Socioeconomic factors and risk for hospitalisation due to asthma in children in the municipalities of Mato Grosso State, Brazil.

Elaine Cardoso De Oliveira Souza,Clóvis Botelho,Antonia Maria Rosa,Emerson Soares Dos Santos

doi:10.1590/1413-81232018238.18692016

Abstract

This ecological study used data accumulated between 2001 and 2012 hospital admissions of children under five years of age with asthma in 141 municipalities in the Mato Grosso. Hospital data were extracted from the SIH/SUS system, and hospitalisation rates were estimated using the Bayesian inference method. SaTScan software was used for the calculation of the relative risk (RR). Differences in socioeconomic characteristics among municipalities with high and low hospitalization rates were evaluated by nonparametric Wilcoxon-Mann-Whitney test. This test indicates that municipalities with better socioeconomic characteristics have lower hospitalization rates. The analysis of the linear models in the two study periods indicated that the decreasing trend in the number of admissions was 3-fold higher in the 2005-2012 period compared with the 2001-2004 period. In addition, a decrease of 76% in the hospitalisation incidence rate was observed during the 12-year study period; this decrease was more evident from 2005 onward. The municipalities identified as having increased risk of hospitalisation of children with asthma were located in areas subjected to intense burning practices and with low municipal development indices.

Highlights

Asthma is a chronic and multifactorial disease resulting from a complex interaction between genetic, socioeconomic, and environmental factors[1].The need for hospitalization suggests lack of disease control because of difficulties in treatment, and increased exposure to risk factors that trigger complications
The identification and characterization of these areas can be performed by scanning spatiotemporal Scan, that can be executed in SaTScan software[7], which calculates the relative risk of occurrence of an event within a study area
The SIH/SUS database contained 17,975 records of hospitalisations for asthma in children under five years of age living in 141 municipalities of Mato Grosso in the study period

Summary

Introduction

Asthma is a chronic and multifactorial disease resulting from a complex interaction between genetic, socioeconomic, and environmental factors[1].The need for hospitalization suggests lack of disease control because of difficulties in treatment, and increased exposure to risk factors that trigger complications. The main risk factors for hospitalisation are acute respiratory infections, being under five years of age, asthma severity, climatic factors, and exposure to environmental pollution[2,3,4,5,6] All these characteristics are geographically heterogeneous, with existence of areas that add favorable conditions for infection and subsequent worsening of asthma in children. The identification and characterization of these areas can be performed by scanning spatiotemporal Scan, that can be executed in SaTScan software[7], which calculates the relative risk of occurrence of an event within a study area Epidemiologists worldwide use this software to describe spatial clusters of infectious and chronic diseases, disease vectors, and risk factors[8]

Objectives

Methods

Results

Discussion

Conclusion