Clinical and epidemiological characteristics associated with unfavorable tuberculosis treatment outcomes in TB-HIV co-infected patients in Brazil : a hierarchical polytomous analysis

Background: TB patients co-infected with HIV have worse treatment outcomes than non-coinfected patients. How clinical characteristics of TB and socioeconomic characteristics influence these outcomes is poorly understood. Here, we use polytomous regression analysis to identify clinical and epidemiological characteristics associated with unfavorable treatment outcomes among TB-HIV co-infected patients in Brazil. Methods: TB-HIV cases reported in the Brazilian information system (SINAN) between January 1, 2001 and December 31, 2011 were identified and categorized by TB treatment outcome (cure, default, death, and development of MDR TB). We modeled treatment outcome as a function of clinical characteristics of TB and patient socioeconomic characteristics by polytomous regression analysis. For each treatment outcome, we used cure as the reference outcome. Results: between 2001 and 2011, 990,017 cases of TB were reported in SINAN, of which 93,147 (9.4%) were HIV co-infected. Patients aged 15–19 (OR = 2.86; 95% CI: 2.09–3.91) and 20–39 years old (OR = 2.30; 95% CI: 1.81–2.92) were more likely to default on TB treatment than those aged 0–14 years old. In contrast, patients aged ≥60 years were more likely to die from TB (OR = 2.22; 95% CI: 1.43–3.44) or other causes (OR = 2.86; 95% CI: 2.14–3.83). Black patients were more likely to default on TB treatment (OR = 1.33; 95% CI: 1.22–1.44) and die from TB (OR = 1.50; 95% CI: 1.29–1.74). Finally, alcoholism was associated with all unfavorable outcomes: default (OR = 1.94; 95% CI: 1.73–2.17), death due to TB (OR = 1.46; 95% CI: 1.25–1.71), death due to other causes (OR = 1.38; 95% CI: 1.21–1.57) and MDR-TB (OR = 2.29; 95% CI: 1.46–3.58). Conclusions: socio-economic vulnerability has a significant effect on treatment outcomes among TB-HIV co-infected patients in Brazil. Enhancing social support, incorporation of alcohol abuse screening and counseling into current TB surveillance programs and targeting interventions to specific age groups are interventions that could improve treatment outcomes

Text mining analysis to understand the impact of online news on public health response: case of syphilis epidemic in Brazil

BackgroundTo effectively combat the rising incidence of syphilis, the Brazilian Ministry of Health (MoH) created a National Rapid Response to Syphilis with actions aimed at bolstering epidemiological surveillance of acquired, congenital syphilis, and syphilis during pregnancy complemented with communication activities to raise population awareness and to increase uptake of testing that targeted mass media outlets from November 2018 to March 2019 throughout Brazil, and mainly areas with high rates of syphilis. This study analyzes the volume and quality of online news content on syphilis in Brazil between 2015 and 2019 and examines its effect on testing.MethodsThe collection and processing of online news were automated by means of a proprietary digital health ecosystem established for the study. We applied text data mining techniques to online news to extract patterns from categories of text. The presence and combination of such categories in collected texts determined the quality of news that were analyzed to classify them as high-, medium-and low-quality news. We examined the correlation between the quality of news and the volume of syphilis testing using Spearman’s Rank Correlation Coefficient.Results1,049 web pages were collected using a Google Search API, of which 630 were categorized as earned media. We observed a steady increase in the number of news on syphilis in 2015 (n = 18), 2016 (n = 26), and 2017 (n = 42), with a substantial rise in the number of news in 2018 (n = 107) and 2019 (n = 437), although the relative proportion of high-quality news remained consistently high (77.6 and 70.5% respectively) and in line with similar years. We found a correlation between news quality and syphilis testing performed in primary health care with an increase of 82.32, 78.13, and 73.20%, respectively, in the three types of treponemal tests used to confirm an infection.ConclusionEffective communication strategies that lead to dissemination of high quality of information are important to increase uptake of public health policy actions

Causas da queda progressiva das taxas de vacinação da poliomielite no Brasil / Causes of the progressive fall in polyomyelite vaccination rates in Brazil

Introdução: A Poliomielite é uma doença infectocontagiosa que acomete indivíduos de qualquer faixa etária, com maior ocorrência, principalmente em crianças. Nos primeiros anos de vida, os indivíduos acometidos passam por episódios de internações longas e inúmeros procedimentos médicos, portanto, além do dano físico, há um enorme dano psicossocial gerado pelo isolamento, separação da família e amigos, sentimentos de abandono, desamparo, medo, entre outros. Mesmo após a reabilitação, ainda existem muitas dificuldades a serem enfrentadas por sua condição física e pela barreira social aos deficientes físicos. No Brasil, as coberturas vacinais municipais ainda são heterogêneas e isso possibilita a reintrodução do poliovírus selvagem (comprometendo o processo de certificação de eliminação). Desta forma, e? importante que autoridades, gestores e profissionais de saúde trabalhem para minimizar os riscos e a possibilidade de reintrodução do poliovírus no território brasileiro. Metodologia: Trata-se de um estudo transversal com análise espacial da cobertura vacinal de Poliomielite no Brasil, em 2018 e correlação com as variáveis: escolaridade, IDH, assistência à saúde e acesso à internet. A coleta de dados foi realizada a partir do Instituto Brasileiro de Geografia e Estatística (IBGE) e Programa Nacional de Imunização (PNI), DataSUS, os limites espaciais obtidos por meio dos sites do Laboratório de Processamento de Imagens e Geoprocessamento (LAPIG) e Pastagem. Os dados e limites espaciais foram tabulados e processados pelo programa Microsoft Office Excel 2010 e gerados os mapas, em formato Shapefiles (SHP), com auxílio do software ArcGis. Resultados: Nas regiões Norte e Nordeste as coberturas vacinais foram satisfatórias (acima de 95%). Nas demais regiões as coberturas foram insatisfatórias na faixa etária entre um ano e dois anos incompletos. As regiões que não atingiram as coberturas adequadas foram as que apresentam maior IDH, maior escolaridade e maior acesso à internet, conforme esperado. A assistência à saúde não apresentou relação direta com os resultados. Discussão: Em levantamento realizado sobre o monitoramento da cobertura vacinal para Poliomielite, entre 1990 e 2016, foi satisfatório, ou seja, acima de 95% da população alvo, a partir de então, se iniciou um declínio na adesão da população persistindo até os dias atuais. Podemos citar prováveis razões para a ocorrência da queda da vacinação: percepção enganosa de que esta não é necessária, uma vez que a doença desapareceu; desconhecimento do PNI; temor de reações adversas ou sobrecarga do sistema imunológico; falta de tempo dos cuidadores. A queda da cobertura vacinal pode trazer grandes consequências, como epidemias frequentes de doenças que são imunopreveníveis (a exemplo do que está ocorrendo com o sarampo), além do risco de uma reintrodução do vírus selvagem da Poliomielite em nosso país. Conclusão: É necessária a elaboração de estratégias que objetivem alcançar as metas de vacinação em todo o país através da conscientização da população em relação a alguns temas como: a disseminação, principalmente pela internet, de conteúdos não confiáveis contra a vacinação; a importância de uma boa cobertura vacinal para a sociedade; o risco de epidemias de doenças que já haviam sido erradicadas; e a confiabilidade das vacinas.

Development of a Cyclic Voltammetry-Based Method for the Detection of Antigens and Antibodies as a Novel Strategy for Syphilis Diagnosis

54/2017). Publisher Copyright: © 2022 by the authors.The improvement of laboratory diagnosis is a critical step for the reduction of syphilis cases around the world. In this paper, we present the development of an impedance-based method for detecting T. pallidum antigens and antibodies as an auxiliary tool for syphilis laboratory diagnosis. We evaluate the voltammetric signal obtained after incubation in carbon or gold nanoparticle-modified carbon electrodes in the presence or absence of Poly-L-Lysine. Our results indicate that the signal obtained from the electrodes was sufficient to distinguish between infected and non-infected samples immediately (T0′) or 15 min (T15′) after incubation, indicating its potential use as a point-of-care method as a screening strategy.publishersversionpublishe

Safety and Quality in the Agricultural Product Chain in Brazil

An agriculture-intensive country should be aware of natural toxins, including both mycotoxins and cyanotoxins, which are closely associated with the quality of raw materials, for food safety and industry. The major production chains – corn, wheat, beef, and broiler chicken – are the top components of agribusiness, and they should be tracked by reliable and practical tools. The corn chain is of particular concern in food production; intensive controls, multi-year mycotoxin monitoring, and improved harmless/sustainable management methods for uninterrupted farming in the tropic-subtropics are needed to achieve a long-lasting trend. The rapid control of natural toxins (mycotoxin and cyanotoxin) has focused on immunochemical methods developed with highly specific monoclonal antibodies (mAb) matched with chromatographic methods. In parallel, the promising widespread application of non-destructive analytical methods based on NIR (Near Infrared Reflectance) spectroscopy, computer vision and hyperspectral imaging coupled with multivariate analyses have been introduced as an alternative for the prediction of quality and compositional parameters. Rapid quality control and product traceability are discussed, as well as accurate monitoring, which is essential for potentially launching an innovative system for food production in Brazil

The Text Mining Technique Applied to the Analysis of Health Interventions to Combat Congenital Syphilis in Brazil: The Case of the "Syphilis No!" Project

Congenital syphilis (CS) remains a threat to public health worldwide, especially in developing countries. To mitigate the impacts of the CS epidemic, the Brazilian government has developed a national intervention project called "Syphilis No." Thus, among its range of actions is the production of thousands of writings featuring the experiences of research and intervention supporters (RIS) of the project, called field researchers. In addition, this large volume of base data was subjected to analysis through data mining, which may contribute to better strategies for combating syphilis. Natural language processing is a form of knowledge extraction. First, the database extracted from the "LUES Platform" with 4,874 documents between 2018 and 2020 was employed. This was followed by text preprocessing, selecting texts referring to the field researchers' reports for analysis. Finally, for analyzing the documents, N-grams extraction (N = 2,3,4) was performed. The combination of the TF-IDF metric with the BoW algorithm was applied to assess terms' importance and frequency and text clustering. In total, 1019 field activity reports were mined. Word extraction from the text mining method set out the following guiding axioms from the bigrams: "confronting syphilis in primary health care;" "investigation committee for congenital syphilis in the territory;" "municipal plan for monitoring and investigating syphilis cases through health surveillance;" "women's healthcare networks for syphilis in pregnant;" "diagnosis and treatment with a focus on rapid testing." Text mining may serve public health research subjects when used in parallel with the conventional content analysis method. The computational method extracted intervention activities from field researchers, also providing inferences on how the strategies of the "Syphilis No" Project influenced the decrease in congenital syphilis cases in the territory

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio