Using geo-spatial analysis for assessing the risk of hospital admissions due to community-acquired pneumonia in under-5 children and its association with socially vulnerable areas (Brazil)

Social vulnerability among Brazilian children in early childhood: a scoping review

OBJECTIVE

To identify, map, and describe studies involving Brazilian children in early childhood in situations of social vulnerability.

SOURCE OF DATA

A scoping review including full articles published in Portuguese and English up to March 2023, with no temporal restrictions. Searches were conducted in the MEDLINE/PubMed, Scielo, EMBASE, Cochrane, Scopus, CINAHL, Web of Science, PEDro, and LILACS databases. Journal metrics, sample characteristics, study area, characterization of the situation of social vulnerability, and study outcomes were extracted.

SUMMARY OF THE FINDINGS

Seventy-six articles involving a total of 107.740 children in early childhood were included in this study. These studies presented relevant findings, including the temporal publication trend, the variability of social vulnerability indicators, the scarcity of intervention studies, and the fact that 100% of eligible studies were from the health area. Negative outcomes were associated with the condition of social vulnerability in almost the entire sample, reinforcing the need for government policies capable of protecting early childhood from the effects of social vulnerability.

CONCLUSION

This scoping review mapped important findings involving Brazilian children in social vulnerability. It also identified literature gaps such as the need for intervention and multisectoral studies among health, education, and social protection.

Spatial patterns and spatially-varying factors associated with childhood acute respiratory infection: data from Ethiopian demographic and health surveys (2005, 2011, and 2016)

BACKGROUND

In Ethiopia, acute respiratory infections (ARIs) are a leading cause of morbidity and mortality among children under five years. Geographically linked data analysis using nationally representative data is crucial to map spatial patterns of ARIs and identify spatially-varying factors of ARI. Therefore, this study aimed to investigate spatial patterns and spatially-varying factors of ARI in Ethiopia.

METHODS

Secondary data from the Ethiopian Demographic Health Survey (EDHS) of 2005, 2011, and 2016 were used. Kuldorff's spatial scan statistic using the Bernoulli model was used to identify spatial clusters with high or low ARI. Hot spot analysis was conducted using Getis-OrdGi statistics. Eigenvector spatial filtering regression model was carried out to identify spatial predictors of ARI.

RESULTS

Acute respiratory infection spatially clustered in 2011 and 2016 surveys year (Moran's I:-0.011621-0.334486). The magnitude of ARI decreased from 12.6% (95%, CI: 0.113-0.138) in 2005 to 6.6% (95% CI: 0.055-0.077) in 2016. Across the three surveys, clusters with a high prevalence of ARI were observed in the North part of Ethiopia. The spatial regression analysis revealed that the spatial patterns of ARI was significantly associated with using biomass fuel for cooking and children not initiating breastfeeding within 1-hour of birth. This correlation is strong in the Northern and some areas in the Western part of the country.

CONCLUSION

Overall there has been a considerable decrease in ARI, but this decline in ARI varied in some regions and districts between surveys. Biomass fuel and early initiation of breastfeeding were independent predictors of ARI. There is a need to prioritize children living in regions and districts with high ARI.

Analysis of intra annual spatial dynamics of community-aсquired pneumonia incidence in the urban environment

Background. The spread of community-acquired pneumonia (CAP) in children and adults is interconnected and conditioned by natural, climatic and social factors.

The aim. To assess the relationship between the incidences of CAP in different seasons of the year with the location of educational institutions in the urban settlement.

Materials and methods. A cross-sectional study of the spatial distribution and seasonal dynamics of CAP cases in 2015 in a Siberian city with a population of more than 600 thousand people was carried out. Using GIS, 787 cases of CAP were analyzed among children of preschool and school age and adults. For statistical processing, 111 analyzed territorial units (ATUs) with an area of 250 m2 each were allocated on the maps. The dynamics of morbidity was assessed by weeks and seasons of the year among different age groups.

Results. There was a direct moderate correlation between the number of CAP cases registered during the year with the number of schools and preschool educational institutions in ATU (r = 0.59; p < 0.001). ATUs with the presence and absence of educational institutions differed in the number of epidemic foci of CAP among the total population in winter and spring. The maximum number of cases of CAP among children and adults was registered in the second half of winter (weeks 3–13), the minimum – in the summer months (weeks 25–34).

Conclusions. GIS analysis confirms the more frequent registration of CAP diseases among the total population in urban areas with educational institutions. There was established a direct moderate correlation between the incidence of CAP in children and adults by weeks of the year. Statistically significant differences in the number of cases in areas with and without educational institutions were noted in seasons with a higher incidence (autumn and winter).