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Background Leptospirosis is an endemic disease in Brazil of social and economic relevance related to behavioural and socioenvironmental factors. This study aimed to analyse the spatiotemporal distribution of the incidence of leptospirosis and its association with social determinants in health in a state of northeastern Brazil. Methods An ecological study of temporal series with techniques of spatial analysis using secondary data of the cases of leptospirosis notified in the Information System of Notifiable Diseases of the state of Sergipe (2008–2017) was conducted. The analysis of temporal trends was performed using Poisson regression. Spatial analyses were performed using the Moran index, the local empirical Bayesian model, scan statistics and spatial regression. Results The incidence rate decreased from 3.66 to 1.44 cases per 100 000 inhabitants in 2008 and 2017, respectively. Leptospirosis was associated with social inequities, mostly affecting males aged 20–49 y living in urban areas. The space-time scan indicated the formation of a risk cluster in municipalities in the metropolitan region of the state. Conclusions The data indicated the persistence of leptospirosis transmission, maintaining a pattern of high endemicity in some municipalities associated with social inequities. The study showed the temporal and spatial dynamics of the disease to better target specific actions for prevention and control.

Background: Social inequalities in health have been linked to disproportional impacts in COVID-19 mortality. Therefore, this study aimed to analyze the spatiotemporal distribution of the COVID-19-related mortality and its association with the Social Determinants of Health (SDH) in Sergipe, Northeastern Brazil. Method: Ecological study using spatiotemporal analysis tools. All confirmed deaths related to COVID-19 in Sergipe, Brazil, from March 14 th to October 31 st 2020, were included and we calculated moving averages. Mortality crude rates were smoothed through Empirical Bayesian Method and were used for spatial analysis. We carried out the retrospective spatiotemporal scan statistics using the Poisson’s probability model. We used the spatial regression models to identify the association between COVID-19 mortality and Social Determinants of Health. Findings: 2,206 deaths by COVID-19 were registered in Sergipe. There was an increase of the moving averages, reaching the peak at of July 2020. A spatiotemporal cluster of mortality, comprising the metropolitan area and the neighboring cities. Illiteracy rate of people ≥15 years-old, percentage of children

To analyse spatial patterns and the temporal tendency of mortality related to Chagas disease, in order to identify priority control areas in the state of Sergipe, Northeast Brazil.We conducted an ecological and time-series study with spatial analysis techniques on deaths from Chagas disease in the state of Sergipe (1996-2016). We used data from the Mortality Information System (SIM). The temporal analysis was performed using a statistical technique capable of describing changes in the trend pattern for the period. Thematic maps were elaborated from point and polygonal analyses.There were 247 deaths related to Chagas disease, with a mean of 11.7 deaths/year, most of them male (64%), and aged 50-59 years (21%) and 60-69 years (26%). Two segments with increasing, non-constant and significant trends were identified: 1996-2005 (APC = 21.6%; P = 0.01) and 2005-2016 (APC = 4.4%; P = 0.01), with APPC = 11.8% (P = 0.01). A positive and significant spatial autocorrelation with areas of higher risk of death was found in the southern region of the state.The trend of mortality related to Chagas disease in the state of Sergipe was increasing during the period analysed, with a heterogeneous distribution of cases. A main risk area was identified in the southern region of the state.Analyser les profils spatiaux et la tendance temporelle de la mortalité liée à la maladie de Chagas, afin d'identifier les domaines de priorité de lutte dans l'Etat de Sergipe, dans le nord-est du Brésil. MÉTHODES: Nous avons mené une étude écologique et de séries chronologiques avec des techniques d'analyse spatiale sur les décès dus à la maladie de Chagas dans l'état de Sergipe (1996-2016). Nous avons utilisé les données du système d'information sur la mortalité (SIM). L'analyse temporelle a été réalisée à l'aide d'une technique statistique capable de décrire les changements dans le profil de tendance pour la période. Des cartes thématiques ont été élaborées à partir d'analyses ponctuelles et polygonales. RÉSULTATS: Il y a eu 247 décès liés à la maladie de Chagas, avec une moyenne de 11,7 décès/an, pour la plupart de sexe masculin (64%), et âgés de 50 à 59 ans (21%) et de 60 à 69 ans (26%). Deux segments avec des tendances à la hausse, non constantes et significatives ont été identifiés: 1996-2005 (APC = 21,6%; p = 0,01) et 2005-2016 (APC = 4,4%; p = 0,01), avec APPC = 11,8% (p = 0,01). Une autocorrélation spatiale positive et significative avec des zones à haut risque de décès a été trouvée dans la région sud de l'Etat.La tendance de la mortalité liée à la maladie de Chagas dans l'état de Sergipe a augmenté au cours de la période analysée , avec une répartition hétérogène des cas. Une principale zone à risque a été identifiée dans la région sud de l'Etat.

Objetivo: classificar o risco das doenças imunopreveníveis e sua distribuição espacial nos municípios sergipanos.Método: estudo epidemiológico, com utilização de bases de informaçoes secundárias pelo Sistema de Informações do Programa Nacional de Imunizações no ano de 2017, referente ao esquema vacinal até o segundo ano de idade, nos 75 municípios sergipanos. Para análise estatística dos dados, utilizou-se o programa Epi Info versão 7.2.2.6 e QGIS para elaboração do mapa.Resultados: 46,7% dos municípios sergipanos apresentaram cobertura vacinal adequada para BCG. Em todo estado, os imunobiológicos analisados apresentaram grau de homogeneidade baixo. A vacina Tríplice viral teve a mais elevada taxa de abandono 73 (97,3%) .Conclusão: identificou-se quadro de alto risco de desenvolvimento de doenças preveníveis por vacinas na maioria dos municípios sergipanos. Esforços cumulativos são necessários por parte dos usuários, profissionais de saúde e gestores do Sistema Único de Saúde para assegurar êxito e boa adesão às atividades de imunização. Objective: to classify the risk of vaccine-preventable diseases and their spatial distribution inmunicipalities of Sergipe.Method: an epidemiological study, using secondary information bases from the InformationSystem of the National Immunization Program in 2017, regarding the vaccination scheduleof children up to two years of age, in the 75 municipalities of Sergipe. For data statisticalanalysis, the Epi Info program, version 7.2.2.6 and QGIS were used to prepare the map.Results: only 46.7% of the municipalities in Sergipe had adequate vaccination coverage forBCG. In the entire state, the vaccines analyzed showed a very low degree of homogeneity.The measles, mumps and rubella had the highest dropout rate of 73 (97.3%).Conclusion: a high risk of developing vaccine-preventable diseases was identified in mostmunicipalities in Sergipe. Cumulative efforts are needed by SUS users, health professionalsand managers to ensure success and good adherence to immunization activities. Objetivo: Clasificar el riesgo de las enfermedades inmunoprevenibles y su distribución espacialen los municipios de Sergipe, Brasil.Método: Estudio epidemiológico, utilizando bases de datos secundarias, por Sistema deInformación del Programa Nacional de Inmunizaciones en 2017, respecto del esquema devacunación infantil hasta los dos años en los 75 municipios de Sergipe. Se utilizó Epi Infoversión 7.2.2.6 para análisis estadístico y QGIS para elaboración del mapa.Resultados: Solamente el 46,7% de los municipios de Sergipe mostraron cobertura vacunaladecuada para BCG. En todo el estado, los inmunobiológicos analizados demostraron muybajo grado de homogeneidad. La vacuna Triple Viral tuvo la más alta tasa de abandono: 73(97,3%).Conclusión: Se identificó marco de alto riesgo para desarrollo de enfermedades preveniblespor vacunación en la mayoría de los municipios de Sergipe. Se requieren esfuerzos acumulativospara asegurar éxito y adhesión a las actividades de inmunización.

Objective: To analyze the spatial distribution and temporal trend of mortality due to penilecancer in Sergipe.Method: An ecological study with spatial analysis techniques. Secondary data on penile cancerdeaths from residents of Sergipe municipalities from 2000 to 2015 were used, obtained fromthe Mortality Information System. The analysis of the temporal trends was performed in theJoinpoint program through Poisson regression. Spatial analyses were performed using theempirical Bayesian model, kernel estimator and Moran indexes.Results: 67 deaths due to penile cancer occurred and a rising trend in mortality rates from0.11 (2000) to 0.64 (2015) per 100,000 men was recorded. A positive spatial autocorrelation(I=0.64; p=0.01) was observed with areas of higher risk of death in the southern region of thestate.Conclusion: There was an increase in the coefficients of mortality due to penile cancer andheterogeneous geographical distribution of the risk areas. Objetivo: analisar a distribuição espacial e a tendência temporal da mortalidade por câncer depênis em Sergipe.Método: estudo ecológico, com técnicas de análise espacial. Foram utilizados dados secundáriosdos óbitos por câncer de pênis de residentes dos municípios de Sergipe de 2000 a 2015, obtidosno Sistema de Informações sobre Mortalidade. A análise das tendências temporais foi realizadapelo programa Joinpoint por meio da regressão Poisson. As análises espaciais foram realizadas pormeio do modelo bayesiano empírico, estimador de Kernel e Índices de Moran.Resultados: ocorreram 67 óbitos por câncer de pênis e uma tendência crescente dos coeficientesde mortalidade, de 0,11 (2000) para 0,64 (2015) por 100.000 homens. Observou-se autocorrelaçãoespacial positiva (I=0,64; p=0,01) com áreas de maior risco de morte localizadas na região sul doestado.Conclusão: houve aumento dos coeficientes de mortalidade por câncer de pênis e distribuiçãogeográfica heterogênea das áreas de risco. Objetivo: analizar la distribución espacial y la tendencia temporal de la mortalidad por cáncerde pene en Sergipe.Método: estudio ecológico, con técnicas de análisis espacial. Se utilizaron datos secundariosde las muertes por cáncer de pene en residentes de los municipios de Sergipe de 2000 a2015, obtenidos del Sistema de Informaciones sobre Mortalidad. El análisis de las tendenciastemporales se realizó en el programa Joinpoint por medio de la regresión Poisson. Los análisisespaciales se realizaron por medio del modelo bayesiano empírico, del estimador de Kernely de los Índices de Moran.Resultados: se registraron 67 muertes por cáncer de pene y una tendencia creciente delos coeficientes de mortalidad, de 0,11 (2000) a 0,64 (2015) por cada 100.000 hombres. Seobservó una autocorrelación positiva (I=0,64; p=0,01) con áreas de mayor riesgo de muertelocalizadas en la región sur del estado.Conclusión: se registró un aumento de los coeficientes de mortalidad por cáncer de pene yuna distribución héterogenea de las áreas de riesgo.

Objective: to analyze the epidemiological characteristics and spatial distribution of leprosy cases in an endemic municipality. Methods: epidemiological, retrospective study with spatial analysis techniques developed with data from the National System of Compulsory Notification. Leprosy cases were georeferenced using a Geographic Positioning System receiver for the spatial location of the households. Spatial analysis was performed by the Kernel method. Results: one hundred new cases of leprosy were reported, and there was predominance of males and patients with low education. The Virchowian clinical form was predominant (32.0%) and 48.0% of the cases presented some degree of disability at the time of diagnosis. There was an increasing temporal trend in the detection rate. The spatial analysis identified critical areas for occurrence of leprosy, which was concentrated in the urban area (71.0%). Conclusion: the municipality presented high endemicity for leprosy, with heterogeneous distribution of cases and risk cluster in the urban area. Objetivo: analisar as características epidemiológicas e a distribuição espacial dos casos de hanseníase em um município do nordeste do Brasil. Método: estudo transversal, retrospectivo com técnicas de análise espacial desenvolvido a partir de dados do Sistema Nacional de Notificação Compulsória. Os casos de hanseníase foram georreferenciados utilizando-se um receptor GPS para a localização espacial dos domicílios. A análise espacial se deu pelo método de Kernel. Resultados: Foram notificados 100 casos novos de hanseníase com predomínio do sexo masculino e baixa escolaridade. A forma clínica Virchowiana foi a predominante (32%) e 48% dos casos apresentaram algum grau de incapacidade no momento do diagnóstico. A tendência temporal apresentou-se crescente. A análise espacial identificou áreas críticas para ocorrência da hanseníase e concentrando-se na zona urbana (71%). Conclusão: o município apresentou alta endemicidade para a hanseníase com distribuição heterogênea dos casos e cluster de risco na área urbana.

This is an ecological study with exploratory analysis of spatial and temporal data based on mortality data with respect to prostate cancer obtained from the Mortality Information System concerning residents of the state of Sergipe, Brazil between 2000 and 2015. The analysis of temporal trends was performed using the Joinpoint Regression Program through Poisson regression. Spatial analysis was performed using the empirical Bayesian model, Kernel analysis, Global Moran and Local indices. There were 1,986 deaths due to prostate cancer, most of which occurring after 60 years of age. An increasing, non-constant but significant trend in mortality rates was noted. The kernel density estimator showed hotspot densities of the highest rates of prostate cancer mortality in the north-eastern and central regions of the state. High-risk clusters were identified for prostate cancer mortality (I = 0.55, P

Objective: to analyze the epidemiological characteristics and spatial distribution of leprosy cases in an endemic municipality. Methods: epidemiological, retrospective study with spatial analysis techniques developed with data from the National System of Compulsory Notification. Leprosy cases were georeferenced using a Geographic Positioning System receiver for the spatial location of the households. Spatial analysis was performed by the Kernel method. Results: one hundred new cases of leprosy were reported, and there was predominance of males and patients with low education. The Virchowian clinical form was predominant (32.0%) and 48.0% of the cases presented some degree of disability at the time of diagnosis. There was an increasing temporal trend in the detection rate. The spatial analysis identified critical areas for occurrence of leprosy, which was concentrated in the urban area (71.0%). Conclusion: the municipality presented high endemicity for leprosy, with heterogeneous distribution of cases and risk cluster in the urban area.