1116Spatial diffusion of the 2015-2016 Zika, dengue, and chikungunya epidemics in Rio de Janeiro, Brazil.

RIO de Janeiro (Brazil); BRAZIL

Background Text: Different countries, especially Brazil, that have faced recurrent dengue epidemics for decades and chikungunya epidemics since 2014, have had to restructure their health services to combat a triple epidemic of arboviruses - Zika, dengue, and Chikungunya - transmitted by the same vector, mainly Aedes aegypti , in 2015-2016. Several efforts have been made to better understand these three arboviruses. The knowledge of the patterns of spatial diffusion of diseases during an epidemic can contribute to the planning of surveillance actions and control of these diseases. This study aimed to identify spatial diffusion processes of these viruses in the context of the triple epidemic in 2015-2016 in Rio de Janeiro, Brazil. Methods Text: Two study designs were used: cross-sectional and ecological. Zika, dengue, and chikungunya cases notified to the national notificable disease surveillance system of the Ministry of Health of Brazil in 2015 and 2016 were used. The residential addresses of the cases were geocoded. Sequential Kernel maps, nearest-neighbor ratios calculated cumulatively over time, Moran global autocorrelation correlograms, and local autocorrelation changes over time were used to identify spatial diffusion patterns. Results Text: Our findings suggest an expansion diffusion pattern for the 2015-2016 triple epidemic of Zika, dengue and chikungunya in the city of Rio de Janeiro, Brazil, as well as the sites most affected by the diseases. Conclusions Text: The spatial diffusion pattern of expansion was suggested by the results of the spatial analysis used. Key messages Text: These findings can be considered for more effective control measures and for new studies on the dynamics of these three arboviruses. [ABSTRACT FROM AUTHOR]

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