Population mobility, demographic, and environmental characteristics of dengue fever epidemics in a major city in Southeastern Brazil, 2007-2015

Johansen, Igor Cavallini; Castro, Marcia Caldas de; Alves, Luciana Correia; Carmo, Roberto Luiz do

doi:10.1590/0102-311X00079620

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ARTIGO • Cad. Saúde Pública 37 (4) • 2021 • https://doi.org/10.1590/0102-311X00079620 linkcopy

Population mobility, demographic, and environmental characteristics of dengue fever epidemics in a major city in Southeastern Brazil, 2007-2015

Mobilidade populacional e características demográficas e ambientais das epidemias de dengue em uma metrópole no Sudeste do Brasil, 2007-2015

Movilidad de la población y características demográficas y ambientales de la epidemia de dengue en una gran ciudad del sudeste de Brasil, 2007-2015

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstracts

Around 14% of world dengue virus (DENV) cases occur in the Americas, most of them in Brazil. While socioeconomic, environmental, and behavioral correlates have been analyzed thoroughly, the role played by population mobility on DENV epidemics, especially at the local level, remains scarce. This study assesses whether the daily pattern of population mobility is associated with DENV incidence in Campinas, a Brazilian major city with over 1.2 million inhabitants in São Paulo State. DENV notifications from 2007 to 2015 were geocoded at street level (n = 114,884) and combined with sociodemographic and environmental data from the 2010 population census. Population mobility was extracted from the Origin-Destination Survey (ODS), carried out in 2011, and daily precipitation was obtained from satellite imagery. Multivariate zero-inflated negative binomial regression models were applied. High population mobility presented a relevant positive effect on higher risk for DENV incidence. High income and residence in apartments were found to be protective characteristics against the disease, while unpaved streets, number of strategic points (such as scrapyards and tire repair shops), and precipitation were consistently risk factors.

Keywords:
Dengue; Population Dynamics; Environment

Variables	Mean	SD	Range
Reported dengue cases by OD-week (outcome)
Count (number of cases)
2007	2.97	8.88	0-97
2008	0.77	0.33	0-6
2009	0.46	0.28	0-5
2010	0.61	2.16	0-43
2011	0.80	2.65	0-35
2012	0.15	0.60	0-11
2013	1.68	6.20	0-106
2014	10.74	33.91	0-481
2015	16.19	47.09	0-527
Rate (cases per 100,000)
2007	17.99	66.88	0.0-1,498.1
2008	0.60	7.80	0.0-3,74.5
2009	0.21	1.93	0.0-87.1
2010	3.79	16.58	0.0-374.5
2011	6.03	34.92	0.0-1,084.0
2012	0.91	8.20	0.0-374.5
2013	10.22	40.66	0.0-749.1
2014	63.22	164.66	0.0-2,264.8
2015	96.92	256.30	0.0-4,494.4
Climate (exposure)
Precipitation lagged eight weeks (sum in mm)
2007	27.31	33.53	0.0-188.1
2008	28.86	26.32	0.0-137.5
2009	26.09	26.31	0.0-109.4
2010	30.19	37.78	0.0-163.8
2011	28.91	36.62	0.0-208.9
2012	32.32	33.68	0.0-172.5
2013	32.09	31.58	0.0-120.5
2014	24.90	25.87	0.0-124.1
2015	28.09	26.25	0.0-108.7
Demographic (exposure)
Household income per capita (BRL)	1,347.13	850.18	397.4-4,031.8
Total population sex ratio (male/female per 100)	95.46	8.15	78.7-118.7
Population density (persons/km²)	3,260.38	2,878.71	15.1-13,180.3
Environmental (exposure)
Number of SP	9.8	13.6	0-65
Residence in apartments (%)	18.94	22.46	0.0-95.0
Households in unpaved streets (%)	7.21	11.34	0.0-59.8
Households with open sewage (%)	3.82	8.1	0.0-38.4

Variables and description	Value	Observations (%)	Total
Scale (exposure)
High week *	0 = No 1 = Yes	22,176 (71.6) 8,778 (28.4)	30,954
High area **	0 = No 1 = Yes	30,317 (97.9) 637 (2.1)	30,954
Mobility (exposure)
High mobility ***	0 = No 1 = Yes	15,477 (50.0) 15,477 (50.0)	30,954

Parameter	Model 1 (n = 30,954)		Model 2 (n = 8,778)		Model 3 (n = 22,176)		Model 4 (n = 637)		Model 5 (n = 30,317)
Parameter	IRR	95%CI	IRR	95%CI	IRR	95%CI	IRR	95%CI	IRR	95%CI
Climate
Precipitation	1.01 *	1.00-1.01	0.99	0.99-1.00	1.01 *	1.01-1.02	1.00	0.99-1.00	1.01 *	1.00-1.01
Demographic
Income	0.99 *	0.99-0.99	0.99 *	0.99-0.99	0.99	0.99-1.00	0.99 *	0.99-0.99	0.99 *	0.99-0.99
Sex ratio	0.94 *	0.94-0.95	0.93 *	0.92-0.93	0.98 **	0.96-0.99	0.91 *	0.91-0.92	0.96 *	0.95-0.97
Population density	1.00 *	1.00-1.00	1.00 *	1.00-1.00	1.00 *	1.00-1.00	1.00 *	1.00-1.00	1.00 *	1.00-1.00
High mobility	1.41 *	1.32-1.49	1.46 *	1.38-1.55	1.26 *	1.12-1.42	1.69 *	1.52-1.88	1.35 *	1.26-1.44
Environmental
SP	1.03 *	1.02-1.03	1.03 *	1.02-1.03	1.03 *	1.02-1.03	1.02 *	1.02-1.02	1.03 *	1.03-1.03
Apartment	0.98 *	0.98-0.99	0.98 *	0.98-0.98	0.99 *	0.98-0.99	0.99 *	0.99-0.99	0.98 *	0.98-0.99
Unpaved	1.01 *	1.01-1.01	1.02 *	1.01-1.02	0.99	0.99-1.01	1.03 *	1.03-1.04	1.00	0.99-1.01
Open sewage	1.01 *	1.01-1.02	1.01 *	1.00-1.01	1.02 *	1.00-1.03	0.98 *	0.97-0.99	1.02 *	1.01-1.02
Scale
High week	15.19 *	14.32-16.11					2.22 *	1.72-2.88	15.57 *	14.62-16.58
High area	3.01 *	2.67-3.41	3.10 *	2.85-3.38	8.14 *	3.57-18.56
Year (reference: 2015)
2007	0.21 *	0.19-0.23	0.29 *	0.27-0.33	0.16 *	0.13-0.19	0.29 *	0.21-0.41	0.20 *	0.18-0.22
2008	0.01 *	0.01-0.01	0.01 *	0.00-0.01	0.01 *	0.01-0.02	0.12	0.01-1.07	0.01 *	0.00-0.01
2009	0.00 *	0.00-0.00	0.00 *	0.00-0.00	0.00 *	0.00-0.01	1.00	-	0.00 *	0.00-0.00
2010	0.05 *	0.04-0.05	0.07 *	0.06-0.07	0.03 *	0.02-0.04	0.19 *	0.06-0.61	0.05 *	0.04-0.05
2011	0.05 *	0.05-0.06	0.07 *	0.06-0.08	0.04 *	0.03-0.05	0.26 *	0.16-0.45	0.05 *	0.04-0.05
2012	0.01 *	0.01-0.01	0.01 *	0.01-0.01	0.02 *	0.01-0.02	0.12	0.01-1.13	0.01 *	0.01-0.01
2013	0.11 *	0.10-0.12	0.15 *	0.14-0.17	0.09 *	0.08-0.18	0.24 *	0.17-0.35	0.11 *	0.09-0.19
2014	0.64 *	0.59-0.69	0.84 *	0.77-0.91	0.55 *	0.48-0.63	0.91	0.83-1.00	0.62 *	0.57-0.68

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[TFN1] SD: standard deviation; SP: strategic points.

[TFN2] Source: dengue - Information System on Diseases of Notification (SINAN); climate - Climate Hazards Group InfraRed Precipitation with Station data (CHIRPS); demographic (Household income per capita, Total population sex ratio, Population density) and environmental data (Residence in apartments, Households in unpaved streets, Households with open sewage) - population census, Brazilian Institute of Geography and Statistics (IBGE), 2010; Number of SP - Superintendence for Control of Endemic Diseases (SUCEN).