Distribuição espacial dos casos de Zika Vírus no RN e sua relação com determinantes que refletem a desigualdade social

Abstract

Introduction: Aedes aegypti-transmitted arboviruses are currently considered a worldwide public health problem, with the hypotesis that socioeconomic and environmental factors would be involved in the increased incidence of arboviruses coirculate in Brazil, and Rio Grande do Norte is one of the northeastern states with the highest number of cases of ZIKV. Objective: To verify the possible relationship of indicators that reflect social inequality on the spatial distribution of ZIKV cases in a Northeastern Brazilian state in the 2015-2016 Biennium. Methods: an ecological study with data from case reports of ZIKV and sociodemographic indicators of the state of Rio Grande do Norte calculated from data from the State Department of Public Health (SESAP-RN), DATASUS and the Brazilian Institute of Geography (IBGE). Data were analyzed in Terraview version 4.2.2, GeoDa version 1.12 and IBM SPSS Statistics 21. Results: Both the Mean Incidence Rate (IMR) of ZIKV cases in the 2015-2016 biennium (Moran = 0.139; p = 0.03) regarding violence IMR (Moran = 0.295; p = 0.02), mean income (Moran = 0.344; p = 0.01), unemployment rate (Moran = 0.231; p = 0.01) and home density (Moran = -0.073; p = 0.01) obeyed a geographical pattern of spatial distribution. In the multiple linear regression analysis the variables IMR of violence incidence in 2014, mean income in 2010 and population density explained 61.2% of the ZIKV IMR variation in the 2015-2016 biennium (adjusted R2 = 0.612). In this study, municipalities with more reports of violence and favorable mean income, such as the capital, have higher IMR of ZYKV cases, a phenomenon possibly mediated by the existence of health services more sensitive to notification in these municipalities.