Background Currently, Brazil is experiencing one of the fastest increasing coronavirus disease (COVID-19) mortality rates worldwide, with a minimum of 158,000 confirmed deaths presently. The city of São Paulo is particularly vulnerable because it is the most populated city in Brazil. Thus, this study aimed to analyse COVID-19 mortality in a spatiotemporal context in São Paulo, with respect to socio-economic levels. Method We modelled the deaths using spatiotemporal architectures and Poisson probability distributions using a latent Gaussian Bayesian model approach. Results Both total deaths and confirmed deaths showed similar spatial patterns. Mortality was higher in men and increased with age. The most critical period regarding mortality occurred between the 20 th and 23 rd epidemiological weeks, followed by an apparent stabilisation of the epidemiological trend. The risk of death was greater in areas with the worst social conditions during the study period. However, this pattern was not uniform over time, since we identified a shift of high risk from the areas with the best socio-economic conditions to those with the worst conditions. Conclusions Our study corroborated the relationship between COVID-19 mortality and socio-economic conditions, revealing the importance of geographic screening in the integration of better actions to face the pandemic.

BackgroundBrazil is a tropical country that is largely covered by rainforests and other natural ecosystems, which provide ideal conditions for the existence of many arboviruses. However, few analyses have examined the associations between environmental factors and arboviral diseases. Thus, based on the hypothesis of correlation between environment and epidemiology, the proposals of this study were (1) to obtain the probability of occurrence of Oropouche, Mayaro, Saint Louis and Rocio fevers in Brazil based on environmental conditions corresponding to the periods of occurrence of the outbreaks; (2) to describe the macroclimatic scenario in Brazil in the last 50 years, evaluating if there was any detectable tendency to increase temperatures and (3) to model future expansion of those arboviruses in Brazil based on future temperature projections.Methodology/Principal findingsOur model assessed seven environmental factors (annual rainfall, annual temperature, elevation, seasonality of temperature, seasonality of precipitation, thermal amplitude, and daytime temperature variation) for their association with the occurrence of outbreaks in the last 50 years. Our results suggest that various environmental factors distinctly influence the distribution of each arbovirus, with temperature being the central determinant of disease distribution in all high-risk areas. These areas are subject to change, since the average temperature of some areas has increased significantly over the time.Conclusions/SignificanceThis is the first spatio-temporal study of the Oropouche, Mayaro, Saint Louis, and Rocio arboviruses, and our results indicate that they may become increasingly important public health problems in Brazil. Thus, next studies and control programs should include these diseases and also take into consideration key environmental elements.

Many areas across the Brazilian territory are exposed to ZIK or CHIK infection risks, which are related mainly to land use. The study findings offer valuable information to support time-sensitive public health decision-making at the local and national levels.

No abstract

BackgroundMosquitoes, Plasmodium parasites, and humans live in sympatry in some extra-Amazonian regions of Brazil. Recent migrations of people from Amazonia and other countries to extra-Amazonian regions have led to many malaria outbreaks. Lack of relevant expertise among health professionals in non-endemic areas can lead to a neglect of the disease, which can be dangerous given its high fatality rate. Therefore, understanding the spatial and temporal epidemiology of malaria is essential for developing strategies for disease control and elimination. This study aimed to characterize imported (IMP) and autochthonous/introduced (AU/IN) cases in the extra-Amazonian regions and identify risk areas and groups.MethodsEpidemiological data collected between 2007 and 2014 were obtained from the Notifiable Diseases Information System of the Ministry of Health (SINAN) and from the Department of the Unified Health System (DATASUS). High malaria risk areas were determined using the Local Indicator of Spatial Association. IMP and AU/IN malaria incidence rates were corrected by Local Empirical Bayesian rates.ResultsA total of 6092 malaria cases (IMP: 5416, 88.9 %; AU/IN: 676, 11.1 %) was recorded in the extra-Amazonian regions in 2007–2014. The highest numbers of IMP and AU/IN cases were registered in 2007 (n = 862) and 2010 (n = 149), respectively. IMP cases were more frequent than AU/IN cases in all states except for Espírito Santo. Piauí, Espírito Santo, and Paraná states had high incidences of AU/IN malaria. The majority of infections were by Plasmodium falciparum in northeast and southeast regions, while Plasmodium vivax was the predominant species in the south and mid-west showed cases of dual infection. AU/IN malaria cases were concentrated in the coastal region of Brazil, which contains the Atlantic Forest and hosts the Anopheles transmitters. Several malaria clusters were also associated with the Brazilian Pantanal biome and regions bordering the Amazonian biome.ConclusionMalaria is widespread outside the Amazonian region of Brazil, including in more urbanized and industrialized states. This fact is concerning because these highly populated areas retain favourable conditions for spreading of the parasites and vectors. Control measures for both IMP and AU/IN malaria are essential in these high-risk areas.Electronic supplementary materialThe online version of this article (doi:10.1186/s12936-015-0934-6) contains supplementary material, which is available to authorized users.