Gonçalves Nelson Veiga, Leal Alessandra Lima, Guimarães Heloisa Maria Melo E Silva, Bernardes Arthur Carneiro, Brito Silvana Rossy de, Alves Taiana Moita Koury, Filgueiras Tainara Carvalho Garcia Miranda, Moraes Thayse Moraes de, Rocha Matheus Pereira do Couto, Cardoso Renan Faria, Sousa Bruno Yudi Shimomaebara, Miranda Claudia do Socorro Carvalho
Laboratory of Epidemiology and Geoprocessing of Amazon, University of the State of Pará (UEPA), Belém, Brazil.
Programa de Pós-Graduação em Saúde Coletiva na Amazônia, Federal University of Pará (UFPA), Belém, Brazil.
PLoS One. 2025 Mar 12;20(3):e0318607. doi: 10.1371/journal.pone.0318607. eCollection 2025.
Severe Acute Respiratory Syndrome is an important public health problem in Brazil due to the large number of cases. It has a high mortality rate related to risk factors that include systemic arterial hypertension, type 2 diabetes mellitus, male gender and advanced age. This cross-sectional and ecological study analyzed the spatial distribution of this disease related to the evolution of COVID-19 cases and their epidemiological, demographic, socioeconomic and public health policy conditions in the administrative districts of Belém, state of Pará, in the eastern Brazilian Amazon, from 2021 to 2023. Data from the Ministry of Health, the National Institute for Space Research and the Brazilian Institute of Geography and Statistics were used. The statistical and spatial analysis of the data used the chi-square test of equal expected proportions with a significance level of 0.05% and the techniques of ordinary multivariate linear regression and percentiles, with the results expressed by means of choropleth maps, using the Bioestat 5.4 and Arcgis 10.5.1 software. The epidemiological profile analyzed 3,511 cases, following the national pattern with statistical significance. The pathology was not distributed homogeneously in spatial terms and was associated with a territorial and socioeconomic segregation of the population in the neighborhoods and their administrative districts, with great differences in their demographic characteristics, living conditions and public services for treating the disease, especially when we consider the relationship between the outskirts and the center of the municipality. This has revealed unequal development, which has produced health inequalities in the study area. With that in mind, we emphasize the urgency of expanding these services in the places identified as most vulnerable, with a view to equal care access for the disease.
由于病例数量众多，严重急性呼吸综合征在巴西是一个重要的公共卫生问题。它具有较高的死亡率，与包括系统性动脉高血压、2型糖尿病、男性性别和高龄在内的风险因素相关。这项横断面和生态研究分析了2021年至2023年期间，巴西亚马逊地区东部帕拉州贝伦市行政区内，该疾病的空间分布与新冠病例演变及其流行病学、人口统计学、社会经济和公共卫生政策状况之间的关系。使用了来自卫生部、国家空间研究所和巴西地理与统计研究所的数据。对数据的统计和空间分析采用了预期比例相等的卡方检验，显著性水平为0.05%，以及普通多元线性回归和百分位数技术，结果通过等值线图表示，使用的软件是Bioestat 5.4和Arcgis 10.5.1。流行病学概况分析了3511例病例，符合具有统计学意义的全国模式。从空间角度来看，病理分布并不均匀，并且与社区及其行政区内人口的地域和社会经济隔离相关，在人口特征、生活条件和疾病治疗公共服务方面存在很大差异，尤其是当我们考虑市郊与市中心之间的关系时。这揭示了发展的不平等，在研究区域产生了健康不平等。考虑到这一点，我们强调在确定为最脆弱的地区扩大这些服务的紧迫性，以期为该疾病提供平等的医疗服务。
