A correspondência entre o Aedes aegypti, adoecimento e internações pela dengue conforme os atributos espaciais do ambiente urbano

Abstract

The dengue is a urban diseases that come in worrying sanitary authorities in many sides of the world, especially on the tropical regions, such as Brazil. Despite Brazilian society come living with this epidemic phenomenon by decades, still not find a definitive solution, or a efficient palliative, or any other definitive solution. Within of the perspectives mentioned, the approached of this research have been looking for understand the dengue about the geographic knowledge. Where this disease have happening with more violence and why? The objective of this work was to reach more understanding about the geographic behavior of the dengue, having how parameter the transscale approach of this trouble, and, of this way, to contribute for the best planning of actions that aim for preservation and mitigation. The methodology consisted of several steps: first, the database was assembled and organized and its descriptive analysis was carried out regarding hospitalizations due to dengue in Brazil, between 1998 and 2019; later, still at this stage, the inferential analysis was carried out and the spatialization of cartographic data; in the third part, the organization of data and its descriptive temporal analysis were carried out on patients with dengue in Brazil according to the epidemiological weeks of the ministry of health; then, an exploratory analysis was performed regarding the registered rates of people affected by dengue in the municipalities of the States of the Southeast region of Brazil, correlating them with the following variables: municipal human development index (IDHM), percentage of urban population, income per capita, life expectancy at birth and economically active population (EAP) over 18 years old. In the fourth stage, for the city of Montes Claros-MG, the acquisition of data related to the number of people infected with dengue, by neighborhoods, in the years 2015, 2016 and 2017; obtaining the Breteau indices on larval infestation by Aedes aegypti in the respective years; use of satellite images for surface temperature estimation (STE); acquisition of data on land elevation and family income. Subsequently, the organization of the database was carried out; use of descriptive analysis; application of multiple linear regression and interpolation. Showed results demonstrate that exist strong relationship between time-space in the propagation of dengue, being the areas more prone staying besieged in tropical regions with average annual temperatures above 18ºC and well-defined rainy and dry seasons. According with epidemiological weeks, the most quantitative records for infected by dengue have been cataloged between the months january at july of the years. In the Southeast of Brazil, the state that presented the most averages rates of incidence of dengue was the Rio de Janeiro (average 280,198); Minas Gerais (average 159,386) was the state with the lowest incidence. In these data, there was a correlation between dengue infections and IDHM in the following federative units: Minas Gerais, Rio de Janeiro and São Paulo. Between dengue infections and percentage of urban population: in Minas Gerais, Espírito Santo and São Paulo. Between dengue and per capita income: in Minas and Rio de Janeiro. Between dengue and life expectancy at birth: in Minas and São Paulo. In Montes Claros, the results demonstrate the associative relationship between time and characteristics of the inhabited space for the highest rates of A. aegypti, and show that it is necessary to observe the change in the local microclimate in the process of urbanization and soil sealing, mitigating the occurrence of heat islands. Added to this factor, in places where there was a higher incidence, the lower the elevation, the greater the infestation by the mosquito due to the greater propensity to accumulate standing water. Generally, the larval infestation by Aedes aegypti has occurred in the western portion of Montes Claros, while the infection of people by dengue is more likely in the eastern portion of the city, two parts with different economic situations, where in the west the population with higher income is concentrated. . This factor denotes the fragility of the low-income population in terms of public health and its greater lack of strategic care. For the efficient fight against dengue, an action plan involving communities with their spatial specificities and public management, can become more fruitful when observing the need to eliminate the breeding sites of transmission pests, which involves quality management, urban, especially in denser environments and, therefore, more affected by the disease in question.