Spatial variation and detection of COVID-19 hotspots in Panama: an analysis based on census data

Abstract

COVID-19, an infectious disease of zoonotic origin, has spread globally, significantly impacting Panama. Identifying risk areas (hotspots) using geoepidemiological techniques is essential for implementing effective control measures. Objective: To conduct a spatial analysis of the COVID-19 epidemic in Panama using recent census data to better understand the virus's distribution characteristics and explore its geographic patterns, particularly spatial clustering. Materials and Methods: Data from the 2023 Population and Housing Census of Panama were used, which included information on COVID-19 incidence in households and household size to calculate the COVID-19 rate. The 82 districts of Panama were geocoded for the study. Statistical analyses were conducted using GEODA, applying the global Moran's I, Getis-Ord GI* local hotspot analysis, and Local Indicators of Spatial Association (LISA) to detect COVID-19 risk clusters. Maps were generated using R. Results: The COVID-19 rate showed spatial clustering in Panama's districts (Moran's I=0.672, p=0.001). Significant local clusters were identified in six districts of Herrera province: Chitré (GI*=0.022, LISA=2.34, p=0.011), Santa María (GI*=0.02, LISA=1.07, p=0.02), Pesé (GI*=0.02, LISA=1.12, p=0.002), Parita (GI*=0.021, LISA=1.11, p=0.003), Los Pozos (GI*=0.017, LISA=0.52, p=0.038) and Ocú (GI*=0.018, LISA=0.54, p=0.013); seven districts in Los Santos province: Las Tablas (GI*=0.022, LISA=2.23, p=0.002), Macaracas (GI*=0.021, LISA=1.97, p=0.001), Guararé (GI*=0.023, LISA=2.38, p=0.001), Pedasí (GI*=0.022, LISA=1.87, p=0.005), Los Santos (GI*=0.023, LISA=2.19, p=0.001), Pocrí (GI*=0.022, LISA=1.88, p=0.014) and Tonosí (GI*=0.02, LISA=1.14, p=0.008); and Mariato in Veraguas (GI*=0.017, p=0.024). Conclusion: The distribution of COVID-19 exhibits specific geographic patterns based on spatial clustering. These findings suggest that identified areas should be prioritized for virus control and prevention measures for COVID-19 and similar future outbreaks.