Spatio-temporal GAMLSS modeling of the incidence of schistosomiasis in the central region of the State of Minas Gerais, Brazil

In Brazil, millions of people live in areas with risk of schistosomiasis, a neglected chronic disease with high morbidity. The Schistosoma mansoni helminth is present in all macroregions of Brazil, including the State of Minas Gerais, one of the most endemic states. For this reason, the identification of potential foci is essential to support educational and prophylactic public policies to control this disease. This study aims to model schistosomiasis data based on spatial and temporal aspects and assess the importance of some exogenous socioeconomic variables and the presence of the main Biomphalaria species. Considering that, when working with incident cases, a discrete count variable requires an appropriate modeling, the GAMLSS modeling was chosen since it jointly considers a more appropriate distribution for the response variable due to zero inflation and spatial heteroscedasticity. Several municipalities presented high incidence values from 2010 to 2012, and a downward trend was observed until 2020. We also noticed that the distribution of incidence behaves differently in space and time. Municipalities with dams presented risk 2.25 times higher than municipalities without dams. The presence of B. glabrata was associated with the risk of schistosomiasis. On the other hand, the presence of B. straminea represented a lower risk of the disease. Thus, the control and monitoring of B. glabrata snails is essential to control and eliminate schistosomiasis; and the GAMLSS model was effective in the treatment and modeling of spatio-temporal data.

Biochemical markers and anthropometric profile of children enrolled in public daycare centers

OBJECTIVE

The nutritional status resultant from dietary habits along with socioeconomic conditions and the school environment are directly related to the individual's health condition not only in their childhood but also throughout adulthood. The aim of this study was to evaluate the effects of socioeconomic factors on the anthropometric profile and to analyze a probable association between this profile and biochemical markers in children attending public daycare centers.

METHODS

It is a transversal study developed in a probability sample of clusters of children from 6 months to 5 years old. Anthropometric and socioeconomic data were gathered at the CMEIs, questionnaires on the nutritional status were applied and blood was collected at the Family Health Units (USFs).

RESULTS

Female children are three times more likely to be underweight; in families with five members, it is 1/3 more likely that children of higher-educated parents are overweight. Among the results of the biochemical tests, hypervitaminosis A was a relevant aspect, positively correlating with copper (p=0.005) and zinc (p=0.008).

CONCLUSION

Therefore, since the influence of the family is an important predictor of overweight and its future outcomes related to nutritional deficiencies and inadequate dietary intake, educational interventions are vital as a way to pave the path to prevention.

Assessment of Primary Health Care for rural workers exposed to pesticides

OBJECTIVE

To evaluate the attributes of Primary Health Care (PHC) for rural workers; to analyze sociodemographic conditions, history of poisoning and hospitalizations for pesticides and use of personal protective equipment; and to verify exposure to pesticides by determining bioindicators.

METHODS

Cross-sectional, descriptive-analytical study with a sample of 1,027 rural workers living in municipalities belonging to a regional health department in Southern Minas Gerais, whose PHC is governed by the Family Health Strategy model. We used the adult version of the Primary Care Assessment Tool (PCATool Brazil) and a structured questionnaire to collect socioeconomic data, history of poisoning and hospitalization for pesticides and use of personal protective equipment. Blood samples were collected to measure biomarkers of pesticide exposure and signs of renal and hepatic sequelae.

RESULTS

Low education was prevalent, as well as the intense contact of workers with pesticides. Frequent use of personal protective equipment was higher among men, as was the history of poisoning and hospitalizations for pesticides. Rates of 20% poisoning, 15% liver disease and 2% nephropathy were detected. Signs of hepatotoxicity were more frequent in men. Gender differences were all statistically significant. Regarding PHC, only the attribute "degree of affiliation" had a high score. None of the poisoning cases detected in the study were previously diagnosed.

CONCLUSIONS

Despite the high coverage of the Family Health Strategy, occupational risk and its consequences have not been detected by health services, which do not seem oriented to primary care, even lacking their essential attributes. There is a need for immediate and effective adaptation of public policies regarding the health of rural workers, with adequate training of teams and review of the portfolio of PHC services offered.

Assessment of exposure to pesticides in rural workers in southern of Minas Gerais, Brazil

The aim of the study was to assess of occupational exposure to pesticides in rural workers using genotoxicity test, bioindicators and clinical evaluation. Blood, urine and buccal samples from persons, rural workers exposed to a complex mixture of pesticides with organophosphates (n=94) and without organophosphates (n=94) were collected to compare the activities of cholinesterases, the levels of urinary dialkyl phosphates, genotoxicity data, from a cytome assay. Biomarkers were analysed by traditional/published methods Control group consisted of 50 other persons, non- occupationally exposed to pesticides from the city of Alfenas, Minas Gerais, Brazil. All subjects underwent a clinical evaluation. In the group exposed to organophosphates, the activity of acetylcholinesterase, butyrylcholinesterase and total cholinesterase was lower by 63.8%, 12.8%, and 14.8%, respectively, and 92.6% of the group had dialkyl phosphates present in their urine. The cytome assay was used to measure biomarkers of DNA damage (micronuclei and/or elimination of nuclear material by budding), cytokinetic defects (binucleated cells), and proliferative potential (basal cell) and/or cell death (condensed chromatin, karyorrhectic, pyknotic, and karyolytic cells). The group exposed to organophosphates showed significant changes in all these parameters compared to the control group and showed significant changes in budding, condensed chromatin and karyolytic cells compared with the group non-exposed to organophosphates. Data from the clinical evaluation showed significant changes in the central nervous, respiratory and auditory systems. The studied biomarkers are able to distinguish occupational and environmental exposure to pesticides and the data showed hazardous exposure to organophosphates and afforded valuable data to estimate the risk to cancer development.

Pensamentos, Emoções de um Grupo de Cadeirantes frente aos Problemas causados pela Falta de Acessibilidade nas Universidades/Thoughts, Emotions of a Group of College Wheelchair facing the Problems Caused by Lack of Accessibility in the Universities

Objetivo: Conhecer a percepção dos sentimentos em 7 universitários cadeirantes, frente aos obstáculos físicos dentro da instituição de ensino, os sintomas de depressão e a interação desses alunos com outros colegas da universidade. Materiais e Métodos: Trata-se de um estudo descritivo, de corte transversal entre sete cadeirantes estudantes de graduação, homens (5) e mulheres (2) na faixa etária de 20 a 25 anos. A coleta de dados foi obtida através de questionário autoavaliativo, composto por perguntas descritivas e objetivas. O acesso aos participantes aconteceu dentro da universidade frequentada pela pesquisadora, no domicilio e via internet. Resultados: Observou-se que todos os cadeirantes alegaram que as universidades não oferecem acesso adequado e 71,5% disseram que diante da falta de acesso se sentem dependentes para executar algumas atividades. A respeito da interação com os colegas 14,2% atribuem a falta de acessibilidade como fator que impede a interação, 42,9% referem que somente em algumas situações. Os sentimentos relatados foram exclusão e raiva (42,9%), constrangimento (28,6%) e revolta (28,6%). Conclusão: Os alunos cadeirantes foram unânimes ao responderem que a falta de acesso não influência no rendimento escolar e não impedem que estudem. Não houve relações significativas com a falta de acesso, e o desempenho escolar, interação e incidência de depressão. Palavras Chave: Acessibilidade, Universidade, Cadeirantes.