Reis Larissa Nunes Moreira, Pedro Alexandre San, Santos Jefferson Pereira Caldas Dos, Santos Yasmin Toledo, Praça Heitor Levy Ferreira, Conceição Paula Barbosa, Gibson Gerusa
Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil.
Instituto de Tecnologia em Fármacos, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.
Cad Saude Publica. 2025 Feb 7;40(12):e00166724. doi: 10.1590/0102-311XPT166724. eCollection 2025.
This study aimed to analyze the profile of measles cases in the municipality of Rio de Janeiro, Brazil, from 2007 to 2021 and to describe their diffusion and cluster formation in epidemic years. Neighborhoods were considered as the units of this ecological study. A bivariate analysis of socioeconomic and epidemiological variables was conducted according to previous vaccination and hospitalization. Cluster and spatial diffusion analyses were performed by the SCAN screening method and Inverse Distance Weighting. Of the 774 confirmed cases, 57.6% were men, 72.9% were adults, and 63.7% self-identified as white. A higher proportion of previous vaccination occurred in white individuals and in those who were aged from 5 to 11 years. The stratum with higher schooling showed a higher proportion of previous vaccination. About 16.3% underwent hospitalization, with the highest risk occurring in those aged from 5 to 11 years and the lowest for those aged from 18 to 29 years old when compared to children up to one year of age. The first cases in the epidemic occurred in the Greater Tijuca area, then spreading to western and southern zones, showing hierarchical diffusion by relocation. The highest risk clusters were formed in the south and center zones. Findings confirm the change in the epidemiological profile of the disease and its diffusion pattern under the influence of the intra-urban hierarchy of the municipality, the neighborhoods of which with greater commerce and tourism act as initiators and diffusers of transmission. Such aspects should support control strategies, guiding immunization campaigns that address the most affected age groups and with custom actions in the areas of disease diffusion.
本研究旨在分析2007年至2021年巴西里约热内卢市麻疹病例的概况，并描述其在流行年份的传播情况和聚集性形成。本生态研究将社区视为单位。根据既往疫苗接种情况和住院情况，对社会经济和流行病学变量进行了双变量分析。采用SCAN筛查方法和反距离加权法进行聚集性和空间扩散分析。在774例确诊病例中，57.6%为男性，72.9%为成年人，63.7%自我认定为白人。白人个体以及5至11岁人群中既往接种疫苗的比例更高。受教育程度较高的阶层既往接种疫苗的比例更高。约16.3%的病例住院治疗，与1岁及以下儿童相比，5至11岁人群住院风险最高，18至29岁人群住院风险最低。疫情中的首例病例出现在大蒂茹卡地区，随后蔓延至西部和南部地区，呈现出通过迁移的分层传播。最高风险聚集区形成于南部和中部地区。研究结果证实了该疾病流行病学特征的变化及其在该市城市内部层级影响下的传播模式，其中商业和旅游业较发达的社区是传播的发起者和扩散者。这些方面应支持防控策略，指导针对受影响最严重年龄组的免疫运动，并在疾病传播地区采取定制行动。
