ABSTRACT
Objective:
To examine spatiotemporal variability and identify clustering patterns of hospitalization rates for diarrhea in children younger than five years in Mato Grosso, Brazil, from 2011 to 2020.
Methods:
An ecological study was conducted using hospitalization records associated with diarrhea from the Brazilian Hospital Information System/Unified Health System. The relative risk of hospitalization for diarrhea in each municipality was calculated using SaTScan software considering a statistical significance level of 5% and 999 Monte Carlo replications.
Results:
A total of 13,315 diarrhea-associated hospitalizations for 5-year-old children were recorded. From 2011 to 2020, the annual rates for hospitalizations related to diarrhea decreased from 8.50 to 3.45/1,000 live births among children younger than one year and from 4.99 to 1.57 for children aged 1–4 years. Clusters of municipalities with high relative risk for hospitalizations due to diarrhea, statistically significant, predominated in the North, Northeast, and Southwest health administrative macro-regions of Mato Grosso for both age groups until 2016. From 2016 to 2020, clusters of the lowest relative risk were identified in the North and Center South health administrative macro-regions for children younger than five years.
Conclusion:
Results showed that hospitalization rates for diarrhea in children younger than five years reduced with the presence of low-risk clusters in Mato Grosso in the final years of the study. Public health surveillance should incorporate spatial analysis to investigate the diarrhea-related morbidity.
Keywords:
Diarrhea; Child health; Spatial analysis; Epidemiological monitoring; Morbidity
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(a) Brazil in the South American region. (b) Mato Grosso state in Brazil. (c) The five-health administrative macro-regions (HAMs) of the state of Mato Grosso and respective Human Development Index (HDI) in 2010, using a scale of blue, where darker blue levels represent very low HDI, while light blue represents a high HDI. State’s capital; NT (North), NE (Northeast), SW (Southwest), SC (South Center), SE (Southeast). Light gray lines delimit the municipalities; red lines indicate main highways; black lines establish the HAMs of the state of Mato Grosso. HDI: very low 0–0.499; low 0.500–0.599; medium 0.600–0.699; high 0.700–0.799; very high 0.800–1.000.
Light gray lines delimit the municipalities; red lines indicate main highways; and black lines establish the health administrative macro-regions of the state of Mato Grosso.
Picture a: Orange color indicates the primary cluster (RR=4.67); blue indicates the first secondary cluster (RR=0.22); and yellow indicates the second secondary cluster (RR=4.31). Picture b: Blue color indicates the primary cluster (RR=0.17); orange indicates the first secondary cluster (RR=4.33); and yellow indicates the second secondary cluster (RR=2.86).State’s capital; NT (North), NE (Northeast), SW (Southwest), SC (South Center), and SE (Southeast). Light gray lines delimit the municipalities; red lines indicate the main highways; and black lines establish the health administrative macro-regions of the state of Mato Grosso.