Spatial and temporal patterns and factors associated with mortality from Chagas' disease: an ecological study, Ceará,...

To describe the temporal and spatial pattern of mortality from Chagas' disease in Ceará in the period 2002-2022.

This is an ecological study, which considered Ceará, its health macro-regions and municipalities as the units of analysis, based on secondary data from the Mortality Information System. Temporal analysis was performed to calculate the annual percentage variation, as well as the spatial autocorrelation indicators (global and local Moran index, Getis-Ord Gi* and scanning). The indicators were inserted into non-spatial and spatial regression models.

1,041 deaths were reported, with an average mortality rate of 0.57 deaths/100,000 inhabitants. Cariri (35.45%) and Litoral Leste (the East Coast) (23.05%) stood out in notifications, while the Litoral Norte (North Coast) region had a higher mortality rate (2.15/100 thousand inhabitants). There was a significant increase in mortality rates from the disease on the Litoral Leste and in the Sertão Central (Central Hinterlands). High coefficients were observed for the Gini indices (9.6; p-value<0.001) and municipal human development (17.1; p-value<0.001), which suggested that areas with greater income inequality and lower human development indices are impacted to a greater extent by mortality from Chagas' disease. Areas of high mortality tend to be close to other areas with high mortality rates.

Areas of greater risk were identified, especially in the Litoral Leste and Sertão Central macro-regions, while other regions showed stability throughout the period. Spatial models pointed to influence from factors such as income inequality and human development.