目的:分析巴西脑膜炎的时空流行病学动态,2010年至2019年。
方法:在国家应报告疾病信息系统(SistemadeInformaçisdeAgravosdeNotificação-SINAN)中对巴西脑膜炎(2010-2019年)的病例和死亡进行描述性生态学研究。进行了以下分析:(I)病例和死亡的频率分析,患病率,死亡率,杀伤力,费希尔的精确检验,和卡方检验;(II)Prais-Winstein回归;(III)全球,本地Moran\'s索引,和内核密度。
结果:巴西报告了182,126例脑膜炎,其中16866人(9.26%)死亡,患病率为9.03/10万居民,0.84/100,000居民的死亡率,杀伤力为9.26%。有明显的患病率下降趋势(-9.5%,95%置信区间-95CI-13.92;-4.96,p<0.01)和死亡率(-11.74%,95CI-13.92;-9.48,p<0.01),而致死率保持稳定(-2.08%,95CI-4.9;0.8;p<0.1941)。大多数病例为病毒性脑膜炎(45.7%),1-9岁(32.2%),虽然死亡比例最高的是细菌性脑膜炎(68%),40-59岁(26.3%)。在患病率和死亡率的Moran和Kernel图中,南方的城市,东南,东北部的伯南布哥州首府以很高的比率脱颖而出;至于杀伤力,北方,东北,重点介绍了东南沿海地区。
结论:在这项研究中发现脑膜炎病例和死亡人数有所减少;然而,在患病率较低的地区,致死率较高,强调需要加强识别行动,监测,并为病例提供医疗保健,扩大疫苗接种覆盖面。
OBJECTIVE: To analyze the spatiotemporal epidemiological dynamics of
meningitis in Brazil, between 2010 and 2019.
METHODS: Descriptive ecological study with cases and deaths due to
meningitis in Brazil (2010-2019) in the National Notifiable Diseases Information System (Sistema de Informações de Agravos de Notificação - SINAN). The following analyses were performed: (I) frequency analyses of cases and deaths, prevalence rates, mortality, lethality, Fisher\'s exact test, and chi-square test; (II) Prais-Winstein regression; and (III) Global, Local Moran\'s index, and Kernel density.
RESULTS: 182,126 cases of
meningitis were reported in Brazil, of which 16,866 (9.26%) resulted in death, with prevalence rates of 9.03/100,000 inhabitants, mortality of 0.84/100,000 inhabitants, and lethality of 9.26%. There was a noted trend of decreasing prevalence rates (-9.5%, 95% confidence interval - 95%CI -13.92; -4.96, p<0.01) and mortality (-11.74%, 95%CI -13.92; -9.48, p<0.01), while lethality remained stable (-2.08%, 95%CI -4.9; 0.8; p<0.1941). The majority of cases were viral meningitis (45.7%), among 1-9 years old (32.2%), while the highest proportion of deaths was due to bacterial
meningitis (68%), among 40-59 years old (26.3%). In the Moran and Kernel maps of prevalence and mortality rates, municipalities in the South, Southeast, and the capital of Pernambuco in the Northeast stood out with high rates; as for lethality, the North, Northeast, and Southeast coastal areas were highlighted.
CONCLUSIONS: A decrease in
meningitis cases and deaths was found in this study; however, the lethality rate was higher in areas with lower prevalence, emphasizing the need to enhance actions for identifying, monitoring, and providing health care for cases, as well as expanding vaccination coverage.