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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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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9610189/
https://www.ncbi.nlm.nih.gov/pubmed/36288053
http://dx.doi.org/10.3390/tropicalmed7100312
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author 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
author_facet 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
author_sort Lima, Deanna dos Santos
collection PubMed
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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spelling pubmed-96101892022-10-28 Space–Time Clustering and Socioeconomic Factors Associated with Mortality from Diarrhea in Alagoas, Northeastern Brazil: A 20-Year Population-Based Study 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 Trop Med Infect Dis Article 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. MDPI 2022-10-18 /pmc/articles/PMC9610189/ /pubmed/36288053 http://dx.doi.org/10.3390/tropicalmed7100312 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
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
Space–Time Clustering and Socioeconomic Factors Associated with Mortality from Diarrhea in Alagoas, Northeastern Brazil: A 20-Year Population-Based Study
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 Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9610189/
https://www.ncbi.nlm.nih.gov/pubmed/36288053
http://dx.doi.org/10.3390/tropicalmed7100312
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