhabitants was calculated by census tracts during the study period. For the identification of the spatial risk clusters, the Kernel density estimator and the Getis-Ord Gi* technique were performed. Generalized additive models were used to verify the association between areas with social vulnerability and the occurrence of childhood pneumonia. Results The study included 265 children under the age of five, hospitalized due to community-acquired pneumonia. A concentration of cases was identified in the regions with greater social vulnerability (low income, poor housing conditions and homelessness), as well as a lower occurrence of cases in the most developed and economically privileged area of the city. The majority of the children lived in territories served by traditional primary healthcare units, in which the health surveillance and family and community focus are limited. It is important to highlight that the tracts with the highest degrees of vulnerability, such as those identified as high vulnerability (urban) and very high vulnerability (subnormal urban clusters). Conclusions The results contribute to the comprehension of the social factors involved in child hospitalization due to pneumonia, based on the analysis of the spatial distribution. This approach revealed a strategic tool for diagnosing the disparities as well presenting evidences for the planning in health and strength health care system in achieving equity, welfare and social protection of children.
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spelling doaj.art-6c6e0b1d81ee43199649b0c06309e1142022-12-22T00:58:23ZengBMCBMC Pediatrics1471-24312020-11-0120111410.1186/s12887-020-02398-xUsing geo-spatial analysis for assessing the risk of hospital admissions due to community-acquired pneumonia in under-5 children and its association with socially vulnerable areas (Brazil)Juliana Coelho Pina0Luana Seles Alves1Luiz Henrique Arroyo2Ricardo Alexandre Arcêncio3Ellen Cristina Gondim4Maria Cândida de Carvalho Furtado5Débora Falleiros de Mello6Federal University of Santa CatarinaUniversity of São Paulo at Ribeirão Preto College of NursingUniversity of São Paulo at Ribeirão Preto College of NursingUniversity of São Paulo at Ribeirão Preto College of NursingUniversity of São Paulo at Ribeirão Preto College of NursingUniversity of São Paulo at Ribeirão Preto College of NursingUniversity of São Paulo at Ribeirão Preto College of NursingAbstract Background The concentration of under-5 child morbidity and mortality due to pneumonia in developing countries reflects the social inequities. This study aimed to map and assess the spatial risk for hospitalization due to Community-Acquired Pneumonia in children under 5 years of age and its association with vulnerable areas. Methods Ecological study in the city of Ribeirão Preto, state of São Paulo, Brazil. The study population consisted of hospitalized under-5 children, diagnosed with community-acquired pneumonia, in Ribeirão Preto-São Paulo-Brazil, from 2012 to 2013. Data were collected in different databases, by a trained team, between March 2012 and August 2013 and from the 2010 Demographic Census of the Brazilian Institute of Geography and Statistics. The 956 urban census tracts were considered as the units of analysis. The incidence of cases per 10,000 inhabitants was calculated by census tracts during the study period. For the identification of the spatial risk clusters, the Kernel density estimator and the Getis-Ord Gi* technique were performed. Generalized additive models were used to verify the association between areas with social vulnerability and the occurrence of childhood pneumonia. Results The study included 265 children under the age of five, hospitalized due to community-acquired pneumonia. A concentration of cases was identified in the regions with greater social vulnerability (low income, poor housing conditions and homelessness), as well as a lower occurrence of cases in the most developed and economically privileged area of the city. The majority of the children lived in territories served by traditional primary healthcare units, in which the health surveillance and family and community focus are limited. It is important to highlight that the tracts with the highest degrees of vulnerability, such as those identified as high vulnerability (urban) and very high vulnerability (subnormal urban clusters). Conclusions The results contribute to the comprehension of the social factors involved in child hospitalization due to pneumonia, based on the analysis of the spatial distribution. This approach revealed a strategic tool for diagnosing the disparities as well presenting evidences for the planning in health and strength health care system in achieving equity, welfare and social protection of children.http://link.springer.com/article/10.1186/s12887-020-02398-xPneumoniaChild healthSpatial analysisPrimary health care
spellingShingle Juliana Coelho Pina
Luana Seles Alves
Luiz Henrique Arroyo
Ricardo Alexandre Arcêncio
Ellen Cristina Gondim
Maria Cândida de Carvalho Furtado
Débora Falleiros de Mello
Using geo-spatial analysis for assessing the risk of hospital admissions due to community-acquired pneumonia in under-5 children and its association with socially vulnerable areas (Brazil)
BMC Pediatrics
Pneumonia
Child health
Spatial analysis
Primary health care
title Using geo-spatial analysis for assessing the risk of hospital admissions due to community-acquired pneumonia in under-5 children and its association with socially vulnerable areas (Brazil)
title_full Using geo-spatial analysis for assessing the risk of hospital admissions due to community-acquired pneumonia in under-5 children and its association with socially vulnerable areas (Brazil)
title_fullStr Using geo-spatial analysis for assessing the risk of hospital admissions due to community-acquired pneumonia in under-5 children and its association with socially vulnerable areas (Brazil)
title_full_unstemmed Using geo-spatial analysis for assessing the risk of hospital admissions due to community-acquired pneumonia in under-5 children and its association with socially vulnerable areas (Brazil)
title_short Using geo-spatial analysis for assessing the risk of hospital admissions due to community-acquired pneumonia in under-5 children and its association with socially vulnerable areas (Brazil)
title_sort using geo spatial analysis for assessing the risk of hospital admissions due to community acquired pneumonia in under 5 children and its association with socially vulnerable areas brazil
topic Pneumonia
Child health
Spatial analysis
Primary health care
url http://link.springer.com/article/10.1186/s12887-020-02398-x
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