OBJECTIVE:To describe the sociodemographic and clinical-epidemiological characteristics of tuberculosis cases and identify associated factors with abandoning treatment and death whilst undergoing treatment. METHODS:Epidemiological study based on cases of tuberculosis recorded in indigenous and non-indigenous individuals according to race/color in Mato Grosso do Sul, Midwestern Brazil, between 2001 and. Descriptive analysis of the cases was carried out according to the variables of sex, age group, residence, type of test used in the diagnosis, clinical form, supervised treatment and final status, according to race/color. Univariate/multivariate logistic regression analyses were used to identify predictors of abandoning treatment and death, using odds ratio as a measure of association. A time series of incidence according to race/color was constructed. RESULTS:In the period, 6,962 new cases of tuberculosis were registered, 15.6% being among indigenous. The illness was predominantly found in men and adults (20-44 years old) in all groups. Most of the indigenous patients lived in rural areas (79.8%) and 13.5% of the records in indigenous occurred in children aged < 10 years. The average incidence in the state was 34.5/100,000 inhabitants, being 209.0, 73.1, 52.7, 23.0 and 22.4 in indigenous, and those with yellow, black, white and brown skin, respectively. Patients aged 20 to 44 years (OR = 13.3, 95%CI 1.9;96.8), male (OR = 1.6, 95%CI 1.1;2.3) and of black race/color (OR = 2.5, 95%CI 1.0;6.3) were associated with abandoning treatment, while patients aged > 45 years (OR = 3.0, 95%CI 1.2;7.8) and with the mixed form (OR = 2.3, 95%CI 1.1;5.0) showed association with death. Although they only account for 3.0% of the population, the indigenous were responsible for 15.6% of cases recorded during the period. CONCLUSIONS:Major inequalities in the tuberculosis illness process were found between the categories studied. Incidence in the indigenous population was consistently higher than recorded in any other group, reaching more than six times the national average. It was among those with black and brown skin that the worst treatment results were observed, as they were twice as likely to abandon treatment as the indigenous. Poor program performance was strongly associated with abandoning treatment and death. It is thought that as long as there is no reduction in poverty inequalities in health indicators will remain.

This study analyzed the spatial and temporal distribution of crude and adjusted rates of incidence of tuberculosis (TB) between 1997 and 2006, identifying areas of greatest risk to the indigenous and non-indigenous population of Rondônia State, Brazil. An ecological study was conducted analyzing municipalities and Indian reserves, using the local empirical Bayesian method. The crude average rate of incidence of TB among the non-indigenous population was 35.6/100,000 inhabitants, while for the indigenous population it was 415.0/100,000. Rates greater than 600/100,000 were reported in the Karipuna, Sete de Setembro, Igarapé, Ribeirão and Karitiana reserves. We observed a greater number of cases in under 15 year-olds with little schooling in contrast to the situation in the non-indigenous population. After making adjustments, the rates in some Indian reserves exceeded 240/100,000 inhabitants, while in coinciding municipalities incidence was between the range of 61-120/100,000. The Bayesian method led to decreased overall heterogeneity in rates. Evidence suggests that the indigenous population is more vulnerable to contracting TB and highlighted areas that require further attention to ensure the adequate control of TB in Rondônia.

OBJECTIVE:To identify areas at risk of dengue transmission by means of cluster analysis. METHODS:A cluster analysis in which the primary analysis units were the 48 districts of the municipality of Niterói, Southeastern Brazil, was conducted. The districts were grouped into six strata according to sociodemographic conditions, using the k-means cluster analysis method. After defi ning the strata, the incidence of dengue was calculated for each stratum in relation to four different periods : 1998 -2000; 2001; 2002; 2003 -2006. RESULTS:The analysis on the incidence showed that the rates for the last three study periods were greatest in the stratum 2.1, which had the worst sanitation infrastructure conditions and high population increases, and in stratum 3.1, which had the highest percentage of shantytowns. Stratum 1.2 presented the lowest incidence and the best sanitation and income indicators, along with small increases in population and a low proportion of shantytowns. The incidence rates in 2001 and 2002 were high in most strata except for stratum 1.2, which had the districts with the least heterogeneity in relation to the indicators used. In 2001, the strata presented high rates of incidence when group immunity had supposedly become established for serotype I, thus expressing the transmission strength of this agent. CONCLUSIONS:The cluster analysis technique made it possible to recognize priority areas. It indicated areas where the dengue control and surveillance actions needed to be improved, along with structural improvements that infl uenced the living conditions and health of the municipality's population.

O presente artigo mostra a distribuição espacial da esquistossomose, correlacionando focos de caramujos com os casos humanos, por meio de análise espacial. As localidades estudadas foram Merepe III, Pantanal, Salinas e Socó, que representam 70% da área habitada de Porto de Galinhas. No inquérito realizado em 2000, foram identificados 15 focos do vetor Biomphalaria glabrata; os casos humanos foram diagnosticados e registrados por quarteirão de residência. A análise espacial foi realizada no programa TerraView, utilizando-se o estimador de intensidade kernel. Com relação aos focos de moluscos vetores, as taxas de infecção total variaram entre 15% e 32,4%. Os resultados da análise indicam a existência de uma forte tendência espacial para o risco de transmissão nas localidades de Salinas e Socó. Em Merepe, ocorreu o maior número de focos, mas as taxas de infecção dos moluscos foram as mais baixas e a análise espacial evidenciou menor concentração de risco em relação às outras localidades estudadas. Com relação aos casos humanos, observaram-se duas áreas em que os aglomerados de maior intensidade são representados por tons mais escuros.

In order to investigate the historical trends, epidemiological profile, and spatial distribution of hospital admissions and deaths from schistosomiasis in the State of Pernambuco, Brazil, an analysis was conducted of data from the Hospital Information System and Mortality Information System from 1992 to 2000. The results showed a reduction in hospital admissions and mortality, while identifying more admissions and deaths among males. There was a lower percentage of deaths and admissions from schistosomiasis in individuals under 30 years of age. However, schistosomiasis is still of relevant magnitude, as evidenced by the number of deaths from this cause and the number of patients admitted to the hospital system in Pernambuco. A spatial analysis of the endemic's distribution in the State showed that although from 1995 to 1999 there was a greater spread of admissions due to schistosomiasis in the municipalities (counties) of the Sertão (backlands) and São Francisco river valley, the number of municipalities with hospitalizations due to schistosomiasis decreased from 1995 to 1998, followed by an increase in 1999 and 2000.