Forecasting Dengue, Chikungunya and Zika cases in Recife, Brazil: a spatio-temporal approach based on climate conditions, health notifications and machine learning

Dengue has become a challenge for many countries. Arboviruses transmitted by Aedes aegypti spread rapidly over the last decades. The emergence chikungunya fever and zika in South America poses new challenges to vector monitoring and control. This situation got worse from 2015 and 2016, with the rapid spread of chikungunya, causing fever and muscle weakness, and Zika virus, related to cases of microcephaly in newborns and the occurrence of Guillain-Barret syndrome, an autoimmune disease that affects the nervous system. The objective of this work was to construct a tool to forecast the distribution of arboviruses transmitted by the mosquito Aedes aegypti by implementing dengue, zika and chikungunya transmission predictors based on machine learning, focused on multilayer perceptrons neural networks, support vector machines and linear regression models. As a case study, we investigated forecasting models to predict the spatio-temporal distribution of cases from primary health notification data and climate variables (wind velocity, temperature and pluviometry) from Recife, Brazil, from 2013 to 2016, including 2015’s outbreak. The use of spatio-temporal analysis over multilayer perceptrons and support vector machines results proved to be very effective in predicting the distribution of arbovirus cases. The models indicate that the southern and western regions of Recife were very susceptible to outbreaks in the period under investigation. The proposed approach could be useful to support health managers and epidemiologists to prevent outbreaks of arboviruses transmitted by Aedes aegypti and promote public policies for health promotion and sanitation

A review exploring the overarching burden of Zika virus with emphasis on epidemiological case studies from Brazil

This paper explores the main factors for mosquito-borne transmission of the Zika virus by focusing on environmental, anthropogenic, and social risks. A literature review was conducted bringing together related information from this genre of research from peer-reviewed publications. It was observed that environmental conditions, especially precipitation, humidity, and temperature, played a role in the transmission. Furthermore, anthropogenic factors including sanitation, urbanization, and environmental pollution promote the transmission by affecting the mosquito density. In addition, socioeconomic factors such as poverty as well as social inequality and low-quality housing have also an impact since these are social factors that limit access to certain facilities or infrastructure which, in turn, promote transmission when absent (e.g., piped water and screened windows). Finally, the paper presents short-, mid-, and long-term preventative solutions together with future perspectives. This is the first review exploring the effects of anthropogenic aspects on Zika transmission with a special emphasis in Brazil

Global burden of cardiovascular diseases and risk factors, 1990–2019: update from the GBD 2019 study

Cardiovascular diseases (CVDs), principally ischemic heart disease (IHD) and stroke, are the leading cause of global mortality and a major contributor to disability. This paper reviews the magnitude of total CVD burden, including 13 underlying causes of cardiovascular death and 9 related risk factors, using estimates from the Global Burden of Disease (GBD) Study 2019. GBD, an ongoing multinational collaboration to provide comparable and consistent estimates of population health over time, used all available population-level data sources on incidence, prevalence, case fatality, mortality, and health risks to produce estimates for 204 countries and territories from 1990 to 2019. Prevalent cases of total CVD nearly doubled from 271 million (95% uncertainty interval [UI]: 257 to 285 million) in 1990 to 523 million (95% UI: 497 to 550 million) in 2019, and the number of CVD deaths steadily increased from 12.1 million (95% UI:11.4 to 12.6 million) in 1990, reaching 18.6 million (95% UI: 17.1 to 19.7 million) in 2019. The global trends for disability-adjusted life years (DALYs) and years of life lost also increased significantly, and years lived with disability doubled from 17.7 million (95% UI: 12.9 to 22.5 million) to 34.4 million (95% UI:24.9 to 43.6 million) over that period. The total number of DALYs due to IHD has risen steadily since 1990, reaching 182 million (95% UI: 170 to 194 million) DALYs, 9.14 million (95% UI: 8.40 to 9.74 million) deaths in the year 2019, and 197 million (95% UI: 178 to 220 million) prevalent cases of IHD in 2019. The total number of DALYs due to stroke has risen steadily since 1990, reaching 143 million (95% UI: 133 to 153 million) DALYs, 6.55 million (95% UI: 6.00 to 7.02 million) deaths in the year 2019, and 101 million (95% UI: 93.2 to 111 million) prevalent cases of stroke in 2019. Cardiovascular diseases remain the leading cause of disease burden in the world. CVD burden continues its decades-long rise for almost all countries outside high-income countries, and alarmingly, the age-standardized rate of CVD has begun to rise in some locations where it was previously declining in high-income countries. There is an urgent need to focus on implementing existing cost-effective policies and interventions if the world is to meet the targets for Sustainable Development Goal 3 and achieve a 30% reduction in premature mortality due to noncommunicable diseases

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

Spatiotemporal forecasting for dengue, chikungunya fever and Zika using machine learning and artificial expert committees based on meta-heuristics

Purpose: Dengue is considered one of the biggest public health problems in recent decades. Climate and demographic changes, the disorderly growth of cities and international trade have brought new arboviruses such as chikungunya and Zika. Control of arboviruses depends on control of the vector: the Aedes aegypti mosquito. Objective: In this work, we propose a methodology for building disease predictors capable of predicting infected cases and locations based on machine learning. We also propose an artificial experts committee based on meta-heuristic methods to detect the most relevant risk factors. Method As a case study, we applied the methodology to forecast dengue, chikungunya and Zika, with data from the City of Recife, Brazil, from 2013 to 2016. We used arboviruses cases data and climatic and environmental information: wind speeds, temperatures and precipitation. Results The best prediction results were obtained with 10-tree Random Forest regression, with Pearson’s correlation above 0.99 and RMSE (%) below 6%. Additionally, the artificial experts committee was able to present the most relevant factors for predicting cases in each two-month period. Conclusion: The spatiotemporal prediction results showed the evolution of arboviruses, pointing out as major focuses on both regions richer in urban green areas and low-income neighborhood with irregular water supply. Determining the most relevant factors for prediction, as well as the spatial distribution of cases, can be useful for the planning and execution of public policies aimed at improving the health infrastructure and planning and controlling the vector