Hospitalisations for mycoses as an indicator of socio‐environmental vulnerability in the Brazilian Amazon‐Savanna transition region

• Published in: Mycoses Vol. 63; no. 2; pp. 151 - 161
• Main Authors: Silva, Letícia Chagas, Oliveira, Lorena Vívien Neves, Silva, Fabrício Brito, Santos, Jessflan Rafael Nascimento, Araújo, Mayara Lucyanne Santos, Mendes, Amanda Graziela Gonçalves, Miranda, Rita de Cássia Mendonça de, Santos, Daniel Assis, Holanda, Rodrigo Assuncao, Santos, Julliana Ribeiro Alves
• Format: Journal Article
• Language: English
• Published: Germany Wiley Subscription Services, Inc 01-02-2020
• Subjects: climate; Environmental factors; Environmental impact; Fungi; Infectious diseases; mycoses; Mycosis; Population density; precipitation; Sewage; socio‐environmental; temperature; vulnerability; Brazil; temperature; mycoses; precipitation; socio-environmental; climate; vulnerability
• ISSN: 0933-7407; 1439-0507
• DOI: 10.1111/myc.13036

Background
The infections caused by fungi represent a global concern and an important cause of hospital admissions in endemic areas. The influence of socio‐environmental factors in infectious diseases has been documented; however, this phenomenon remains unclear regarding mycoses.
Objectives
This study aimed to analyse the spatio‐temporal dynamics of hospitalisations for mycoses (HM) and the association with socio‐economic and climate data in the Amazon‐Savanna Transition Region in the state of Maranhão, Brazil.
Methods
In this study, Spearman's correlation was applied to determine the correlation between HM, socio‐economic and climatic data obtained from national databases in the period from 1998 to 2016. Hospitalisations for mycoses data were spatialised and analysed using the local Moran's index.
Results
Our data revealed a negative and significant correlation between HM and socio‐economic data regarding population, demographic density, human development index, health facilities and sanitary sewage. Significant correlations were observed between HM and precipitation, maximum temperature and minimum temperature. The main modulating climatic variable was the minimum temperature. The spatial autocorrelation analysis showed the dynamics of HM in municipalities belonging to the different regions of the state influenced by socio‐economic conditions. We observed the presence of municipalities with high incidence of HM surrounded by others with low HM cases and vice versa.
Conclusions
Our results indicate that hospitalisations for mycoses represent an important indicator of socio‐environmental vulnerability in the Amazon‐Savanna transition region in Brazil. We encourage the adoption of measures to mitigate social and environmental impact on these diseases, especially in municipalities with low socio‐economic status.
New insights into the modulation of social, economic (HDI: human development index, health facilities, and sanitary sewage), and environmental conditions (precipitation, maximum temperature, and minimum temperature) on hospitalisations for mycoses, which represents an important indicator of socioenvironmental vulnerability. Unfavorable socioeconomic conditions together with climate variables such as precipitation and minimum and maximum temperatures may positively or negatively modulate depending on the etiologic agent of mycosis.