Impact of COVID-19 on the indigenous population of Brazil: A geo-epidemiological study

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Abstract

This study aimed to analyze the geographical distribution of COVID-19 and to identify highrisk areas for the occurrence of cases and deaths from the disease in the indigenous population of Brazil. This is an ecological study whose units of analysis were the Special Indigenous Sanitary Districts. Cases and deaths by COVID-19 notified by the Special Secretariat for Indigenous Health between March and October 2020 were included. To verify the spatial association, the Getis-Ord General G and Getis-Ord Gi * techniques were used. High spatial risk clusters have been identified by the scan statistics technique. 32,041 cases of COVID-19 and 471 deaths were reported. The incidence and mortality rates were between 758.14 and 18530.56 cases and 5.96 and 265.37 deaths per 100 thousand inhabitants, respectively. The non-randomness of cases (z-score = 5.40; p <0.001) and deaths (z-score = 3.83; p <0.001) was confirmed. Hotspots were evidenced for both events with confidence levels of 90, 95 and 99% concentrated in the North and Midwest regions of the country. Eight high-risk spatial clusters for cases with a relative risk (RR) between 1.08 and 4.11 (p <0.05) and two risk clusters for deaths with RR between 3.08 and 3.97 (p <0.05) were identified. The results indicate critical areas in the indigenous territories of Brazil and contribute to better targeting the control actions of COVID-19 in this population.

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  1. SciScore for 10.1101/2021.01.12.21249703: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: Ethical considerations: Because it is research with secondary data of public access using data in an aggregated form and without the nominal identification of the subjects, the opinion by a Research Ethics Committee was waived, according to the National Health Council Resolution 510/2016.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    SatScan® software version 9.6 was used for the spatial scan statistic technique.
    SatScan®
    suggested: None
    The spatial association and the construction of maps were performed using ArcGis® software version 10.6.
    ArcGis®
    suggested: (ArcGIS for Desktop Basic, RRID:SCR_011081)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).


    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    One of the limitations of this study is the use of secondary sources of information, which does not exclude the possibility of incomplete data. However, the information is obtained from each of the 34 SIHDs and, afterwards, is validated by the Department of Attention to Indigenous Health [10]. Another issue is that the data provided by the Ministry of Health are aggregated by SIHD, which includes several ethnic groups and villages within the same region. The provision of aggregated data in smaller geographical units, would allow a more detailed analysis, with the inclusion of variables related to sociocultural diversity and health determinants of these communities. The possibility of underreporting COVID-19 cases should also be considered. Admittedly, the indigenous population has a high degree of vulnerability for both COVID-19 and other diseases, and our study showed that this population suffers strongly from the impacts of this worldwide pandemic, since it has indicators that far exceed those of the general population. The results showed that the cases and deaths by COVID-19 peaked in July, and increased even in the face of the contingency plans launched by the government [23]. The incidence and mortality in the SIHDs for the period studied reached 18530.56 cases per 100000 people and 265.37 deaths per 100000 people, respectively, significantly exceeding the national rates registered in July, which were 1139.4 cases per 100000 people and 41.1 deaths per 100000 people [9,10...

    Results from TrialIdentifier: No clinical trial numbers were referenced.


    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.


    Results from JetFighter: We did not find any issues relating to colormaps.


    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

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