The influence of the number of hospital beds, age and municipal development on mortality and fatality rates due to dengue in the state of São Paulo (ESP)

https://doi.org/10.63923/smhs.2026.42

Abstract

Dengue is an endemic arbovirus in tropical and subtropical regions, affecting half of the world’s population. In the elderly (60-79 years), it presents more severely, due to comorbidities and immunological changes. Incidence, mortality, and lethality data were analyzed in the XXVII Epidemiological Surveillance Group (GVE) and the State of São Paulo (ESP). This is a retrospective cross-sectional descriptive study based on secondary data (DATASUS, CNES 2024, SEADE 2023). In 2024, the ESP registered more than 2.1 million probable cases of dengue, with 62.4% in adults (20-59 years) and 16% in the elderly. Mortality (M), per 100,000 inhabitants, ranged from 1.92, in young adults (20-39 years), to 19.56 (70-79 years). Lethality (L), per 100 inhabitants (%), was 12.6 times higher in the elderly aged 70-79 years compared to the younger population. In the GVE, there were 144,326 cases and 219 deaths (L:0.15%; M:20.05); while the ESP had 2,180,064, and 2,197 (L: 0.1% Mortality?), respectively. Of the regional notifications, São José dos Campos (SJC) and Jacareí accounted for 69.5% and 23.5%, respectively, compared to the GVE. Among the elderly, in GVE XXVII, 23,597 cases and 169 deaths were registered, and the distribution occurred as follows: 55.5% of cases and 32 deaths in the 60-69 age group; 32.2% of cases and 58 deaths in the 70-79 age group; and 12.3% of cases and 76 deaths in individuals aged 80 years or more. The overall lethality was 0.7%. The municipality of Jacareí presented the highest mortality and lethality rates in all age groups. The bed supply in the GVE was 261.53 per 100 thousand inhabitants, higher than the ESP (256.95). However, SJC, with more beds, had 39.6% higher lethality; while Jacareí, with 30.5% fewer beds, had 150.9% higher lethality (60-79 years), suggesting the influence of inequality in health infrastructure and socioeconomic regional areas. Despite the higher incidence in young adults, the high mortality among the elderly requires public policies focused on epidemiological surveillance and expanding access to health services.

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