Dengue fever, chikungunya fever, and zika virus infections are increasing public
health problems in the world, the last two diseases having recently emerged in
Brazil. This ecological study employed spatial analysis of probable cases of
dengue fever, chikungunya fever, and zika virus infections reported to the
National Mandatory Reporting System (SINAN) in Maranhao State from 2015 to 2016.
The software GeoDa version 1.10 was used for calculating global and local Moran
indices. The global Moran index identified a significant autocorrelation of
incidence rates of dengue (I=0.10; p=0.009) and zika (I=0.07; p=0.03). The study
found a positive spatial correlation between dengue and the population density
(I=0.31; p<0.001) and a negative correlation with the Performance Index of
Unified Health System (PIUHS) by basic care coverage (I=-0.08; p=0.01).
Regarding chikungunya fever, there were positive spatial correlations with the
population density (I=0.06; p=0.03) and the Municipal Human Development Index
(MHDI) (I=0.10; p=0.002), and a negative correlation with the Gini index
(I=-0.01; p<0.001) and the PIUHS by basic care coverage (I=-0.18;
p<0.001). Lastly, we found positive spatial correlations between Zika virus
infections and the population density (I=0.13; p=0.005) and the MHDI (I=0.12;
p<0.001), as well as a negative correlation with the Gini index (I=-0.11;
p<0.001) and the PIUHS by basic care coverage (I=-0.05; p=0.03). Our results
suggest that several socio-demographic factors influenced the occurrence of
dengue fever, chikungunya fever, and zika virus infections in Maranhao
State.