Patricia Marques Moralejo Bermudi, Raquel Gardini Sanches Palasio, Monica Pirani, Lídia Maria Reis Santana, Gerson Laurindo Barbosa, Marta Blangiardo, Francisco Chiaravalloti Neto
Despite its burden, dengue remains neglected, with few studies comparing its incidence, mortality, case-fatality, and key variables such as socioeconomic factors, healthcare access, and serotype distribution.
BACKGROUND: Despite its burden, dengue remains neglected, with few studies comparing its incidence, mortality, case-fatality, and key variables such as socioeconomic factors, healthcare access, and serotype distribution. METHODS: This ecological study analyzed dengue cases and deaths (2014-2024) in intermediate regions of Brazil. Covariates included illiteracy rate, hospital bed availability, serotype distribution, and private healthcare coverage. High- and low-risk spatial clusters were identified using the SaTScan Poisson model. Statistical analysis assessed significant covariate differences between risk groups. RESULTS: High-incidence clusters were found in areas with lower illiteracy rates, whereas high-case fatality clusters were found in areas with higher illiteracy rates. DENV-2 was associated with high-risk case-fatality areas; in contrast, DENV-1 showed the opposite pattern, appearing to be more common but associated with lower severity. CONCLUSIONS: These findings provide a basis for generating hypotheses for future modeling studies on these associations.