Dengue incidence, mortality, and case-fatality in Brazil: spatial patterns, socioeconomic contrasts, and serotype impact

IF 5.6 3区医学 Q1 INFECTIOUS DISEASES

Travel Medicine and Infectious Disease Pub Date : 2025-11-01 Epub Date: 2025-11-06 DOI:10.1016/j.tmaid.2025.102934

Patricia Marques Moralejo Bermudi , Raquel Gardini Sanches Palasio , Monica Pirani , Lidia Maria Reis Santana , Gerson Laurindo Barbosa , Marta Blangiardo , Francisco Chiaravalloti-Neto

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引用次数: 0

Abstract

Background

Despite its burden, dengue remains neglected, with few studies comparing its incidence, mortality, case-fatality, and key variables such as socioeconomic factors, healthcare access, and serotype distribution.

Methods

This ecological study analyzed dengue cases and deaths (2014–2024) in intermediate regions of Brazil. Covariates included illiteracy rate, hospital bed availability, serotype distribution, and private healthcare coverage. High- and low-risk spatial clusters were identified using the SaTScan Poisson model. Statistical analysis assessed significant covariate differences between risk groups.

Results

High-incidence clusters were found in areas with lower illiteracy rates, whereas high-case fatality clusters were found in areas with higher illiteracy rates. DENV-2 was associated with high-risk case-fatality areas; in contrast, DENV-1 showed the opposite pattern, appearing to be more common but associated with lower severity.

Conclusions

These findings provide a basis for generating hypotheses for future modeling studies on these associations.

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巴西登革热发病率、死亡率和病死率：空间格局、社会经济对比和血清型影响

背景：尽管登革热负担沉重，但仍被忽视，很少有研究比较其发病率、死亡率、病死率和社会经济因素、卫生保健可及性和血清型分布等关键变量。方法：本生态研究分析了巴西中部地区2014-2024年登革热病例和死亡病例。协变量包括文盲率、医院床位可用性、血清型分布和私人医疗保险覆盖率。利用SaTScan泊松模型确定了高风险和低风险的空间集群。统计分析评估了风险组之间显著的协变量差异。结果：文盲率低的地区出现高发病聚集性，文盲率高的地区出现高病死率聚集性。DENV-2与高危病死率地区相关；相比之下，DENV-1表现出相反的模式，似乎更常见，但与较低的严重程度相关。结论：这些发现为未来这些关联的建模研究提供了假设基础。

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来源期刊

Travel Medicine and Infectious Disease PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-INFECTIOUS DISEASES

CiteScore

19.40

自引率

1.70%

发文量

211

审稿时长

49 days

期刊介绍： Travel Medicine and Infectious Disease Publication Scope: Publishes original papers, reviews, and consensus papers Primary theme: infectious disease in the context of travel medicine Focus Areas: Epidemiology and surveillance of travel-related illness Prevention and treatment of travel-associated infections Malaria prevention and treatment Travellers' diarrhoea Infections associated with mass gatherings Migration-related infections Vaccines and vaccine-preventable disease Global policy/regulations for disease prevention and control Practical clinical issues for travel and tropical medicine practitioners Coverage: Addresses areas of controversy and debate in travel medicine Aims to inform guidelines and policy pertinent to travel medicine and the prevention of infectious disease Publication Features: Offers a fast peer-review process Provides early online publication of accepted manuscripts Aims to publish cutting-edge papers