Geospatial modeling of microcephaly and zika virus spread patterns in Brazil


Autoři: Pedro Amaral aff001;  Lucas Resende de Carvalho aff001;  Thiago Augusto Hernandes Rocha aff002;  Núbia Cristina da Silva aff003;  João Ricardo Nickenig Vissoci aff004
Působiště autorů: CEDEPLAR/UFMG, Center for Development and Regional Planning, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil aff001;  PAHO/WHO, Brasília, Federal District, Brazil aff002;  CEPEAD/UFMG, Center of Higher Studies and Research in Administration, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil aff003;  Duke University, Duke School of Medicine, Department of Surgery, Division of Emergency Medicine, Durham, North Carolina, United States of America aff004
Vyšlo v časopise: PLoS ONE 14(9)
Kategorie: Research Article
doi: 10.1371/journal.pone.0222668

Souhrn

Microcephaly and Zika Virus infection (ZIKV) were declared Public Health Emergencies of International Concern by the World Health Organization in 2016. Brazil was considered the epicenter of the outbreak. However, the occurrence of both ZIKV and microcephaly in Brazil was not evenly distributed across the country. To better understand this phenomenon, we investigate regional characteristics at the municipal level that can be associated with the incidence of microcephaly, our response variable, and its relationship with ZIKV and other predictors. All epidemiological data in this study was provided by the Ministry of Health official database (DATASUS). Microcephaly was only confirmed after birth and the diagnostic was made regardless of the mother’s ZIKV status. Using exploratory spatial data analysis and spatial autoregressive Tobit models, our results show that microcephaly incidence is significantly, at 95% confidence level, related not only to ZIKV, but also to access to primary care, population size, gross national product, mobility and environmental attributes of the municipalities. There is also a significant spatial autocorrelation of the dependent variable. The results indicate that municipalities that show a high incidence of microcephaly tend to be clustered in space and that incidence of microcephaly varies considerably across regions when correlated only with ZIKV, i.e. that ZIKV alone cannot explain the differences in microcephaly across regions and their correlation is mediated by regional attributes.

Klíčová slova:

Brazil – Infants – Primary care – Sanitation – Microcephaly – Zika virus – Spatial autocorrelation – Chikungunya infection


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PLOS One


2019 Číslo 9

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