Spatial analysis of the distribution of dengue cases and its relationship with socio-environmental factors in the state of Paraíba, Brazil, 2007-2016

ABSTRACT Dengue is a serious public health problem, especially in countries that have favorable socio-environmental conditions for the development and proliferation of its transmitting agent. This study aimed to analyze the spatial distribution of the incidence of dengue in the state of Paraíba between 2007 and 2016, evaluating the existence of geographic dependence and its relationship with socioeconomic and environmental factors. Ecological study, with the unit of analysis of the 223 municipalities in the state. The global and local Moran Index and the Geary c statistic were used to assess the spatial autocorrelation of dengue and the association with socioenvironmental variables. The analyzes were performed using statistical software R Core Team version 3.3.2. When analyzing the distribution of dengue cases in the municipalities of Paraíba, it can be identified that the disease has been advancing and affecting a greater number of cities each year. The disease was present in all the cities analyzed, which demonstrated the need to implement disease prevention actions across the state. Through this research, it became clear that dengue, in the state of Paraíba, is not determined by a single and isolated factor, but, rather, by the combination of several factors of the socioeconomic and environmental context.

【摘要】登革热是一类严重的公共卫生问题，尤其在社会环境条件适宜其传播媒介滋生与扩散的国家中更为突出。本研究旨在剖析2007年至2016年帕拉伊巴州登革热发病率的空间分布格局，评估空间依赖性的存在及其与社会经济、环境因素的关联。本研究为生态学研究，分析单元为该州下辖的223个市镇（municipalities）。研究采用全局莫兰指数（global Moran Index）、局部莫兰指数（local Moran Index）及Geary c统计量（Geary c statistic），以评估登革热的空间自相关性，并分析其与社会环境变量的关联。所有分析均借助R核心团队（R Core Team）研发的统计软件R 3.3.2版完成。
对帕拉伊巴州各市镇的登革热病例分布进行分析后可发现，该病呈逐年蔓延态势，受影响的城市数量逐年递增。本次研究覆盖的所有市镇均有登革热病例报告，这表明全州范围内亟需开展系统性的疾病预防工作。
本研究结果证实，帕拉伊巴州的登革热流行并非由单一孤立因素决定，而是由社会经济与环境背景下的多种因素共同作用所致。