Tendência temporal das hospitalizações por doenças respiratórias em crianças residentes em Governador Valadares, Minas Gerais: análise epidemiológica entre 2015 e 2025

Abstract

Respiratory diseases are among the leading causes of morbidity, mortality, and hospitalization in the pediatric population, representing a major public health concern due to their high hospitalization rates, negative impacts on child development, burden on healthcare services, and associated healthcare costs. In recent years, particularly following the COVID-19 pandemic, changes in the epidemiological patterns of these conditions have highlighted the need for continuous monitoring of temporal trends. Therefore, this study aimed to analyze the temporal trends in hospitalizations for respiratory diseases among children aged 0 to 14 years residing in Governador Valadares, Minas Gerais, Brazil, from 2015 to 2025. This retrospective ecological timeseries study was conducted using secondary data obtained from the Brazilian Unified Health System Hospital Information System (Hospital Information System of the Brazilian Unified Health System – SIH/SUS). Hospitalizations for pneumonia, bronchiolitis, asthma, and influenza were analyzed according to sex, age group, inhospital mortality, length of hospital stay, hospitalization costs, and age-adjusted hospitalization rates. Temporal trends were assessed using Joinpoint regression analysis, with estimation of the Annual Percent Change (APC) and the Average Annual Percent Change (AAPC). Findings were compared with corresponding trends observed in the state of Minas Gerais and throughout Brazil. During the study period, 5,280 hospitalizations for respiratory diseases were recorded among children aged 0 to 14 years. Pneumonia was the leading cause of hospitalization, whereas acute viral bronchiolitis occurred predominantly among infants younger than one year of age. Hospitalizations were more frequent among males, and most in-hospital deaths occurred in children under five years of age. Joinpoint regression identified an inflection point in 2019, followed by a significant increase in hospitalization rates in Governador Valadares during the subsequent period (APC = 32.26%; 95% CI: 14.18–53.20; p < 0.01), corresponding to an approximate increase of 326.5% between 2019 and 2025, substantially exceeding the increases observed in Minas Gerais and Brazil. In contrast, in-hospital mortality showed a declining trend throughout the study period, with no significant inflection points. Additionally, respiratory disease hospitalizations imposed a considerable economic burden, reflected by substantial healthcare expenditures and extensive use of pediatric hospital beds. These findings demonstrate important changes in the epidemiological profile of pediatric respiratory diseases following the COVID-19 pandemic and reinforce the need to strengthen Primary Health Care through expanded vaccination coverage, improved well-child care, enhanced epidemiological surveillance, and continuous monitoring of temporal trends. Furthermore, the results provide valuable evidence to support healthcare planning and policymaking, contributing to the development of strategies aimed at reducing avoidable hospitalizations and improving child healthcare services.