Spatial diffusion of COVID-19 in Algeria during the third wave.

The differential geographic impact of the third wave of COVID-19 is unknown in Algeria. We thus analyze the spatiotemporal variations of cases and deaths of COVID-19 in Algeria, between January and mid-August 2021. Cases and deaths due to COVID-19 were aggregated at the wilaya (province) level. The space-time permutation scan statistic was applied retrospectively to identify spatial-temporal clusters of COVID-19 cases and deaths. We detected 14 spatio-temporal clusters of COVID-19 cases, with only one high risk cluster. Among the 13 low risk clusters, 7 clusters emerged before the start of the third wave and were mostly located in wilayas with lower population density compared to the clusters that emerged during the third wave. For deaths, the largest geographic low-risk cluster emerged in southern Algeria, between April and early July 2021. Northern and coastal wilayas should be prioritized when allocating resources and implementing various quarantine and isolation measures to slow viral transmission.

Desigualdades socioespaciales de la mortalidad por Covid-19 después de la vacunación masiva en Buenos Aires, Argentina.

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Educational inequalities in suicide in the highly volatile economy of Argentina.

PURPOSE: Little is known about how economic fluctuations affect educational inequalities in mortality in low- or middle-income countries. The objective of this study is to analyze the temporal variations in educational differentials in suicide in four Argentinian provinces. METHODS: Data on suicides for ages 25 years and over and three age groups (25-44, 45-64, and 65 +) in four Argentinian provinces during the period 1999-2013 were linked to population data and information on the educational level of the deceased. Regression models were estimated using age, sex, year, province of residence, educational level, and economic character of the year (expansion or recession) as explanatory variables. RESULTS: The educational gap in suicide mortality widened since the expansion following the crisis of 1999-2002, and then only decreased in 2005 and 2011. For ages 45-64, the confidence intervals of the suicide rate overlapped each year, and the suicide rate of the middle-high education population exceeded the suicide rate of the low-education population in 2 recession years, 1999 and 2002. Considering the years of economic expansion or recession as a dichotomous variable, at ages 45-64 differences in suicide rates by educational level disappeared during years of recession, while they were present in years of expansion. CONCLUSION: Suicides rise during economic downturns but these periods could reduce the educational gaps of suicide mortality by increasing the vulnerability of adults of high educational level to changes in the economy.

The COVID-19 pandemic and changes in spatio-temporal patterns of suicide: monthly variations among localities in Argentina.

The aim of this study was to assess space-time clustering of suicide in Argentina between 2017 and 2020. A spatio-temporal scan statistic using a space-time permutation model was employed to retrospectively detect clusters of total suicides by sex and by age group. From 2017 to 2020, six statistically significant spatio-temporal clusters were identified in Argentina with either more or less suicides than expected. Two clusters extended from May 2019 to July and September 2020, while the remaining four clusters were detected only during 2020. The start of the COVID-19 pandemic seems to have changed the spatio-temporal patterns of suicide in Argentina. Despite the national decrease in the number of suicides during 2020 compared to previous years, the spatio-temporal analysis revealed both areas with decreases and increases in suicide. This heterogeneous scenario highlights the need for the study of local effects behind the emergence of these spatio-temporal suicide clusters.

COVID-19 mortality: educational inequalities and socio-spatial context in two provinces of Argentina. / Mortalidad por COVID-19: desigualdades educativas y contexto socio-espacial en dos provincias de Argentina.

Motivation for the study. There are very few studies on the educational inequalities in COVID-19 mortality, taking into account social contextual factors. Main findings. We found educational inequalities of COVID-19 mortality during both the 2020 and 2021 waves, regardless of the level of poverty and urbanization in the departments of Mendoza and San Juan provinces (Argentina). Implications. Preventive policies should focus not only in areas with high levels of poverty, but also in areas with adults of low educational level. With the aim of describing the association between sociodemographic characteristics and contextual factors with COVID-19 mortality during 2020-2021 in the provinces of Mendoza and San Juan in Argentina, we conducted an ecological study, which included the sociodemographic factors: age, sex and educational level, and the contextual factors: poverty and urbanization at the departmental level. The analyses were estimated using negative binomial Bayesian hierarchical models. Educational inequalities existed regardless of socioeconomic context and level of urbanization. The exception was the age group 65 years and older during 2021, which, regardless of educational level, showed a higher risk of death by COVID-19 in departments with high levels of structural poverty. In conclusion, educational inequality is an indicator of social inequality that increases vulnerability to COVID-19 mortality.

Con el objetivo de describir la asociación entre las características sociodemográficas y factores contextuales con la mortalidad por COVID-19, durante 2020-2021 en las provincias de Mendoza y San Juan en Argentina se realizó un estudio de tipo ecológico, donde los factores sociodemográficos fueron la edad, el sexo y el nivel educativo y contextuales la pobreza y la urbanización a nivel departamental. Los análisis se estimaron mediante modelos jerárquicos bayesianos binomial negativos. Existieron desigualdades educacionales independientemente del contexto socioeconómico y el nivel de urbanización. La excepción fue el grupo etario de 65 a más años durante 2021 que, independientemente del nivel educativo, mostró un riesgo de muerte por COVID-19 mayor en departamentos con niveles altos de pobreza estructural. En conclusión, la desigualdad educativa es un indicador de desigualdad social que aumenta la vulnerabilidad para la mortalidad por COVID-19. Motivación para realizar el estudio. Existen muy pocos estudios que den cuenta de las desigualdades educacionales de la mortalidad por COVID-19, tomando en cuenta factores sociales contextuales. Principales hallazgos. Durante ambas olas de 2020 y 2021, se encontraron desigualdades educativas de la mortalidad por COVID-19, independientemente del nivel de pobreza y de urbanización de los departamentos de las provincias de Mendoza y San Juan (Argentina). Implicancias. Se sugiere focalizar políticas preventivas no sólo en áreas con niveles altos de pobreza, sino también a escala de aquellos hogares con personas adultas de nivel educativo bajo.

[Deaths from road injuries in Argentina: a spatial analysis for the 2001-2009 period]. / Muertes por lesiones de tránsito en Argentina: un análisis espacial para el período 2001-2009.

Traffic injuries in Argentina are the most frequent cause of death from external injuries and a public health problem of increasing magnitude at the global level. The objectives of this study are to establish the level of spatial autocorrelation at the department level and identify the formation of groupings by calculating local indicators of spatial association at the national level. The results reveal a significantly positive level of autocorrelation in Argentina. A negative level of spatial autocorrelation was recorded when mortality from road injuries was related to population density. It was also noted that mortality from road injuries could pose a more serious problem outside large urban areas.

[COVID-19 and older adults: spatiotemporal comparison between mortality and vaccination in the province of Buenos Aires, Argentina]. / COVID-19 y adultos mayores: comparación espaciotemporal entre mortalidad y vacunación en la provincia de Buenos Aires, Argentina.

The aim of this study was to analyze the spatiotemporal variations of COVID-19 mortality and vaccination against COVID-19 in older adults. We used data from deaths due to COVID-19 and persons aged 70 years and older immunized with the first dose of vaccines against this disease, from districts of the province of Buenos Aires, between December 29, 2020, and June 30, 2021. Spatiotemporal scanning techniques were used to detect clusters. The parties of Greater Buenos Aires that had the highest vaccination rate with the first dose of the Sputnik V vaccine in population aged 70 years and older, between mid-March and early April 2021, also registered a decrease in mortality in this population, between the end of April and the end of June 2021. This study showed some signs of the positive impact associated with the application of the first dose of Sputnik V vaccine in Greater Buenos Aires.

El objetivo de este estudio fue analizar las variaciones espaciotemporales de la mortalidad por COVID-19 en adultos mayores y de la vacunación contra la COVID-19 en esta población. Se utilizaron datos de defunciones por COVID-19 y de personas de 70 a más años inmunizadas con la primera dosis de vacunas contra esta enfermedad, en partidos de la provincia de Buenos Aires, desde el 29 de diciembre del 2020 al 30 de junio de 2021. Se emplearon técnicas de escaneo espaciotemporal para detectar conglomerados. Los partidos del Gran Buenos Aires que tuvieron mayor vacunación con la primera dosis de la vacuna Sputnik V en población de 70 a más años, entre mediados de marzo y principios de abril de 2021, coincidieron mayormente en registrar una disminución de la mortalidad en esta población, entre finales de abril y finales de junio de 2021. Este estudio mostró algunos indicios del impacto positivo de la aplicación de la primera dosis de la vacuna Sputnik V en el Gran Buenos Aires.

Scaling of mortality in 742 metropolitan areas of the Americas.

We explored how mortality scales with city population size using vital registration and population data from 742 cities in 10 Latin American countries and the United States. We found that more populated cities had lower mortality (sublinear scaling), driven by a sublinear pattern in U.S. cities, while Latin American cities had similar mortality across city sizes. Sexually transmitted infections and homicides showed higher rates in larger cities (superlinear scaling). Tuberculosis mortality behaved sublinearly in U.S. and Mexican cities and superlinearly in other Latin American cities. Other communicable, maternal, neonatal, and nutritional deaths, and deaths due to noncommunicable diseases were generally sublinear in the United States and linear or superlinear in Latin America. Our findings reveal distinct patterns across the Americas, suggesting no universal relation between city size and mortality, pointing to the importance of understanding the processes that explain heterogeneity in scaling behavior or mortality to further advance urban health policies.

[Does geographic context matter in diabetes-related mortality? Spatial and time trends in Argentina, 1990-2012]. / ¿El contexto geográfico importa en la mortalidad por diabetes mellitus? Tendencias espacio-temporales en Argentina, 1990-2012.

The aim of this study was to identify spatial-temporal clusters of high and low diabetes-related mortality from 1990 to 2012 in Argentina. This was a spatial-temporal retrospective ecological study in the population older than 34 years living in Argentina, according to sex, from 1990 to 2012. The spatial units of analysis consisted of the country's departments (subdivisions of the provinces) plus the Autonomous City of Buenos Aires. Spatial-temporal exploration technique was used to detect clusters with high and low mortality. Areas with high mortality from diabetes mellitus were found in the Central-West of the country, and areas with low mortality were found in the coastal region of the province of Buenos Aires and Patagonia. Clusters with high mortality occupied a period from 1995 to 2008; clusters with low mortality shifted towards the years 2002 to 2012. The recent drop in mortality from diabetes was not geographically homogeneous, but displayed a marked decrease in the eastern area of the Province of Buenos Aires and the Autonomous City of Buenos Aires.

Residence place as a risk factor in different types of fatal car accidents.

The association between place of residence, population density, relief and type of event (collision or non-collision of the vehicle) has not been evaluated in developing countries. The main objective of this study is to determine the differential factors associated with the occurrence of deaths of collision and non-collision automobile users in Patagonia, Argentina. A multiple logistic regression analysis was performed using as the dependent variable death by car accident (collision or non-collision of the vehicle) and sex, age, place of residence of the victim, relief and population density as the independent variables. Collision fatalities were related to areas of high population density, while non-collision fatalities were related to areas of low population density, mountainous landscape and place of residence of the victims outside the Patagonian region. The results obtained in this study indicate the need to develop differential primary prevention policies by place of residence of car occupants, focusing on Patagonia non-resident drivers and by emphasising non-collision accidents.

Spatiotemporal trends of cases of pandemic influenza A(H1N1)pdm09 in Argentina, 2009-2012.

The aim of this paper was to analyze the spatiotemporal variations of cases of influenza A(H1N1)pdm09 in Argentina. A space-time permutation scan statistic was performed to test the non-randomness in the interaction between space and time in reported influenza A(H1N1)pdm09 cases. In 2009, two clusters were recorded in the east of Buenos Aires Province (May and June) and in the central and northern part of Argentina (July and August). Between 2011 and 2012, clusters near areas bordering other countries were registered. Within the clusters, in 2009, the high notification rates were first observed in the school-age population and then extended to the older population (15-59 years). From 2011 onwards, higher rates of reported cases of influenza A(H1N1)pdm09 occurred in children under five years in center of the country. Two stages of transmission of influenza A(H1N1)pdm09 can be characterized. The first stage had high rates of notification and a possible interaction with individuals from other countries in the major cities of Argentina (pattern of hierarchy), and the second stage had an increased interaction in some border areas without a clear pattern of hierarchy. These results suggest the need for greater coordination in the Southern Cone countries, in order to implement joint prevention and vaccination policies.

¿El contexto geográfico importa en la mortalidad por diabetes mellitus? Tendencias espacio-temporales en Argentina, 1990-2012 / Does geographic context matter in diabetes-related mortality? Spatial and time trends in Argentina, 1990-2012 / É importante o contexto geográfico na mortalidade por diabetes mellitus? Tendências espaço-temporais na Argentina, 1990-2012

Resumen: El objetivo de esta investigación fue identificar conglomerados espacio-temporales de alta y baja mortalidad por diabetes mellitus durante el período 1990-2012 en Argentina. Se realizó un estudio ecológico retrospectivo espacio-temporal. Se consideró la población mayor de 34 años residente en Argentina, según sexo, durante el período 1990-2012. Las unidades espaciales de análisis estuvieron conformadas por departamentos más la Ciudad Autónoma de Buenos Aires. Se empleó la técnica de exploración espacio-temporal para la detección de conglomerados de alta y baja mortalidad. Se encontraron áreas de elevada mortalidad por diabetes mellitus en el centro-oeste del país, y zonas de baja mortalidad en la región costera de la provincia de Buenos Aires y Patagonia. Los conglomerados de alta mortalidad ocuparon un período comprendido entre 1995 y 2008; los de baja mortalidad se desplazaron hacia los años 2002-2012. El descenso reciente en la mortalidad por diabetes mellitus no fue geográficamente homogéneo, con una disminución marcada en el este de la Provincia de Buenos Aires y la Ciudad Autónoma de Buenos Aires.

Abstract: The aim of this study was to identify spatial-temporal clusters of high and low diabetes-related mortality from 1990 to 2012 in Argentina. This was a spatial-temporal retrospective ecological study in the population older than 34 years living in Argentina, according to sex, from 1990 to 2012. The spatial units of analysis consisted of the country's departments (subdivisions of the provinces) plus the Autonomous City of Buenos Aires. Spatial-temporal exploration technique was used to detect clusters with high and low mortality. Areas with high mortality from diabetes mellitus were found in the Central-West of the country, and areas with low mortality were found in the coastal region of the province of Buenos Aires and Patagonia. Clusters with high mortality occupied a period from 1995 to 2008; clusters with low mortality shifted towards the years 2002 to 2012. The recent drop in mortality from diabetes was not geographically homogeneous, but displayed a marked decrease in the eastern area of the Province of Buenos Aires and the Autonomous City of Buenos Aires.

Resumo: O objetivo desta pesquisa foi identificar conglomerados espaço-temporais de alta e baixa mortalidade por diabetes mellitus durante o período 1990-2012 na Argentina. Foi realizado um estudo ecológico retrospectivo espaço-temporal, considerando a população maior de 34 anos, residente na Argentina, segundo o sexo, durante o período de 1990-2012. As unidades espaciais de análises foram constituídas pelos departamentos, junto com a Cidade Autônoma de Buenos Aires. Foi empregada a técnica de exploração espaço-temporal para a detecção de conglomerados de alta e baixa mortalidade. Foram encontradas áreas de elevada mortalidade por diabetes mellitus no Centro-oeste do país, e zonas de baixa mortalidade na região costeira da província de Buenos Aires e Patagônia. Os conglomerados de alta mortalidade ocuparam um período compreendido entre 1995 e 2008; os de baixa mortalidade foram no período de 2002-2012. A diminuição recente na mortalidade por diabetes mellitus não foi geograficamente homogênea, com destaque para o leste da província de Buenos Aires e a Cidade Autônoma de Buenos Aires.

Spatiotemporal rrends of cases of pandemic influenza a(h1n1)pdm09 in Argentina, 2009-2012 / Tendencias espacio-temporales en los casos de gripe A(H1N1)pdm09 en Argentina, 2009-2012

The aim of this paper was to analyze the spatiotemporal variations of cases of influenza A(H1N1)pdm09 in Argentina. A space-time permutation scan statistic was performed to test the non-randomness in the interaction between space and time in reported influenza A(H1N1)pdm09 cases. In 2009, two clusters were recorded in the east of Buenos Aires Province (May and June) and in the central and northern part of Argentina (July and August). Between 2011 and 2012, clusters near areas bordering other countries were registered. Within the clusters, in 2009, the high notification rates were first observed in the school-age population and then extended to the older population (15-59 years). From 2011 onwards, higher rates of reported cases of influenza A(H1N1)pdm09 occurred in children under five years in center of the country. Two stages of transmission of influenza A(H1N1)pdm09 can be characterized. The first stage had high rates of notification and a possible interaction with individuals from other countries in the major cities of Argentina (pattern of hierarchy), and the second stage had an increased interaction in some border areas without a clear pattern of hierarchy. These results suggest the need for greater coordination in the Southern Cone countries, in order to implement joint prevention and vaccination policies.

El objetivo de este trabajo es analizar las variaciones espaciotemporales de los casos de gripe A(H1N1)pdm09 en Argentina. Se realizó un escaneo estadístico espacio-temporal por permutaciones para poner a prueba la no aleatoriedad en la interacción entre espacio y tiempo de los casos registrados de gripe A(H1N1)pdm09. Durante 2009 se identificaron dos conglomerados espacio-temporales, en el este de la provincia de Buenos Aires (mayo y junio) y en la mayor parte del centro-norte de la Argentina (julio y agosto). Durante 2011 y 2012 se registraron conglomerados próximos a zonas limítrofes con otros países. Al interior de los conglomerados, primero se observaron mayores tasas de notificación en población de edad escolar para luego extenderse a población mayor (15-59 años). A partir de 2011, las mayores tasas se observaron en menores de 5 años residentes en el centro del país. Se pudieron caracterizar dos etapas de transmisión espacio-temporal de la gripe A(H1N1)pdm09. La primera etapa se caracterizó por altas tasas de notificación y una posible interacción con individuos provenientes de otros países llegados a las grandes ciudades de la Argentina (patrón de jerarquía). La segunda etapa mostró una mayor interacción en algunas zonas fronterizas y sin un patrón claro de jerarquía. Estos resultados plantean la necesidad de generar una mayor coordinación en países del Cono Sur, con el objetivo de implementar políticas más efectivas de prevención y vacunación.

Muertes por lesiones de tránsito en Argentina: un análisis espacial para el período 2001–2009 / Deaths from road injuries in Argentina: a spatial analysis for the 2001–2009 period

Traffic injuries in Argentina are the most frequent cause of death from external injuriesand a public health problem of increasing magnitude at the global level. Theobjectives of this study are to establish the level of spatial autocorrelation at the departmentlevel and identify the formation of groupings by calculating local indicatorsof spatial association at the national level. The results reveal a significantly positivelevel of autocorrelation in Argentina. A negative level of spatial autocorrelation wasrecorded when mortality from road injuries was related to population density. Itwas also noted that mortality from road injuries could pose a more serious problemoutside large urban areas.

Las lesiones de tránsito representan la causa más frecuente de muerte por causas externasen Argentina y un problema de creciente magnitud para la salud pública a nivel global. Losprincipales objetivos de este trabajo son establecer el nivel de autocorrelación espacial experimentadoa nivel de departamentos e identificar la conformación de agrupamientos medianteel cálculo de los indicadores locales de asociación espacial a nivel nacional. Los resultadosmostraron un nivel de autocorrelación significativamente positivo en Argentina. Al relacionarlas tasas de mortalidad por lesiones de tránsito con la densidad poblacional, se registró unnivel de autocorrelación espacial negativo. Se observó también que la mortalidad por lesionesde tránsito podría representar un problema más grave fuera de las grandes aglomeraciones.