The role of inter-regional flows in the spread of epidemics in a city of regional influence with a tropical climate

https://doi.org/10.18294/sc.2018.1206

Published 11 April 2018 Open Access


Maria Aparecida de Oliveira Post-doctoral Fellow. Departamento de Saúde Ambiental, Faculdade de Saúde Pública, Universidade de São Paulo, Brazil image/svg+xml , Marta Inenami Epidemiological Surveillance Nurse. Serviço Especial de Saúde de Araraquara, Faculdade de Saúde Pública, Universidade de São Paulo, Brazil. image/svg+xml , Rosangela Maria Gasparetto da Silva Epidemiological Surveillance Nurse. Serviço Especial de Saúde de Araraquara, Faculdade de Saúde Pública, Universidade de São Paulo, Brazil. image/svg+xml , Carlos Castillo-Salgado Professor. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Maryland, USA , Helena Ribeiro Full Professor. Departamento de Saúde Ambiental, Faculdade de Saúde Pública, Universidade de São Paulo, Brazil. image/svg+xml



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Keywords:

Dengue, Spatial Analysis, Geographic Information Systems, Epidemiological Surveillance, Brazil

Abstract


The aim of this research was to investigate the origin of imported cases of dengue in the city of Araraquara, Brazil and to describe the disease’s main epidemiological characteristics. The study encompassed all confirmed cases of dengue recorded in the Information System for Notifiable Diseases (SINAN) [Sistema de Informação de Agravos de Notificação] from 1998 to 2013. Cases whose origin of infection was likely located outside Araraquara were considered imported. The epidemiological study entailed a descriptive analysis of the data, regarding the distribution of cases by gender, age, and classification of imported and autochthonous cases. A geographic information system was used to map flows and estimate distances. There were 6,913 confirmed cases, 419 of which were imported. In most cases, the origin of infection was located in the state of São Paulo as well as other Brazilian regions. The results indicate the relevance of imported cases and differences in the epidemiological profile with respect to age and sex. Conclusions indicate the need to increase epidemiological and environmental health surveillance at ports, airports, truck stops, and bus and train terminals.


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