Machado Juliana Pires, Oliveira Rosely Magalhães de, Souza-Santos Reinaldo
Gerência de Produção e Análise de Informações, Agência Nacional de Saúde Suplementar, Rio de Janeiro, Brasil.
Cad Saude Publica. 2009 May;25(5):1025-34. doi: 10.1590/s0102-311x2009000500009.
The reemergence, spread, and persistence of dengue are currently challenging the Brazilian health system. Factors related to living conditions have been addressed to understand different health outcomes. This study examines the occurrence of dengue and its relationship to living conditions in the city of Nova Iguaçu, Rio de Janeiro State, from 1996 to 2004. Data on dengue occurrence were obtained from the Brazilian National Disease Notification System (SINAN). A composite indicator of socioeconomic and urban infrastructure variables was created to characterize the prevailing living conditions, using 2000 census data. Operations between layers were used to identify spatial associations between the composite indicator and dengue incidence by neighborhood. The results do not show a linear relationship between poor living conditions and disease occurrence, but the spatial patterns indicated greater susceptibility of areas with inequalities in living conditions and behind highway access routes. The results also suggest that such inequalities can influence the dengue time trend. Thus, models that consider the interaction between socioeconomic variables (and not only the quantification of social indicators) can be useful for dengue surveillance.
登革热的再度出现、传播和持续存在目前正对巴西卫生系统构成挑战。人们已探讨了与生活条件相关的因素，以了解不同的健康结果。本研究调查了1996年至2004年期间里约热内卢州新伊瓜苏市登革热的发生情况及其与生活条件的关系。登革热发生数据来自巴西国家疾病通报系统（SINAN）。利用2000年人口普查数据，创建了一个社会经济和城市基础设施变量的综合指标，以描述普遍的生活条件。通过分层运算来确定综合指标与各街区登革热发病率之间的空间关联。结果并未显示生活条件差与疾病发生之间存在线性关系，但空间格局表明，生活条件不平等且位于高速公路出入路线后方的地区易感性更高。结果还表明，这种不平等会影响登革热的时间趋势。因此，考虑社会经济变量之间相互作用（而不仅仅是社会指标量化）的模型可能有助于登革热监测。
