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The 1918-1919 Influenza Pandemic in Portugal: a Regional Analysis of Death Impact

2018-12-01Journal article Restricted access
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dc.contributor.authorNunes, Baltazar
dc.contributor.authorSilva, Susana
dc.contributor.authorRodrigues, Ana
dc.contributor.authorRoquette, Rita
dc.contributor.authorBatista, Inês
dc.contributor.authorRebelo-de-Andrade, Helena
dc.date.accessioned2019-03-08T14:42:28Z
dc.date.available2019-03-08T14:42:28Z
dc.date.issued2018-12-01
dc.description.abstractAlthough the impact of deaths occurring during the 1918-1919 influenza pandemic has been assessed in many archeo-epidemiologic studies, detailed estimates are not available for Portugal. We applied negative binomial models to monthly data on respiratory-related and all-cause deaths at the national and district levels from Portugal for 1916-1922. Influenza-related excess mortality was computed as the difference between observed and expected deaths. Poisson regression was used to estimate the association of geographic and sociodemographic factors with excess mortality. Two waves of pandemic influenza-July 1918 to January 1919 and April to May 1919-were identified, for which the excess all-cause death rate was 195.7 per 10,000 persons. All districts of Portugal were affected. The pandemic hit earlier in southeastern districts and the main cities, but excess mortality was highest in the northeast, in line with the high death burden experienced by northern Spanish provinces. During the period of intense excess mortality (fall/winter 1918-1919), population density was negatively associated with pandemic impact. This pattern changed during the March 1919 to June 1920 wave, when excess mortality increased with population density and in northern and western directions. Portuguese islands were less and later affected. Given the geographic heterogeneity evidenced in our study, subnational sociodemographic characteristics and connectivity should be integrated in pandemic preparedness plans.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationAm J Epidemiol. 2018 Dec 1;187(12):2541-2549. doi: 10.1093/aje/kwy164pt_PT
dc.identifier.doi10.1093/aje/kwy164pt_PT
dc.identifier.issn0002-9262
dc.identifier.urihttp://hdl.handle.net/10400.18/6098
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherOxford University Press/ Johns Hopkins Bloomberg School of Public Healthpt_PT
dc.relation.publisherversionhttps://academic.oup.com/aje/article/187/12/2541/5067655pt_PT
dc.subject1918 Pandemicpt_PT
dc.subjectExcess Mortalitypt_PT
dc.subjectInfluenzapt_PT
dc.subjectPortugalpt_PT
dc.subjectSociodemographic Characteristicspt_PT
dc.subjectEstados de Saúde e de Doençapt_PT
dc.titleThe 1918-1919 Influenza Pandemic in Portugal: a Regional Analysis of Death Impactpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage2549pt_PT
oaire.citation.issue12pt_PT
oaire.citation.startPage2541pt_PT
oaire.citation.titleAmerican Journal of Epidemiologypt_PT
oaire.citation.volume187pt_PT
rcaap.rightsembargoedAccesspt_PT
rcaap.typearticlept_PT

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