Análise da reemergência da coqueluche no Brasil

Abstract

Pertussis, an infectious-contagious disease, is currently presenting a reemerging profile. Factors such as decreased immunity years after vaccination, changes in the genotype of the bacteria and increased susceptibility among young and adults are considered to have contributed to increase the disease incidence rate. Therefore, this study aimed to verify the spatial distribution of confirmed pertussis cases between 2007 and 2015; to identify the patterns in the time-series of pertussis incidence rates during the period 2001 to 2015 in Brazil and to verify the association of pertussis vaccine with the occurrence of the disease in the state of Rio Grande do Norte. Thus, the methodological path of the research was divided into three parts. The analysis of the spatial distribution considered the 482 Regions Immediate Urban Articulation as unit of analysis and used the Terraview software to construct the thematic maps. In order to verify the trend in the series we chose to use the adjustment of a polynomial function in time, using polynomial regression models. Regarding the association, the confirmation of the case was established as inclusion criteria in accordance with the criteria established by the Ministry of Health, being excluded those files that were not properly filled or had any uncertainties that could compromise the data collection. The results suggests that the disease has a democratic spatial distribution throughout the country, forming small clusters with high incidence rates in the urban articulation present in the South and Southeast regions. It was also identified in the time-series an increasing tendency of the disease over a period of 15 years. Finally, the results indicate that regardless of vaccination status individuals are being infected with pertussis, which did not generate enough scientific evidence to measure the effectiveness of the vaccine. The findings suggest that aspects related to vaccination need further investigation in order to guarantee disease control. There is also a need for improvements in surveillance actions, which can ensure a reliable epidemiological representation of the disease.