Geography and public health: analysis of the epidemiological dynamics of meningitis in Brazil, between 2010 and 2019

Silva, Luis Roberto da; Arruda, Laís Eduarda Silva de; Barreto, Isabel de Jesus Brandão; Aragão, João Victor Rodrigues de; Silva, Maria Luiza Ferreira Imburana da; Lira, Guilherme; Teixeira, Camila Maria Barros; Oliveira, Emília Carolle Azevedo de

doi:10.1590/1980-549720240031

Luis Roberto da Silva CORRESPONDING AUTHOR: Luis Roberto da Silva, Caixa Postal 90, Passira (PE), Brasil. E-mail: robertosiilva059@gmail.com

Data curation

Writing – original draft

Writing – review & editing

Methodology

Validation

Visualization

School of Medicine of Universidade de São Paulo, Postgraduate Program in Public Health – São Paulo (SP), Brazil.

https://orcid.org/0000-0002-6194-7615

Laís Eduarda Silva de Arruda

Data curation

Writing – original draft

Writing – review & editing

Methodology

Visualization

Fundação Oswaldo Cruz, Instituto Aggeu Magalhães, Multiprofessional Residency Program in Public Health – Recife (PE), Brazil.

https://orcid.org/0000-0002-5023-5460

Isabel de Jesus Brandão Barreto

Data curation

Writing – original draft

Writing – review & editing

Methodology

Visualization

Universidade Federal de Pernambuco, Academic Center of Vitória, Multiprofessional Residency Program for Internalization of Health Care – Vitória de Santo Antão (PE), Brazil.

https://orcid.org/0000-0002-7965-0860

João Victor Rodrigues de Aragão

Data curation

Writing – original draft

Writing – review & editing

Methodology

Visualization

Centro Universitário Uninovafapi – Teresina (PI), Brazil.

https://orcid.org/0000-0002-9219-5081

Maria Luiza Ferreira Imburana da Silva

Data curation

Writing – original draft

Writing – review & editing

Methodology

Visualization

Recife Health Secretariat, Multiprofessional Residency Program in Health Surveillance – Recife (PE), Brazil.

https://orcid.org/0000-0003-3131-6166

Guilherme Lira

Data curation

Writing – original draft

Writing – review & editing

Methodology

Visualization

Universidade Federal de Pernambuco, Technology and Geosciences Center – Recife (PE), Brazil.

https://orcid.org/0000-0002-5433-946X

Camila Maria Barros Teixeira

Data curation

Writing – original draft

Writing – review & editing

Methodology

Visualization

Universidade Federal de Pernambuco, Technology and Geosciences Center – Recife (PE), Brazil.

https://orcid.org/0000-0002-5630-4180

Emília Carolle Azevedo de Oliveira

Formal analysis

Data curation

Writing – review & editing

Methodology

Validation

Visualization

Supervision

Fundação Oswaldo Cruz, Instituto Aggeu Magalhães – Recife (PE), Brazil.

https://orcid.org/0000-0002-0957-1542

CORRESPONDING AUTHOR: Luis Roberto da Silva, Caixa Postal 90, Passira (PE), Brasil. E-mail: robertosiilva059@gmail.com

CONFLICT OF INTERESTS: nothing o declare

Characteristics		Cases		Deaths		p-value
		n	%	n	%
		182,126	100	16,866	100
Gender
	Male	107,671	59.12	9,905	58.73	0.5677^* * Fisher's exact test;
	Female	74,429	40.87	6,959	41.26
	Ignored	26	0.01	2	0.01
Age range (years)
	<1	27,117	14.89	1,912	11.34	<0.01^† † χ2 test;
	1 to 9	58,608	32.18	2,214	13.13
	10 to 19	23,172	12.72	1,652	9.79
	20 to 39	35,309	19.39	3,860	22.89
	40 to 59	25,412	13.95	4,442	26.34
	60 and more	12,340	6.78	2,769	16.42
	Ignored/blank	168	0.09	17	0.10
Race/color
	White	82,274	45.17	6,605	39.16	<0.01^† † χ2 test;
	Black	7,447	4.09	1,150	6.82
	Brown	53,862	29.57	6,089	36.10
	Yellow	895	0.49	94	0.56
	Indigenous	531	0.29	92	0.55
	Ignored/blank	37,117	20.38	2,836	16.81
Confirmation criteria
	Culture	23,334	12.81	4,917	29.15	<0.01^† † χ2 test;
	IEC	492	0.27	130	0.77
	Latex agglutination	6,597	3.62	1,469	8.71
	Clinical	17,655	9.69	3,112	18.45
	Bacterioscopy	4,554	2.50	649	3.85
	Chemocytological	111,076	60.99	3,623	21.48
	Clinical-epidemiological	2,957	1.62	264	1.57
	Viral isolation	416	0.23	11	0.07
	PCR — viral	10,723	5.89	1,720	10.20
	Other technique	3,878	2.13	877	5.20
	Ignored/blank	444	0.24	94	0.56
		n	%	n	%
		182,055 ^‡ ‡ The online database showed a divergence in the total number of cases and deaths, when the data for the "etiology" variable were tabulated.	100%	16,861 ^‡ ‡ The online database showed a divergence in the total number of cases and deaths, when the data for the "etiology" variable were tabulated.	100%
Etiology
	Meningococcemia	5,202	2.86	1,903	11.28	<0.01^† † χ2 test;
	Meningococcal meningitis	7,194	3.95	889	5.27
	Meningococcal meningitis + Meningococcemia	5,426	2.98	1,031	6.11
	Tuberculous meningitis	3,665	2.01	661	3.92
	Bacterial meningitis	28,516	15.66	3,735	22.15
	Unspecified meningitis	28,895	15.87	2,824	16.74
	Viral meningitis	83,218	45.69	1,057	6.27
	Meningitis due to other etiologies	7,541	4.14	1,461	8.66
	Hemophilus meningitis	1,308	0.72	211	1.25
	S. pneumoniae meningitis	10,481	5.75	3,035	17.99
	Ignored/blank	609	0.33	54	0.32
		n	%
		182,126	100%
Evolution
	High	144,554	79.37	-	-
	Death from meningitis	16,866	9.26	-	-
	Death from another cause	6,853	3.76	-	-
	Ignored/blank	13,853	7.61	-	-	-
		n	%	n	%
		182,126	100%	16,866	100%
Pregnant
	1^st trimester	185	0.10	24	0.14	<0.01^† † χ2 test;
	2^nd trimester	312	0.17	32	0.19
	3^rd trimester	175	0.10	26	0.15
	Gestational age unknown	90	0.05	8	0.05
	No	25,744	14.14	3,327	19.73
	Not applicable	150,527	82.65	12,771	75.72
	Ignored/blank	5,093	2.80	678	4.02

Rates		Rates		APC^* * Prais-Winsten regression.	95%CI^* * Prais-Winsten regression.	p-value	Trend
Rates		2010	2019	APC^* * Prais-Winsten regression.	95%CI^* * Prais-Winsten regression.	p-value	Trend
Prevalence
	Viral meningitis	4.36	3.68	-5.5	-5.26; −5.66	0.077	Stationary
	Bacterial meningitis	4.11	2.27	-14.2	-14.03; −14.35	< 0.01	Decreasing
	Other types of meningitis	2.25	1.50	-10.5	-10.31; −10.77	< 0.01	Decreasing
	Ignored/blank	0.04	0.01	-31.2	-29.42; −32.9	0.126	Stationary
	Total	10.76	7.46	-9.5	-9.36; −9.72	< 0.01	Decreasing
Mortality
	Viral meningitis	0.06	0.05	-1.1	-0.78; −1.42	0.654	Stationary
	Bacterial meningitis	0.76	0.42	-14.4	-14.18; −14.52	< 0.01	Decreasing
	Other types of meningitis	0.24	0.18	-5.9	-5.82; −6.02	< 0.01	Decreasing
	Ignored/blank	0.01	0.01	–	–	–	–
	Total	1.07	0.65	-11.8	-11.65; −11.87	< 0.01	Decreasing
Lethality
	Viral meningitis	1.26	1.38	8.0	8.41; 7.49	0.122	Stationary
	Bacterial meningitis	18.56	18.38	-0.3	-0.28; −0.4	0.507	Stationary
	Other types of meningitis	10.89	11.93	3.6	3.87; 3.37	0.328	Stationary
	Ignored/blank	13.92	35.48	27.3	29.71; 24.91	0.348	Stationary
	Total	9.93	8.73	-2.1	-1.97; −2.23	0.194	Stationary

[1] CORRESPONDING AUTHOR: Luis Roberto da Silva, Caixa Postal 90, Passira (PE), Brasil. E-mail: robertosiilva059@gmail.com

Brasil

Brasil

Geography and public health: analysis of the epidemiological dynamics of meningitis in Brazil, between 2010 and 2019

ABSTRACT

Objective:

Methods:

Results:

Conclusion: