Faculdade de Saúde Pública, University of São Paulo School of Public Health, São Paulo, Brazil.
Am J Trop Med Hyg. 2012 Feb;86(2):328-34. doi: 10.4269/ajtmh.2012.11-0074.
In this study, we aimed to estimate the effect that environmental, demographic, and socioeconomic factors have on dengue mortality in Latin America and the Caribbean. To that end, we conducted an observational ecological study, analyzing data collected between 1995 and 2009. Dengue mortality rates were highest in the Caribbean (Spanish-speaking and non-Spanish-speaking). Multivariate analysis through Poisson regression revealed that the following factors were independently associated with dengue mortality: time since identification of endemicity (adjusted rate ratio [aRR] = 3.2 [for each 10 years]); annual rainfall (aRR = 1.5 [for each 10(3) L/m(2)]); population density (aRR = 2.1 and 3.2 for 20-120 inhabitants/km(2) and > 120 inhabitants/km(2), respectively); Human Development Index > 0.83 (aRR = 0.4); and circulation of the dengue 2 serotype (aRR = 1.7). These results highlight the important role that environmental, demographic, socioeconomic, and biological factors have played in increasing the severity of dengue in recent decades.
在这项研究中，我们旨在估计环境、人口和社会经济因素对拉丁美洲和加勒比地区登革热死亡率的影响。为此，我们进行了一项观察性生态学研究，分析了 1995 年至 2009 年期间收集的数据。加勒比地区（西班牙语和非西班牙语地区）的登革热死亡率最高。通过泊松回归进行的多变量分析表明，以下因素与登革热死亡率独立相关：确定地方性（调整后的比率比[aRR]=3.2[每 10 年]）以来的时间；年降雨量（aRR=1.5[每 10(3)L/m(2)]）；人口密度（aRR=2.1 和 3.2 分别适用于 20-120 人和>120 人/km(2)）；人类发展指数>0.83（aRR=0.4）；以及登革热 2 型血清型的循环（aRR=1.7）。这些结果突出表明，环境、人口、社会经济和生物因素在过去几十年中对登革热的严重程度产生了重要影响。
