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https://www.arca.fiocruz.br/handle/icict/1331
SPATIAL POINT ANALYSIS BASED ON DENGUE SURVEYS AT HOUSEHOLD LEVEL IN CENTRAL BRAZIL
Autor(es)
Afiliação
Institute of Tropical Pathology and Public Health, Federal University of Goias, Department of Collective Health, Goias, Brazil
Institute of Tropical Pathology and Public Health, Federal University of Goias, Department of Collective Health, Goias, Brazil
Oswaldo Cruz Foundation. Center for Scientific and Technological Information. Rio de Janeiro, RJ, Brazil.
Oswaldo Cruz Foundation. Centro de Pesquisas Aggeu Magalhães. Recife, PE, Brazil.
Oswaldo Cruz Foundation. Scientific Computation Program. Rio de Janeiro, RJ, Brazil.
Federal University of Goias. Institute of Tropical Pathology and Public Health. Department of Collective Health, Goiânia, GO, Brazil.
Federal University of Goias. Institute of Tropical Pathology and Public Health. Department of Collective Health, Goiânia, GO, Brazil.
Federal University of Goias. Institute of Tropical Pathology and Public Health. Department of Collective Health, Goiânia, GO, Brazil.
Federal University of Goias. Institute of Tropical Pathology and Public Health. Department of Collective Health, Goiânia, GO, Brazil.
Institute of Tropical Pathology and Public Health, Federal University of Goias, Department of Collective Health, Goias, Brazil
Oswaldo Cruz Foundation. Center for Scientific and Technological Information. Rio de Janeiro, RJ, Brazil.
Oswaldo Cruz Foundation. Centro de Pesquisas Aggeu Magalhães. Recife, PE, Brazil.
Oswaldo Cruz Foundation. Scientific Computation Program. Rio de Janeiro, RJ, Brazil.
Federal University of Goias. Institute of Tropical Pathology and Public Health. Department of Collective Health, Goiânia, GO, Brazil.
Federal University of Goias. Institute of Tropical Pathology and Public Health. Department of Collective Health, Goiânia, GO, Brazil.
Federal University of Goias. Institute of Tropical Pathology and Public Health. Department of Collective Health, Goiânia, GO, Brazil.
Federal University of Goias. Institute of Tropical Pathology and Public Health. Department of Collective Health, Goiânia, GO, Brazil.
Resumo em Inglês
Background: Dengue virus (DENV) affects nonimunne human populations in tropical and subtropical regions.
In the Americas, dengue has drastically increased in the last two decades and Brazil is considered one of the most
affected countries. The high frequency of asymptomatic infection makes difficult to estimate prevalence of
infection using registered cases and to locate high risk intra-urban area at population level. The goal of this spatial
point analysis was to identify potential high-risk intra-urban areas of dengue, using data collected at household
level from surveys.
Methods: Two household surveys took place in the city of Goiania (~1.1 million population), Central Brazil in
the year 2001 and 2002. First survey screened 1,586 asymptomatic individuals older than 5 years of age. Second
survey 2,906 asymptomatic volunteers, same age-groups, were selected by multistage sampling (census tracts;
blocks; households) using available digital maps. Sera from participants were tested by dengue virus-specific IgM/
IgG by EIA. A Generalized Additive Model (GAM) was used to detect the spatial varying risk over the region.
Initially without any fixed covariates, to depict the overall risk map, followed by a model including the main
covariates and the year, where the resulting maps show the risk associated with living place, controlled for the
individual risk factors. This method has the advantage to generate smoothed risk factors maps, adjusted by sociodemographic
covariates.
Results: The prevalence of antibody against dengue infection was 37.3% (95%CI [35.5–39.1]) in the year 2002;
7.8% increase in one-year interval. The spatial variation in risk of dengue infection significantly changed when
comparing 2001 with 2002, (ORadjusted = 1.35; p < 0.001), while controlling for potential confounders using
GAM model. Also increasing age and low education levels were associated with dengue infection.
Conclusion: This study showed spatial heterogeneity in the risk areas of dengue when using a spatial multivariate
approach in a short time interval. Data from household surveys pointed out that low prevalence areas in 2001
surveys shifted to high-risk area in consecutive year. This mapping of dengue risks should give insights for control
interventions in urban areas.
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