Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil.
Laboratório de Parasitologia, Instituto Butantan, São Paulo, Brazil; Departamento de Parasitologia, Programa de Pós-Graduação Biologia da Relação Patógeno-Hospedeiro, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brazil.
Int J Infect Dis. 2018 May;70:20-29. doi: 10.1016/j.ijid.2018.02.007. Epub 2018 Feb 14.
While Brazil has witnessed an unprecedented Zika (ZIK) epidemic, chikungunya (CHIK) has also recently come into prominence as a threat in the Americas. The aim of this study was to identify the regions with increased probabilities of ZIK and CHIK occurrence, based on environmental and social conditions.
A statistical Maxent model was used to assess the potential spatial risk of ZIK and CHIK dissemination; this considered the number of probable autochthonous ZIK and CHIK cases in 2015 and 2016, along with environmental variables and social indicators.
Land use was the most significant variable that best defined the distribution of ZIK and CHIK. Of the social variables, garbage destination, type of sanitary installation, and pipe-borne water were the most significant. An estimated 65 million people in Brazil live in areas at high risk of ZIK and 75 million people in areas at high risk of CHIK. The southeast and northeast regions of Brazil presented the largest areas of high risk for both ZIK and CHIK.
Many areas across the Brazilian territory are exposed to ZIK or CHIK infection risks, which are related mainly to land use. The study findings offer valuable information to support time-sensitive public health decision-making at the local and national levels.
巴西曾爆发过史无前例的寨卡（ZIK）疫情，基孔肯雅热（CHIK）也在近期成为美洲地区的一大威胁。本研究旨在根据环境和社会条件，确定寨卡和基孔肯雅热发生概率增加的地区。
使用统计 Maxent 模型评估寨卡和基孔肯雅热传播的潜在空间风险；该模型考虑了 2015 年和 2016 年可能发生的本地寨卡和基孔肯雅热病例数，以及环境变量和社会指标。
土地利用是最能定义寨卡和基孔肯雅热分布的重要变量。在社会变量中，垃圾处理地点、卫生设施类型和管道供水是最重要的。巴西约有 6500 万人生活在寨卡病毒高风险地区，7500 万人生活在基孔肯雅热高风险地区。巴西东南部和东北部地区的寨卡和基孔肯雅热高风险区域最大。
巴西大部分地区都面临寨卡或基孔肯雅热感染的风险，这主要与土地利用有关。本研究结果为地方和国家各级的及时公共卫生决策提供了有价值的信息。
