Incidência de dengue em uma região de tríplice fronteira internacional: determinantes sociodemográficos

• Autor(a) principal: Souza, Anielle dos Santos de
• Data de Publicação: 2019
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações do UNIOESTE
• Texto Completo: http://tede.unioeste.br/handle/tede/4521
• topic: Dengue; Fronteira internacional; Condicionantes sociodemográficos; Dengue fever; International border; Sociodemographic condition; Dengue; Frontera internacional; Condicionantes sociodemográficos; ENFERMAGEM::ENFERMAGEM DE SAUDE PUBLICA

Dengue fever is an infectious disease of abrupt onset and classified as a syndromic disease that spread through intermittent outbreaks occurring every 3 to 5 years in Americas’ region. The tri-national border of Brazil, Paraguay and Argentina, is distinguished by the presence of floating population and regions characterized by social inequalities, that may influence it’s incidence rate of dengue fever. Methods: It is an analytical ecological study using spatial analysis approaches. The data of dengue fever cases registered in the period of 2012 a 2017, in the Brazilian Notification of Injury Information System (SINAN) were obtained in the Epidemiological Surveillance Sector and from Zoonosis Control Centre of Foz do Iguaçu. The demographic information was obtained from Brazilian Institute of Geography and Statistics (IBGE). The Moran Univariate global and local (LISA) analysis, as well as, classical regression (OLS) and multivariate spatial analysis (spatial lag and spatial error) were performed using the GeoDa 1.6.7 program. Results: A total of 1.4607 cases of dengue fever were confirmed, mostly in females and the age group of 10 to 29 years-old. A significant positive Moran’s univariate spatial autocorrelation was found (I = 0.173 and p = 0.001), involving the epidemiological years, but not the non-epidemiological ones, indicating the presence of census sector clusters according to its dengue fever incidence rates during the dengue epidemical years. Dengue Fever epidemics occurred in 2013, 2015 and 2016, and 98% of municipality’s census sectors presented high incidence rates (>300 cases/100 thousand inhabitants). High-High type clusters of census tracts, considering the dengue fever incidence rate, were identified mainly in the regions of international borders close to Paraguai (Ciudad del Este) and Argentina (Puerto Iguazú). In linear regression, the sociodemographic variables which correlated positively and significantly with dengue fever incidence rates were: 0.5 to 1 minimum wage (MW) per capita income and 7 to 9 persons per residence, indicating relation with social inequalities. The Spatial Error multivariate model presented better parameters (R²= 0.332, AIC= 5.615,36) than OLS and Spatial Lag models and shown that the variables ‘7 to 9 persons per residence’ and ’0.5 to 1 MW per capita’, '1 to 3 MW per capita ’and > 5 MW per capita’ correlated significantly and positively with dengue incidence rates in census tracts. Conclusion: Therefore, the municipality presents high rates of incidence of the disease during the epidemic years, and their distributions presented spatial dependence, determined by socio-demographic variables, mainly populational aglomerations and per capita income. Clusters of census tracts located in international borders close to Paraguai (Ciudad del Este) and Argentina (Puerto Iguazú) presented spatial high-high type pattern, considering the dengue incidence rates, indicanting that preventive health public policies should involve governs of the involved countries.