Geography and public health: analysis of the epidemiological dynamics of meningitis in Brazil, between 2010 and 2019.

OBJECTIVE: To analyze the spatiotemporal epidemiological dynamics of meningitis in Brazil, between 2010 and 2019. METHODS: Descriptive ecological study with cases and deaths due to meningitis in Brazil (2010-2019) in the National Notifiable Diseases Information System (Sistema de Informações de Agravos de Notificação - SINAN). The following analyses were performed: (I) frequency analyses of cases and deaths, prevalence rates, mortality, lethality, Fisher's exact test, and chi-square test; (II) Prais-Winstein regression; and (III) Global, Local Moran's index, and Kernel density. RESULTS: 182,126 cases of meningitis were reported in Brazil, of which 16,866 (9.26%) resulted in death, with prevalence rates of 9.03/100,000 inhabitants, mortality of 0.84/100,000 inhabitants, and lethality of 9.26%. There was a noted trend of decreasing prevalence rates (-9.5%, 95% confidence interval - 95%CI -13.92; -4.96, p<0.01) and mortality (-11.74%, 95%CI -13.92; -9.48, p<0.01), while lethality remained stable (-2.08%, 95%CI -4.9; 0.8; p<0.1941). The majority of cases were viral meningitis (45.7%), among 1-9 years old (32.2%), while the highest proportion of deaths was due to bacterial meningitis (68%), among 40-59 years old (26.3%). In the Moran and Kernel maps of prevalence and mortality rates, municipalities in the South, Southeast, and the capital of Pernambuco in the Northeast stood out with high rates; as for lethality, the North, Northeast, and Southeast coastal areas were highlighted. CONCLUSION: A decrease in meningitis cases and deaths was found in this study; however, the lethality rate was higher in areas with lower prevalence, emphasizing the need to enhance actions for identifying, monitoring, and providing health care for cases, as well as expanding vaccination coverage.

Geography and public health: analysis of the epidemiological dynamics of meningitis in Brazil, between 2010 and 2019 / Geografia e saúde coletiva: análise da dinâmica epidemiológica das meningites no Brasil, entre os anos de 2010 e 2019

ABSTRACT Objective: To analyze the spatiotemporal epidemiological dynamics of meningitis in Brazil, between 2010 and 2019. Methods: Descriptive ecological study with cases and deaths due to meningitis in Brazil (2010-2019) in the National Notifiable Diseases Information System (Sistema de Informações de Agravos de Notificação - SINAN). The following analyses were performed: (I) frequency analyses of cases and deaths, prevalence rates, mortality, lethality, Fisher's exact test, and chi-square test; (II) Prais-Winstein regression; and (III) Global, Local Moran's index, and Kernel density. Results: 182,126 cases of meningitis were reported in Brazil, of which 16,866 (9.26%) resulted in death, with prevalence rates of 9.03/100,000 inhabitants, mortality of 0.84/100,000 inhabitants, and lethality of 9.26%. There was a noted trend of decreasing prevalence rates (−9.5%, 95% confidence interval — 95%CI −13.92; −4.96, p<0.01) and mortality (−11.74%, 95%CI −13.92; −9.48, p<0.01), while lethality remained stable (−2.08%, 95%CI −4.9; 0.8; p<0.1941). The majority of cases were viral meningitis (45.7%), among 1-9 years old (32.2%), while the highest proportion of deaths was due to bacterial meningitis (68%), among 40-59 years old (26.3%). In the Moran and Kernel maps of prevalence and mortality rates, municipalities in the South, Southeast, and the capital of Pernambuco in the Northeast stood out with high rates; as for lethality, the North, Northeast, and Southeast coastal areas were highlighted. Conclusion: A decrease in meningitis cases and deaths was found in this study; however, the lethality rate was higher in areas with lower prevalence, emphasizing the need to enhance actions for identifying, monitoring, and providing health care for cases, as well as expanding vaccination coverage.

RESUMO Objetivo: Analisar a dinâmica epidemiológica espaçotemporal das meningites no Brasil, entre os anos de 2010 e 2019. Métodos: Estudo ecológico descritivo com os casos e óbitos por meningites no Brasil (2010-2019) no Sistema de Informações de Agravos de Notificação. Realizaram-se (I) análises de frequências dos casos e óbitos, taxas de prevalência, mortalidade, letalidade, testes de exato de Fisher e qui-quadrado; (II) regressão de Prais-Winsten; e (III) índice de Moran global, local e densidade de Kernel. Resultados: Notificaram-se 182.126 casos de meningites no Brasil, dos quais 16.866 (9,26%) evoluíram para óbito, com taxas de prevalência de 9,03/100.000/habitantes, mortalidade de 0,84/100.000/habitantes e letalidade de 9,26%. Destaca-se a tendência de decrescimento das taxas de prevalência (−9,5%, intervalo de confiança de 95% — IC95% −13,92; −4,96, p<0,01) e mortalidade (−11,74%, IC95% −13,92; −9,48, p<01,01), enquanto a letalidade se manteve estacionária (−2,08%, IC95% −4,9; 0,8; p<0,1941). A maioria dos casos foi de meningites virais (45,7%), entre 1 e 9 anos (32,2%), enquanto a maior parcela dos óbitos foi por meningites bacterianas (68%), entre 40 e 59 anos (26,3%). Nos mapas de Moran e Kernel das taxas de prevalência e mortalidade, destacaram-se com altas taxas os municípios do sul, sudeste e a capital de Pernambuco, no nordeste; já na letalidade, evidenciaram-se o norte, o nordeste e o litoral do sudeste. Conclusão: Encontrou-se decréscimo dos casos e óbitos por meningites neste estudo, entretanto a taxa de letalidade foi maior em áreas com menor prevalência, reforçando a necessidade do aprimoramento das ações de identificação, vigilância e assistência em saúde dos casos, bem como da ampliação da cobertura vacinal.

Analysis of the time series of pertussis in Brazil from 2010 to 2019 / Análise da série temporal da coqueluche no Brasil no período de 2010 a 2019

Abstract Objectives: to analyze a decade of spatio-temporal behavior of pertussis in Brazil and its epidemiological characteristics. Methods: ecological time series study of pertussis cases and deaths from the Notifable Diseases Information System in Brazil (2010-2019). The method of generalized linear analysis of Prais-Winsten and the Kernel analysis were used. Results: 32,849 cases were reported, of which 466 (1.42%) evolved to death, with a prevalence of 1.63/100,000 inhabitants and a mortality rate of 0.023/100,000 inhabitants. In the temporal analysis, the cyclical behavior of pertussis was evidenced, with trend variations in the period in 2014. Most cases occurred in children under 1 year of age (60.16%, p<0.01), sex female (55.28%, p=0.066) and white (48.42%, p=0.14). The largest share of deaths was in children aged <1 year (98.07, p<0.01), females (56.01%, p=0.066) and whites (43.78%, p=0.14). In the Kernel of prevalence, the South, Southeast and Northeast regions stood out with high density; while for mortality, the Southeast and Northeast stood out. Conclusions: the cyclical behavior of pertussis was observed, with a decreasing trend in recent years and the concentration of cases in children. This reinforces the importance of strengthening the population's immunization process.

Resumo Objetivos: analisar uma década do comportamento espaço-temporal da coqueluche no Brasil e as suas características epidemiológicas. Métodos: estudo ecológico de série temporal dos casos e óbitos por coqueluche do Sistema de Informação de Agravos de Notificação no Brasil (2010-2019). Utilizou-se o método de análise linear generalizada de Prais-Winsten e a análise de Kernel. Resultados: notificaram-se 32.849 casos, desses 466 (1,42%) evoluíram para óbito, com prevalência de 1,63/100.000 habitantes e coeficiente de mortalidade de 0,023/100.000 habitantes. Na análise temporal, evidenciou-se o comportamento cíclico da coqueluche com variações de tendência no período em 2014. A maioria dos casos ocorreu em menores de 1 ano (60,16%, p<0,01), sexo feminino (55,28%, p=0,066) e brancos (48,42%, p=0,14). A maior parcela dos óbitos foi em crianças <1 ano (98,07, p<0,01), sexo feminino (56,01%, p=0,066) e brancos (43,78%, p=0,14). No Kernel da prevalência, destacaram-se as regiões Sul, Sudeste e Nordeste com alta densidade; enquanto para mortalidade, sobressaíram-se Sudeste e Nordeste. Conclusão: observou-se o comportamento cíclico da coqueluche, com tendência de decréscimo nos últimos anos e a concentração de casos no público infantil. O que reforça a importância de fortalecer o processo de imunização da população.