The impact of climate suitability, urbanisation, and connectivity on the expansion of dengue in 21st century Brazil.

Dengue is hyperendemic in Brazil, with outbreaks affecting all regions. Previous studies identified geographical barriers to dengue transmission in Brazil, beyond which certain areas, such as South Brazil and the Amazon rainforest, were relatively protected from outbreaks. Recent data shows these barriers are being eroded. In this study, we explore the drivers of this expansion and identify the current limits to the dengue transmission zone. We used a spatio-temporal additive model to explore the associations between dengue outbreaks and temperature suitability, urbanisation, and connectivity to the Brazilian urban network. The model was applied to a binary outbreak indicator, assuming the official threshold value of 300 cases per 100,000 residents, for Brazil's municipalities between 2001 and 2020. We found a nonlinear relationship between higher levels of connectivity to the Brazilian urban network and the odds of an outbreak, with lower odds in metropoles compared to regional capitals. The number of months per year with suitable temperature conditions for Aedes mosquitoes was positively associated with the dengue outbreak occurrence. Temperature suitability explained most interannual and spatial variation in South Brazil, confirming this geographical barrier is influenced by lower seasonal temperatures. Municipalities that had experienced an outbreak previously had double the odds of subsequent outbreaks. We identified geographical barriers to dengue transmission in South Brazil, western Amazon, and along the northern coast of Brazil. Although a southern barrier still exists, it has shifted south, and the Amazon no longer has a clear boundary. Few areas of Brazil remain protected from dengue outbreaks. Communities living on the edge of previous barriers are particularly susceptible to future outbreaks as they lack immunity. Control strategies should target regions at risk of future outbreaks as well as those currently within the dengue transmission zone

The Zika Virus Epidemic in Brazil: From Discovery to Future Implications.

The first confirmed case of Zika virus infection in the Americas was reported in Northeast Brazil in May 2015, although phylogenetic studies indicate virus introduction as early as 2013. Zika rapidly spread across Brazil and to more than 50 other countries and territories on the American continent. The Aedesaegypti mosquito is thought to be the principal vector responsible for the widespread transmission of the virus. However, sexual transmission has also been reported. The explosively emerging epidemic has had diverse impacts on population health, coinciding with cases of Guillain-Barré Syndrome and an unexpected epidemic of newborns with microcephaly and other neurological impairments. This led to Brazil declaring a national public health emergency in November 2015, followed by a similar decision by the World Health Organization three months later. While dengue virus serotypes took several decades to spread across Brazil, the Zika virus epidemic diffused within months, extending beyond the area of permanent dengue transmission, which is bound by a climatic barrier in the south and low population density areas in the north. This rapid spread was probably due to a combination of factors, including a massive susceptible population, climatic conditions conducive for the mosquito vector, alternative non-vector transmission, and a highly mobile population. The epidemic has since subsided, but many unanswered questions remain. In this article, we provide an overview of the discovery of Zika virus in Brazil, including its emergence and spread, epidemiological surveillance, vector and non-vector transmission routes, clinical complications, and socio-economic impacts. We discuss gaps in the knowledge and the challenges ahead to anticipate, prevent, and control emerging and re-emerging epidemics of arboviruses in Brazil and worldwide

Editorial

A fim de destacarmos e valorarmos os diversos trabalhos que foram apresentados no âmbito do VII GeoSaúde 2015 foram selecionados pela comissão científica e organizadora 19 artigos para ser publicado nessa edição especial da Revista Geografia e Espaço. Além deles, também há um artigo síntese da oficina Ensino e Pesquisa em Geografia da Saúde na Europa, África e América Latina. Esse conjunto de artigos retrata de forma substancial as linhas de pesquisas atuais no âmbito da Geografia da Saúde no Brasil e em alguns países da América Latina

Combined effects of hydrometeorological hazards and urbanisation on dengue risk in Brazil: a spatiotemporal modelling study.

BACKGROUND: Temperature and rainfall patterns are known to influence seasonal patterns of dengue transmission. However, the effect of severe drought and extremely wet conditions on the timing and intensity of dengue epidemics is poorly understood. In this study, we aimed to quantify the non-linear and delayed effects of extreme hydrometeorological hazards on dengue risk by level of urbanisation in Brazil using a spatiotemporal model. METHODS: We combined distributed lag non-linear models with a spatiotemporal Bayesian hierarchical model framework to determine the exposure-lag-response association between the relative risk (RR) of dengue and a drought severity index. We fit the model to monthly dengue case data for the 558 microregions of Brazil between January, 2001, and January, 2019, accounting for unobserved confounding factors, spatial autocorrelation, seasonality, and interannual variability. We assessed the variation in RR by level of urbanisation through an interaction between the drought severity index and urbanisation. We also assessed the effect of hydrometeorological hazards on dengue risk in areas with a high frequency of water supply shortages. FINDINGS: The dataset included 12 895 293 dengue cases reported between 2001 and 2019 in Brazil. Overall, the risk of dengue increased between 0-3 months after extremely wet conditions (maximum RR at 1 month lag 1·56 [95% CI 1·41-1·73]) and 3-5 months after drought conditions (maximum RR at 4 months lag 1·43 [1·22-1·67]). Including a linear interaction between the drought severity index and level of urbanisation improved the model fit and showed the risk of dengue was higher in more rural areas than highly urbanised areas during extremely wet conditions (maximum RR 1·77 [1·32-2·37] at 0 months lag vs maximum RR 1·58 [1·39-1·81] at 2 months lag), but higher in highly urbanised areas than rural areas after extreme drought (maximum RR 1·60 [1·33-1·92] vs 1·15 [1·08-1·22], both at 4 months lag). We also found the dengue risk following extreme drought was higher in areas that had a higher frequency of water supply shortages. INTERPRETATION: Wet conditions and extreme drought can increase the risk of dengue with different delays. The risk associated with extremely wet conditions was higher in more rural areas and the risk associated with extreme drought was exacerbated in highly urbanised areas, which have water shortages and intermittent water supply during droughts. These findings have implications for targeting mosquito control activities in poorly serviced urban areas, not only during the wet and warm season, but also during drought periods. FUNDING: Royal Society, Medical Research Council, Wellcome Trust, National Institutes of Health, Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro, and Conselho Nacional de Desenvolvimento Científico e Tecnológico. TRANSLATION: For the Portuguese translation of the abstract see Supplementary Materials section

The specificities of spatial health data analysis

Made available in DSpace on 2010-08-23T16:58:42Z (GMT). No. of bitstreams: 3 license.txt: 1848 bytes, checksum: fe0da9e24d7b9fdc28c590fffdd6ddac (MD5) BARCELLOS_Specificitles of spatial health_2001.pdf: 53476 bytes, checksum: 7cce47140d81c6552da079029d412fc7 (MD5) BARCELLOS_Specificitles of spatial health_2001.pdf.txt: 10529 bytes, checksum: 01e84f63d6207205e74a3f20bd33601d (MD5) Previous issue date: 2001-09Made available in DSpace on 2010-11-04T14:20:01Z (GMT). No. of bitstreams: 3 BARCELLOS_Specificitles of spatial health_2001.pdf.txt: 10529 bytes, checksum: 01e84f63d6207205e74a3f20bd33601d (MD5) BARCELLOS_Specificitles of spatial health_2001.pdf: 53476 bytes, checksum: 7cce47140d81c6552da079029d412fc7 (MD5) license.txt: 1848 bytes, checksum: fe0da9e24d7b9fdc28c590fffdd6ddac (MD5) Previous issue date: 2001-09Fundação Oswaldo Cruz. Centro de Informação Científica e Tecnológica. Departamento de Informação e Saúde. Rio de Janeiro, RJ, Brasil

Who will sustain such development?

Submitted by Cléa Mara Barradas ([email protected]) on 2010-10-28T16:00:09Z No. of bitstreams: 1 Barcellos_ Quem sustenta tanto desenvolvimento.pdf: 28637 bytes, checksum: 97f0266e5a9c0f359a9cde825f28c6c2 (MD5)Made available in DSpace on 2010-10-28T16:00:09Z (GMT). No. of bitstreams: 1 Barcellos_ Quem sustenta tanto desenvolvimento.pdf: 28637 bytes, checksum: 97f0266e5a9c0f359a9cde825f28c6c2 (MD5) Previous issue date: 2009Made available in DSpace on 2010-11-04T14:19:40Z (GMT). No. of bitstreams: 2 license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) Barcellos_ Quem sustenta tanto desenvolvimento.pdf: 28637 bytes, checksum: 97f0266e5a9c0f359a9cde825f28c6c2 (MD5) Previous issue date: 2009Fundação Oswaldo Cruz, Instituto de Comunicação e Informação Científica e Tecnológica em Saúde. Rio de Janeiro, RJ, Brasil

Unidades y escalas en los análisis espaciales en salud

Made available in DSpace on 2010-08-23T16:58:38Z (GMT). No. of bitstreams: 3 license.txt: 1848 bytes, checksum: 75e92ac2d27da62b79e00ea330bf3e40 (MD5) BARCELLOS_Evolucion y tendencias_2003.pdf: 78693 bytes, checksum: 53d6bb40d922f63784cb35066417c8c4 (MD5) BARCELLOS_Evolucion y tendencias_2003.pdf.txt: 28818 bytes, checksum: 5d2e2707345f87c033dd693119cb386a (MD5) Previous issue date: 2003-10Made available in DSpace on 2010-11-04T14:19:37Z (GMT). No. of bitstreams: 3 BARCELLOS_Evolucion y tendencias_2003.pdf.txt: 28818 bytes, checksum: 5d2e2707345f87c033dd693119cb386a (MD5) BARCELLOS_Evolucion y tendencias_2003.pdf: 78693 bytes, checksum: 53d6bb40d922f63784cb35066417c8c4 (MD5) license.txt: 1848 bytes, checksum: 75e92ac2d27da62b79e00ea330bf3e40 (MD5) Previous issue date: 2003-10Fundación Oswaldo Cruz. Departamento de Información en Salud. Centro de Información Científica y Tecnológica. Rio de Janeiro, RJ, Brasil.El espacio geográfico es una categoría de síntesis y convergencia, a través del que se expresan diversos procesos involucrados en las condiciones de vida, ambiente y salud de las poblaciones. Una de las más importantes tareas para la evaluación de situaciones de salud, es el desarrollo de indicadores que sean capaces de encontrar y reflejar condiciones de riesgo para la salud que tengan origen en condiciones ambientales y sociales adversas. Sin embrago, los resultados que se pueden obtener del análisis espacial de indicadores son sensibles a diversas elecciones realizadas a lo largo de estos procesos: desde la selección de indicadores de las fuentes de información, de la escala de análisis, de unidades espaciales de referencia, y de los métodos de análisis espacial, o de la concepción de espacio geográfico. En este trabajo se discute el efecto de la selección de unidades de agregación de datos y de escalas en el análisis espacial para la evaluación de situaciones de salud, usando como ejemplo la distribución de la mortalidad por cáncer de esófago en el sur de Brasil.The geographic space is a category of synthesis and convergence through which several processes involved in the life, environment and health of the population are expressed. One of the most important tasks for the evaluation of health situations is the development of indicators capable of finding and reflecting risk conditions for health and originated from adverse environmental and social conditions. However, the results that may be obtained from the spatial analysis of indicators are subjected to different choices made throughout these processes, that is, the selection of indicators of the information sources, of the level of analysis, of spatial units of reference, of spatial analysis methods and even the conception of geographical space. This paper discusses the effect of selection of data and scale aggregating units on the spatial analysis for the evaluation of health situations, using the distribution of mortality rates from esophageal cancer in the south of Brazil as an example

Elos entre geografia e epidemiologia (Debate sobre o artigo de Dina Czeresnia & Adriana Maria Ribeiro)

Made available in DSpace on 2010-08-23T16:58:30Z (GMT). No. of bitstreams: 3 license.txt: 1848 bytes, checksum: f8c45136ed120e52c4ef767216dffff3 (MD5) BARCELLOS_Geografia e epidemiologia_2000.pdf: 120816 bytes, checksum: 3806be0c99a2d0a81aa7c44a8f5d867c (MD5) BARCELLOS_Geografia e epidemiologia_2000.pdf.txt: 118363 bytes, checksum: 03710f9410396f856604aa2844098214 (MD5) Previous issue date: 2000-07Made available in DSpace on 2010-11-04T14:20:03Z (GMT). No. of bitstreams: 1 license.txt: 1848 bytes, checksum: f8c45136ed120e52c4ef767216dffff3 (MD5) Previous issue date: 2000-07Fundação Oswaldo Cruz. Centro de Informação Científica e Tecnológica. Departamento de Informações em Saúde. Rio de Janeiro, RJ, Brasil

Homicidios e disputas territoriales en las barriadas de Rio de Janeiro

Submitted by Anderson Silva ([email protected]) on 2014-10-22T11:29:18Z No. of bitstreams: 1 Homicídios e disputas.pdf: 673032 bytes, checksum: ad98a4910393a51a88de6e9a1247a028 (MD5)Approved for entry into archive by Anderson Silva ([email protected]) on 2014-10-22T11:29:29Z (GMT) No. of bitstreams: 1 Homicídios e disputas.pdf: 673032 bytes, checksum: ad98a4910393a51a88de6e9a1247a028 (MD5)Made available in DSpace on 2014-10-22T11:51:10Z (GMT). No. of bitstreams: 1 Homicídios e disputas.pdf: 673032 bytes, checksum: ad98a4910393a51a88de6e9a1247a028 (MD5) Previous issue date: 2014Fundação Oswaldo Cruz. Instituto de Comunicação e Informação Científica e Tecnológica em Saúde. Rio de Janeiro, RJ, BrasilUniversidade do Estado do Rio de Janeiro. Instituto de Estudos Sociais e Políticos. Rio de Janeiro, RJ, BrasilOBJETIVO : Avaliar o risco de homicídios em favelas do Rio de Janeiro, considerando as disputas territoriais em curso na cidade. MÉTODOS : O estudo baseou-se em dados de mortalidade por homicídios na cidade do Rio de Janeiro, de 2006 a 2009. Foram avaliados os riscos em favelas e seus entornos, em função da sua localização e do domínio por grupos armados e tráfico de drogas. Foram empregados métodos e conceitos da geografia e etnografia, com as abordagens de observação participante, entrevistas e análise de dados secundários de saúde. RESULTADOS : As taxas de mortalidade por homicídios no interior das favelas foram equivalentes ou mesmo menores que o restante da cidade, mas consideravelmente maiores nos arredores das favelas, sobretudo em zonas de conflito entre domínios armados rivais. CONCLUSÕES : A presença do tráfico armado em zonas estratégicas da cidade aumenta as taxas de mortalidade por violência e promove a “ecologia do perigo” no entorno de favelas.OBJETIVO : Evaluar el riesgo de homicidios en barriadas de Rio de Janeiro, considerando las disputas territoriales en curso en la ciudad. MÉTODOS : El estudio se basó en datos de mortalidad por homicidios en la ciudad de Rio de Janeiro, de 2006 a 2009. Se evaluaron los riesgos en barriadas y sus entornos, en función de su localización y del dominio por grupos armados y tráfico de drogas. Se emplearon métodos y conceptos de la geografía y etnografía, con los abordajes de observación participante, entrevistas y análisis de datos secundarios de salud. RESULTADOS : Las tasas de mortalidad por homicidios en el interior de las barriadas fueron equivalente o inclusive menores que en el resto de la ciudad, pero considerablemente mayores en los alrededores de las barriadas, sobretodo en zonas de conflicto entre dominios armados rivales. CONCLUSIONES : La presencia del tráfico armado en zonas estratégicas de la ciudad aumenta las tasas de mortalidad por violencia y promueve la “ecología del peligro” en el entorno de las barriadas

Tourism and health: methodological approaches and courses of action

Submitted by Cléa Mara Barradas ([email protected]) on 2011-05-01T19:56:14Z No. of bitstreams: 1 Relacoes entre turismo_2010.pdf: 82451 bytes, checksum: 612724cfda95871db2faca035c62a1b0 (MD5)Made available in DSpace on 2011-05-01T19:56:14Z (GMT). No. of bitstreams: 1 Relacoes entre turismo_2010.pdf: 82451 bytes, checksum: 612724cfda95871db2faca035c62a1b0 (MD5) Previous issue date: 2010Fundação Oswaldo Cruz. Instituto de Comunicação e Informação Científica e Tecnológica em Saúde. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto de Comunicação e Informação Científica e Tecnológica em Saúde. Rio de Janeiro, RJ, Brasil.Objetivo. Identificar as relações entre turismo e saúde e as metodologias empregadas em estudos publicados sobre esse tema. Método. Realizou-se uma busca nas bases PubMed e SciELO em março de 2008 utilizando a seguinte estratégia: traveler or traveller or tourism or tourist AND risk or hazard or vulnerability AND health or surveillance. Foram excluídos os artigos sobre saúde animal, artigos conceituais e de revisão, artigos sobre viajantes que não turistas, artigos escritos em idiomas diferentes de português, inglês, italiano e espanhol. Dos 153 artigos localizados, 112 foram eliminados e 41 foram examinados. Resultados. O número de artigos sobre o tema cresceu de um artigo na década de 1970 para 34 na década de 2000. A maior parte dos estudos foi realizada na Europa, seguida das Américas, e abordou doenças transmitidas por insetos, doenças transmitidas entre pessoas por via respiratória e doenças gastrointestinais. Foi predominante a utilização de questionários para a coleta de dados, aplicados pessoalmente, por telefone ou por carta. Quanto ao local da pesquisa, 21 estudos foram realizados no local de origem da viagem, 17 no destino e 3 não informaram. Quatro estudos foram realizados antes da viagem, 9 durante a viagem, 24 após a viagem, e 3 não informaram. A maioria dos estudos abordou o turista como vítima preferencial de problemas de saúde, despreparado para enfrentar situações de vulnerabilidade durante a viagem. Conclusões. É clara a necessidade de implantar políticas de saúde voltadas para o turista, com ênfase em doenças infecciosas e ações emergenciais para detectar surtos envolvendo turistas. Também é necessário um sistema de vigilância e notificação específico para turistas, e maior preparo das instituições de saúde para atender demandas individuais dessa população.OBJECTIVE: To identify relationships between tourism and health as well as the methods employed in studies about this topic. METHODS: The PubMed and SciELO databases were searched in March of 2008 using the following strategy: traveler or traveller or tourism or tourist AND risk or hazard or vulnerability AND health or surveillance. The following were excluded: articles on animal health, conceptual and review articles, articles about non-tourist travel, and articles written in languages other than Portuguese, English, Italian, and Spanish. Of 153 articles identified, 112 were excluded, and 41 articles were examined. RESULTS: The number of articles on tourism and health increased from one in the 1970s to 34 in the 2000s. Most studies were carried out in Europe, followed by the Americas, and most covered insect-borne diseases, respiratory diseases transmitted from person to person, and gastrointestinal diseases. Mail, telephone, or face-to-face questionnaires were generally used for data collection. In terms of location, 21 studies were performed at the place of departure, 17 at the destination, and in 3 this information was not specified. Four studies were carried out before the trip, 9 during the trip, 24 after the trip, and 3 did not specify this information. Most studies focus on the tourist as a likely victim of health problems, unprepared to face situations of exposure during the trip. CONCLUSIONS: The need to implement health care policies aimed at the tourist population is evident, with emphasis on infectious diseases and emergency actions to detect outbreaks involving tourists. A tourist-specific surveillance and notification system is also necessary, together with measures to prepare health care institutions to meet the individual demands of this population