Temporal and spatial analysis of municipal dengue cases in Paraná and social and environmental indicators, 2012 to 2021: ecological study

Abstract

Objective: Analyze the temporal trend and spatial distribution of the incidence rate of dengue cases in Paraná and its regions between 2012 to 2021 and investigate associated sociodemographic and environmental variables. Methods: Ecological study with temporal and spatial analysis of the dengue incidence rate reported in the Disease and Notification Information System (SINAN) in the period 2012 to 2021 and investigation of sociodemographic and environmental variables. To identify differences between municipal incidence rates the Mann-Whitney and Kruskal-Wallis test followed by Dunn’s test for multiple comparisons were used. Prais-Winsten regression was used for temporal trend analysis and for spatial analysis the univariate and bivariate Local Moran analysis were applied. Results: 548,683 cases of dengue were confirmed in the period, the highest state incidence rate was observed in 2020, with 15 health regions presenting more than 500 cases/100,000 inhabitants. Higher incidences were observed among women, age group of 20-59 years and white color/race. Despite annual variations, a stationary trend was observed for incidence rates according to sex, age group, color/race and macro-region. More than half of the municipalities in Paraná formed spatial clusters (Moran’s I=0.679), where 73 (18.3%) municipalities with high incidence rate formed clusters. High-High clusters of dengue incidence rate with urbanization and High-Low clusters of incidence rate with vegetation cover were observed. Conclusion: Sociodemographic and environmental determinants were related to the high incidence rates of dengue and heterogeneous spatial distribution in the state of Paraná, indicating the need to strengthen health surveillance actions.