[The spatiotemporal diffusion of measles: an intra-urban analysis in Rio de Janeiro, Brazil].

Abstract

This study aimed to analyze the profile of measles cases in the municipality of Rio de Janeiro, Brazil, from 2007 to 2021 and to describe their diffusion and cluster formation in epidemic years. Neighborhoods were considered as the units of this ecological study. A bivariate analysis of socioeconomic and epidemiological variables was conducted according to previous vaccination and hospitalization. Cluster and spatial diffusion analyses were performed by the SCAN screening method and Inverse Distance Weighting. Of the 774 confirmed cases, 57.6% were men, 72.9% were adults, and 63.7% self-identified as white. A higher proportion of previous vaccination occurred in white individuals and in those who were aged from 5 to 11 years. The stratum with higher schooling showed a higher proportion of previous vaccination. About 16.3% underwent hospitalization, with the highest risk occurring in those aged from 5 to 11 years and the lowest for those aged from 18 to 29 years old when compared to children up to one year of age. The first cases in the epidemic occurred in the Greater Tijuca area, then spreading to western and southern zones, showing hierarchical diffusion by relocation. The highest risk clusters were formed in the south and center zones. Findings confirm the change in the epidemiological profile of the disease and its diffusion pattern under the influence of the intra-urban hierarchy of the municipality, the neighborhoods of which with greater commerce and tourism act as initiators and diffusers of transmission. Such aspects should support control strategies, guiding immunization campaigns that address the most affected age groups and with custom actions in the areas of disease diffusion.