Spatial pattern of congenital toxoplasmosis incidence and its relationship with vulnerability and national health indicators in Brazil

Abstract

There is a gap in evidence regarding spatial clusters of the congenital toxoplasmosis (CT) and its association with social and health indicators in the Brazilian territory. Thus, we aimed herein to identify CT risk areas in Brazil and its association with social vulnerability and health indicators. An ecological and population-based study was conducted. The CT incidence coefficient was calculated and smoothed using the Local Empirical Bayesian method. Global regression models and local spatial regression model were applied. High-incidence clusters of the disease were identified throughout the country. Additionally, a positive association was observed between the incidence of congenital toxoplasmosis and the Social Vulnerability Index, coverage of community health agents, and the percentage of prenatal consultations. This association was stronger the further south in the country. Herewith, the implementation and strengthening of public strategies, with focus on priority intersectoral actions for prevention, early diagnosis, and prompt treatment, is urgently required for the effective control of CT in Brazilian municipalities.

Keywords: Community health status indicators; Congenital toxoplasmosis; Epidemiology; Social vulnerability index; Spatial analysis; Spatial regression.