This study evaluates the performance of a semi-dynamic negative binomial model with cubic spline smoothing to characterize the spatiotemporal dynamics of COVID-19 mortality in Peru, a setting marked by significant data inconsistency and reporting delays. Using nationwide weekly mortality data, we compared a Poisson regression against a semi-dynamic NB model with a population offset and cubic splines (df = 6). The models were evaluated using Akaike Information Criterion and log-likelihood to handle overdispersion and temporal non-stationarity. The NB model demonstrated a superior fit, reducing the AIC from 136,596.4 to 75,668.25 and improving log-likelihood by over 30,000 points. Demographic analysis revealed an 81.6% higher risk of death in males (IRR = 1.816; 95% CI: 1.753–1.881) and an exponential gradient with age, peaking at an IRR of 4.717 (95% CI: 4.499–4.945) for individuals ≥80 years. Departmental fixed effects identified significant spatial heterogeneity, with higher diffusion in coastal regions. The semi-dynamic NB model with splines provides a robust, parsimonious, and scalable framework for epidemiological surveillance in resource-limited settings. By effectively correcting for overdispersion and stabilizing weekly reporting fluctuations, this approach offers a reliable tool for public health decision making in environments with fragmented data quality.
Valderrama-Rios et al. (Thu,) studied this question.
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