Relationship between social inequality indicators and the spatial distribution of Zika Virus cases

Abstract The aim of this article was to analyze the possible relationship between social inequality indicators and the spatial distribution of ZIKV cases in a state in Northeastern Brazil in 2015-16. This is an ecological study with the data of notified ZIKV cases and the sociodemographic indicators of Rio Grande do Norte state (RN), based on information from the State Public Health Department (SESAP-RN) and DATASUS. The data were analyzed in Terraview version 4.2.2, Geoda version 1.12 and IBM SPSS Statistics 21. Both the average incidence rate (AIR) of ZIKV cases in 2015-16 (Moran = 0.139; p= 0.03) and the AIR of violence (Moran= 0.295; p= 0.02), average household income (Moran= 0.344; p=0.01) and unemployment rate (Moran= 0.231; p=0.01) exhibited a geographic spatial distribution pattern. In multiple linear regression analysis, the variables AIR of violence and average household income explained 55% of the variation in the AIR of ZIKV in 2015-16 (adjusted R2 = 0.55). Municipalities with more notifications of violence and higher average income, such as the state capital, reported a higher number of ZIKV cases, possibly due to better organization, greater awareness of socioenvironmental problems and easier access to health services.