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

Abstract

This study aimed to analyze the geographical distribution of COVID-19 and to identify high-risk 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.