Renata R Silva1, Caique J N Ribeiro2, Tatiana R Moura3, Márcio B Santos3, Allan D Santos2, Débora S Tavares4, Priscila L Santos4. 1. Health Sciences Postgraduate Program, Federal University of Sergipe, Rua Cáudio Batista, s/n, Palestina, CEP 49060-108, Aracaju, Sergipe, Brazil. 2. Department of Nursing, Federal University of Sergipe, Av. Governador Marcelo Déda, 13, Centro, CEP 49 400-000, Lagarto, Sergipe, Brazil. 3. Department of Morphology, Federal University of Sergipe, Av. Marechal Rondom, s/n, Jardim Rosa Elze, CEP 49 100-000, São Cristóvão, Sergipe, Brazil. 4. Department of Health Education, Federal University of Sergipe, Av. Governador Marcelo Déda, 13, Centro, CEP 49 400-000, Lagarto, Sergipe, Brazil.
Abstract
BACKGROUND: Basic sanitation could be a potential indicator of the spread of coronavirus disease-2019 (COVID-19) and, in this context, space-time patterns are important tools with which to elucidate the spread of disease and identify risk factors. The aim of this study was to assess a possible association between basic sanitation indices and COVID-19 rates in all the 5570 municipalities of Brazil and its spatial distribution. METHODS: Data of COVID-19 cases registered in Brazil from 28 February until 31 May 2020 and independent variables associated with basic sanitation were included. RESULTS: High incidence rates were significantly associated with precarious water service index (0-25% coverage) and offstandard faecal coliforms index for tap water (5-50% and 75-100% of samples tested). A significant association between high mortality rates and sewage collection (0-25% coverage)/treatment (25-50% coverage) indices was also verified. In addition, clusters with significant spatial autocorrelation were identified mainly in the North and Northeast regions for mortality and incidence rates (high-high risk areas) and for offstandard faecal coliforms index. Those regions are considered the poorest in Brazil, presenting with low incomes, human agglomerations, as well as a poor basic sanitation system, which also hinder the implementation of COVID-19-preventative measures. CONCLUSIONS: A precarious basic sanitation infrastructure could potentially be associated with the high transmission of severe acute respiratory syndrome coronavirus-2 in Brazil.
BACKGROUND: Basic sanitation could be a potential indicator of the spread of coronavirus disease-2019 (COVID-19) and, in this context, space-time patterns are important tools with which to elucidate the spread of disease and identify risk factors. The aim of this study was to assess a possible association between basic sanitation indices and COVID-19 rates in all the 5570 municipalities of Brazil and its spatial distribution. METHODS: Data of COVID-19 cases registered in Brazil from 28 February until 31 May 2020 and independent variables associated with basic sanitation were included. RESULTS: High incidence rates were significantly associated with precarious water service index (0-25% coverage) and offstandard faecal coliforms index for tapwater (5-50% and 75-100% of samples tested). A significant association between high mortality rates and sewage collection (0-25% coverage)/treatment (25-50% coverage) indices was also verified. In addition, clusters with significant spatial autocorrelation were identified mainly in the North and Northeast regions for mortality and incidence rates (high-high risk areas) and for offstandard faecal coliforms index. Those regions are considered the poorest in Brazil, presenting with low incomes, human agglomerations, as well as a poor basic sanitation system, which also hinder the implementation of COVID-19-preventative measures. CONCLUSIONS: A precarious basic sanitation infrastructure could potentially be associated with the high transmission of severe acute respiratory syndrome coronavirus-2 in Brazil.