Dados do Trabalho

Título

Rising Incidence of Congenital Toxoplasmosis in Brazil: A Spatio-Temporal and Socioeconomic Analysis (2019-2023)

Introdução

South America stands out globally for having the highest rate of congenital toxoplasmosis, including the most pathogenic strains. In Brazil, cultural habits, socioeconomic conditions, and geo-environmental factors contribute to this reality. The incidence of cases in Brazil varies from 0.3 to 3.4 per 1000 live births according to studies conducted in the last twenty years; however, the most recent data have not been thoroughly reviewed.

Objetivo (s)

To outline the national incidence profile of congenital toxoplasmosis (CT) cases from 2019 to 2023, verifying the spatio-temporal association of incidences with the social vulnerability index (SVI).

Material e Métodos

The incidence profile of congenital toxoplasmosis per 1,000 live births per municipality was obtained by consulting the Ministry of Health databases (TABNET/DATASUS) for the period 2019 to 2023, and the 2010 SVI from the Institute of Applied Economic Research (IPEA). Averages of incidences per municipality and year, per state and year, and per region and year were calculated in EpiInfo 7.2 and Microsoft Excel 2023. Spatio-temporal analysis of incidences was performed using a discrete Poisson model in SaTScan 10.1.2, and univariate local cluster analysis (LISA) of incidences and bivariate (BiLISA) spatial association of incidences and SVI was performed using Moran's I statistic in GeoDA 1.20.

Resultados e Conclusão

Average incidences of CT tend to increase, except in the South. In Tocantins, however, average incidences increased, peaking at 4.82 cases per 1000 live births in 2022. Spatio-temporal model revealed two clusters, one in the South with rr = 2.69, and a second cluster including municipalities in MG, GO, and the Northeast Region, with rr =1.79, both in 2021 and 2022. Spatial cluster analysis revealed between 57 and 69 municipalities with high incidence and spatial correlation with high vulnerability indexes in up to 92 municipalities, mainly in Goiás and Tocantins. Despite being compulsory since 2016,  notification of CT still in process of implementation in many states, and results show a trend of decreasing incidences in states with earlier implementation of notification. The incidences of Congenital Toxoplasmosis continue to rise in Brazil, with the formation of high incidence clusters in the South and Northeast regions, and occasionally in the states of Minas Gerais and Goiás. There is a correlation between high CT incidence and social vulnerability in the states of Goiás and Tocantins.

Palavras Chave

Congenital Toxoplasmosis; Spatio-Temporal Analysis; Social Vulnerability Index.