Analysis of the Hospitalization Rate Due to Waterborne and Foodborne Diseases in Brazil in 2021

Objective: Waterborne and Foodborne Diseases (WFD) represent a significant public health issue, with considerable impacts on morbidity, mortality, and the burden on healthcare services. The ingestion of food or water contaminated by biological, chemical, or physical agents can trigger outbreaks with varying degrees of clinical severity, often requiring hospitalization. In this context, the present study aimed to analyze the factors associated with the hospitalization rate resulting from WFD outbreaks in Brazil, focusing on epidemiological data from the year 2021. Theoretical Framework: WFD outbreaks have been widely studied in the scientific literature, with emphasis on etiological agents such as Escherichia coli, Salmonella spp., and protozoa associated with the consumption of açaí and contaminated water. The literature also highlights the importance of epidemiological surveillance and data quality for the prevention and control of these outbreaks. Method: This is a descriptive study with a quantitative approach, based on secondary data extracted from the Notifiable Diseases Information System (SINAN), accessed through Tabwin/DATASUS. Statistical analysis was conducted using R software, applying the zero-and-one inflated beta regression model, suitable for proportional variables with extreme value concentrations (0 and 1), such as the hospitalization rate. Results and Discussion: The results showed that bacterial outbreaks were the most prevalent, especially those caused by Escherichia coli and Salmonella spp. Most outbreaks occurred in households, followed by restaurants and events. Açaí was the main food associated with protozoan outbreaks, while water was strongly linked to bacterial and viral outbreaks. Statistical modeling indicated that outbreaks classified as “scattered cases” had a lower average hospitalization rate, suggesting lower clinical severity. On the other hand, symptoms such as diarrhea and vomiting were significantly associated with hospitalization, while fever showed an inverse association. The absence of information on improper food handling was related to a higher likelihood of outbreaks without hospitalization, which may indicate underreporting or lower case severity. Research Implications: The analysis of model parameters (μ, σ, ν, and τ) allowed the identification of factors associated with the mean hospitalization rate, its dispersion, the total absence of hospitalizations, and the complete hospitalization of cases, respectively. These findings reinforce the importance of epidemiological surveillance, data quality, and the adoption of rigorous preventive measures, especially in domestic environments, to reduce the severity of outbreaks and the need for hospitalizations. Originality/Value: This study contributes to the understanding of the determinants of hospitalization due to WFD and provides insights for improving public policies on food safety and public health in Brazil.