Dengue incidence, mortality, and case-fatality in Brazil: spatial patterns, socioeconomic contrasts, and serotype impact
File(s)
Published version
Author(s)
Moralejo Bermudi, Patricia Marques
Sanches Palasio, Raquel Gardini
Pirani, Monica
Reis Santana, Lidia Maria
Barbosa, Gerson Laurindo
Type
Journal Article
Abstract
Background
Despite its burden, dengue remains neglected, with few studies comparing its incidence, mortality, case-fatality, and key variables such as socioeconomic factors, healthcare access, and serotype distribution.
Methods
This ecological study analyzed dengue cases and deaths (2014–2024) in intermediate regions of Brazil. Covariates included illiteracy rate, hospital bed availability, serotype distribution, and private healthcare coverage. High- and low-risk spatial clusters were identified using the SaTScan Poisson model. Statistical analysis assessed significant covariate differences between risk groups.
Results
High-incidence clusters were found in areas with lower illiteracy rates, whereas high-case fatality clusters were found in areas with higher illiteracy rates. DENV-2 was associated with high-risk case-fatality areas; in contrast, DENV-1 showed the opposite pattern, appearing to be more common but associated with lower severity.
Conclusions
These findings provide a basis for generating hypotheses for future modeling studies on these associations.
Despite its burden, dengue remains neglected, with few studies comparing its incidence, mortality, case-fatality, and key variables such as socioeconomic factors, healthcare access, and serotype distribution.
Methods
This ecological study analyzed dengue cases and deaths (2014–2024) in intermediate regions of Brazil. Covariates included illiteracy rate, hospital bed availability, serotype distribution, and private healthcare coverage. High- and low-risk spatial clusters were identified using the SaTScan Poisson model. Statistical analysis assessed significant covariate differences between risk groups.
Results
High-incidence clusters were found in areas with lower illiteracy rates, whereas high-case fatality clusters were found in areas with higher illiteracy rates. DENV-2 was associated with high-risk case-fatality areas; in contrast, DENV-1 showed the opposite pattern, appearing to be more common but associated with lower severity.
Conclusions
These findings provide a basis for generating hypotheses for future modeling studies on these associations.
Date Issued
2025-11-12
Date Acceptance
2025-11-05
Citation
Travel Medicine and Infectious Disease, 2025, 68
ISSN
1477-8939
Publisher
Elsevier BV
Journal / Book Title
Travel Medicine and Infectious Disease
Volume
68
Copyright Statement
© 2025 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
License URL
Identifier
10.1016/j.tmaid.2025.102934
Publication Status
Published
Article Number
102934
Date Publish Online
2025-11-06