Microcephaly infant mortality in Brazil before zika outbreak
José Edgardo Dipierri, Lavinia Schuler-Faccini1, Valeria Fernanda Chapur
1Universidade Federal do Rio Grande do Sul. Departamento de Genética. Hospital de Clínicas de Porto Alegre.Serviço de Genética Médica do; Porto Alegre. Brasil. lavinia.faccini@ufrgs.br.
Introduction:
We present temporal and spatial variation of deaths from microcephaly in children under 1 year of age is analyzed at regional, state, and municipal level in the pre-Zika period in Brazil.
Materials And Methods:
Data on births and deaths of infants with microcephaly was obtained from DATASUS from 1996 to 2013. Infant mortality rate from microcephaly (IMR-M) was estimated at Region, Federative Unit (UF), and Municipality level. Secular trend (ST) and risk of death variation were estimated using a Poisson regression model. Satscan software was used to obtain a statistic spatial scan for the Poisson model.
Results:
IMR-M shows a non-significant negative ST in the Southeast, South and Central West Regions of Brazil. A greater IMR-M risk of death variation is found in the North and Northeast Regions. Most UFs in the Southeast, South and Central West Regions showed a negative ST, in contrast to what occurs in the UFs of the North and Northeast Regions showed a positive ST. Six high risk significant clusters were found: 3 in the North-Northeast and 3 in the South-SouthWest-Center-West.
Conclusions:
The North and Northeast Regions showed positive ST for IRM-M and higher death risk, which was not observed in the other regions. Cluster distribution for higher IMR-M and risk resembles the distribution of the microcephaly and Zika cases in the outbreak period.
Insights
Infant mortality from microcephaly in Brazil showed higher risk and positive trends in the North and Northeast regions pre-Zika. These patterns, including high-risk clusters, align with later Zika-related microcephaly cases.
Area of Science:
- Public Health
- Epidemiology
- Pediatrics
Background:
- Microcephaly poses a significant public health challenge, particularly in infants.
- Understanding the epidemiology of microcephaly-related mortality is crucial for public health preparedness.
Purpose of the Study:
- To analyze the temporal and spatial variations in infant mortality due to microcephaly in Brazil before the Zika virus outbreak.
- To identify regional disparities in microcephaly mortality trends and risk.
Main Methods:
- Utilized DATASUS data (1996-2013) to calculate infant mortality rate from microcephaly (IMR-M) at regional, state, and municipal levels.
- Employed Poisson regression for secular trend (ST) analysis and risk variation estimation.
- Applied Satscan software for spatial scan statistics to identify high-risk clusters.
Main Results:
- Infant mortality rate from microcephaly (IMR-M) exhibited a non-significant negative secular trend in the Southeast, South, and Central West regions.
- The North and Northeast regions demonstrated a greater risk variation and a positive secular trend for IMR-M.
- Six significant high-risk clusters were identified, with three in the North-Northeast and three in the South-SouthWest-Center-West areas.
Conclusions:
- The North and Northeast regions displayed higher mortality risk and positive trends for IMR-M, contrasting with other regions.
- The spatial distribution of high IMR-M risk clusters mirrored patterns observed during the Zika virus outbreak period.
- Findings highlight pre-existing regional vulnerabilities to microcephaly mortality in Brazil.
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