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Revista Costarricense de Salud Pública
versão impressa ISSN 1409-1429
Resumo
ALVARADO-PRADO, Rebeca e NIETO LOPEZ, Emmanuel. Socioeconomic and environmental factors associated with the incidence of dengue: an ecological study in Costa Rica, 2016. Rev. costarric. salud pública [online]. 2019, vol.28, n.2, pp.227-238. ISSN 1409-1429.
Introduction:
Dengue continues to be a public health problem present in tropical and subtropical regions. This study sought to identify the magnitude of the effect of some of the proximal determinants of social and environmental nature associated to the rate of dengue incidence in Costa Rica during 2016.
Methodology:
This was an ecological study, taking as dependent variable the rate of dengue incidence for 2016. The independent variables were the socioeconomic and environmental factors documented in the most-recent national population census conducted in 2011. The analysis units were the cantons. A spatial analysis was performed through the global and local Moran index, additionally including a simple and multivariate Poisson regression statistical analysis.
Principal results:
The Central Pacific concentrated the highest incidence and rate ratio of dengue for 2016 adjusted for gender and age. The risk factors impacting upon this health event were the concentration of income measured with the Gini coefficient and poverty according to Unsatisfied Basic Needs; as protective factors, higher levels of schooling and collection practices of solid wastes and recycling were identified.
Conclusions:
This research evidences that dengue and possibly other arboviruses, like Chikungunya and Zika, do not solely depend on the good management of public policy; rather, an intervention is necessary on the social determinants that influence directly on the behavior of these diseases.
Palavras-chave : Dengue; Social Determinants of Health; Costa Rica; Epidemiology..