Social epidemiology of a large outbreak of chickenpox in the Colombian sugar cane producer region: a set theory-based analysis

Epidemiología social de una gran epidemia de varicela en la región colombiana productora de caña de azúcar: un análisis basado en teoría de conjuntos

Alvaro J. Idrovo Cidronio Albavera-Hernández Jorge Martín Rodríguez-Hernández About the authors

There are few social epidemiologic studies on chickenpox outbreaks, although previous findings suggested the important role of social determinants. This study describes the context of a large outbreak of chickenpox in the Cauca Valley region, Colombia (2003 to 2007), with an emphasis on macro-determinants. We explored the temporal trends in chickenpox incidence in 42 municipalities to identify the places with higher occurrences. We analyzed municipal characteristics (education quality, vaccination coverage, performance of health care services, violence-related immigration, and area size of planted sugar cane) through analyses based on set theory. Edwards-Venn diagrams were used to present the main findings. The results indicated that three municipalities had higher incidences and that poor quality education was the attribute most prone to a higher incidence. Potential use of set theory for exploratory outbreak analyses is discussed. It is a tool potentially useful to contrast units when only small sample sizes are available.

Chickenpox; Disease Outbreaks; Delivery of Health Care

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