scholarly journals Epidemiology and Spatiotemporal Patterns of Leprosy Detection in the State of Bahia, Brazilian Northeast Region, 2001–2014

2018 ◽  
Vol 3 (3) ◽  
pp. 79 ◽  
Author(s):  
Eliana Amorim de Souza ◽  
Anderson Fuentes Ferreira ◽  
Jorg Heukelbach ◽  
Reagan Nzundu Boigny ◽  
Carlos Alencar ◽  
...  
Keyword(s):  
High Risk ◽  
Public Health Problem ◽  
The State ◽  
Older Age ◽  
Late Diagnosis ◽  
Spatiotemporal Patterns ◽  
Control Measures ◽  
Case Detection ◽  
Heterogeneous Distribution ◽  
The North

The detection of leprosy cases is distributed unequally in Brazil, with high-risk clusters mainly in the North and Northeast regions. Knowledge on epidemiology and spatiotemporal patterns of leprosy occurrence and late diagnosis in these areas is critical to improve control measures. We performed a study including all leprosy cases notified in the 417 municipalities of Bahia state, from 2001 to 2014. New case detection (overall and pediatric <15 years) and grade 2 disability (G2D) rates were calculated and stratified according to socio-demographic variables. Spatial analyses were performed to detect high-risk areas for occurrence and late diagnosis. A total of 40,060 new leprosy cases was reported in the period (mean = 2861 cases/year), 3296 (8.2%) in <15-year-olds, and 1921 (4.8%) with G2D. The new case detection rate was 20.41 cases/100,000 inhabitants (95% CI: 19.68–21.17). A higher risk was identified in older age groups (RR = 8.45, 95% CI: 7.08–10.09) and in residents living in the state capital (RR = 5.30, 95% CI: 4.13–6.79), in medium-sized cities (RR = 2.80; 95% CI: 2.50–3.13), and in the west (RR = 6.56, 95% CI: 5.13–8.39) and far south regions of the state (RR = 6.56, 95% CI: 5.13–8.39). A higher risk of G2D was associated with male gender (RR = 2.43, 95% CI: 2.20–2.67), older age (RR = 44.08, 95% CI: 33.21–58.51), Afro-Brazilian ethnicity (RR = 1.59; 95% CI: 1.37–1.85), living in medium-sized cities (RR = 2.60; 95% CI: 2.27–2.96) and residency in the north (RR = 5.02; 95% CI: 3.74–6.73) and far south (RR = 7.46; 95% CI: 5.58–9.98) regions. Heterogeneous space–time patterns of leprosy distribution were identified, indicating high endemicity, recent transmission, and late diagnosis. This heterogeneous distribution of the disease was observed throughout the study period. Leprosy remains a relevant public health problem in Bahia state. The disease has a focal distribution. We reinforce the importance of integrating surveillance, prevention and control actions in regions of higher risk of leprosy detection and late diagnosis, and in the most vulnerable populations.

scholarly journals Spatial patterns of leprosy in a hyperendemic state in Northern Brazil, 2001-2012

2015 ◽  
Vol 49 (0) ◽  
Author(s):  
Lorena Dias Monteiro ◽  
Francisco Rogerlândio Martins-Melo ◽  
Aline Lima Brito ◽  
Carlos Henrique Alencar ◽  
Jorg Heukelbach
Keyword(s):  
High Risk ◽  
Spatial Patterns ◽  
Detection Rate ◽  
Disease Risk ◽  
Late Diagnosis ◽  
Control Measures ◽  
Case Detection ◽  
Detection Rates ◽  
Case Detection Rate ◽  
Brazilian State

ABSTRACT OBJECTIVE To describe the spatial patterns of leprosy in the Brazilian state of Tocantins. METHODS This study was based on morbidity data obtained from the Sistema de Informações de Agravos de Notificação (SINAN – Brazilian Notifiable Diseases Information System), of the Ministry of Health. All new leprosy cases in individuals residing in the state of Tocantins, between 2001 and 2012, were included. In addition to the description of general disease indicators, a descriptive spatial analysis, empirical Bayesian analysis and spatial dependence analysis were performed by means of global and local Moran’s indexes. RESULTS A total of 14,542 new cases were recorded during the period under study. Based on the annual case detection rate, 77.0% of the municipalities were classified as hyperendemic (> 40 cases/100,000 inhabitants). Regarding the annual case detection rate in < 15 years-olds, 65.4% of the municipalities were hyperendemic (10.0 to 19.9 cases/100,000 inhabitants); 26.6% had a detection rate of grade 2 disability cases between 5.0 and 9.9 cases/100,000 inhabitants. There was a geographical overlap of clusters of municipalities with high detection rates in hyperendemic areas. Clusters with high disease risk (global Moran’s index: 0.51; p < 0.001), ongoing transmission (0.47; p < 0.001) and late diagnosis (0.44; p < 0.001) were identified mainly in the central-north and southwestern regions of Tocantins. CONCLUSIONS We identified high-risk clusters for transmission and late diagnosis of leprosy in the Brazilian state of Tocantins. Surveillance and control measures should be prioritized in these high-risk municipalities.

scholarly journals Antimicrobial Resistance of Shigella spp. isolated in the State of Pará, Brazil

2011 ◽  
Vol 44 (5) ◽  
pp. 607-610 ◽  
Author(s):  
Flávia Corrêa Bastos ◽  
Edvaldo Carlos Brito Loureiro
Keyword(s):  
Antibiotic Resistance ◽  
Resistance Rate ◽  
The State ◽  
Control Measures ◽  
Health Concern ◽  
The North ◽  
The Family ◽  
Shigella Spp ◽  
And Control ◽  
Disk Method

INTRODUCTION: Shigella spp. are Gram-negative, nonsporulating, rod-shaped bacteria that belong to the family Enterobacteriaceae and are responsible for shigellosis or bacillary dysentery, an important cause of worldwide morbidity and mortality. METHODS: We studied the antibiotic resistance profiles of 122 Shigella spp. strains (81 S. flexneri, 41 S. sonnei, 1 S. boydii) isolated from patients (female and male from 0 to 80 years of age) presenting diarrhea in different districts of the State of Pará, in the North of Brazil. The antibiotic resistance of the strains, isolated from human fecal samples, was determined by the diffusion disk method and by using the VITEK-2 system. RESULTS: The highest resistance rate found was the resistance rate to tetracycline (93.8%), followed by the resistance rate to chloramphenicol (63.9%) and to trimethoprim/sulfamethoxazole (63.1%). Resistance to at least three drugs was more common among S. flexneri than S. sonnei (39.5% vs. 10%). Six (4.9%) strains were susceptible to all the antibiotics tested. All strains were susceptible to cefotaxime, ceftazidime, ciprofloxacin, nalidixic acid and nitrofurantoin. CONCLUSIONS: High rates of multidrug resistance in Shigella spp. are a serious public health concern in Brazil. It is extremely important to continuously monitor the antimicrobial resistances of Shigella spp. for effective therapy and control measures against shigellosis.

scholarly journals Epidemiological and geographical characterization of leprosy in a Brazilian hyperendemic municipality

2018 ◽  
Vol 34 (8) ◽  
Author(s):  
Lucia Helena Soares Camargo Marciano ◽  
Andréa de Faria Fernandes Belone ◽  
Patrícia Sammarco Rosa ◽  
Neusa Maria Broch Coelho ◽  
Cássio César Ghidella ◽  
...  
Keyword(s):  
High Risk ◽  
Public Health Problem ◽  
Control Measures ◽  
Scan Statistics ◽  
Mapping Technique ◽  
Socioeconomic Indicators ◽  
Mato Grosso ◽  
Choropleth Mapping ◽  
Risk Areas

Abstract: This study aimed to identify the distribution pattern of leprosy in a hyperendemic municipality in Brazil and determine its relationship with the clinico-epidemiological situation over 11 years. The geographic information system, MapInfo, spatial scan statistics and the Moran I index were used to analyze new cases. The digital cartographic base was used to map clusters of new paucibacillary and multibacillary cases and cases in minors under 15 years old. Socioeconomic indicators are shown using the choropleth mapping technique. A reduction in the detection coefficient, increases in high-risk spatial clusters, marked changes in the distribution of high-risk and low-risk clusters, and high-risk clusters of minors under 15 years old were observed from 2006 to 2010, showing recent illness, the presence of active foci, and overlapping of high-risk clusters of multibacillary infection in minors under 15 years old. Leprosy remains a public health problem in Rondonópolis, Mato Grosso State; the high-risk areas require an intensification of control measures and active search strategies to detect new cases.

scholarly journals Mortality due to Chagas disease in Brazil from 1979 to 2009: trends and regional differences

2012 ◽  
Vol 6 (11) ◽  
pp. 817-824 ◽  
Author(s):  
Francisco Rogerlândio Martins-Melo ◽  
Alberto Novaes Ramos Jr ◽  
Carlos Henrique Alencar ◽  
Jorg Heukelbach
Keyword(s):  
Chagas Disease ◽  
National Level ◽  
Public Health Problem ◽  
Mortality Rates ◽  
Control Measures ◽  
Triatoma Infestans ◽  
Mortality Data ◽  
Primary Role ◽  
The North ◽  
Proportional Mortality

Introduction: Studies on mortality due to parasitic diseases such as Chagas disease are useful to understand the epidemiology and to plan and guide control measures for these diseases. We analyzed mortality trends due to Chagas disease in Brazil and regions, between 1979 and 2009. Methodology: Mortality data (underlying cause of death) were obtained from the nationwide Mortality Information System (SIM) of the Ministry of Health. We calculated crude mortality rates and rates standardized by age, as well as proportional mortality. Results: In total, 27,560,043 deaths occurred in the study period. In 172,066 deaths, Chagas disease was mentioned as the underlying cause (proportional mortality: 0.62%). The mean crude and age-standardized mortality rates were 3.61 and 5.19 deaths/100,000 inhabitants/year, respectively. During the observation period, Chagas mortality declined significantly at the national level (R2=97%, p < 0.001), with different patterns between regions. There was a significant reduction in mortality in the Central-West (R2=90%, p < 0.001), Southeast (R2=98%, p < 0.001) and South (R2=94%, p < 0.001), but in the North (R2=34%, p=0.001) and Northeast (R2=65%, p < 0.001) regions mortality increased. Conclusions: Despite the overall decline in mortality due to Chagas disease in Brazil, it remains an important public health problem. After successful control of the primary vector Triatoma infestans, intervention measures must focus on improved access to health care and secondary prevention. The North and Northeast regions, where vectors other than T. infestans have a primary role, need special attention.

scholarly journals EVALUATION OF FOREST FIRES IN PARANÁ IN 2018 AND 2019

FLORESTA ◽  
2021 ◽  
Vol 51 (4) ◽  
pp. 971
Author(s):  
Kendra Zamproni ◽  
Heitor Renan Ferreira ◽  
Antonio Carlos Batista
Keyword(s):  
Forest Fires ◽  
Vegetation Type ◽  
Fire Department ◽  
The State ◽  
Control Measures ◽  
Metropolitan Region ◽  
Vacant Lots ◽  
The North ◽  
Prevention And Control Measures ◽  
And Control

Forest fires represent significant environmental, economic, and social damage in many countries. Historical knowledge of their characteristics aids in making preventive decisions, as well as fighting forest fires. However, the general data of fires in Paraná are outdated. The objective of this study was to evaluate the forest fires in the state of Paraná in 2018 and 2019, surveying the following information: municipality and region affected; month and day of occurrence; and vegetation type. To this end, data obtained from the Paraná Fire Department through the SysBMNew-CCB platform were analyzed. The fire density by region was verified and compared through cluster analysis. Compared to the previous year, 2019 showed a 42.25% increase in the number of fires. In both years, most forest fires occurred in the North-central region, followed by the Metropolitan Region of Curitiba. The municipality of Curitiba recorded the highest number of fires in both years. According to the Fire Department classification, the vegetation type most affected by the fires was vacant lots. From the data obtained, we verified the need for environmental education measures aimed at the prevention of fires in vacant lots. Further research is recommended so that a profile of forest fires can be traced in the state and thus base prevention and control measures.

Ras al Khaimah: further archaeological discoveries

Antiquity ◽  
1976 ◽  
Vol 50 (200) ◽  
pp. 216-222
Author(s):  
Beatrice De Cardi
Keyword(s):  
United Arab Emirates ◽  
The State ◽  
Focused Attention ◽  
North East ◽  
The North ◽  
History Of ◽  
The City

Ras a1 Khaimah is the most northerly of the seven states comprising the United Arab Emirates and its Ruler, H. H. Sheikh Saqr bin Mohammad al-Qasimi, is keenly interested in the history of the state and its people. Survey carried out there jointly with Dr D. B. Doe in 1968 had focused attention on the site of JuIfar which lies just north of the present town of Ras a1 Khaimah (de Cardi, 1971, 230-2). Julfar was in existence in Abbasid times and its importance as an entrep6t during the sixteenth and seventeenth centuries-the Portuguese Period-is reflected by the quantity and variety of imported wares to be found among the ruins of the city. Most of the sites discovered during the survey dated from that period but a group of cairns near Ghalilah and some long gabled graves in the Shimal area to the north-east of the date-groves behind Ras a1 Khaimah (map, FIG. I) clearly represented a more distant past.

MEASLES OUTBREAK IN A RURAL AREA OF A DEVELOPING COUNTRY: A CASE CONTROL STUDY

2018 ◽  
Vol 7 (4) ◽  
pp. 197-201
Author(s):  
Mir M Hassan Bullo ◽  
Mirza Amir Baig ◽  
Jawad Faisal Malik ◽  
Ejaz Ahmad Khan ◽  
Muazam Abbas Ranjha ◽  
...  
Keyword(s):  
Risk Factors ◽  
Vaccine Coverage ◽  
Significant Risk ◽  
Public Health Problem ◽  
Maculopapular Rash ◽  
Healthcare Facility ◽  
Control Measures ◽  
Major Public Health Problem ◽  
District Health ◽  
Active Case

Background: Measles is highly contagious vaccine preventable disease (VPD), and a major public health problem considered as leading cause of morbidity and mortality in developing countries like Pakistan. An outbreak of measles was reported in Sharifabad Islamabad on 15th of April 2017, and an investigation was launched to assess the magnitude of outbreak, evaluate risk factors and recommend control measures. Methods: A comprehensive house to house active case search along with vaccine coverage survey was conducted from April 19-22, 2017. A case was defined as "onset of maculopapular rash with fever in a resident of Sharifabad with at least one of the following signs/ symptoms, Coryza, Conjunctivitis, Cough, Otitis media or Pneumonia present in between 19 March to 22nd April 2017". Four age & sex matched controls were selected from the neighborhood. Data was collected through interview method using structured questionnaire and vaccination coverage was determined by using Epi survey form. Blood samples were sent for laboratory confirmation. Results: A total of eight cases were identified through active case finding while three were reported by local practitioner. Mean age of cases were 20 months (range 8-36 months). Severely affected age-group was 1-2 years with attack rate of 46%. Around two-third (64%) of cases and a few (16%) of controls were unvaccinated against measles. Contact with measles patient [OR 25.2, CI 3.9-160.1, P=0.00], unvaccinated children [OR 9.2 CI 2.12-40.4, P=0.000], social misconception regarding vaccination [OR 7.8 CI 1.42-42.6, P=0.00], and distance from healthcare facility [OR 5.7 CI 1.15-28.35, P=0.02] were significant risk factors. Vaccine efficacy was 90%. Conclusion: Main reasons of the outbreak were contact with the cases, and low vaccination status. We recommended comprehensive measles vaccination and community awareness sessions. On our recommendations district health authority Islamabad carried out mop up of whole area.

A Synopsis of Dicliptera (Acanthaceae) in Brazil, with the Description of Two New Species

2020 ◽  
Vol 45 (2) ◽  
pp. 340-348
Author(s):  
James Lucas da Costa-Lima ◽  
Earl Celestino de Oliveira Chagas
Keyword(s):  
New Species ◽  
South America ◽  
The State ◽  
Northeastern Brazil ◽  
Mato Grosso ◽  
The North ◽  
New Synonyms ◽  
Two New Species ◽  
Mato Grosso Do Sul ◽  
A New Species

Abstract—A synopsis of Dicliptera (Acanthaceae) for Brazil is presented. Six species are recognized: Dicliptera ciliaris, D. sexangularis, and D. squarrosa, widely distributed in South America; D. purpurascens, which ranges from the North Region of Brazil (in the state of Acre) to eastern Bolivia; D. gracilirama, a new species from the Atlantic Forest of northeastern Brazil; and D. granchaquenha, a new species recorded in dry and semideciduous forests in Bolivia and western Brazil, in the state of Mato Grosso do Sul. Furthermore, we propose new synonyms and designate lectotypes for eleven names. An identification key to the six accepted Dicliptera species in Brazil is provided.

THE CURRENT MIGRATION SITUATION IN THE BORDER REGIONS OF THE NORTH CAUCASUS: ANALYSIS OF THE STATE AND PROSPECTS OF DEVELOPMENT

2019 ◽  
pp. 22-33
Author(s):  
Ruzanna V. Miroshnichenko ◽  
◽  
Anna Yu. Lukyanova ◽  
Svetlana A. Fedorova ◽  
Svetlana V. Nedvizhaj ◽  
...  
Keyword(s):  
The State ◽  
North Caucasus ◽  
Border Regions ◽  
The North

Healthcare-Associated Infections: Not Only a Clinical Burden, But a Forensic Point of View

2019 ◽  
Vol 20 (8) ◽  
pp. 658-664 ◽  
Author(s):  
Marco Di Paolo ◽  
Luigi Papi ◽  
Paolo Malacarne ◽  
Federica Gori ◽  
Emanuela Turillazzi
Keyword(s):  
Health Care ◽  
Clinical Medicine ◽  
Methodological Approach ◽  
Care Facility ◽  
Public Health Problem ◽  
Control Measures ◽  
Major Public Health Problem ◽  
Healthcare Associated Infections ◽  
Open Communication ◽  
Healthcare Associated

Background: Healthcare-associated infections (HCAIs) occur when patients receiving treatment in a health care setting develop an infection. They represent a major public health problem, requiring the integration of clinical medicine, pathology, epidemiology, laboratory sciences, and, finally, forensic medicine. Methods: The determination of cause of death is fundamental not only in the cases of presumed malpractice to ascertain the causal link with any negligent behavior both of health facilities and of individual professionals, but also for epidemiological purposes since it may help to know the global burden of HCAIs, that remains undetermined because of the difficulty of gathering reliable diagnostic data. A complete methodological approach, integrating clinical data by means of autopsy and histological and laboratory findings aiming to identify and demonstrate the host response to infectious insult, is mandatory in HCAIs related deaths. Results: Important tasks for forensic specialists in hospitals and health services centers are the promotion of transparency and open communication by health-care workers on the risk of HCAIs, thus facilitating patients’ engagement and the implementation of educational interventions for professionals aimed to improve their knowledge and adherence to prevention and control measures. Conclusion: HCAIs are a major problem for patient safety in every health-care facility and system around the world and their control and prevention represent a challenging priority for healthcare institution and workers committed to making healthcare safer. Clinicians are at the forefront in the war against HCAIs, however, also forensic pathologists have a remarkable role.

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