{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T14:17:54Z","timestamp":1785161874766,"version":"3.55.0"},"reference-count":33,"publisher":"Pan American Health Organization","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,27]]},"abstract":"<title>RESUMO<\/title>\n                  <sec>\n                    <title>Objetivos:<\/title>\n                    <p>Analisar a din\u00e2mica espa\u00e7o-temporal da incid\u00eancia de chikungunya nos munic\u00edpios da regi\u00e3o Nordeste do Brasil, de 2015 a 2023.<\/p>\n                  <\/sec>\n                  <sec>\n                    <title>M\u00e9todos:<\/title>\n                    <p>\n                      Estudo ecol\u00f3gico de s\u00e9rie temporal com casos prov\u00e1veis de chikungunya notificados no Sistema de Informa\u00e7\u00e3o de Agravos de Notifica\u00e7\u00e3o (SINAN). A tend\u00eancia temporal mensal foi analisada pela regress\u00e3o por pontos de inflex\u00e3o (\n                      <italic>joinpoint<\/italic>\n                      ), c\u00e1lculo do Percentual de Varia\u00e7\u00e3o Mensal (PVM) e intervalos de Confian\u00e7a de 95% (IC95%). Identificaram-se aglomerados espa\u00e7o-temporais de alto risco pela varredura Scan de Poisson (risco relativo - RR, valor\n                      <italic>p<\/italic>\n                      &lt; 0,05).\n                    <\/p>\n                  <\/sec>\n                  <sec>\n                    <title>Resultados:<\/title>\n                    <p>Foram notificados 769.986 casos (2015-2023), concentrados nos estados do Cear\u00e1 (27,9%), Bahia (25,3%) e Pernambuco (14,5%). Epidemias explosivas ocorreram em 2016, 2017 e 2022, intercaladas por per\u00edodos de baixa transmiss\u00e3o. A an\u00e1lise temporal revelou PVMs iniciais elevados, como no Maranh\u00e3o (127,4%; IC95%: 112,5\u2013172,6). Em 2022, epidemias explosivas voltaram a ocorrer, com destaque para Alagoas (PVM = 342,4%; IC95%: 187,2\u2013557,3) e Piau\u00ed (PVM = 242,9%; IC95%: 162,6\u2013441,8). Foram identificados aglomerados espa\u00e7o-temporais significativos, 70% deles com in\u00edcio em 2016. Observou-se dissocia\u00e7\u00e3o entre extens\u00e3o geogr\u00e1fica e intensidade do risco: o maior RR (45,5; IC95%: 43,7\u201347,3) ocorreu em um cluster na Bahia, em 2020, e o de maior abrang\u00eancia envolveu 431 munic\u00edpios de quatro estados, em 2016.<\/p>\n                  <\/sec>\n                  <sec>\n                    <title>Conclus\u00e3o:<\/title>\n                    <p>A din\u00e2mica da chikungunya no Nordeste caracterizou-se por heterogeneidade espa\u00e7o-temporal, com deslocamento de epicentros e persist\u00eancia de bols\u00f5es de alto risco, refor\u00e7ando a necessidade de vigil\u00e2ncia e controle integrados e regionalizados, visando responder \u00e0 transmiss\u00e3o sustentada em bols\u00f5es de alto risco e aos clusters interestaduais.<\/p>\n                  <\/sec>","DOI":"10.26633\/rpsp.2026.66","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T13:54:35Z","timestamp":1785160475000},"page":"1","source":"Crossref","is-referenced-by-count":0,"title":["An\u00e1lise espa\u00e7o-temporal da expans\u00e3o e persist\u00eancia da chikungunya no Nordeste do Brasil (2015\u20132023)"],"prefix":"10.26633","volume":"50","author":[{"given":"Suzanne Santos","family":"de Lima","sequence":"first","affiliation":[{"name":"Funda\u00e7\u00e3o Oswaldo Cruz, Instituto Aggeu Magalh\u00e3es, Recife, PE, Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda Priscila de Santana","family":"Cabral Silva","sequence":"additional","affiliation":[{"name":"Universidade Federal de Pernambuco, Vit\u00f3ria de Santo Ant\u00e3o, PE, Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos Feitosa","family":"Luna","sequence":"additional","affiliation":[{"name":"Funda\u00e7\u00e3o Oswaldo Cruz, Fiocruz, Recife, PE, Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wayner Vieira","family":"de Souza","sequence":"additional","affiliation":[{"name":"Funda\u00e7\u00e3o Oswaldo Cruz, Fiocruz, Recife, PE, Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia","family":"Braga","sequence":"additional","affiliation":[{"name":"cynthia.braga@fiocruz.br"},{"name":"Funda\u00e7\u00e3o Oswaldo Cruz, Fiocruz, Recife, PE, Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"11167","reference":[{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Puntasecca CJ, King CH, LaBeaud AD. 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