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. 2025 Mar 19;17(3):443.
doi: 10.3390/v17030443.

Analysis of Morbidity and Mortality Due to Yellow Fever in Brazil

Luisa Sousa Machado  1 , Antonio Francisco Marinho Sobrinho  1 , Andrielly Gomes De Jesus  2 , Juarez Antônio Simões Quaresma  3   4   5   6 , Helierson Gomes  1
Affiliations

Analysis of Morbidity and Mortality Due to Yellow Fever in Brazil

Luisa Sousa Machado et al. Viruses. .

Abstract

Introduction: Yellow fever (YF) is a viral hemorrhagic fever transmitted by mosquitoes, characterized by a high mortality due to kidney and liver failure, massive coagulation disorders, and hemorrhages. With no specific treatment, prevention through vaccination and vector control is essential. This study investigates the epidemiology of YF in Brazil from 2011 to 2020, focusing on its trends and distribution across the territory.

Methods: This ecological time-series study analyzed confirmed YF cases in Brazil's 27 federative units between 2011 and 2020. Data were sourced from DATASUS, IBGE, and IPEA. Incidence rates per 100,000 inhabitants were calculated, and various sociodemographic and health indicators were analyzed. Prais-Winsten autoregressive models assessed the trends, while a spatial analysis identified the risk areas using global and local Moran's I statistics. The data were processed using Stata and GeoDa® software, version 1.12.

Results: YF cases were concentrated in the Amazon and Atlantic Forest biomes. The majority of the cases occurred in males (83.3%), non-white individuals (94.3%), and rural workers. Pará showed an increasing trend in incidence. A higher vaccination coverage correlated with a lower YF incidence, though endemic areas with good vaccination coverage still exhibited high rates. Health and socioeconomic indicators were inversely related to incidence, highlighting disparities in regional development.

Conclusion: Effective YF control requires multidisciplinary strategies, including expanded vaccination coverage, intensified vector control, and active surveillance. Research should focus on developing better vaccines, monitoring immunity, and improving the global response coordination.

Keywords: environmental health; epidemiology; socioeconomic factors; vaccination; yellow fever.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Yellow fever cases in Brazil according to biome and environmental characteristics. Source: SVS, 2024, PRODES, 2024. Prepared by Helierson Gomes in 2024.
Figure 2
Figure 2
Areas at risk for yellow fever infection (incidence > 20 cases per 100,000 inhabitants).
Figure 3
Figure 3
Spatial autocorrelation between health indicators and yellow fever incidence levels in Brazil.
Figure 4
Figure 4
Spatial autocorrelation between socioeconomic indicators and yellow fever incidence levels in Brazil.
Figure 5
Figure 5
Spatial autocorrelation between health indicators and yellow fever mortality levels in Brazil.
Figure 6
Figure 6
Spatial autocorrelation between socioeconomic indicators and yellow fever lethality levels in Brazil.
See this image and copyright information in PMC

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