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.
Objective: to describe dengue virus circulation in Belo Horizonte, Brazil, from 2009 to 2014. Methods: this is a series study of cases of dengue infected by different virus serotypes, identified by virus isolation or RT-PCR; database linkage was performed between the Notifiable Health Conditions Information System (SINAN), the Brazilian National Health System Hospital Information System (SIH/SUS) and the Laboratory Environment Manager (GAL). Results: 91.1% of the records were linked (n=775); among the cases (n=851), 60.4% (n=514) were confirmed as DENV-1, 22.1% (n=188) DENV-4, 9.8% (n=83) as DENV-2, and 7.7% (n=66) as DENV-3; DENV-2 accounted for a higher percentage of severe cases (4.5%). Conclusion: DENV-1 prevailed and circulated in all evaluated years.
<strong>Introduction:</strong> The growth of the immigrant population in Portugal has been consistent over the past decades. Nevertheless, information on the health of immigrant populations is scarce. This research uses data collected from the population from the Indian subcontinent living in the district of Lisbon to produce recommendations for the provision of culturally adapted health services.<br /><strong>Material and Methods:</strong> Cross-sectional study with the immigrant community of the Indian subcontinent (Bangladesh, India and Pakistan) living in Lisbon, selected based on a snowball sampling technique and using privileged access interviewers. The questionnaire focused on health, health care access, lifestyle and attitudes towards death. The data were subject to a descriptive analysis and an<br />age-standardized comparison between the three nationalities was made.<br /><strong>Results:</strong> Surveys were administered to 1011 individuals with a participation rate of 97%. Most participants were adult males. Indian immigrants most frequently reported barriers to use of health services and had a higher frequency of chronic diseases. Pakistani immigrants had worse lifestyle indicators.<br /><strong>Discussion:</strong> The immigrant population from the Indian subcontinent tends to report more language difficulties in health care access when compared with other immigrant populations. Based on recommendations of the World Health Organization, it was possible to adapt this knowledge to produce recommendations adapted to the Portuguese context.<br /><strong>Conclusion:</strong> There are several aspects in the management of health services in Portugal that can be better adapted to the immigrant population from the Indian subcontinent.
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