Social inequality and pneumonia hospitalization in children under five years of age in Maranhão, Brazil

Abstract

Objectives: to describe the characteristics of pneumonia hospitalizations in children under five years of age across the State of Maranhão, Brazil, and explore patterns of spatial distribution of admissions. Methods: ecological study using data on occurrences (age, gender, skin color/race, month of occurrence, and municipality of residence) between 2012 and 2017 taken from the Unified Health System’s Hospital Information System and municipal level socioeconomic indicators for 2010. Each respiratory disease, including pneumonia, was presented as a percentage of overall admissions for respiratory tract diseases, together with the monthly distribution of admissions as a percentage of total annual cases, and annual rate of admissions by gender. The General G* statistic was calculated to identify significant clustering of municipalities with similar proportions of hospital admissions for pneumonia relative to overall hospital admissions. Results: pneumonia was the leading cause of admissions for respiratory disease, accounting for 57% of all cases and occurring with greater frequency in the rainy season (February to June) and in cities with lower socioeconomic indicator values. The rate of admissions decreased over the study period. Significant clusters (p<0.05) of municipalities with high proportions of hospital admissions for pneumonia relative to overall hospital admissions occurred predominantly in the south of the state, while clusters with low propor-tions were located mainly in and around the metropolitan region of the state capital São Luís. Conclusions: pneumonia was shown to be a key cause of hospitalization in children and its distribution was associated with contextual socioeconomic factors, reflecting the quality of life and health status of children in Maranhão.

Pneumonia in Children under 5 Years: Temporal Trends and Spatial Patterns of Hospitalizations in Brazil

“…11 The incidence of pneumonia is related to less favored social contexts, an insufficient and inefficient healthcare network, low Human Development Index (HDI), among other factors. 12 To reduce childhood pneumonia mortality in Brazil, one strategy adopted by the Ministry of Health was the implementation of the Pact for Life, the result of strategic and financial efforts of managers to meet the main demands of the Brazilian population, subdivided into some agreed priorities. The objective of the strategies of the Pact is to reduce childhood pneumonia mortality by 20%.…”

Perfil Epidemiológico de pacientes com pneumonia no Estado de Sergipe / Epidemiological profile of pneumonia patients in the State of Sergipe

“…Nesse contexto, é relevante destacar as características epidemiológicas, individuais, físicas socioeconômicas e sanitárias diante do indivíduo, onde o seu surgimento poderá ter efeitos mais negativos em grupos populacionais específicos 4,5 .…”