Introduction This study aimed to analyze the relationship between the
incidence of
severe dengue during the 2008
epidemic in Rio de Janeiro,
Brazil, and socioeconomic
indicators, as well as
indicators of
health service availability and previous circulation of the
dengue virus serotype-3 (DENV-3).
Methods In this ecological study, the units of
analysis were the districts of Rio de Janeiro. The data were incorporated into generalized
linear models, and the
incidence of
severe dengue in each district was the outcome variable. Results The districts with more cases of
dengue fever in the 2001
epidemic and a higher percentage of residents
who declared their
skin color or
race as black had higher
incidence rates of
severe dengue in the 2008
epidemic [
incidence rate ratio (IRR)= 1.21; 95%
confidence interval (95%CI)= 1.05-1.40 and IRR= 1.34; 95%CI= 1.16-1.54, respectively]. In contrast, the districts with
Family Health Strategy (FHS) clinics were more likely to have lower
incidence rates of
severe dengue in the 2008
epidemic (IRR= 0.81; 95%CI= 0.70-0.93). Conclusions At the ecological level, our findings suggest the persistence of
health inequalities in this region of
Brazil that are possibly due to greater
social vulnerability among the
self-declared black
population. ...