Spatial analysis of tuberculosis/HIV coinfection: its relation with socioeconomic levels in a city in south-eastern Brazil

INTRODUÇÃO: Analisar espacialmente a co-infecção tuberculose/vírus da imunodeficiência humana e associá-la com variáveis socioeconômicos, São José do Rio Preto, SP, 1998-2006. MÉTODOS: Foram geocodificados casos novos de TB/HIV e calculados coeficientes de incidência segundo unidades espaciais. Utilizou-se o índice de Moran para avaliar a dependência espacial das incidências. Regressões múltiplas foram realizadas para selecionar variáveis com maior poder de explicação da dependência espacial. O indicador local de associação espacial foi utilizado para identificação de agrupamentos espaciais significantes. RESULTADOS: O índice de Moran foi de 0,0635 (p = 0,0000), indicando ocorrência de dependência espacial. A variável que apresentou maior poder de explicação da dependência espacial da incidência foi a porcentagem de chefes de família com até três anos de instrução. O LISA cluster map para os coeficientes de incidência de co-infecção TB/HIV evidenciou aglomerados de alta incidência na região norte e baixa incidência na sul e oeste do município. CONCLUSÕES: O estudo possibilitou a compreensão da distribuição geográfica espacial da co-infecção TB/HIV no município e apontou a sua associação com variáveis socioeconômicas dando subsídios para o planejamento orientado para a priorização das regiões com maior carência social e consequentemente maiores incidências da doença.INTRODUCTION: Spatial analysis of the distribution of tuberculosis/HIV coinfection was performed and associated with socioeconomic indicators in São José do Rio Preto, from 1998 to 2006. METHODS: New TB/HIV coinfection cases were georeferenced and incidence coefficients were calculated for spatial units. Moran's index was used to evaluate spatial associations of incidences. Multiple regressions selected variables that could best explain the spatial association of incidences. The local indicator of spatial association was used to identify significant spatial groupings. RESULTS: Moran's index was 0.0635 (p=0.0000) indicating that the incidence association occurred. The variable that best explained the spatial association of incidence was the percentage of heads of families with up to three years of education. The LISA cluster map for TB/HIV coinfection incidence coefficients showed groups with high incidence rates in the North and low incidence in the South and West regions of the municipality. CONCLUSIONS: The study elucidated the spatial geographic distribution of TB/HIV coinfection and determined its association with socioeconomic variables, thus providing data for oriented planning, prioritizing socially disadvantaged regions that present a higher incidence of the disease.CNP

Maternal obesity and gestational diabetes are associated with DNA methylation alterations in the offspring throughout the first year of life

Objective: Obesity is a chronic metabolic disease of increasing prevalence and health importance in modern societies, which represents an added risk for the development of multiple pathologies. Moreover, epidemiological studies have shown how maternal obesity or gestational diabetes during pregnancy constitutes an important risk factor related to the appearance of cardiovascular and metabolic diseases in the offspring. Furthermore, this period of life is especially sensitive to extrinsic and intrinsic influence, so epigenetic remodelling may help explain the molecular mechanisms that underlie epidemiological findings. The main objective of this work was to determine the DNA methylation landscape of children born to mothers with obesity and gestational diabetes across their first year of life. Design and method: We have characterized the methylome of blood samples from a paediatric cohort of 39 subjects consisting of children born to mothers who suffered from obesity or obesity with gestational diabetes during pregnancy and healthy controls. We performed longitudinal measurements throughout the first year of life (0, 6 and 12 months; total N = 92) using Illumina Infinium MethylationEPIC BeadChip arrays to profile more than 770,000 CpG sites. The design allowed us to carry out both cross-sectional and longitudinal analyses in order to derive DNA methylation alterations associated with developmental and pathological-related epigenomics. Results: We have identified abundant DNA methylation alterations during child development from birth to 6 months and, to a lesser extent, until 12 months of age. At the same time, using cross-sectional analyses, we have identified DNA methylation biomarkers that discriminate children born to mothers who suffered from obesity or obesity with gestational diabetes during pregnancy compared to their healthy counterparts. Moreover, our longitudinal design allowed us to determine that these alterations are at least maintained during the first year of life. In addition, gene enrichment analyses revealed that these DNA methylation alterations are associated with regions and genes related to feeding behaviour, appetite, metabolism and cell signalling. Conclusions: Our results support the existence of an intrauterine-mediated maternal obesity effect with an impact on the childhood methylome and possible functional implications

Maternal obesity and gestational diabetes reprogram the methylome of offspring beyond birth by inducing epigenetic signatures in metabolic and developmental pathways

This work was supported by: the Spanish Association Against Cancer (Grant number PROYE18061FERN to M.F.F.), the Asturias Government (PCTI) cofounding 2018–2022/FEDER (Grant number IDI/2018/146 to M.F.F.), the Fundación General CSIC (Grant number 0348_CIE_6_E to M.F.F.), the Institute of Health Carlos III (Plan Nacional de I + D + I) cofounding FEDER (Grant numbers PI18/01527 and PI21/01067 to M.F.F. and A.F.F.; Grant numbers PI17/01517 and PI20/00269 to E.L.), and the Spanish Ministry of Science and Innovation (Grant number SGL2021-03-039/40 to M.F.F.) cofounding NextGenerationEU. J.R.T. is supported by a Juan de la Cierva fellowship from the Spanish Ministry of Science and Innovation (Grant number IJC2018-36825-I). J.J.A.L. is supported by the Spanish Association Against Cancer (Grant number PRDAS21642ALBA). R.F.P. and D.B.R. are supported by the Severo Ochoa program (Grant numbers BP17-114 and BP20-186). We also acknowledge support from the Institute of Oncology of Asturias (IUOPA, supported by Obra Social Cajastur Liberbank, Spain), the Health Research Institute of Asturias (ISPA-FINBA), the Health Research Institute INCLIVA and the Biomedical Research Networking Center on Rare Diseases (CIBERER-ISCIII).Peer reviewe

Tuberculosis Recurrence: Associated Factors in an Epidemiological Surveillance Group of São Paulo

Analyze the factors related to cases of tuberculosis (TB) recurrence in reports of the Epidemiological Surveillance Group XXIX/São José do Rio Preto/SP. This is a case-control study that analyzes pulmonary TB reports in the period between 1996 and 2014. Cases were reports of “Recurrence" and control: reports classified as "New" case and with "Healed" outcome. Odds ratio and multivariate analysis with 95% confidence interval were used to analyze the data. The variables of gender and adverse outcome in the 7th month remained significantly associated with recurrence. Males showed 1.8 times greater risk (p = 0.0551) and individuals who obtained an adverse outcome in the 7th month of treatment were 4.6 times more likely to recur (p = 0.0000). We found two factors associated with recurrence: male gender and adverse treatment outcome, which shows the need to assess the quality of the care provided