Dryland adaptation in Northeast Brazil: Lessons from a community-based pilot project

Family farmers in Brazil’s semi-arid region (the Sertão) are highly vulnerable to climate change. In this context, the community-based Adapta Sertão (“adapt Sertão” or “adapt the Sertão”) pilot project aims to strengthen the adaptive capacity of such families in the region of Pintadas, State of Bahia, through integration of immediate livelihood needs with community empowerment and market-based incentives. This short paper discusses the project’s main components, its results and constraints since implementation in 2006. The project is found to have contributed to rural livelihood improvement of its beneficiaries, especially where related to local capacity building. However, the impacts of the strongest drought recorded in the last 50 years continue to affect beneficiaries. CBA in semiarid Brazil may thus need to interact more broadly with those public policies, plans and programs help reduce vulnerability to climatic, social, environmental and economic stressors in general, in order to help family farmers better to sustainably adapt to future climate change.Los agricultores familiares en la región semiárida de Brasil (Sertão) son muy vulnerables al cambio climático. En este contexto, el proyecto piloto basado en la comunidad Adapta Sertão («adaptar Sertão» o «adaptar la región de Sertão») está dirigido a fortalecer la capacidad de adaptación de dichas familias en la región de Pintadas, Estado de Bahía, a través de la integración de las necesidades de subsistencia inmediatas mediante capacitación de la comunidad e iniciativas basadas en el mercado. Este informe breve aborda los principales elementos del proyecto, sus resultados y limitaciones desde su implementación en 2006. Se ha descubierto que el proyecto ha contribuido a la mejora de las condiciones de subsistencia de sus beneficiarios en regiones rurales, en especial, en relación con la construcción de capacidades locales. No obstante, el impacto de la sequía más importante registrada en los últimos 50 años sigue afectando a los beneficiarios. De este modo, la CBA en la región semiárida de Brasil tendrá que interactuar en mayor profundidad con políticas, planes y programas para la reducción de la vulnerabilidad a factores de estrés climáticos, sociales, medioambientales y económicos en general, a fin de ayudar a los agricultores familiares a adaptarse de una forma más sostenible al cambio climático futuro.Les familles d'exploitants agricoles du Sertão, région semi-aride du Brésil, sont très vulnérables au changement climatique. Dans ce contexte, le projet pilote communautaire Adapta Sertão ("adapter le Sertão") vise à renforcer la capacité d'adaptation de ces familles dans la région de Pintadas, dans l'Etat de Bahia, par l'intégration des besoins de moyens de subsistance immédiats via l'autonomisation des communautés et des incitations commerciales. Ce court article expose les principaux éléments du projet, ses résultats et ses contraintes depuis sa mise en oeuvre en 2006. Ce projet a contribué à améliorer la vie rurale de ses bénéficiaires, en particulier concernant le développement des capacités locales. Toutefois, les conséquences de la plus forte sécheresse qu'ait connu le Brésil au cours de ces 50 dernières années, continuent d'affecter les bénéficiaires. L'adaptation communautaire dans les régions semi-arides du Brésil peut ainsi passer par une interaction à plus grande échelle avec ces politiques, plans et programmes publics visant à réduire la vulnérabilité aux facteurs de stress climatiques, sociaux, environnementaux et économiques en général, afin de faciliter l'adaptation des familles d'exploitants agricoles au changement climatique futur de manière durable

Malaria at international borders: challenges for elimination on the remote Brazil-Peru border

Understanding local epidemiology is essential to reduce the burden of malaria in complex contexts, such as Brazilian municipalities that share borders with endemic countries. A descriptive study of malaria in the period 2003 to 2020 was conducted using data from the Malaria Epidemiological Surveillance Information System related to a remote municipality with an extensive border with Peru to understand the disease transmission, focusing on the obstacles to its elimination. The transmission increases at the end of the rainy season. During the period of 18 years, 53,575 malaria cases were reported (Mean of API 224.7 cases/1,000), of which 11% were imported from Peru. Thirteen outbreaks of malaria were observed during the studied period, the last one in 2018. The highest burden of cases was caused by P. vivax (73.2%), but P. falciparum was also prevalent at the beginning of the study period (50% in 2006). Several changes in the epidemiological risk were observed: (1) the proportion of international imported cases of malaria changed from 30.7% in 2003 to 3.5% in 2020 (p<0.05); (2) indigenous people affected increased from 24.3% in 2003 to 89.5% in 2020 (p<0.0001); (3) infected children and adolescents < 15 years old increased from 50.2% in 2003 to 67.4% in 2020 (p<0.01); (4) the proportion of men decreased from 56.7% in 2003 to 50.4% in 2020 (p<0.01); (5) the likelihood of P. falciparum malaria has significantly declined (p<0.01). The number of cases and the incidence of malaria in 2019 and 2020 were the lowest in the period of 18 years. The burden of malaria in indigenous areas and its determinants, seasonality, geographical access and the long international border are obstacles for the elimination of malaria that must be overcome

Socioenvironmental conditions and intestinal parasitic infections in Brazilian urban slums: a cross-sectional study

Intestinal parasitic infections (IPIs) are neglected diseases with limited data regarding prevalence in Brazil and many other countries. In increasingly urban societies, investigating the profile and socioenvironmental determinants of IPIs in the general population of slum dwellers is necessary for establishing appropriate public policies catered to these environments. This study assessed the socioenvironmental conditions and prevalence of IPIs in slums of Rio de Janeiro, RJ State, Brazil. Methods A cross-sectional study covering an agglomeration of urban slums was conducted between 2015 and 2016 using participants observation, a socioeconomic survey, and the spontaneous sedimentation method with three slides per sample to analyze fresh stool specimens ( n =595) searching for intestinal parasites. Results Endolimax nana ( n =95, 16.0%) and Entamoeba coli ( n =65, 10.9%) were the most frequently identified agents, followed by Giardia intestinalis ( n =24, 4.0%) and Ascaris lumbricoides ( n =11, 1.8%). Coinfections caused by E. nana and E. histolytica/dispar and by Entamoeba coli/A. lumbricoides were significant. The use of piped water as drinking water, the presence of A. lumbricoides , and contamination with coliform bacteria and Escherichia coli were more common in major area (MA) 1. Children (0-19 years) had a greater chance of living in poverty (OR 3.36; 95% CI: 2.50- 4.52;

Social Cost of Leptospirosis Cases Attributed to the 2011 Disaster Striking Nova Friburgo, Brazil

The aim of this study was to estimate the social cost of the leptospirosis cases that were attributed to the natural disaster of January 2011 in Nova Friburgo (State of Rio de Janeiro, Brazil) through a partial economic assessment. This study utilized secondary data supplied by the Municipal Health Foundation of Nova Friburgo. Income scenarios based on the national and state minimum wages and on average income of the local population were employed. The total social cost of leptospirosis cases attributed to the 2011 disaster may range between US$21,500 and US$66,000 for the lower income scenario and between US$23,900 and US$100,800 for that of higher income. Empirical therapy represented a total avoided cost of US$14,800, in addition to a reduction in lethality. An estimated 31 deaths were avoided among confirmed cases of the disease, and no deaths resulted from the leptospirosis cases attributed to the natural disaster. There has been a significant post-disaster rise in leptospirosis incidence in the municipality, which illustrates the potential for increased cases—and hence costs—of this illness following natural disasters, which justifies the adoption of preventive measures in environmental health

Organização dos serviços urbanos de saúde frente à mudança do clima e ao risco de desastres na América Latina

Países da América Latina que sofreram com eventos extremos e desastres nas últimas décadas têm buscado alternativas para melhorar a organização e a capacidade de resposta dos serviços de saúde, evitando o impacto que a população sofreria no caso de tais serviços serem afetados. Neste artigo são relatadas experiências de países da América Latina no que se refere à preparação e adaptação às mudanças do clima no setor saúde, que poderiam ser replicadas em outros locais. Espera-se, por meio desta revisão crítica da literatura, que se possa motivar o setor saúde a se reorganizar para que se torne menos vulnerável aos efeitos das mudanças do clima

A gestão ambiental no setor público: uma questão de relevância social e econômica

Este texto apresenta uma discussão a respeito da necessidade de implantar um sistema de gestão ambiental nos órgãos da administração pública. Efetua-se breve descrição de práticas gerenciais de empresas de setores variados que assumem o compromisso de estabelecer a melhor relação possível entre atividade empresarial, meio ambiente e necessidades humanas presentes e futuras. Expõem-se alguns argumentos de caráter econômico, referentes aos benefícios obtidos por iniciativas privadas que adotaram critérios de ecoeficiência que, em si, seriam suficientes para justificar a implantação de uma política efetiva de gestão ambiental nas instituições públicas. Destaca-se a relevância da criação da Agenda Ambiental na Administração Pública (A3P), que pretende instaurar uma nova cultura institucional, visando à mobilização dos servidores para a otimização dos recursos, para o combate ao desperdício e para a busca de uma melhor qualidade do ambiente de trabalho. Evidencia-se que para o êxito e efetivação da agenda será decisivo o grau de engajamento do próprio servidor e de seus dirigentes

El estrabismo en el niño y anestesia Strabismus in the child and anesthesia

Se analiza el manejo anestésico de 41 niños tratados por estrabismo con anestesia general, administrada a 37 de ellos por vía endotraqueal para la corrección quirúrgica y a los 4 restantes por vía intravenosa para la inyección de toxina botulínica (TBX) tipo A en microdosis intraocular. Se destacan aspectos importantes de interés anestesiológico como son las implicaciones clínicas que pudieran resultar del manejo anestésico, los cuidados especiales que requieren estos pacientes, la importancia de la evaluación preoperatoria que considere aspectos de interés especial y propios, etc. No hubo complicaciones transoperatorias. El vómito fue la complicación posoperatoria vista en 6 pacientes y sólo 1 sometido a tratamiento quirúrgico requirió además del mantenimiento de una hidratación intravenosa con la administración de una dosis de dimenhidrinato, antihistamínico de fuerte acción antiemética. Se presenta el manejo anestésico para la inyección intraocular de microdosis de TBX tipo A realizada con buenos resultados con Atropina, Diazepán y Clorhidrato de Ketamina por vía intravenosa.<br>The anesthetic management of 41 children with strabismus treated with general anesthesia is analyzed. 37 of them were administered intratracheal anesthesia for surgical correction and the other 4 intravenous anesthesia for the injection of an intraocular microdose of botulinum toxin A (TBX). Important aspects of anesthesiologic interest as the clinical implications that may result from the anesthetic management, the special care required by these patients, the importance of the preoperative evaluation that takes into account aspects of special interest, of the authors' interest and others, are stressed . There were no transoperative complications. Vomiting was the postoperative complication observed in 6 patients and only one of those who underwent surgery required besides the maintenance of an intravenous hydration the administration of a dose of dimenhydrinate, an antihistamine drug of strong antiemetic action. The anesthetic management for the intraocular injection of a microdose of TBX A had good results by the intravenous administration of Atropine, Diazepam and Ketamine Hydrochloride