The Shortage of Benzathine Penicillin and Its Impact on Congenital Syphilis Incidence: An Ecologic Study in the City of Rio de Janeiro

2020 ◽  
Author(s):  
José Ueleres Braga ◽  
Rachel Sarmeiro Araujo ◽  
Ana Sara Semeão de Souza
Keyword(s):  
Rio De Janeiro ◽  
Congenital Syphilis ◽  
Fold Increase ◽  
Benzathine Penicillin ◽  
Ecologic Study ◽  
Binomial Regression ◽  
Study Population ◽  
Health Organization ◽  
The City ◽  
Strength Of Association

Abstract Background The Pan American Health Organization indicates that increased incidence of congenital syphilis (CS) can be attributed to the lack of penicillin. This study aimed to analyze the relationship between the benzathine penicillin shortage and the significant increase in the incidence of congenital syphilis in the city of Rio de Janeiro from 2013 to 2017. Methods We used a mixed ecologic study design (temporal and multiple groups). Analysis units were the neighborhoods (spatial) and quarters (temporal) during those years. The study population consisted of CS patients who were living in the city of Rio de Janeiro. The benzathine penicillin supply measure for use in gestational syphilis considered the ratio between (1) the number of bottles dispensed to health facilities in each neighborhood and (2) the number of bottles necessary to treat pregnant women diagnosed with syphilis and their respective partners residing in each neighborhood. To evaluate the association between shortages and a significant increase in CS incidence, the negative-inflated zero-binomial regression model (longitudinal model) was used. Results During the study period, the incidence rate of CS in Rio de Janeiro neighborhoods was on average 19.6 per 1000 live births. In the simple analysis, shortage was associated with a 2.17-fold increase in the risk of a significant increase in CS incidence. After adjustment for the sufficient minimum set, the strength of association increased to 2.23 (95% confidence interval, 1.15–4.30). Conclusions We conclude that the benzathine penicillin shortage had an impact on the increase in the incidence of CS in Rio de Janeiro.

scholarly journals The shortage of benzathine penicillin and its impact on congenital syphilis incidence: an ecologic study in the city of Rio de Janeiro

2020 ◽  
Author(s):  
Jose Ueleres Braga ◽  
Rachel Sarmeiro Araujo ◽  
Ana Sara Semeão de Souza
Keyword(s):  
Rio De Janeiro ◽  
Congenital Syphilis ◽  
Scientific Evidence ◽  
Fold Increase ◽  
Directed Acyclic Graphs ◽  
Epidemiological Surveillance ◽  
Benzathine Penicillin ◽  
Ecologic Study ◽  
The Impact ◽  
The City

Abstract Background The Pan American Health Organization indicates that the increased congenital syphilis (CS) incidence can be attributed to (i) the improvement of epidemiological surveillance, (ii) the expansion of rapid diagnostic tests, and (iii) the lack of penicillin. However, there is no scientific evidence to support the impact of the penicillin shortage on the increase in the incidence of CS. This study aimed to analyze the relationship between the benzathine penicillin (BP) shortage and the significant increase in the incidence of congenital syphilis in the city of Rio de Janeiro from 2013 to 2017. Methods We used a mixed ecologic study design (temporal and multiple groups). Analysis units were the neighborhoods (spatial) and quarters (temporal) during those years. The study population consisted of CS patients reported to the Brazil Information System of Notifiable Diseases (SINAN) that were living in the city of Rio de Janeiro, which was geocoded by neighborhood. The BP supply measure for use in Gestational Syphilis considered the ratio between two Benzatin Pencil Dispenser bottle quantities: (a) the number of bottles dispensed to health facilities in each neighborhood and (b) the number of bottles necessary to treat pregnant women diagnosed with syphilis and their respective partners residing in each neighborhood. To evaluate the association between shortages and a significant increase in CS incidence, the negative-inflated zero-binomial regression model (longitudinal model) was used. Crude and adjusted odds ratios were calculated to express the magnitude of the associations. A theoretical model was proposed with four dimensions: sociodemographic, economic, geographical, and prenatal care. The selection of adjustment variables was considered using Directed Acyclic Graphs. Results During the study period, the incidence rate of CS in Rio de Janeiro neighborhoods was on average 19.6/1000 live births. In the simple analysis, shortage was associated with a 2.17-fold increase in the risk of a significant increase in CS incidence. After adjustment for the sufficient minimum set, the strength of association increased to 2.23 (95% confidence interval, 1.15–4.30). Conclusions We conclude that the benzathine penicillin shortage impacted the increase in the incidence of congenital syphilis in Rio de Janeiro.

Environmental Effects of Aluminum Used in Water Treatment Plants of Rio de Janeiro State, Brazil

1994 ◽  
Vol 29 (4) ◽  
pp. 571-580
Author(s):  
Jose M. Azcue ◽  
Olaf Malam ◽  
Wolfgang G. Pfeiffer
Keyword(s):  
Water Treatment ◽  
Rio De Janeiro ◽  
River System ◽  
Average Concentration ◽  
World Health ◽  
Water Treatment Plants ◽  
Alum Sludge ◽  
Health Organization ◽  
The City ◽  
Janeiro State

Abstract The effect of the extended use of alum on the concentration of aluminum in water treatment was investigated. Water from the Paraiba do Sul-Guandu River (PSR-GR) system, collected after conventional treatment, was analyzed from the six water treatment plants (WTPs). One of the WTPs, the Guandu WTP, supplies water to the city of Rio de Janeiro (11 million inhabitants) with a flow of 40 m3/s. The concentrations of aluminum found were near and sometimes over the values recommended by the World Health Organization (200 µg/L), with an average concentration of 306 µg/L, reaching seasonally maximum values of 877 µg/L at the WTP and 2,100 µg/L in household taps. The discharge of alum sludge back to the river system is the predominant pathway in the aluminum cycling in the study area, followed by sedimentation and enhanced availability to the biota.

scholarly journals Association of socioeconomic, labor and health variables related to Food Insecurity in workers of the Popular Restaurants in the city of Rio de Janeiro

2015 ◽  
Vol 28 (1) ◽  
pp. 77-87 ◽  
Author(s):  
Ana Cristina Marcotullio Lopes Falcão ◽  
Odaleia Barbosa de Aguiar ◽  
Maria de Jesus Mendes da Fonseca
Keyword(s):  
Food Security ◽  
Food Insecurity ◽  
Rio De Janeiro ◽  
Cross Sectional Study ◽  
Food Composition ◽  
Sectional Study ◽  
Cross Sectional ◽  
Study Population ◽  
Lower Education ◽  
The City

Objective: This study aimed to analyze the prevalence of perceived food insecurity in households of employees of Popular Restaurants, as well as associate this perception with socioeconomic, labor and health variables. Methods: This is a cross-sectional study of 273 workers from seven restaurants located in the city of Rio de Janeiro, Brazil. We applied a questionnaire with different scales and anthropometric measurements were taken. Assessment of food insecurity was performed using the Brazilian Food Insecurity Scale, classifying individuals in food security and food insecurity. The analyses were performed by calculating the gross and adjusted odds ratio. The logistic regression was performed considering three groups of variables: socio-economic, employment and health. Results: The estimated prevalence of food insecurity was 53.7%. The variables: education (OR=2.39; 95%CI=1.38-4.16), time working in kitchens <29 months (OR=2.72; 95%CI=1.44-5.16) and opinion on the satisfaction with food composition and regularity (OR=2.01; 95%CI=1.12-3.57) were significantly associated with food insecurity. Conclusion: Although the study population find themselves inserted into a social facility to promote food security, food insecurity results are worrying. Additionally, factors like lower education and less time working in restaurants increased the chance to realize their households in food insecurity.

Impact of age and schooling on performance on the Brief Cognitive Screening Battery: A study of elderly residents in the City of Rio de Janeiro, Brazil.

2018 ◽  
Vol 11 (3) ◽  
pp. 317-328 ◽  
Author(s):  
Verônica C. Araujo ◽  
Christina M. B. Lima ◽  
Eduarda N. B. Barbosa ◽  
Flávia P. Furtado ◽  
Helenice Charchat-Fichman
Keyword(s):  
Rio De Janeiro ◽  
Cognitive Screening ◽  
Screening Battery ◽  
The City

Incidência da utilização de protetores bucais em diversos esportes de contato

2020 ◽  
Vol 12 (45) ◽  
pp. 118-122
Author(s):  
Victor Paes Dias Gonçalves ◽  
Hugo Leonardo Matias Nahmias ◽  
Marcus Menezes Alves Azevedo
Keyword(s):  
Martial Arts ◽  
Rio De Janeiro ◽  
Dental Trauma ◽  
Primary Objective ◽  
Type Ii ◽  
Contact Sports ◽  
The Face ◽  
Secondary Objective ◽  
The City

Among contact sports, the practice of martial arts offers a greater risk of causing dental trauma and fractures as contact with the face is more frequent. The primary objective of the research is to evaluate the incidence of mouthguard use, and the secondary objective is to verify which type has a greater predominance and the difficulties in its use correlating to the type of mouthguard used. A documentary study was carried out with 273 athletes of different contact sports, among them: MMA, Boxing, Muay Thai, Jiu-Jitsu, and Taekwondo of the city of Campos dos Goytacazes, Rio de Janeiro, Brazil. It was concluded that the most commonly used mouthguard is PB Boils and Bites - Type II and its level of approval is poor, interfering with the athletes’ performance, mainly in relation to the breathing factor.

Categorias analíticas do espaço e Turismo: o exemplo da Fortaleza de Santa Cruz, Niterói/RJ

GEOgraphia ◽  
2010 ◽  
Vol 8 (16) ◽  
Author(s):  
Miguel Ângelo Ribeiro
Keyword(s):  
Social Sciences ◽  
Urban Space ◽  
Rio De Janeiro ◽  
Future Generations ◽  
Guanabara Bay ◽  
Single Family ◽  
Spatial Dynamic ◽  
Santa Cruz ◽  
Military Installations ◽  
The City

O objetivo que permeia a presente pesquisa é utilizar a Fortaleza de Santa Cruz, localizada no bairro de Jurujuba, em Niterói, construída em 1555, na entrada da barra da Baía de Guanabara, como foco de antílise, ressaltando a importância deste fixo social enquanto atração turística e de lazer, incluindo a cidade de Niterói no circuito destas atividades, complementares à cidade do Rio de Janeiro; além de abordar conceitos e categorias analíticas, oriundos das ciências sociais, principalmente provenientes da Geografia, pertinentes ao estudo das atividades em tela. Neste contexto, na dinâmica espacial da cidade de Niterói, o processo de mudança de função dos fixos sociais têm sido extraordinário. Residencias unifamiliares, prédios e até mesmo fortificações militares, verdadeiras monumentalidades, foram refuncionalizadas, passando por um processo de turistificação. Assim, a refuncionalização da respectiva Fortaleza em espaço cultural toma-se um importante atrativo da história, do patrimônio, da cultura, marcando no espaço urbano sua expressões e monumentalidade, criada pelo homem como símbolo de seus ideais, objetivos e atos, constituindo-se em um legado as gerações futuras, formando um elo entre passado, presente e futuro. Abstract This paper focuses on Santa Cruz Fortress, built in 1555 in Jurujuba (Niterói), to guard the entrance of Guanabara bay, and stresses its role as a towist attraction and leisure' area, as a social fix which links the city of Niterói to the complementary circuit of these activities in the city of Rio de Janeiro. The study uses important concepts and analytic categories fiom social sciences, particularly fiom Geography.In the spatial dynamic of the city of Niterói, change in functions of social fuces has been extraordinary. Single-family dwellings, buildings and even military installations have been re-functionalized, undergoing a process of touristification. In that way, the refunctionalization of the Fortress as a cultural space provides an important attraction in the domains of history, patrimony, and culture, providing the urban space with an expression of monumentality, created by man as a symbol of his ideals, aims and actions, a legacy to future generations forming a link between past, present and future.

A utopia do direito à cidade: Possibilidades de superação da dicotomia favela-bairro no Rio de Janeiro

GEOgraphia ◽  
2010 ◽  
Vol 7 (14) ◽  
Author(s):  
Márcio Piñon de Oliveira
Keyword(s):  
Rio De Janeiro ◽  
The Other ◽  
Right To The City ◽  
Other Hand ◽  
The Right ◽  
The City

A utopia do direito à cidade,  no  caso específico do Rio de Janeiro, começa, obrigatoriamente, pela  superação da visão dicotômica favela-cidade. Para isso, é preciso que os moradores da favela possam sentir-se tão cidadãos quanto os que têm moradias fora das favelas. A utopia do direito à cidade tem de levar a favela a própria utopia da cidade. Uma cidade que não se fragmente em oposições asfalto-favela, norte-sul, praia-subúrbio e onde todos tenham direito ao(s) seu(s) centro(s). Oposições que expressam muito mais do que diferenças de  localização e que  se apresentam recheadas de  segregação, estereótipos e  ideologias. Por outro  lado, o direito a cidade, como possibilidade histórica, não pode ser pensado exclusivamente a partir da  favela. Mas as populações  que aí habitam guardam uma contribuição inestimável para  a  construção prática  desse direito. Isso porque,  das  experiências vividas, emergem aprendizados e frutificam esperanças e soluções. Para que a favela seja pólo de um desejo que impulsione a busca do direito a cidade, é necessário que ela  se  pense como  parte da história da própria cidade  e sua transformação  em metrópole.Abstract The right  to the city's  utopy  specifically  in Rio de Janeiro, begins by surpassing  the dichotomy approach between favela and the city. For this purpose, it is necessary, for the favela dwellers, the feeling of citizens as well as those with home outside the favelas. The right to the city's utopy must bring to the favela  the utopy to the city in itself- a non-fragmented city in terms of oppositions like "asphalt"-favela, north-south, beach-suburb and where everybody has right to their center(s). These oppositions express much more the differences of location and present  themselves full of segregation, stereotypes and ideologies. On  the other  hand, the right to  the city, as historical possibility, can not be thought  just from the favela. People that live there have a contribution for a practical construction of this right. 

scholarly journals Epidemiological and clinical characteristics of immunocompromised patients infected with Pneumocystis jirovecii in a twelve-year retrospective study from Norway

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Stine Grønseth ◽  
Tormod Rogne ◽  
Raisa Hannula ◽  
Bjørn Olav Åsvold ◽  
Jan Egil Afset ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Fold Increase ◽  
Epidemiological Data ◽  
Opportunistic Pathogen ◽  
Incidence Rates ◽  
Clinical Findings ◽  
Pneumocystis Jirovecii ◽  
Common Denominator ◽  
Study Population ◽  
Cardinal Symptoms

Abstract Background Pneumocystis pneumonia (PCP) severely menaces modern chemotherapy and immunosuppression. Detailed description of the epidemiology of Pneumocystis jirovecii today is needed to identify candidates for PCP-prophylaxis. Methods We performed a 12-year retrospective study of patients with P. jirovecii detected by polymerase chain reaction in Central Norway. In total, 297 patients were included. Comprehensive biological, clinical and epidemiological data were abstracted from patients’ medical records. Regional incidence rates and testing trends were also assessed. Results From 2007 to 2017 we found a 3.3-fold increase in testing for P. jirovecii accompanied by a 1.8-fold increase in positive results. Simultaneously, regional incidence rates doubled from 5.0 cases per 100,000 person years to 10.8. A majority of the study population had predisposing conditions other than human immunodeficiency virus (HIV). Hematological (36.0%) and solid cancers (25.3%) dominated. Preceding corticosteroids were a common denominator for 72.1%. Most patients (74.4%) presented with at least two cardinal symptoms; cough, dyspnea or fever. Main clinical findings were hypoxia, cytopenias and radiological features consistent with PCP. A total of 88 (29.6%) patients required intensive care and 121 (40.7%) suffered at least one complication. In-hospital mortality was 21.5%. Three patients (1.0%) had received prophylaxis. Conclusions P. jirovecii is re-emerging; likely due to increasing immunosuppressants use. This opportunistic pathogen threatens the life of heterogenous non-HIV immunosuppressed populations currently at growth. Corticosteroids seem to be a major risk factor. A strategy to increase prophylaxis is called for.

scholarly journals The effects of greening the supplier and innovation on environmental performance and competitive advantage

2013 ◽  
Vol 7 (1) ◽  
Author(s):  
Unine Van den Berg ◽  
Jean-Pierre Labuschagne ◽  
Hugo Van den Berg
Keyword(s):  
South Africa ◽  
Competitive Advantage ◽  
Environmental Performance ◽  
Competitive Advantages ◽  
Latent Constructs ◽  
Confirmatory Factor ◽  
Environmental Goals ◽  
The City ◽  
Strength Of Association ◽  
Managerial Innovation

Companies in South Africa should realise the important influence of greening their suppliers and of innovation to achieve environmental goals and competitive advantages. In order to prove this, a questionnaire survey was conducted with 75 companies from 11 industries in the City of Johannesburg Metropolitan Municipality region, South Africa. A confirmatory factor analysis was done, followed by bivariate correlations to determine the strength of association between the latent constructs. Correlations between greening the supplier, innovation, environmental performance and competitive advantages were done. The research found that a green innovative process had a significant effect on environmental performance. Green managerial innovation further had a significant correlation with competitive advantage. The primary result of the study indicated that all the constructs positively related to each other, meaning that greening suppliers, by means of green innovation, leads to an enhanced environmental performance and to competitive advantages.

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