Trends and spatial patterns of mortality related to neglected tropical diseases in Brazil

We analysed nationwide trends and spatial distribution of NTD-related mortality in Brazil. We included all death certificates in Brazil from 2000 to 2011, in which NTDs were recorded as any causes of death. A total of 100,814/12,491,280 (0.81%) death certificates were identified, which mentioned at least one NTD. Age-adjusted NTD-related mortality rates showed a significant decrease over time (annual percent change [APC]: − 2.1%; 95% CI: − 2.8 to − 1.3), with decreasing mortality rates in the Southeast, South, and Central-West regions, stability in the Northeast region, and increase in the North region. We identified spatial and spatiotemporal high-risk clusters for NTD-related mortality in all regions, with a major cluster covering a wide geographic range in central Brazil. Despite nationwide decrease of NTD-related mortality in the observation period, regional differences remain, with increasing mortality trends especially in the socioeconomically disadvantaged regions of the country. The existence of clearly defined high-risk areas for NTD-related deaths reinforces the need for integrated prevention and control measures in areas with highest disease burden

Artificial neural networks for predicting the generation of acetaldehyde in pet resin in the process of injection of plastic packages

The industrial production of preforms for the manufacture of PET bottles, during the plastic injection process, is essential to regulate the drying temperature of the PET resin, to control the generation of Acetaldehyde (ACH), which alters the flavor of carbonated or non-carbonated drinks, giving the drink a citrus flavor and putting in doubt the quality of packaged products. In this work, an Artificial Neural Network (ANN) of the Backpropagation type (Cascadeforwardnet) is specified to support the decision-making process in controlling the ideal drying temperature of the PET resin, allowing specialists to make the necessary temperature regulation decisions  for the best performance by decreasing ACH levels. The materials and methods were applied according to the manufacturer\u27s characteristics on the moisture in the PET resin grain, which may contain between 50 ppm and 100 ppm of ACH. Data were collected for the method analysis, according to temperatures and residence times used in the blow injection process in the manufacture of the bottle preform, the generation of ACH from the PET bottle after solid post-condensation stage reached residual ACH levels below (3-4) ppm, according to the desired specification, reaching levels below 1 ppm. The results found through the Computational Intelligence (IC) techniques applied by the ANNs, where they allowed the prediction of the ACH levels generated in the plastic injection process of the bottle packaging preform, allowing an effective management of the parameters of production, assisting in strategic decision making regarding the use of temperature control during the drying process of PET resin

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

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 Informacoes de Agravos de Notificacao (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

Social determinants of leprosy in a hyperendemic State in North Brazil

Objective: To identify the socioeconomic, demographic, operational, and health service-related factors associated with the occurrence of leprosy in a hyperendemic State in North Brazil. Methods: This is an ecological study based on secondary data from the Sistema de Informacoes de Agravos de Notificacao in municipalities of the State of Tocantins from 2001 to 2012. Units of analysis were the 139 municipalities of the State. Negative binomial log linear regression models were used to estimate incidence rate ratios. Results: In bivariate analysis, the incidence rate ratios were significantly higher for municipalities with higher income ratio of the poorest 20.0% (1.47; 95% CI 1.19-1.81) and better Municipal Human Development Index (1.53; 95% CI 1.14-2.06). In multivariate analysis, the incidence rate ratios were significantly higher in municipalities with higher proportion of immigrants (1.31; 95% CI 1.11-1.55) and higher proportion of households with waste collection (1.37; 95% CI 1.11-1.69). There was a significant reduction in the incidence rate ratio with increased coverage of the Bolsa Familia Program (0.98; 95% CI 0.96-0.99). Conclusions: Control programs need to focus on activities in municipalities of greater social vulnerability with intersectoral investment for the improvement of the living conditions of the population

Zika virus outbreak in Brazil

Zika virus (ZIKV) infection is spreading rapidly within the Americas after originating from an outbreak in Brazil. We describe the current ZIKV infection epidemic in Brazil and the neurological symptoms arising. First cases of an acute exanthematic disease were reported in Brazil's Northeast region at the end of 2014. In March 2015, autochthonous ZIKV was determined to be the causative agent of the exanthematic disease. As cases of neurological syndromes in regions where ZIKV, dengue and/or Chikungunya viruses co-circulate were reported, ZIKV was also identified in the cerebrospinal fluid of patients with acute neurological syndromes and previous exanthematic disease. By the end of September 2015, an increasing number of infants with small head circumference or microcephaly were noted in Brazil's Northeast which was estimated to be 29 cases between August and October. ZIKV was identified in blood and tissue samples of a newborn and in mothers who had given birth to infants with microcephaly and ophthalmological anomalies. In 2015, there were an estimated 440,000-1,300,000 Zika cases in Brazil. There have been 4,783 suspected cases of microcephaly, most of them in the Northeast of Brazil associated with 76 deaths. The Ministry of Health is intensifying control measures against the mosquito Aedes aegypti and implemented intensive surveillance actions. Further studies are needed to confirm the suspected association between ZIKV infection and microcephaly; to identify antiviral, immunotherapy, or prophylactic vaccine; to introduce diagnostic ELISA testing. Clinical and epidemiological studies must be performed to describe viral dynamics and expansion of the outbreak

Entropy-Based Temporal Downscaling of Precipitation as Tool for Sediment Delivery Ratio Assessment

Many regions around the globe are subjected to precipitation-data scarcity that often hinders the capacity of hydrological modeling. The entropy theory and the principle of maximum entropy can help hydrologists to extract useful information from the scarce data available. In this work, we propose a new method to assess sub-daily precipitation features such as duration and intensity based on daily precipitation using the principle of maximum entropy. Particularly in arid and semiarid regions, such sub-daily features are of central importance for modeling sediment transport and deposition. The obtained features were used as input to the SYPoME model (sediment yield using the principle of maximum entropy). The combined method was implemented in seven catchments in Northeast Brazil with drainage areas ranging from 10−3 to 10+2 km2 in assessing sediment yield and delivery ratio. The results show significant improvement when compared with conventional deterministic modeling, with Nash–Sutcliffe efficiency (NSE) of 0.96 and absolute error of 21% for our method against NSE of −4.49 and absolute error of 105% for the deterministic approach.DFG, 414044773, Open Access Publizieren 2021 - 2022 / Technische Universität Berli

Zika virus infection, associated microcephaly, and low yellow fever vaccination coverage in Brazil: is there any causal link?

Introduction: Since the end of 2014, Zika virus (ZIKV) infection has been rapidly spreading in Brazil. Methodology: To analyze the possible association of yellow fever vaccine with a protective effect against ZIKV-related microcephaly, the following spatial analyses were performed, using Brazilian municipalities as units: i) yellow fever vaccination coverage in Brazilian municipalities in individuals aged 15-49; ii) reported cases of microcephaly by municipality; and iii) confirmed cases of microcephaly related to ZIKV, by municipality. SaTScan software was used to identify clusters of municipalities for high risk of microcephaly. Results: There were seven significant high risk clusters of confirmed microcephaly cases, with four of them located in the Northeast where yellow fever vaccination rates were the lowest. The clusters harbored only 2.9% of the total population of Brazil, but 15.2% of confirmed cases of microcephaly. Conclusion: We hypothesize that pregnant women in regions with high yellow fever vaccination coverage may pose their offspring to lower risk for development of microcephaly. There is an urgent need for systematic studies to confirm the possible link between low yellow fever vaccination coverage, Zika virus infection and microcephaly

High occurrence of disabilities caused by leprosy: census from a hyperendemic area in Brazil's savannah region

Objectives: To describe leprosy-related disabilities, we performed a census including people affected by leprosy in 78 municipalities of Tocantins state in northern Brazil. The study consisted of a review of patient charts, structured questionnaires, and clinical examinations for disabilities of eyes, hands, and feet (August – December 2009), according to WHO standards. Results: A total of 910 individuals diagnosed from 2006 to 2008 were included (clinical examination and application of questionnaires), but information from patient charts was not available in all cases, resulting in different denominators. The majority (783/858; 91·3%) had completed multidrug therapy. The most common clinical findings included: enlarged/painful peripheral nerves (412/910, 45·3%), namely of ulnar (207; 22·7%), posterior tibial (196; 21·6%), peroneal (186; 20·5%), and radial cutaneous nerves (166; 18·2%); reduction/loss of sensibility 201/907 (22·2%) and reduced motor function (185/906, 20·4%). At diagnosis, 142/629 (22·6%) had Grade 1 disability (G1D), and 28/629 (4·5%) had Grade 2 disability (G2D). At the time of the study, 178/910 (19·6%) presented with G1D, and 84/910 (9·2%) with G2D. Disability grading was significantly higher in males ( P , 0·01). Subjects with G2D showed claw hands (26; 2·9%), followed by plantar ulcers (23; 2·5%), abrasion/excoriation on the foot (12; 1·3%), claw foot (7; 0·7%), and drop foot (7; 0·7%). Conclusions: Leprosy- related disabilities were common in a highly endemic area. Prevention and rehabilitation measures, especially after release from treatment, should be intensified by the primary health care system. Policy makers need to be aware of an ongoing demand for leprosy control programmes, even in a world of constantly reducing leprosy detection

La Lepra en el municipio de Fortaleza, CE, Brasil: aspectos epidemiológicos y operacionales en menores de 15 años (1995-2006)

Estudo transversal que objetiva analisar a ocorrência de casos de hanseníase em menores de 15 anos de idade residentes no Município de Fortaleza e notificados no SINAN. Os indicadores epidemiológicos nesta população mostram hiperendemicidade. Operacionalmente observa-se a manutenção da concentração de atendimento em algumas unidades de referência, apesar de alguns avanços. Diagnóstico tardio, elevado grau de incapacidade no diagnóstico e baixo grau de avaliação de contatos registrados revelam a fragilidade das ações de controle. Ressalta-se a possibilidade de erro diagnóstico frente às características da infecção nesta população. A ocorrência de casos de hanseníase nesta população representa um indicador epidemiológico de grande relevância e sua análise amplia a discussão sobre problemas operacionais na rede de serviços de saúde.This is a sectional study that aims to analyze the occurrence of Hansen's disease cases in 15 year-old minors in the Municipality of Fortaleza and notified in SINAN. The epidemiological indicators in this population show hiperendemicity. In operational terms is observed the maintenance of the service concentration in some reference units, in spite of some progress. Late diagnosis, a high degree of incapacity in the diagnosis and low degree of evaluation of contacts registered reveal the fragility of the actions of control. This study emphasizes the possibility of error diagnostic front to the characteristics of the infection in this population. The occurrence of cases of leprosy in this population represents an epidemiologic indicator of great importance and its analysis extends the discussion on operational problems in the network of health services.Estudio transversal con el objetivo de analizar las ocurrencias de los casos de lepra en menores de 15 años de edad sitiados en la ciudad de Fortaleza y enterados en el SINAN. Los indicadores epidémicos en ésta población se presentaron hiperendémicos. En la operacinalización, se observa el mantenimiento de la concentración de atención en algunas unidades recomendables, a pesar de algunos avances. Diagnósticos muy tardes, gran grado de incapacidad en el diagnóstico y bajo grado de evaluación de contactos registrados, muestran la fragilidad de las acciones de control. Se resalta así la posibilidad de error de diagnóstico delante de las características de la infección en ésta población. La ocurrencia de casos de lepra en ésta población representa un indicador epidémico de gran importancia y su análisis amplia la discusión sobre los problemas operacionales en la red de servicios públicos.Edital MCT CNPq/MS SCTIE DECIT Departamento de Ciência e Tecnologia do Ministério da Saúd

Patrón espacio-tiempo de mortalidad del Sida

Objective: to analyze the spatial-temporal distribution of AIDS mortality. Method: this is a quantitative, descriptive study, which evaluated 959 aids deaths reported through the Mortality Information System. The temporal trend was analyzed using the Joinpoint Regression Program, version 4.6.0.0, and the Scan scanning was used to evaluate the formation of purely spatial clusters of deaths, considering a significance level of 5%. Results: most deaths occurred among males (71.1%), with seven years of schooling or less (79.6%), of pardo race (72.2%) and age group from 30 to 39 years (69.2%). There was a statistically significant increase in AIDS mortality of 5.2% per year (p<0.001; 95% CI: 1.0-9.5). The spatial scanning pointed to a statistically significant cluster of deaths (p<0.0001), which covered 18 municipalities, including Oeiras, Parnaíba and those in the metropolitan region of Teresina. Conclusion: the analysis of temporal and spatial trends showed a significant increased mortality over the period studied, as well as the presence of a cluster of deaths that covered 18 municipalities, including Teresina, Oeiras and Parnaíba.Objetivo: analisar a distribuição espaço-temporal da mortalidade por aids. Método: trata-se de um estudo quantitativo, descritivo, que avaliou 959 óbitos por Aids notificados por meio do Sistema de Informação sobre Mortalidade. Analisou-se a tendência temporal por meio do software Joinpoint Regression Program, versão 4.6.0.0, e a varredura Scan foi empregada para avaliar a formação de clusters puramente espaciais de óbitos, considerando-se um nível de significância de 5%. Resultados: verifica-se que a maioria das mortes ocorreu entre indivíduos do sexo masculino (71,1%), com sete anos de estudo ou menos (79,6%), de raça parda (72,2%) e faixa etária de 30 a 39 anos (69,2%). Registrou-se um aumento estatisticamente significativo da mortalidade por Aids de 5,2% ao ano (p<0,001; IC95%: 1,0-9,5). Observa-se que a varredura espacial apontou para um cluster de óbitos estatisticamente significativo (p<0,0001), que abrangeu 18 municípios, incluindo Oeiras, Parnaíba e os da região metropolitana de Teresina. Conclusão: nota-se que a análise das tendências temporal e espacial demonstrou um aumento significativo da mortalidade ao longo do período estudado, bem como a presença de um aglomerado de óbitos que abrangeu 18 municípios, incluindo Teresina, Oeiras e Parnaíba.Objetivo: analizar la distribución espacio-temporal de la mortalidad por SIDA. Método: se trata de un estudio cuantitativo y descriptivo que evaluó 959 muertes por SIDA reportadas a través del Sistema de Información sobre Mortalidad. La tendencia temporal se analizó utilizando el software Joinpoint Regression Program, versión 4.6.0.0, y el escaneo Scan se utilizó para evaluar la formación de grupos puramente espaciales de muertes, considerando un nivel de significancia del 5%. Resultados: se verificó que la mayoría de las muertes ocurrieron entre los varones (71,1%), con siete años de escolaridad o menos (79,6%), de raza parda (72,2%) y grupos de edad de 30 a 39 años (69,2%). Hubo un aumento estadísticamente significativo de la mortalidad por SIDA del 5,2% anual (p<0.001; IC del 95%: 1,0-9,5). Se observó que el escaneo espacial apuntaba a un grupo estadísticamente significativo de muertes (p<0.0001), que abarcaba 18 municipios, incluyendo Oeiras, Parnaíba y los de la región metropolitana de Teresina. Conclusión: se observa que el análisis de las tendencias temporales y espaciales mostró un aumento significativo de la mortalidad durante el período estudiado, así como la presencia de un grupo de muertes que abarcó 18 municipios, entre ellos Teresina, Oeiras y Parnaíba.info:eu-repo/semantics/publishedVersio