Coronavirus disease and basic sanitation: too early to be worried?

Silva, Renata Rocha da; Santos, Márcio Bezerra dos; Santos, Allan Dantas dos; Tavares, Débora dos Santos; Santos, Priscila Lima dos

doi:10.1590/0037-8682-0345-2020

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Revista da Sociedade Brasileira de Medicina Tropical

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Short Communication • Rev. Soc. Bras. Med. Trop. 53 • 2020 • https://doi.org/10.1590/0037-8682-0345-2020 copy

Coronavirus disease and basic sanitation: too early to be worried?

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

INTRODUCTION:

Considering that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been detected in feces, this study aimed to verify a possible relationship between basic sanitation indices and coronavirus disease (COVID-19) numbers/rates.

METHODS:

Data of COVID-19 cases registered in Brazil until May 28, 2020, and independent variables associated with basic sanitation were analyzed.

RESULTS:

A significant correlation between the number of cases and sewage treatment index/population density was observed. In addition, COVID-19 incidence and mortality rates were significantly associated with the total water service index and lethality rate was significantly associated with the sewage treatment index.

CONCLUSIONS:

Precarious basic sanitation infrastructure may potentially increase the SARS-CoV-2 transmission in Brazil.

Keywords:
SARS-CoV-2; COVID-19; Water service supply; Sewage collection; Sewage treatment

Federated Unit	Cases	Deaths	Incidence	Mortality	Lethality	Total water service	Sewage collection	Sewage treatment	Population density
	(n)	(n)	rate	rate	(%)	index [2018]	index [2018]	index [2018]	[2010]
São Paulo	95865	6980	208,8	15,2	7,28	96.19	80.72	80.34	166.23
Rio de Janeiro	44886	4856	260	28,1	10,82	90.46	50.01	60.08	365.23
Ceará	37821	2733	414,2	29,9	7,23	58.96	40.34	90.52	56.76
Amazonas	36146	1964	872,1	47,4	5,43	81.14	30.36	97.35	2.23
Pará	33699	2704	391,7	31,4	8,02	45.62	18.36	43.70	6.07
Pernambuco	30713	2566	321,4	26,8	8,35	80.52	31.54	75.64	89.62
Maranhão	27979	887	395,5	12,5	3,17	56.39	30.45	42.81	19.81
Bahia	15963	570	107,3	3,8	3,57	81.62	57.29	86.80	24.82
Espírito Santo	12203	538	303,7	13,4	4,41	81.24	58.57	74.24	76.25
Paraíba	11132	318	277	7,9	2,86	74.27	48.30	88.07	66.7
Minas Gerais	8686	255	41	1,2	2,94	82.09	65.19	42.42	33.41
Distrito Federal	8300	142	275,3	4,7	1,71	99.00	85.36	100.00	444.66
Rio Grande do Sul	8.234	213	72,4	1,9	2,59	86.40	29.27	82.52	37.96
Amapá	8152	198	963,9	23,4	2,43	34.91	15.62	95.02	4.69
Alagoas	8055	385	241,4	11,5	4,78	74.62	17.86	81.57	112.33
Santa Catarina	8.000	131	111,7	1,8	1,64	89.07	28.15	98.39	65.27
Sergipe	6156	135	267,8	5,9	2,19	86.86	31.98	91.39	94.36
Rio Grande do Norte	5630	254	160,5	7,2	4,51	87.09	32.35	96.10	59.99
Acre	5600	122	635	13,8	2,18	47.07	18.78	99.98	4.47
Rondônia	4252	142	329,2	8	3,34	49.41	12.23	77.83	6.58
Piauí	4243	138	129,6	4,2	3,25	75.89	13.92	94.56	12.4
Paraná	3.984	168	34,8	1,5	4,22	94.39	73.48	99.62	52.4
Tocantins	3277	68	208,3	4,3	2,08	79.34	33.91	98.28	4.98
Goiás	3090	115	44	1,6	3,72	85.55	55.66	88.93	17.65
Roraima	2959	102	488,5	16,8	3,45	81.47	70.17	97.28	2.01
Mato Grosso	1951	51	56	1,5	2,61	89.29	42.04	87.56	3.36
Mato Grosso do Sul	1262	18	45,4	0,6	1,43	86.36	43.83	99.84	6.86

Variables	Spearman’s coefficient	p-value
Number of cases
Total water service index	-0,1007	0,6171
Sewage collection index	0,0635	0,7530
Sewage treatment index	-0,5269	0,0047
Population density	0,4542	0,0173
Number of deaths
Total water service index	-0,1298	0,5189
Sewage collection index	0,0427	0,8324
Sewage treatment index	-0,6118	0,0007
Population density	0,4497	0,0186
Incidence/100000 inhabitants
Total water service index	-0,6319	0,0004
Sewage collection index	-0,3516	0,0721
Sewage treatment index	-0,0232	0,9086
Population density	-0,2033	0,3091
Mortality/100000 inhabitants
Total water service index	-0,4641	0,0148
Sewage collection index	-0,2403	0,2274
Sewage treatment index	-0,2351	0,2379
Population density	0,0064	0,9747
Lethality (%)
Total water service index	-0,0656	0,7449
Sewage collection index	-0,0794	0,6938
Sewage treatment index	-0,5284	0,0046
Population density	0,2355	0,2370

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[1] Corresponding author: Priscila Lima dos Santos. e-mail:plimabio@gmail.com