EPIDEMIOLOGICAL INDICATOR OF VULNERABILITY TO CLIMATE EXTREME TO THE AMAZONIAN REGION AND BRAZILIAN NORTHEAST
Climdex, extreme events, susceptibility and epidemiological
In the amazonian region and the Brazilian northeast, extreme climatic events such as torrential rains and severe droughts are potentiated against a situation of poverty resulting in an increase or intensification of the incidence of endemic diseases, water supply problems, agricultural losses often leading to greater vulnerability. Thus, the main objective of this study is to construct and analyze an epidemiological vulnerability index associated with extreme climatic indexes for the Brazilian Amazon and Northeast region and it was analyzed the mesoregions of the study area according to the risk characteristics to the climatic trend. For this, different datasets were used: meteorological data from Xavier et al. (2015) from a project of the University of Texas and Federal University of Espírito Santo corresponding to the period from 1980 to 2013; health data provided by the Ministry of Health on websites of the System of Information on Mortality (SIM), SUS Hospital Information System (SIH / SUS) of DATASUS and demographic data with the Brazilian Institute of Geography and Statistics (IBGE) and Program of the United Nations (UNDP). The meteorological data were applied to the software RClimdex, which 21 indices were selected, 10 being related to precipitation and 7 to the temperature according to the meteorological and climatic conditions of each region of this study. For the creation of the epidemiological indicator of vulnerability to climatic extreme, the cumulative normal distribution was used to assign scores varying from 0 to 1 for the calculation of vulnerability components: risk, susceptibility and adaptive capacity. For the analysis, understanding and identification of the susceptible areas to morbimortalities, we used cluster analysis. The results showed that the indexes TXx, TNx, TX10p, TX90p, SDII, R20mm, CDD, R95p and PRECPTOT presented the highest trends of climatic changes for Amazonia and Brazilian Northeast, with emphasis on the Sergipe backwoods mesoregion. Although, it has observed high epidemiological vulnerability associated with climatic extreme for the whole region of study. The mesoregion of Marajó and Southeast of Amazonia had the highest vulnerability (0.98), explained by high adaptive incapacity, moderate susceptibility and high climatic risk. On the other hand, mesoregions as metropolitan region of Belém (0.72), East of Sergipe (0.68) and Rio Grande do Norte (0.75) presented lower vulnerabilities, associated with a low adaptive disability and low susceptibility, despite presenting a moderate climatic risk. The results of the cluster analysis revealed that groups that are very susceptible to morbimortalities presented high rates of respiratory diseases and infectious and parasitic diseases. This study made it possible to identify the mesoregions of Amazonia and Brazilian Northeast more vulnerable to the epidemiological aspect in the occurrence of extreme events.