BackgroundStarting in August 2015, there was an increase in the number of cases of neonatal microcephaly in Northeast Brazil. These findings were identified as being an epidemic of microcephaly related to Zika virus (ZIKV) infection. The present study aims to analyse the spatial distribution of microcephaly cases in Recife (2015–2016), which is in Northeast Brazil, and its association with the living conditions in this city.MethodsThis was an ecological study that used data from reported cases of microcephaly from the State Health Department of Pernambuco (August 2015 to July 2016). The basic spatial unit of analysis was the 94 districts of Recife. The case definition of microcephaly was: neonates with a head circumference of less than the cut-off point of −2 standard deviations below the mean value from the established Fenton growth curve. As an indicator of the living conditions of the 94 districts, the percentage of heads of households with an income of less than twice the minimum wage was calculated. The districts were classified into four homogeneous strata using the K-means clustering algorithm. We plotted the locations of each microcephaly case over a layer of living conditions.ResultsDuring the study period, 347 microcephaly cases were reported, of which 142 (40.9%) fulfilled the definition of a microcephaly case. Stratification of the 94 districts resulted in the identification of four strata. The highest stratum in relation to the living conditions presented the lowest prevalence rate of microcephaly, and the overall difference between this rate and the rates of the other strata was statistically significant. The results of the Kruskal-Wallis test demonstrated that there was a strong association between a higher prevalence of microcephaly and poor living conditions. After the first 6 months of the study period, there were no microcephaly cases recorded within the population living in the richest socio-economic strata.ConclusionThis study showed that those residing in areas with precarious living conditions had a higher prevalence of microcephaly compared with populations with better living conditions.

Introduction: Urban transit accident are a global public health problem. The objective of this study was to describe the profile of the victims and the occurrences of urban transit accidents attended to by emergency mobile care services (Serviço de Atendimento Móvel de Urgência-SAMU) in Recife, and their distribution based on spatial analysis. Methodology: An ecological study, developed through secondary data from emergency mobile care services in Recife, referring to the total number of occurrences of urban transit accidents attended to from January 1 to June 30, 2015. The spatial analysis was performed using the Moran index. Results: Basic support units performed most of the emergency services (89.2%). Among the victims, there was a predominance of males (76.8%) and an age group of 20 -29 years old (31.5%). Collisions were responsible for 59.9% of the transit accidents, and motorcycles for 61.6% of the accidents among all means of transportation. Friday was the day that showed the highest risk for treatment, and there was a concentration of events between 6:00 am -8:59am and 6:00pm -8:59pm. The MoranMap identified critical areas where calls came from traffic accidents during the period analyzed. Discussion: The records of the mobile service from the spatial analysis are an important source of information for health surveillance. Conclusion: The spatial analysis of urban transit accidents identified regions with a positive spatial correlation, providing subsidies to the logistical planning of emergency mobile care services. This study is groundbreaking in that it offers such information about the region.

Objectives: to analyze social inequalities in spatial distribution of fetal and infant mortality by avoidable causes and identify the areas of greater risk of occurrence. Methods: avoidable deaths of fetal and infant residents of Recife/Brazil were studied. The rates of avoidable fetal and infant mortality were calculated for two five-year periods, 2006-2010 and 2011-2015. The scan statistics was used for spatial analysis and related to the social deprivation index. Results: out of the total 2,210 fetal deaths, 80% were preventable. Avoidable fetal mortality rates increased by 8.1% in the five-year periods. Of the 2,846 infant deaths, 74% were avoidable, and the infant mortality rate reduced by 0.13%. Conclusions: in the spatial analysis, were identified clusters with higher risk for deaths. The social deprivation index showed sensibility with areas of worse living conditions.

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Resumo Foi analisado o padrão da Síndrome Respiratória Aguda Grave (SRAG) em Pernambuco antes e durante período pandêmico da COVID-19. Estudo ecológico, de janeiro a junho de 2015 a 2019 (período pré-pandemia) e 01 de janeiro a 15 de junho de 2020, período que contempla parte inicial da pandemia. Taxas de detecção por município e Regional de Saúde de residência foram calculadas e, por meio da razão de risco, a dinâmica espacial da SRAG foi estimada. Na pré-pandemia ocorreram 5.617 casos de SRAG, 187 casos/mês e 23,8 casos/100 mil hab. e, na pandemia, 15.100 casos, 2.516 casos/mês e 320,3 casos/100 mil hab., um aumento da detecção mensal em 13 vezes. Foi ampliada (p < 0,001) a ocorrência em idosos (de 7,7% para 48,3%), a coleta de amostras (de 60,9% para 96,5%) e a identificação do agente etiológico causador da SRAG, com predomínio da SRAG por COVID-19 (66,0%). Regiões do interior do estado tiveram razão de detecção de SRAG 20 vezes superior à esperada, sendo o excesso de risco associado a menor IDHM, a condição do município ser sede de Regional de Saúde e a presença de rodovia federal no território municipal. Conhecer a mudança do padrão da ocorrência da SRAG, aliada a análise espacial poderão contribuir para o planejamento de ações a curto e médio prazo nos diferentes níveis de gestão.

Objective: To describe the epidemiological characteristics of suicide mortality in the state of Pernambuco, from 1996 to 2015. Method: Study with data from the Sistema de Informações sobre Mortalidade. The simple linear regression model was used to verify the trend in the period analyzed. Results: There were 6,229 suicides, of which 3,390 (54.4%) occurred in the second decade of study. The mortality rate was 4.7 per 100,000 inhabitants. The temporal trend presented a decrease of 23.5% (p=0.031). For the male sex and the age range between 20 and 39 years, there was a decline in self-inflicted death of 23.8% (p=0.018) and 26.1% (p=0.046), respectively. Conclusion: The temporal analysis revealed a reduction in suicide mortality coefficients. This observation may contribute to better targeting of health interventions, optimizing resources and efforts, especially in suicide prevention.

Resumo: A pandemia de COVID-19 iniciou sua linha do tempo em 31 de dezembro de 2019 na China e o SARS-CoV-2 identificado como agente etiológico. O objetivo deste manuscrito é descrever a dinâmica espacial e temporal da epidemia de COVID-19 nos primeiros cem dias, no Estado de Pernambuco, Brasil. Apresentamos a evolução de casos e óbitos segundo semana epidemiológica. Realizamos a análise da série do acumulado diário de casos da COVID-19 confirmados, com projeções para os 15 dias subsequentes, utilizando o aplicativo JoinPoint. Esse programa possibilita identificar pontos de inflexão testando sua significância estatística. Analisamos também a tendência de interiorização da COVID-19 no estado, considerando a distribuição percentual de casos ocorridos no Recife, municípios da Região Metropolitana de Recife e do interior, por conjuntos de três semanas, com construção de mapas temáticos. Os 100 dias da epidemia de COVID-19 resultaram em 52.213 casos e 4.235 óbitos entre 12 de março, correspondendo se 11, até 20 de junho de 2020 (semana epidemiológica 25). O pico da curva epidêmica ocorreu na semana epidemiológica 21 (23 de maio), seguido por desaceleração do número de casos. Detectou-se, inicialmente, a periferização dos casos na capital e região metropolitana, seguida por rápida disseminação para o interior do estado. Houve redução das taxas de crescimento médio diário a partir de abril, mas com patamar de mais de 6.000 casos semanais de COVID-19, em média. Ao final do período, a série de casos do estado indica persistência da circulação e transmissão comunitária do SARS-CoV-2. Finalmente, questiona-se parafraseando Garcia Marques em Cem Anos de Solidão, se estaríamos diante de “uma estiagem ou prenúncio de recrudescimento”.

INTRODUCTION: Health planning is required for the control and prevention of severe cases of COVID-19 in children. METHODS: Spatial analysis of severe COVID-19 cases in children of Pernambuco in the first six months of the pandemic and its autocorrelation with the Human Development Index was conducted. RESULTS: A total of 551 severe cases (39.4 cases/100,000 inhabitants) was initially concentrated in the metropolitan area, with later interiorization. The spatial autocorrelation of cases was identified. The bivariate analysis revealed alert regions in less developed municipalities (I=0.341; p=0.001). CONCLUSIONS: Considering the local particularities can assist in directing the priorities for decision making.