Dataset Information

Identifying hidden Zika hotspots in Pernambuco, Brazil: a spatial analysis.

ABSTRACT:

Background

Northeast Brazil has the world's highest rate of Zika-related microcephaly. However, Zika case counts cannot accurately describe burden because mandatory reporting was only established when the epidemic was declining in the region.

Methods

To advance the study of the Zika epidemic, we identified hotspots of Zika in Pernambuco state, Northeast Brazil, using Aedes-borne diseases (dengue, chikungunya and Zika) and microcephaly data. We used Kulldorff's Poisson purely spatial scan statistic to detect low- and high-risk clusters for Aedes-borne diseases (2014-2017) and for microcephaly (2015-2017), separately. Municipalities were classified according to a proposed gradient of Zika burden during the epidemic, based on the combination of cluster status in each analysis and considering the strength of the evidence.

Results

We identified 26 Aedes-borne diseases clusters (11 high-risk) and 5 microcephaly clusters (3 high-risk) in Pernambuco. According to the proposed Zika burden gradient, our results indicate that the northeast of Pernambuco and the Sertão region were hit hardest by the Zika epidemic. The first is the most populous area of Pernambuco, while the second has one of the highest rates of social and economic inequality in Brazil.

Conclusion

We successfully identified possible hidden Zika hotspots using a simple methodology combining Aedes-borne diseases and microcephaly information.

SUBMITTER: Freitas LP

PROVIDER: S-EPMC9977212 | biostudies-literature | 2023 Mar

REPOSITORIES: biostudies-literature

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Publications

Identifying hidden Zika hotspots in Pernambuco, Brazil: a spatial analysis.

Freitas Laís Picinini LP Lowe Rachel R Koepp Andrew E AE Alves Sandra Valongueiro SV Dondero Molly M Marteleto Letícia J LJ

Transactions of the Royal Society of Tropical Medicine and Hygiene 20230301 3

<h4>Background</h4>Northeast Brazil has the world's highest rate of Zika-related microcephaly. However, Zika case counts cannot accurately describe burden because mandatory reporting was only established when the epidemic was declining in the region.<h4>Methods</h4>To advance the study of the Zika epidemic, we identified hotspots of Zika in Pernambuco state, Northeast Brazil, using Aedes-borne diseases (dengue, chikungunya and Zika) and microcephaly data. We used Kulldorff's Poisson purely spati ...[more]

PMID: 36326785

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Project description:BackgroundEffective Aedes aegypti control is limited, in part, by the difficulty in achieving sufficient intervention coverage. To maximise the effect of vector control, areas with persistently high numbers of Aedes-borne disease cases could be identified and prioritised for preventive interventions. We aimed to identify persistent Aedes-borne disease hotspots in cities across southern Mexico.MethodsIn this spatial analysis, geocoded cases of dengue, chikungunya, and Zika from nine endemic Mexican cities were aggregated at the census-tract level. We included cities that were located in southern Mexico (the arbovirus endemic region of Mexico), with a high burden of dengue cases (ie, more than 5000 cases reported during a 10-year period), and listed as high priority for the Mexican dengue control and prevention programme. The Getis-Ord Gi*(d) statistic was applied to yearly slices of the dataset to identify spatial hotspots of each disease in each city. We used Kendall's W coefficient to quantify the agreement in the distribution of each virus.Findings128 507 dengue, 4752 chikungunya and 25 755 Zika clinical cases were reported between Jan 1, 2008, and Dec 31, 2016. All cities showed evidence of transmission heterogeneity, with a mean of 17·6% (SD 4·7) of their total area identified as persistent disease hotspots. Hotspots accounted for 25·6% (SD 9·7; range 12·8-43·0) of the population and 32·1% (10·5; 19·6-50·5) of all Aedes-borne disease cases reported. We found an overlap between hotspots of 61·7% for dengue and Zika and 53·3% for dengue and chikungunya. Dengue hotspots in 2008-16 were significantly associated with dengue hotspots detected during 2017-20 in five of the nine cities. Heads of vector control confirmed hotspot areas as problem zones for arbovirus transmission.InterpretationThis study provides evidence of the overlap of Aedes-borne diseases within geographical hotspots and a methodological framework for the stratification of arbovirus transmission risk within urban areas, which can guide the implementation of surveillance and vector control.FundingUSAID, the US Centers for Disease Control and Prevention, the Canadian Institutes of Health Research, International Development Research Centre, Fondo Mixto CONACyT (Mexico)-Gobierno del Estado de Yucatan, and the US National Institutes of Health.TranslationFor the Spanish translation of the abstract see Supplementary Materials section.

Dataset Information

Identifying hidden Zika hotspots in Pernambuco, Brazil: a spatial analysis.

Background

Methods

Results

Conclusion

Publications

Identifying hidden Zika hotspots in Pernambuco, Brazil: a spatial analysis.

Similar Datasets

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