Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Avenida Horácio Macedo, 100 - Cidade Universitária, Rio de Janeiro, RJ, CEP 21941-598, Brazil.
Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
Sci Rep. 2023 Mar 13;13(1):4139. doi: 10.1038/s41598-023-31046-4.
The COVID-19 pandemic caused impact on public health worldwide. Brazil gained prominence during the pandemic due to the magnitude of disease. This study aimed to evaluate the spatial-temporal dynamics of incidence, mortality, and case fatality of COVID-19 and its associations with social determinants in Brazilian municipalities and epidemiological week. We modeled incidence, mortality, and case fatality rates using spatial-temporal Bayesian model. "Bolsa Família Programme" (BOLSAFAM) and "proportional mortality ratio" (PMR) were inversely associated with the standardized incidence ratio (SIR), while "health insurance coverage" (HEALTHINSUR) and "Gini index" were directly associated with the SIR. BOLSAFAM and PMR were inversely associated with the standardized mortality ratio (SMR) and standardized case fatality ratio (SCFR). The highest proportion of excess risk for SIR and the SMR started in the North, expanding to the Midwest, Southeast, and South regions. The highest proportion of excess risk for the SCFR outcome was observed in some municipalities in the North region and in the other Brazilian regions. The COVID-19 incidence and mortality in municipalities that most benefited from the cash transfer programme and with better social development decreased. The municipalities with a higher proportion of non-whites had a higher risk of becoming ill and dying from the disease.
COVID-19 大流行对全球公共卫生造成了影响。巴西在大流行期间因疾病的严重程度而引人注目。本研究旨在评估 COVID-19 在巴西城市和流行病学周的发病率、死亡率和病死率的时空动态及其与社会决定因素的关系。我们使用时空贝叶斯模型对发病率、死亡率和病死率进行建模。“家庭补助金计划”（BOLSAFAM）和“比例死亡率比”（PMR）与标准化发病率比（SIR）呈负相关，而“健康保险覆盖率”（HEALTHINSUR）和“基尼指数”与 SIR 呈正相关。BOLSAFAM 和 PMR 与标准化死亡率比（SMR）和标准化病死率比（SCFR）呈负相关。SIR 和 SMR 过高风险的最高比例始于北部，然后扩展到中西部、东南部和南部地区。SCFR 结果过高风险的最高比例出现在北部地区和巴西其他地区的一些城市。受益于现金转移计划和社会发展更好的城市的 COVID-19 发病率和死亡率下降。非白人比例较高的城市患该病和死亡的风险更高。
