Space–Time Clustering and Socioeconomic Factors Associated with Mortality from Diarrhea in Alagoas, Northeastern Brazil: A 20-Year Population-Based Study
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. Conside...
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MDPI AG
2022-10-01
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| Series: | Tropical Medicine and Infectious Disease |
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| Online Access: | https://www.mdpi.com/2414-6366/7/10/312 |
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| author | Deanna dos Santos Lima Wandklebson Silva da Paz Álvaro Francisco Lopes de Sousa Denise de Andrade Beatriz Juliana Conacci Flávia Silva Damasceno Márcio Bezerra-Santos |
| author_facet | Deanna dos Santos Lima Wandklebson Silva da Paz Álvaro Francisco Lopes de Sousa Denise de Andrade Beatriz Juliana Conacci Flávia Silva Damasceno Márcio Bezerra-Santos |
| author_sort | Deanna dos Santos Lima |
| collection | DOAJ |
| 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; <i>p</i>-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. |
| first_indexed | 2024-03-09T19:25:26Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 2414-6366 |
| language | English |
| last_indexed | 2024-03-09T19:25:26Z |
| publishDate | 2022-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Tropical Medicine and Infectious Disease |
| spelling | doaj.art-f737db44844940a382639f5dbb1df3552023-11-24T03:00:53ZengMDPI AGTropical Medicine and Infectious Disease2414-63662022-10-0171031210.3390/tropicalmed7100312Space–Time Clustering and Socioeconomic Factors Associated with Mortality from Diarrhea in Alagoas, Northeastern Brazil: A 20-Year Population-Based StudyDeanna dos Santos Lima0Wandklebson Silva da Paz1Álvaro Francisco Lopes de Sousa2Denise de Andrade3Beatriz Juliana Conacci4Flávia Silva Damasceno5Márcio Bezerra-Santos6Parasitic Diseases and Environment Graduate Program, Universidade Estadual de Alagoas—Campus II, Santana do Ipanema 57500-000, Alagoas, BrazilParasitic Diseases and Environment Graduate Program, Universidade Estadual de Alagoas—Campus II, Santana do Ipanema 57500-000, Alagoas, BrazilGlobal Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, 1349-008 Lisbon, PortugalFundamental Nursing Program, Department of General and Specialist Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto 14040-902, São Paulo, BrazilFundamental Nursing Program, Department of General and Specialist Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto 14040-902, São Paulo, BrazilLaboratory of Biochemistry of Tryps-LaBTryps, Department of Parasitology, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo 05508-040, São Paulo, BrazilMedical Science Center, Universidade Federal de Alagoas, Arapiraca 57309-005, Alagoas, BrazilAcute 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; <i>p</i>-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.https://www.mdpi.com/2414-6366/7/10/312public healthspatial analysisdiarrheagastroenteritisBrazil |
| spellingShingle | Deanna dos Santos Lima Wandklebson Silva da Paz Álvaro Francisco Lopes de Sousa Denise de Andrade Beatriz Juliana Conacci Flávia Silva Damasceno Márcio Bezerra-Santos Space–Time Clustering and Socioeconomic Factors Associated with Mortality from Diarrhea in Alagoas, Northeastern Brazil: A 20-Year Population-Based Study Tropical Medicine and Infectious Disease public health spatial analysis diarrhea gastroenteritis Brazil |
| title | Space–Time Clustering and Socioeconomic Factors Associated with Mortality from Diarrhea in Alagoas, Northeastern Brazil: A 20-Year Population-Based Study |
| title_full | Space–Time Clustering and Socioeconomic Factors Associated with Mortality from Diarrhea in Alagoas, Northeastern Brazil: A 20-Year Population-Based Study |
| title_fullStr | Space–Time Clustering and Socioeconomic Factors Associated with Mortality from Diarrhea in Alagoas, Northeastern Brazil: A 20-Year Population-Based Study |
| title_full_unstemmed | Space–Time Clustering and Socioeconomic Factors Associated with Mortality from Diarrhea in Alagoas, Northeastern Brazil: A 20-Year Population-Based Study |
| title_short | Space–Time Clustering and Socioeconomic Factors Associated with Mortality from Diarrhea in Alagoas, Northeastern Brazil: A 20-Year Population-Based Study |
| title_sort | space time clustering and socioeconomic factors associated with mortality from diarrhea in alagoas northeastern brazil a 20 year population based study |
| topic | public health spatial analysis diarrhea gastroenteritis Brazil |
| url | https://www.mdpi.com/2414-6366/7/10/312 |
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