巴西亚马孙地区东部帕拉州登革热的时空动态及社会环境决定因素

Spatiotemporal Dynamics of Dengue in the State of Pará and the Socio-Environmental Determinants in Eastern Brazilian Amazon.

作者信息

da Silva Brenda Caroline Sampaio, Guimarães Ricardo José de Paula Souza E, Godoy Bruno Spacek, Parente Andressa Tavares, de Moraes Bergson Cavalcanti, Pimentel Marcia Aparecida da Silva, Ferreira Douglas Batista da Silva, Serra Emilene Monteiro Furtado, Silva Junior João de Athaydes, Dos Anjos Luciano Jorge Serejo, de Souza Everaldo Barreiros

机构信息

Programa de Pos-Graduação em Ciências Ambientais (PPGCA), Instituto de Geociências, Universidade Federal do Pará, Belém 66075-110, PA, Brazil.

Laboratório de Geoprocessamento, Instituto Evandro Chagas, Ananindeua 67030-000, PA, Brazil.

出版信息

Infect Dis Rep. 2025 Aug 11;17(4):99. doi: 10.3390/idr17040099.

DOI:10.3390/idr17040099

PMID:40863261

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12386659/

Abstract

BACKGROUND

The Amazon biome exhibits complex arboviral transmission dynamics influenced by accelerating deforestation, climate change, and socioeconomic inequities.

OBJECTIVES/METHODS: This study integrates official epidemiological records with socioeconomic, environmental, and climate variables by applying advanced geostatistical methods (Moran's I, SaTScan, kernel density estimation) combined with principal component analysis and negative binomial regression to assess the spatiotemporal dynamics of dengue incidence and its association with socio-environmental determinants across municipalities in Pará state (eastern Brazilian Amazon) from 2010 to 2024.

RESULTS

Dengue incidence showed an overall decline but with marked epidemic peaks in 2010-2012, 2016, and 2024. The spatial analysis revealed significant clustering (Moran's I = 0.221, < 0.01), with persistent high-risk hotspots across most of Pará. Of 144 municipalities, 104 exhibited significant dengue risk, while 58 maintained sustained transmission. Negative binomial regression model identified key determinants: illiteracy, low urbanization, reduced GDP, and climate variables.

CONCLUSIONS

Dengue transmission in the Amazon is driven by synergistic socio-environmental disruptions, necessitating intersectoral policies that bridge public health surveillance, sustainable land-use governance, and poverty alleviation. Priority actions include targeted vector control in high-risk clusters, coupled with integrated deforestation and climate monitoring to predict outbreak risks. The findings emphasize the urgency of implementing multisectoral interventions tailored to the territorial and socio-environmental complexities of vulnerable Amazonian regions for effective dengue control.

摘要

背景

亚马逊生物群落呈现出复杂的虫媒病毒传播动态，受到森林砍伐加速、气候变化和社会经济不平等的影响。

目的/方法：本研究通过应用先进的地理统计方法（莫兰指数I、时空扫描统计法、核密度估计），结合主成分分析和负二项回归，将官方流行病学记录与社会经济、环境和气候变量整合起来，以评估2010年至2024年巴西亚马逊州东部帕拉州各城市登革热发病率的时空动态及其与社会环境决定因素的关联。

结果

登革热发病率总体呈下降趋势，但在2010 - 2012年、2016年和2024年出现明显的流行高峰。空间分析显示存在显著的聚集性（莫兰指数I = 0.221，<0.01），帕拉州大部分地区存在持续的高风险热点地区。在144个城市中，104个城市呈现出显著的登革热风险，58个城市维持着持续传播。负二项回归模型确定了关键决定因素：文盲率、低城市化水平、GDP下降和气候变量。

结论

亚马逊地区的登革热传播是由社会环境协同破坏驱动的，需要跨部门政策来衔接公共卫生监测、可持续土地利用治理和扶贫工作。优先行动包括在高风险聚集区进行有针对性的病媒控制，同时结合森林砍伐和气候综合监测以预测疫情风险。研究结果强调了针对脆弱的亚马逊地区的地域和社会环境复杂性实施多部门干预措施以有效控制登革热的紧迫性。