BackgroundVisceral leishmaniasis (VL) is expanding in Brazil and in other South American countries, a process that has been associated with the urbanization of the disease. This study analyzes the spatial and temporal distribution of VL in the Brazilian state of Minas Gerais and identifies the areas with higher risks of transmission.MethodologyAn ecological study with spatial and time series analyzes of new confirmed cases of VL notified to the Brazilian Notifiable Disease Information System between 2002 and 2013, considering the 12 mesoregions of Minas Gerais. Two complementary methodologies were used: thematic maps of incidence and Poisson (log-linear) generalized linear model. Thematic maps using crude and smoothed cumulative incidences were generated for four trienniums. Poisson Regression measured the variation of the average number of cases from one year to the following, for each mesoregion.Principal findingsThe 5,778 cases analyzed revealed a heterogeneous spatial and temporal distribution of VL in Minas Gerais. Six mesoregions (Central Mineira, Jequitinhonha, Metropolitan area of Belo Horizonte, Northwest of Minas, North of Minas, and Vale do Rio Doce) were responsible for the expansion and maintenance of VL, with incidence rates as high as 26/100,000 inhabitants. The Vale do Rio Doce and Jequitinhonha mesoregions showed a considerable increase in the incidence rates in the last period studied. The other six mesoregions reported only sporadic cases and presented low and unsteady incidence rates, reaching a maximum of 1.2/100,000 inhabitants.Conclusions/SignificanceThe results contribute to further the current understanding about the expansion of VL in Minas Gerais and may help guide actions for disease control.
Case-fatality rates were higher than that observed among patients with VL treated with other therapies. Identification of prognostic factors of death from VL may allow early diagnosis of patients prone to such outcome and prompt an expeditious and appropriate management of VL to reduce fatality rates.
Objective: to evaluate the Brazilian Drug-Resistant Tuberculosis Surveillance System (DRTB-SS). Methods: this was an evaluative study, following Centers for Disease Control and Prevention guidelines, using national data from the Special Tuberculosis Treatment Information System (SITETB), and the Notifiable Diseases Information System (SINAN), from 2013 to 2017. Results: average data completeness was 95%
Objetivo: investigar os casos de febre maculosa, verificar os aspectos relacionados à assistência à saúde e caracterizar o perfil epidemiológico desses e do ambiente de infecção. Métodos: estudo descritivo dos casos confirmados de FM entre janeiro e novembro de 2017. Foi elaborado um formulário semiestruturado para coleta dos dados. Para as análises epidemiológicas, foram utilizados os programas EpiInfoTM 7 e Qgis® 2.18.1. Foram calculadas frequências, medidas de tendência central, dispersão e indicadores de oportunidade de assistência. Nos ambientes prováveis de infecção, foram realizadas coletas de carrapatos que foram identificados e submetidos à pesquisa de Rickettsia do grupo da FM. Resultados: foram confirmados 15 casos de FM; desses, a maioria foi do sexo masculino (93%) com média de 42 anos de idade; 10 evoluíram para óbito. Todos apresentaram febre, 13(87%) cefaleia e 12(80%) mialgia. Apresentaram mediana e média de evolução para óbito pela doença de 6 dias (1 a 9), oportunidades de hospitalização, tratamento, diagnóstico e notificação de 4,5(0 a 8); 7(0 a 26); 9(DP±6) e 33(DP±45) dias, respectivamente. Para assistência à saúde, 14(93%) casos procuraram atendimento mais de duas vezes, com tempo de internação de 4,5 dias (0 a 8 dias). O hospital foi o serviço procurado, exclusivamente, no quarto atendimento. Dengue e FM foram as hipóteses diagnósticas mais frequentes. Foram coletados 250 espécimes de carrapatos em quatro municípios, sendo em um município identificado Amblyomma sculptum naturalmente infectados. Conclusões: foram assinaladas condições assistenciais pouco sensíveis à ocorrência da FM, o que, provavelmente, colaborou para ocorrência de óbitos, além da necessidade de sensibilização de equipes de saúde e vigilância quanto à ocorrência da FM na região.
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