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Pereira EDA, do Carmo CN, Araujo WRM, Branco MDRFC. Spatial distribution of arboviruses and its association with a social development index and the waste disposal in São Luís, state of Maranhão, Brazil, 2015 to 2019. Rev Bras Epidemiol 2024; 27:e240017. [PMID: 38716959 PMCID: PMC11073584 DOI: 10.1590/1980-549720240017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 12/21/2023] [Accepted: 01/05/2024] [Indexed: 05/12/2024] Open
Abstract
OBJECTIVE To detect spatial and spatiotemporal clusters of urban arboviruses and to investigate whether the social development index (SDI) and irregular waste disposal are related to the coefficient of urban arboviruses detection in São Luís, state of Maranhão, Brazil. METHODS The confirmed cases of Dengue, Zika and Chikungunya in São Luís, from 2015 to 2019, were georeferenced to the census tract of residence. The Bayesian Conditional Autoregressive regression model was used to identify the association between SDI and irregular waste disposal sites and the coefficient of urban arboviruses detection. RESULTS The spatial pattern of arboviruses pointed to the predominance of a low-incidence cluster, except 2016. For the years 2015, 2016, 2017, and 2019, an increase of one unit of waste disposal site increased the coefficient of arboviruses detection in 1.25, 1.09, 1.23, and 1.13 cases of arboviruses per 100 thousand inhabitants, respectively. The SDI was not associated with the coefficient of arboviruses detection. CONCLUSION In São Luís, spatiotemporal risk clusters for the occurrence of arboviruses and a positive association between the coefficient of arbovirus detection and sites of irregular waste disposal were identified.
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Martins C, da Silva FN, Dias JDJ, Branco MDRFC, dos Santos AM, de Oliveira BLCA. Individual and contextual factors associated with the survival of patients with severe acute respiratory syndrome by COVID-19 in Brazil. Rev Bras Epidemiol 2024; 27:e240019. [PMID: 38655946 PMCID: PMC11027433 DOI: 10.1590/1980-549720240019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 01/22/2024] [Accepted: 01/30/2024] [Indexed: 04/26/2024] Open
Abstract
OBJECTIVE To analyze the influence of individual and contextual factors of the hospital and the municipality of care on the survival of patients with Severe Acute Respiratory Syndrome due to COVID-19. METHODS Hospital cohort study with data from 159,948 adults and elderly with Severe Acute Respiratory Syndrome due to COVID-19 hospitalized from January 1 to December 31, 2022 and reported in the Influenza Epidemiological Surveillance Information System. The contextual variables were related to the structure, professionals and equipment of the hospital establishments and socioeconomic and health indicators of the municipalities. The outcome was hospital survival up to 90 days. Survival tree and Kaplan-Meier curves were used for survival analysis. RESULTS Hospital lethality was 30.4%. Elderly patients who underwent invasive mechanical ventilation and were hospitalized in cities with low tax collection rates had lower survival rates compared to other groups identified in the survival tree (p<0.001). CONCLUSION The study indicated the interaction of contextual factors with the individual ones, and it shows that hospital and municipal characteristics increase the risk of death, highlighting the attention to the organization, operation, and performance of the hospital network.
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Affiliation(s)
- Carlos Martins
- Universidade Federal do Maranhão, Postgraduate Program in Collective
Health – São Luís (MA), Brazil
| | - Fábio Nogueira da Silva
- Universidade Federal do Maranhão, Postgraduate Program in Collective
Health – São Luís (MA), Brazil
| | - José de Jesus Dias
- Universidade Federal do Maranhão, Postgraduate Program in Collective
Health – São Luís (MA), Brazil
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Martins C, Silveira VNDC, da Silva FN, Dias JDJ, Branco MDRFC, dos Santos AM, de Oliveira BLCA. Clinical-epidemiological characteristics and survival of cases of severe acute respiratory syndrome (SARS) due to COVID-19, according to the COVID-19 vaccination schedule in Brazil, 2021-2022: a prospective study. Epidemiol Serv Saude 2023; 32:e2023128. [PMID: 38126542 PMCID: PMC10727126 DOI: 10.1590/s2237-96222023000400003.en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 10/16/2023] [Indexed: 12/23/2023] Open
Abstract
OBJECTIVE To analyze the clinical and sociodemographic characteristics and survival of individuals with severe acute respiratory syndrome due to COVID-19 according to the COVID-19 vaccination schedule, Brazil, 2021-2022. METHODS This was a cohort study based on data from the Influenza Epidemiological Surveillance Information System; the Kaplan-Meier and Survival Tree methods were used to analyze survival. RESULTS Among the 559,866 hospitalized cases, a higher proportion of vaccinated individuals was found among female (15.0%), elderly people aged ≥ 80 (34.5%), people from the Southeast region (15.7%), those who did not undergo respiratory support (21.2%) and those who did progress to death (15.2%); the survival curve showed that risk of death for unvaccinated individuals was higher in all age groups (p-value < 0.001); elderly people aged ≥ 80, who did not undergo mechanical ventilation and who had a booster dose had lower risk when compared to their peers who had two doses or were unvaccinated (hazard ratio = 0.64; 95%CI 0.62;0.67). CONCLUSION Lowest risk of death was found in vaccinated individuals, especially those who had two doses or a booster dose as well. MAIN RESULTS Prevalence was found to be high among unvaccinated individuals. Risk of death was lower among those vaccinated with a booster dose, compared to those not vaccinated, in all age groups analyzed. IMPLICATIONS FOR SERVICES The number of hospitalizations of unvaccinated individuals with severe acute respiratory syndrome was high, which increases the demand for health services to care for these individuals. PERSPECTIVES It is necessary to promote widespread vaccination of the entire population of Brazil, in addition to the regular provision of booster doses for the different population groups.
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Affiliation(s)
- Carlos Martins
- Universidade Federal do Maranhão, Programa de Pós-Graduação em Saúde Coletiva, São Luís, MA, Brazil
| | | | - Fábio Nogueira da Silva
- Universidade Federal do Maranhão, Programa de Pós-Graduação em Saúde Coletiva, São Luís, MA, Brazil
| | - José de Jesus Dias
- Universidade Federal do Maranhão, Programa de Pós-Graduação em Saúde Coletiva, São Luís, MA, Brazil
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Araújo MSM, Branco MDRFC, Costa SDSB, de Oliveira DC, Queiroz RCDS, de Oliveira BLCA, Pasklan ANP, dos Santos AM. [COVID-19 mortality in metropolitan areas vs. other regions of Brazil, 2020 to 2021Mortalidad por COVID-19 en las regiones metropolitanas y en el interior de Brasil, 2020-2021]. Rev Panam Salud Publica 2023; 47:e115. [PMID: 37489235 PMCID: PMC10361444 DOI: 10.26633/rpsp.2023.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 04/21/2023] [Indexed: 07/26/2023] Open
Abstract
Objective To compare hospital mortality rates (HMR) due to severe acute respiratory syndrome (SARS) associated with COVID-19 recorded in metropolitan areas and other regions (interior) of Brazil in 2020 and 2021. Method This ecological study used public data available on OpenDataSUS. The information was accessed in May 2022. The following variables were considered: age, sex, hospitalization, presence of a risk factor, ICU stay, use of ventilatory support, and final classification in the individual registration form of SARS cases due to COVID-19. Cases and deaths were stratified into five age groups (0-19 years, 20-39 years, 40-59 years, 60-79 years, and ≥80 years) and by place of residence (metropolitan area or interior). The HMR had as numerator the absolute number of deaths by SARS associated with covid-19; and, as a denominator, the absolute number of cases of SARS due to covid-19 according to the year of occurrence, area of residence, age bracket, sex, hospitalization, presence of a risk factor, ICU admission, and use of ventilatory support. Results There was a significant increase in HMR due to SARS associated with COVID-19 in 2021 in all age groups, except 0-19 years and ≥80 years, as well as among individuals admitted to an ICU and who used invasive ventilatory support, both in metropolitan areas as well as in the interior. Conclusions There was a worsening of the epidemiological scenario in 2021 with an increase in HMR. However, no differences were identified between the metropolitan regions and the interior of the country.
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Affiliation(s)
- Mayra Sharlenne Moraes Araújo
- Universidade Federal do Maranhão (UFMA)Programa de Pós-Graduação em Saúde ColetivaSão Luís (MA)BrasilUniversidade Federal do Maranhão (UFMA), Programa de Pós-Graduação em Saúde Coletiva, São Luís (MA), Brasil.
| | - Maria dos Remédios Freitas Carvalho Branco
- Universidade Federal do Maranhão (UFMA)Programa de Pós-Graduação em Saúde ColetivaSão Luís (MA)BrasilUniversidade Federal do Maranhão (UFMA), Programa de Pós-Graduação em Saúde Coletiva, São Luís (MA), Brasil.
| | - Silmery da Silva Brito Costa
- Universidade Federal do MaranhãoDepartamento de Saúde ColetivaSão Luís (MA)BrasilUniversidade Federal do Maranhão, Departamento de Saúde Coletiva, São Luís (MA), Brasil.
| | - Daniel Cavalcante de Oliveira
- Universidade Federal do ABC (UFABC)Departamento de Engenharia BiomédicaSanto André (SP)BrasilUniversidade Federal do ABC (UFABC), Departamento de Engenharia Biomédica, Santo André (SP), Brasil.
| | - Rejane Christine de Sousa Queiroz
- Universidade Federal do Maranhão (UFMA)Programa de Pós-Graduação em Saúde ColetivaSão Luís (MA)BrasilUniversidade Federal do Maranhão (UFMA), Programa de Pós-Graduação em Saúde Coletiva, São Luís (MA), Brasil.
| | - Bruno Luciano Carneiro Alves de Oliveira
- Universidade Federal do Maranhão (UFMA)Programa de Pós-Graduação em Saúde ColetivaSão Luís (MA)BrasilUniversidade Federal do Maranhão (UFMA), Programa de Pós-Graduação em Saúde Coletiva, São Luís (MA), Brasil.
| | - Amanda Namíbia Pereira Pasklan
- Universidade Federal do MaranhãoDepartamento de MedicinaSão Luís (MA)BrasilUniversidade Federal do Maranhão, Departamento de Medicina, São Luís (MA), Brasil.
| | - Alcione Miranda dos Santos
- Universidade Federal do Maranhão (UFMA)Programa de Pós-Graduação em Saúde ColetivaSão Luís (MA)BrasilUniversidade Federal do Maranhão (UFMA), Programa de Pós-Graduação em Saúde Coletiva, São Luís (MA), Brasil.
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Pereira AR, Branco MDRFC, Costa SDSB, Lopes DAM, Pinheiro VV, de Oliveira DC, Pasklan ANP, Gomes JA, dos Santos AM, Gama MEA. COVID-19 severe acute respiratory syndrome in Brazilian newborns in 2020-2021. Rev Bras Epidemiol 2023; 26:e230012. [PMID: 36820749 PMCID: PMC9949484 DOI: 10.1590/1980-549720230012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 11/23/2022] [Indexed: 02/22/2023] Open
Abstract
OBJECTIVE To describe the clinical characteristics of cases of COVID-19 severe acute respiratory syndrome (SARS) in Brazilian newborns (NBs) in 2020 and 2021, recorded in the Influenza Epidemiological Surveillance Information System (Sistema de Informação da Vigilância Epidemiológica da Gripe - SIVEP-Gripe). METHODS The variables analyzed were gender, race/skin color, hospitalization, intensive care unit (ICU) admission, use of ventilatory support, signs and symptoms (fever, cough, O2 saturation<95%, dyspnea, respiratory distress, diarrhea, and vomiting), progress (death or cure), risk factors/comorbidities. Categorical variables were expressed as absolute and relative frequencies. RESULTS We found 1,649 records of COVID-19 SARS in NBs, with a predominance of multiracial babies in both years. The most frequent symptoms in 2020 and 2021 were, respectively: respiratory distress (67.0 and 69.7%), fever (46.3 and 46.2%), and cough (37.0 and 46.3%). In 2020, 30.5% of patients received invasive ventilatory support; in 2021, this number was 41.6%. In addition, more than 55% of cases required ICU admission, and over 16% died. CONCLUSION We emphasize the high proportion of cases that required intensive care and progressed to death.
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Silva DPAD, Ribeiro MRC, Branco MDRFC, Marques MTS, Almeida JDS, Gomes JA, Silva AAMD. Deaths, crimes and violence not classified as a crime among children and adolescents in Maranhão, Brazil (2014 to 2020). Ciênc saúde coletiva 2023. [DOI: 10.1590/1413-81232023282.08342022en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Abstract This study compares temporal trends in violent deaths of children and adolescents and analyzes differences in incidents of violence classified and not classified as a crime. We analyzed data from the Mortality Information System and State of Maranhão Public Security Department for the period 2014 to 2020. Child and adolescent were defined as aged 0-11 and 12-17 years old, respectively. Types of violence were organized according to the groups, subgroups, and types of crimes set out in Brazil’s penal code. A total of 1,326 deaths and 8,187 incidents of violence were reported, both of which were more frequent in adolescents. The most frequent types of violence in children and adolescentes, respectively, were: abduction of incapable persons (p < 0.001), abandonment of incapable persons (p = 0.045), rape of vulnerable persons (p = 0.003); homicides (p < 0.001), crimes against individual freedom (p = 0.004), crimes against sexual freedom (p < 0.001), psychological violence (p = 0.034). Domestic violence with bodily harm was more frequent in girls (p < 0.001), while severe bodily harm (p=0.002), homicide (p < 0.001), and harassment (p < 0.001) were more frequent in boys. The findings reveal differences over time in deaths and incidents of violence classified and not classified as crime among both children and adolescents.
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Pereira AR, Branco MDRFC, Costa SDSB, Lopes DAM, Pinheiro VV, Oliveira DCD, Pasklan ANP, Gomes JA, Santos AMD, Gama MEA. Síndrome Respiratória Aguda Grave por COVID-19 em recém-nascidos no Brasil em 2020–2021. Rev bras epidemiol 2023. [DOI: 10.1590/1980-549720230012.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
RESUMO Objetivo: Descrever as características clínicas dos casos de Síndrome Respiratória Aguda Grave (SRAG) por COVID-19 em recém-nascidos (RNs) em 2020 e 2021, no Brasil, registrados no Sistema de Informação da Vigilância Epidemiológica da Gripe (SIVEP-Gripe). Métodos: As variáveis analisadas foram: sexo, raça/cor, hospitalização, internação em unidade de terapia intensiva (UTI), uso de suporte ventilatório, sinais e sintomas (febre, tosse, saturação de O2<95%, dispneia, desconforto respiratório, diarreia e vômitos), evolução (óbito ou cura), fatores de risco/comorbidades. As variáveis categóricas foram apresentadas em frequências absolutas e relativas. Resultados: Houve 1.649 registros de SRAG por COVID-19 em RNs, com predomínio de pardos nos dois anos. Os sintomas mais frequentes foram, respectivamente, em 2020 e 2021: desconforto respiratório (67,0 e 69,7%), febre (46,3 e 46,2%) e tosse (37,0 e 46,3%). Em 2020, 30,5% dos pacientes receberam suporte ventilatório invasivo, e 41,6% em 2021. Além disso, mais de 55% dos casos precisaram de internação em UTI, e acima de 16% morreram. Conclusão: Destaca-se a elevada proporção de casos que precisou de cuidados intensivos e que evoluíram para óbito.
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Falcão Neto PADO, Branco MDRFC, Costa SDSB, Câmara APB, Marques TMNF, Araujo AS, Loureiro FHF, Dias Júnior JDJ, Silva MDSD, Queiroz RCDS, Ribeiro MRC, Kulkarni MA, Silva AAMD, Santos AMD. Análise espacial da taxa de detecção de casos suspeitos de síndrome congênita pelo vírus Zika, Maranhão, 2015 a 2018. Rev bras epidemiol 2022; 25:e220002. [DOI: 10.1590/1980-549720220002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 11/03/2021] [Indexed: 11/21/2022] Open
Abstract
RESUMO: Objetivo: Identificar padrões espaciais em casos de lactentes com alterações de crescimento e desenvolvimento relacionadas à infecção pelo vírus Zika e outras etiologias infecciosas (neste trabalho denominado de síndrome congênita pelo vírus Zika), notificados no Maranhão de 2015 a 2018 e sua relação com variáveis socioeconômicas e demográficas. Métodos: Estudo ecológico de casos suspeitos notificados de síndrome congênita pelo vírus Zika nos 217 municípios do Maranhão, Brasil. Calculou-se a autocorrelação espacial pelos índices de Moran local e global (I) univariado e bivariado da taxa de detecção de casos suspeitos de síndrome congênita pelo vírus Zika com índice de desenvolvimento humano municipal, densidade demográfica, índice de Gini e tempo de emancipação político-administrativa dos municípios. O índice de Moran local foi calculado para localizar clusters com autocorrelação espacial significativa. Resultados: Houve autocorrelação espacial na análise univariada da taxa municipal de detecção de casos suspeitos de síndrome congênita pelo vírus Zika (I=0,494; p=0,001) e, na análise bivariada, correlação positiva da taxa de detecção de casos suspeitos com índice de desenvolvimento humano municipal (I=0,252; p=0,001), densidade demográfica (I=0,338; p=0,001) e tempo de emancipação dos municípios (I=0,134; p=0,001). Não houve correlação significativa da taxa de detecção de casos suspeitos com o índice de Gini (I= -0,033; p=0,131). Cinco clusters de alta detecção de casos suspeitos foram encontrados em áreas distintas do estado. Conclusões: Os municípios com maior índice de desenvolvimento humano municipal, maior densidade demográfica e mais tempo de emancipação político-administrativa tiveram mais casos suspeitos notificados de síndrome congênita pelo vírus Zika.
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de Abreu SLL, de Abreu JDMF, Branco MDRFC, dos Santos AM. In- and Out-of-Hospital Deaths by Acute Myocardial Infarction in Brazilian State Capitals. Arq Bras Cardiol 2021; 117:319-326. [PMID: 34495227 PMCID: PMC8395787 DOI: 10.36660/abc.20200043] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 06/21/2020] [Accepted: 08/12/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Acute myocardial infarction (AMI) is the main cause of death in Brazil and the world. Approximately half of these deaths occur outside the hospital. OBJECTIVES To analyze the distribution, temporal evolution, and sociodemographic characteristics (SDC) of in- and out-of-hospital deaths by AMI in Brazilian state capitals and their relationship with municipal development indicators (MDI). METHODS This is an ecological study of the number of deaths due to AMI reported annually by the 27 Brazilian state capitals from 2007 to 2016; these were divided into 2 groups: in-hospital (H) and out-of-hospital (OH). We evaluated the temporal evolution of mortality rates in each group and differences in SDC. Negative binomial regression models were used to compare the temporal evolution of the number of deaths in each group with the following variables: residing in the South/Southeast regions (S/SE), municipal human development index (MHDI), Gini coefficient, and expected years of schooling (EYS). We considered p-values<0.05 as statisticallysignificant. RESULTS The OH mortality rate increased with time for all state capitals. All studied SDC were different between groups (p<0.001). In the OH group, most deaths were of men and patients aged 80 years or older and not married. S/SE increased the incidence of OH deaths (incidence rate ratio [IRR]=2.84; 95% confidence interval [CI]=1.67-4.85), while higher EYS reduced it (IRR=0.86; 95% CI=0.77-0.97). In the H group, higher MHDI reduced the incidence of deaths (IRR=0.44; 95% CI=0.33-0.58), while higher EYS increased it (IRR=1.09; 95% CI=1.03-1.15). CONCLUSIONS In- and out-of-hospital deaths due to AMI in Brazilian state capitals were influenced by MDI, presented sociodemographic differences and a progressive increase in out-of-hospital occurrences.
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Affiliation(s)
- Sterffeson Lamare Lucena de Abreu
- Universidade Federal do MaranhãoHospital UniversitárioSão LuísMABrasilHospital Universitário da Universidade Federal do Maranhão, São Luís, MA - Brasil
- Universidade Federal do MaranhãoPós Graduação em Saúde ColetivaSão LuísMABrasilUniversidade Federal do Maranhão - Pós Graduação em Saúde Coletiva, São Luís, MA - Brasil
| | - Joana D’Arc Matos França de Abreu
- Universidade Federal do MaranhãoHospital UniversitárioSão LuísMABrasilHospital Universitário da Universidade Federal do Maranhão, São Luís, MA - Brasil
- Universidade Federal do MaranhãoPós Graduação em Saúde ColetivaSão LuísMABrasilUniversidade Federal do Maranhão - Pós Graduação em Saúde Coletiva, São Luís, MA - Brasil
| | - Maria dos Remédios Freitas Carvalho Branco
- Universidade Federal do MaranhãoPós Graduação em Saúde ColetivaSão LuísMABrasilUniversidade Federal do Maranhão - Pós Graduação em Saúde Coletiva, São Luís, MA - Brasil
| | - Alcione Miranda dos Santos
- Universidade Federal do MaranhãoPós Graduação em Saúde ColetivaSão LuísMABrasilUniversidade Federal do Maranhão - Pós Graduação em Saúde Coletiva, São Luís, MA - Brasil
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Silva FDS, Queiroz RCDS, Branco MDRFC, Habenschus MIAT, Scorzafave LG, Saraiva MDCP, Bettiol H, Barbieri MA, Rodrigues MAFR, Barbosa YC, Simões VMF, Silva AAMD. Foco e cobertura do programa Bolsa Família em crianças das coortes de nascimento BRISA, Ribeirão Preto (São Paulo) e São Luís (Maranhão), Brasil. CAD SAUDE PUBLICA 2019; 35:e00159718. [DOI: 10.1590/0102-311x00159718] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 02/15/2019] [Indexed: 11/22/2022] Open
Abstract
Estudo transversal aninhado a uma coorte, que teve como objetivo descrever foco e cobertura do programa Bolsa Família em crianças de 13-35 meses de idade. Fez-se uso de dados das coortes de nascimento BRISA, em Ribeirão Preto, São Paulo, e São Luís, Maranhão, Brasil. O início das coortes ocorreu em 2010, com a inclusão de todos os nascimentos em Ribeirão Preto (7.794) e 5.236 em São Luís, abrangendo amostra aleatória de um terço. No seguimento, realizado de 2011 a 2013, retornaram 3.805 crianças em Ribeirão Preto e 3.308 em São Luís. Foram utilizados dados do momento do seguimento, e estes foram integrados às informações do Cadastro Único (CadÚnico). Consideraram-se dois critérios de elegibilidade para o benefício do Bolsa Família: renda familiar per capita mensal de até R$ 140,00 e classe econômica D/E. Estimaram-se percentuais de foco e cobertura do Bolsa Família. Realizou-se ponderação para perdas de seguimento. O foco do Bolsa Família, segundo renda familiar per capita mensal, foi de 33,8% em São Luís e 15,9% em Ribeirão Preto, e de acordo com a classe econômica foi de 33,7% em São Luís e 15,3% em Ribeirão Preto. A cobertura do Bolsa Família, de acordo com o critério de renda familiar per capita mensal, foi de 82,1% em São Luís e 71,6% em Ribeirão Preto; e segundo classe econômica foi de 68,9% em São Luís e 46,8% em Ribeirão Preto. Foram baixos os percentuais de foco e melhores os de cobertura do Bolsa Família, com estimativas destes indicadores maiores para São Luís em relação a Ribeirão Preto.
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Vissoci JRN, Rocha TAH, da Silva NC, de Sousa Queiroz RC, Thomaz EBAF, Amaral PVM, Lein A, Branco MDRFC, Aquino J, Rodrigues ZMR, da Silva AAM, Staton C. Zika virus infection and microcephaly: Evidence regarding geospatial associations. PLoS Negl Trop Dis 2018; 12:e0006392. [PMID: 29694351 PMCID: PMC5937996 DOI: 10.1371/journal.pntd.0006392] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 05/07/2018] [Accepted: 03/18/2018] [Indexed: 01/06/2023] Open
Abstract
Background Although the Zika virus (ZIKV) epidemic ceased to be a public health emergency by the end of 2016, studies to improve knowledge about this emerging disease are still needed, especially those investigating a causal relationship between ZIKV in pregnant women and microcephaly in neonates. However, there are still many challenges in describing the relationship between ZIKV and microcephaly. The few studies focusing on the epidemiological profile of ZIKV and its changes over time are largely limited to systematic reviews of case reports and dispersal mapping of ZIKV spread over time without quantitative methods to analyze patterns and their covariates. Since Brazil has been at the epicenter of the ZIKV epidemic, this study examines the geospatial association between ZIKV and microcephaly in Brazil. Methods Our study is categorized as a retrospective, ecological study based on secondary databases. Data were obtained from January to December 2016, from the following data sources: Brazilian System for Epidemiological Surveillance, Disease Notification System, System for Specialized Management Support, and Brazilian Institute of Geography and Statistics. Data were aggregated by municipality. Incidence rates were estimated per 100,000 inhabitants. Analyses consisted of mapping the aggregated incidence rates of ZIKV and microcephaly, followed by a Getis-Ord-Gi spatial cluster analysis and a Bivariate Local Moran’s I analysis. Results The incidence of ZIKV cases is changing the virus’s spatial pattern, shifting from Brazil’s Northeast region to the Midwest and North regions. The number of municipalities in clusters of microcephaly incidence is also shifting from the Northeast region to the Midwest and North, after a time lag is considered. Our findings suggest an increase in microcephaly incidence in the Midwest and North regions, associated with high levels of ZIKV infection months before. Conclusion The greatest burden of microcephaly shifted from the Northeast to other Brazilian regions at the beginning of 2016. Brazil’s Midwest region experienced an increase in microcephaly incidence associated with ZIKV incidence. This finding highlights an association between an increase in ZIKV infection with a rise in microcephaly cases after approximately three months. The increasing evidence of a relationship between ZIKV in pregnant women and fetal congenital ZIKV syndrome with microcephaly has been reported in the literature over the last two years. Our findings suggest a spatial dependency between the diseases. Therefore, using the spatial pattern of ZIKV incidence to better understand risk areas for microcephaly may help the design of surveillance policies. Brazil had a large epidemic of ZIKV, leading to several important studies of the ZIKV outbreak and its association with microcephaly. This study used a geospatial analysis approach to examine the association between ZIKV and microcephaly in Brazilian regions. It was possible to highlight a spatial association between ZIKV and microcephaly considering a time lag between diseases. Brazilian regions with the highest incidences of microcephaly were the regions where the highest incidence of ZIKV occurred months before. This finding can help the organization and planning of health services to offer better screening actions dedicated to pregnant women in high-risk areas.
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Affiliation(s)
- João Ricardo Nickenig Vissoci
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
- Department of Surgery, Division of Emergency Medicine, Duke University Health System, Durham, North Carolina, United States of America
- * E-mail:
| | - Thiago Augusto Hernandes Rocha
- Federal University of Minas Gerais, School of Economics, Center of post-graduate and Research in Administration, Belo Horizonte, Minas Gerais, Brazil
| | - Núbia Cristina da Silva
- Federal University of Minas Gerais, Faculty of Economics, Observatory of Human Resources in Health, Belo Horizonte, Minas Gerais, Brazil
| | | | | | - Pedro Vasconcelos Maia Amaral
- Federal University of Minas Gerais, Centre for Development and Regional Planning, Belo Horizonte, Minas Gerais, Brazil
| | - Adriana Lein
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
| | | | - José Aquino
- Federal University of Maranhão, Department of Geosciences, São Luís, Maranhão, Brazil
| | | | | | - Catherine Staton
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
- Department of Surgery, Division of Emergency Medicine, Duke University Health System, Durham, North Carolina, United States of America
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12
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Dias JDJ, Branco MDRFC, Queiroz RCDS, dos Santos AM, Moreira EPB, da Silva MDS. Analysis of dengue cases according to clinical severity, São Luís, Maranhão, Brazil. Rev Inst Med Trop Sao Paulo 2017; 59:e71. [PMID: 29116291 PMCID: PMC5679683 DOI: 10.1590/s1678-9946201759071] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 08/29/2017] [Indexed: 11/22/2022] Open
Abstract
Severe dengue cases have increased in Brazil since 2001, with the first records in Maranhão dating back to 2002. The aim of this study was to determine the prevalence of severe dengue cases by age group and the possible risk factors. This was a study of secondary data on dengue in residents of São Luís, Maranhão, Brazil, using probable cases notified to the National Mandatory Reporting System (SINAN) from 2002 to 2011. The diagnosis and classification of dengue were based on the Brazilian Ministry of Health criteria: dengue fever (DF), dengue hemorrhagic fever (DHF) and dengue fever with complications (DWC). DHF and DWC were considered severe dengue, and DF was classified as non-severe dengue. A logistic regression analysis was performed with severe dengue as the outcome. During the study period, 1,229 cases of severe dengue were reported; of these, 812 in patients under the age of 15 (66%). Among the risk factors evaluated, age under 15 years old (OR = 3.10, 95% CI = 2.69-3.57, p-value = 0.001) was associated with severe dengue. The prevalence of severe dengue in children under the age of 15 was higher, and only this age group was associated with the occurrence of severe dengue.
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Affiliation(s)
- José de Jesus Dias
- Universidade Federal do Maranhão, Programa de Pós-Graduação em Saúde
Coletiva, São Luís, Maranhão, Brazil
| | - Maria dos Remédios Freitas Carvalho Branco
- Universidade Federal do Maranhão, Programa de Pós-Graduação em Saúde
Coletiva, São Luís, Maranhão, Brazil
- Universidade Federal do Maranhão, Programa de Pós-Graduação em Saúde e
Ambiente, São Luís, Maranhão, Brazil
| | | | - Alcione Miranda dos Santos
- Universidade Federal do Maranhão, Programa de Pós-Graduação em Saúde
Coletiva, São Luís, Maranhão, Brazil
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13
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Branco MDRFC, Luna EJDA, Braga Júnior LL, Oliveira RVBD, Rios LTM, Silva MDSD, Medeiros MNL, Silva GF, Nina FCAF, Lima TJ, Brito JA, Oliveira ACCD, Pannuti CS. Risk factors associated with death in Brazilian children with severe dengue: a case-control study. Clinics (Sao Paulo) 2014; 69:55-60. [PMID: 24473560 PMCID: PMC3870309 DOI: 10.6061/clinics/2014(01)08] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Accepted: 07/19/2013] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE The purpose of this case-control study was to evaluate risk factors associated with death in children with severe dengue. METHODS The clinical condition of hospitalized patients with severe dengue who died (cases, n = 18) was compared with that of hospitalized patients with severe dengue who survived (controls, n = 77). The inclusion criteria for this study were age under 13 years; hospital admission in São Luis, northeastern Brazil; and laboratory-confirmed diagnosis of dengue. RESULTS Severe bleeding (hemoptysis), a defining criterion for dengue severity, was the factor most strongly associated with death in our study. We also found that epistaxis and persistent vomiting, both included as warning signs in the World Health Organization (WHO) classification of dengue, were strongly associated with death. No significant association was observed between any of the laboratory findings and death. CONCLUSIONS The finding that epistaxis and persistent vomiting were also associated with death in children with severe dengue was unexpected and deserves to be explored in future studies. Because intensive care units are often limited in resource-poor settings, any information that can help to distinguish patients with severe dengue with a higher risk to progress to death may be crucial.
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Affiliation(s)
| | - Expedito José de Albuquerque Luna
- Departamento de Moléstias Infecciosas e Parasitárias (LIMHC), Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, São Paulo/SP, Brazil, Universidade de Sa˜o Paulo, Instituto de Medicina Tropical de Sa˜o Paulo, Departamento de Mole´ stias Infecciosas e Parasita´ rias (LIMHC), Sa˜o Paulo/SP, Brazil
| | - Leônidas Lopes Braga Júnior
- Hospital da Universidade Federal do Maranhão, São Luís/MA, Brazil, Hospital da Universidade Federal do Maranha˜o, Sa˜o Luı´s/MA, Brazil
| | | | - Lívia Teresa Moreira Rios
- Hospital da Universidade Federal do Maranhão, São Luís/MA, Brazil, Hospital da Universidade Federal do Maranha˜o, Sa˜o Luı´s/MA, Brazil
| | - Maria do Socorro da Silva
- Vigilância Epidemiológica Municipal de São Luís, São Luís/MA, Brazil, Vigilância Epidemiológica Municipal de São Luı´s, Sa˜o Luı´s/MA, Brazil
| | - Maria Nilza Lima Medeiros
- Vigilância Epidemiológica Municipal de São Luís, São Luís/MA, Brazil, Vigilância Epidemiológica Municipal de São Luı´s, Sa˜o Luı´s/MA, Brazil
| | - Gilnara Fontinelle Silva
- Departamento de Patologia, Universidade Federal do Maranhão, São Luís/MA, Brazil, Universidade Federal do Maranha˜ o, Departamento de Patologia, Sa˜o Luı´s/MA, Brazil
| | - Fernanda Campos Amaral Figueiredo Nina
- Departamento de Patologia, Universidade Federal do Maranhão, São Luís/MA, Brazil, Universidade Federal do Maranha˜ o, Departamento de Patologia, Sa˜o Luı´s/MA, Brazil
| | - Taliane Jardim Lima
- Departamento de Patologia, Universidade Federal do Maranhão, São Luís/MA, Brazil, Universidade Federal do Maranha˜ o, Departamento de Patologia, Sa˜o Luı´s/MA, Brazil
| | - Jayron Alves Brito
- Departamento de Patologia, Universidade Federal do Maranhão, São Luís/MA, Brazil, Universidade Federal do Maranha˜ o, Departamento de Patologia, Sa˜o Luı´s/MA, Brazil
| | - Avessandra Costa Cardoso de Oliveira
- Departamento de Patologia, Universidade Federal do Maranhão, São Luís/MA, Brazil, Universidade Federal do Maranha˜ o, Departamento de Patologia, Sa˜o Luı´s/MA, Brazil
| | - Claudio Sergio Pannuti
- Departamento de Moléstias Infecciosas e Parasitárias (LIMHC), Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, São Paulo/SP, Brazil, Universidade de Sa˜o Paulo, Instituto de Medicina Tropical de Sa˜o Paulo, Departamento de Mole´ stias Infecciosas e Parasita´ rias (LIMHC), Sa˜o Paulo/SP, Brazil
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14
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Padilha EM, Fujimori E, Borges ALV, Sato APS, Gomes MN, Branco MDRFC, Santos HJD, Lermen Junior N. [Epidemiological profile of reported beriberi cases in Maranhão State, Brazil, 2006-2008]. CAD SAUDE PUBLICA 2011; 27:449-59. [PMID: 21519696 DOI: 10.1590/s0102-311x2011000300006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2010] [Accepted: 12/04/2011] [Indexed: 11/21/2022] Open
Abstract
This study aimed to describe the epidemiological profile of beriberi cases and related deaths reported from 2006 to 2008 in Maranhão State, Brazil. Data were obtained from beriberi notification forms at the State Health Department. The global Moran index was used to evaluate spatial auto-correlation. 1207 cases and 40 deaths were reported. The western and central regions of the State showed strong spatial auto-correlation of incidence rates. Cases and deaths were concentrated from May to August, in young men (20-40 years). Regular alcohol consumption and smoking were recorded among fatal cases. Low income and heavy labor were widespread among cases. Common symptoms were asthenia, numbness, and swollen legs, difficulty walking, and calf pain. The profile of cases and their symptoms (except swollen legs) are characteristic of dry beriberi. We recommend further studies on the resurgence of beriberi in Brazil.
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Oliveira RVBD, Rios LTM, Branco MDRFC, Braga Júnior LL, Nascimento JMS, Silva GF, Bandeira KP. Valor da ultrassonografia em crianças com suspeita de febre hemorrágica do dengue: revisão da literatura. Radiol Bras 2010. [DOI: 10.1590/s0100-39842010000600013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
O dengue é doença endêmica em regiões tropicais e subtropicais. Quando sintomática, classifica-se em febre do dengue e febre hemorrágica do dengue, com tendência a síndrome do choque do dengue. A febre hemorrágica do dengue é marcada por manifestações hemorrágicas, trombocitopenia e aumento da permeabilidade capilar. A síndrome do choque do dengue apresenta os achados de febre hemorrágica do dengue com hipotensão. Muitos achados ultrassonográficos têm sido descritos, incluindo derrame pleural, ascite, espessamento da parede da vesícula biliar e derrame pericárdico. O objetivo desta revisão da literatura é descrever os achados ultrassonográficos e demonstrar o papel da ultrassonografia em crianças com suspeita de febre hemorrágica do dengue
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Affiliation(s)
| | | | | | | | | | | | - Kemuel Pinto Bandeira
- Universidade Federal do Maranhão, Brasil; Colégio Brasileiro de Radiologia e Diagnóstico por Imagem, Brasil
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16
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Mendes WDS, Silva AAMD, Neiva RF, Costa NM, Assis MSD, Vidigal PMO, Branco MDRFC, Leite MDGL, Rios JMT, Martins JOS, Waquin Neto SJ. An outbreak of bat-transmitted human rabies in a village in the Brazilian Amazon. Rev Saude Publica 2009; 43:1075-7. [PMID: 20027494 DOI: 10.1590/s0034-89102009005000073] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2008] [Accepted: 07/15/2009] [Indexed: 05/26/2023] Open
Abstract
During 45 days without electrical power, 57 individuals (8.7% of the population) from the village of Antônio Dino (municipality of Turiaçu, Northeastern Brazil) were attacked by bats and 16 died from human rabies. The aim of the study was to analyze the factors associated with bat attacks and the development of human rabies. Of the 46 individuals, who suffered bat attacks, 36 (78.3%) were under 17 years of age. The risk factors associated with bat attacks were age under 17 years, having observed bats inside the bedroom and having been without electrical power in the house. Age under 17 years and having been without electrical power in the house were factors associated with human rabies.
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Affiliation(s)
- Wellington da Silva Mendes
- Departamento de Patologia, Universidade Federal do Maranhão, Rua Barão de Itapary 155, São Luís, MA, Brazil.
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Mendes WDS, Branco MDRFC, Medeiros MNL. Clinical case report: Dengue hemorrhagic fever in a patient with acquired immunodeficiency syndrome. Am J Trop Med Hyg 2006; 74:905-7. [PMID: 16687700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/09/2023] Open
Abstract
A person diagnosed with acquired immunodeficiency syndrome in 2000 and who received highly active antiretroviral therapy developed co-infection with dengue virus in 2003. In the course of the co-infection, he developed fever, thrombocytopenia (13,700 cells/mm3), petechia, and hypoalbuminemia, which are compatible with the World Health Organization criteria for a case of dengue hemorrhagic fever. Human immunodeficiency virus was not detected 30 days before co-infection and 10 days afterwards. His CD4 cell count did not show significant alterations in the two periods evaluated. He continued his course of treatment without arterial hypotension, serious hemorrhage, or other life-threatening complications.
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