title: Temporal and Spatial Trends in Childhood Asthma-Related Hospitalizations in Belo Horizonte, Minas Gerais, Brazil and Their Association with Social Vulnerability.
abstract: Asthma is a multifactorial disease and a serious public health problem. Environmental factors and poverty are the main determinants of this disease.
  
  
  
  To describe the spatial and temporal distribution of asthma-related hospitalizations and identify the areas with the highest prevalence of and vulnerability to severe asthma in a major Brazilian city.
  
  
  
  An ecological study of hospitalizations for asthma from 2002 to 2012, in children and adolescents under 15 years of age, living in Belo Horizonte, Southeast Brazil. All events were geocoded by residence address using Hospital Information System data. The socioeconomic vulnerability of residence address was ranked using the Health Vulnerability Index. Raster surfaces were generated and time-series plots were constructed to determine spatial and time trends in the frequency of asthma-related hospitalizations, respectively.
  
  
  
  Asthma-related hospitalization rates were highest in children aged 0-4 years and in boys. There was a decreasing trend in the number of asthma-related hospitalizations across the study period. Approximately 48% of all hospitalizations were children living in health vulnerable areas. Seasonal trends showed a hospitalization peak in March, April, and May, coinciding with the post-rainy period.
  
  
  
  Our findings suggest that social and environmental factors may be determinants of disparities in severe asthma.
authors.affiliation: Department Physiotherapy, Pontifical Catholic University of Minas Gerais (PUC Minas), Belo Horizonte 30535610, Brazil. claudiadiaspuc@yahoo.com.br.|Belo Horizonte Observatory for Urban Health (OSUBH), School of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte 30130100, Brazil. claudiadiaspuc@yahoo.com.br.
authors.forename: Cláudia Silva
authors.initials: CS
authors.lastname: Dias
authors.affiliation: Belo Horizonte Observatory for Urban Health (OSUBH), School of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte 30130100, Brazil. angelica@pbh.gov.br.
authors.forename: Maria Angélica Salles
authors.initials: MA
authors.lastname: Dias
authors.affiliation: Belo Horizonte Observatory for Urban Health (OSUBH), School of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte 30130100, Brazil. gutafriche@gmail.com.
authors.forename: Amélia Augusta de Lima
authors.initials: AA
authors.lastname: Friche
authors.affiliation: Belo Horizonte Observatory for Urban Health (OSUBH), School of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte 30130100, Brazil. cristinaalmeida@gmail.com.
authors.forename: Maria Cristina de Mattos
authors.initials: MC
authors.lastname: Almeida
authors.affiliation: Belo Horizonte Observatory for Urban Health (OSUBH), School of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte 30130100, Brazil. thais_tcv@hotmail.com.
authors.forename: Thaís Claudino
authors.initials: TC
authors.lastname: Viana
authors.affiliation: Belo Horizonte Observatory for Urban Health (OSUBH), School of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte 30130100, Brazil. suelimngt@gmail.com.|Institute of Exact Sciences, Federal University of Minas Gerais (UFMG), Belo Horizonte 31270901, Brazil. suelimngt@gmail.com.
authors.forename: Sueli Aparecida
authors.initials: SA
authors.lastname: Mingoti
authors.affiliation: Belo Horizonte Observatory for Urban Health (OSUBH), School of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte 30130100, Brazil. wcaiaffa@medicina.ufmg.br.
authors.forename: Waleska Teixeira
authors.initials: WT
authors.lastname: Caiaffa
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000453:epidemiology*; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015995:Prevalence; D012621:Seasons; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D062211:Spatio-Temporal Analysis; D014505:Urban Population
keywords: children and adolescents; ecological study; hospitalization for asthma; vulnerability