Impact on human health of particulate matter emitted from burnings in the Brazilian Amazon regionImpactos na saúde humana de partículas emitidas por queimadas na Amazônia brasileira ABSTRACT OBJECTIVE: To analyze the impact on human health of exposure to particulate matter emitted from burnings in the Brazilian Amazon region. METHODS:This was an ecological study using an environmental exposure indicator presented as the percentage of annual hours (AH%) of PM 2.5 above 80 μg/m 3 . The outcome variables were the rates of hospitalization due to respiratory disease among children, the elderly and the intermediate age group, and due to childbirth. Data were obtained from the National Space Research Institute and the Ministry of Health for all of the microregions of the Brazilian Amazon region, for the years 2004 and 2005. Multiple regression models for the outcome variables in relation to the predictive variable AH% of PM 2.5 above 80 μg/m 3 were analyzed. The Human Development Index (HDI) and mean number of complete blood counts per 100 inhabitants in the Brazilian Amazon region were the control variables in the regression analyses. RESULTS:The association of the exposure indicator (AH%) was higher for the elderly than for other age groups (β = 0.10). For each 1% increase in the exposure indicator there was an increase of 8% in child hospitalization, 10% in hospitalization of the elderly, and 5% for the intermediate age group, even after controlling for HDI and mean number of complete blood counts. No association was found between the AH% and hospitalization due to childbirth. CONCLUSIONS:The indicator of atmospheric pollution showed an association with occurrences of respiratory diseases in the Brazilian Amazon region, especially in the more vulnerable age groups. This indicator may be used to assess the effects of forest burning on human health.

Introduction: Dengue is configures in recent decades as an important cause of morbidity and mortality in Brazil and around the world reaching the tropical and subtropical areas. Objective: To review the scientific literature on the occurrence of dengue in Brazil and its relationship with meteorological variables. Method: A systematic review of studies published in databases (SciELO, PubMed, MEDLINE, Lilacs) using descriptors related to weather variations and dengue fever in Brazil, published between 1991 to 2010. It was selected 31 articles that had the study area nationwide. Results: Most epidemiological studies use ecological design, the studies make use of entomological trapping, are common also series of studies of the disease and spatial analysis. It is evident relationship between dengue incidence with temperature and rainfall, the association is more significant from the second to fourth months of the year. Comparative studies of drought and rain show seasonal behavior of the disease. There are difficulties in establishing unique pattern of seasonality of disease incidence and weather variables for the country. Conclusion: Dengue is strongly related to meteorological variables. The seasonal variation in temperature and rainfall influences the dynamics of the vector and the incidence of the disease throughout the country, regardless of the climate category. The number of cases of classic dengue and of dengue hemorrhagic fever has been increasing on an annual basis. It is estimated that 550 thousand hospitalizations with 20 thousand deaths occur per year among a total of approximately 2.5 billion exposed people 4,5 , and an average of 80 million new cases are reported every year 2 . KeywordsAs a reemerging endemic or pandemic disease, it occurs practically in all the tropical and subtropical regions of the planet 1 . The countries located in these regions are more susceptible due to diverse conditioning factors, such as: global changes, climate changes, weather variability, land use, water storage and irrigation, human population growth and urbanization 6 . Such factors, among others, significantly contribute to the proliferation and development of the Aedes aegypti mosquito -the virus vector 7-9 . Climate changes contribute to increase the number of people exposed to dengue to more than 2 billion and the projections for 2085 suggest that approximately 5 to 6 billion people (50 to 60% of the world's population) will be at risk regarding the disease transmission 10 .The seasonal dynamics of the dengue vector is commonly associated with climate changes and fluctuations 9,11 , which include: temperature increase and variations in rainfall and relative air humidity, conditions that favor a higher number of available breeding sites and, consequently, the development of the vector. The latter presents two distinct stages: aquatic, with the development phases of egg, larva and pupa, and terrestrial, which corresponds to the adult mosquito. Both stages are subject to environmental and climate changes 12,13 ...

OBJETIVO: Analisar as internações hospitalares por doenças respiratórias em menores de 15 anos de idade em uma área com elevados níveis de poluição ambiental. MÉTODOS: Estudo transversal da morbidade hospitalar por doenças respiratórias de residentes no município de Tangará da Serra (MT) na Amazônia brasileira, no período de 2000 a 2005, através de dados de internações hospitalares do Sistema Único de Saúde brasileiro e de estimativas populacionais do Instituto Brasileiro de Geografia e Estatística. RESULTADOS: Em 2005, a taxa de internações por doenças respiratórias em menores de 15 anos foi de 70,1/1.000 crianças na microrregião de Tangará da Serra. Entre 2000 a 2005 ocorreram, no município de Tangará da Serra, 12.777 internações de crianças, das quais 8.142 (63,7%) por doenças respiratórias. No período da seca (maio a outubro) houve 10% mais internações por doenças respiratórias que no período da chuva (novembro a abril). As principais causas de internação foram: pneumonias (90,7%) e insuficiência respiratória (8,5%). Em menores de 5 anos de idade, as internações por pneumonia foram mais de 4 vezes o esperado para o município. Os menores de 12 meses de idade foram mais frequentemente internados, com incremento médio de 32,4 internações por 1.000 crianças a cada ano. CONCLUSÕES: Tangará da Serra tem apresentado elevado número de internações por doenças respiratórias, portanto, é coerente considerá-lo como área prioritária para investigação e monitoramento dos fatores de risco ambientais para tais doenças.

OBJECTIVE:To analyze the effects of exposure to fi ne particulate matter from burning on hospital admissions due to respiratory diseases in children and the elderly. METHODS:This is an ecological time series study that took place in the city of Cuiaba, Mato Grosso, in Brazil's Amazon Region, in 2005. Information on the daily levels of fi ne particulate matter PM 2.5 was made available by the Brazilian National Institute for Spatial Research. The model included variables related to temperature, relative humidity and adjusts for seasonality and calendar effects. Poisson regression with generalized additive models was used. RESULTS:A 10 μg/m 3 increase in the level of exposure to PM 2.5 was associated with increases of 9.1%, 9.2% and 12.1% in hospital admissions due to respiratory diseases in children for moving averages of 1, 2 and 5 days, respectively. For the dry season, the level of exposure to particulate matter was associated with increases of 11.4%, 21.6% and 22.0% in hospital admissions in children for moving averages of 1, 5 and 6 days, respectively. No signifi cant link was noticed in the elderly. CONCLUSIONS:The results show the infl uence of PM 2.5 on hospitalizations for respiratory disease in children under 5 in the region studied.

Background Innovative approaches are required for leprosy control to reduce cases and curb transmission of Mycobacterium leprae. Early case detection, contact screening, and chemoprophylaxis are the most promising tools. We aimed to generate evidence on the feasibility of integrating contact tracing and administration of single-dose rifampicin (SDR) into routine leprosy control activities.Methods The leprosy post-exposure prophylaxis (LPEP) programme was an international, multicentre feasibility study implemented within the leprosy control programmes of Brazil,

Abstract

Revisão sistemática das características físico-químicas dos poluentes atmosféricos provenientes das queimadas e combustíveis fósseis e efeitos na saúde no Brasil

INTRODUÇÃO: Na Amazônia é intensa a queima de biomassa decorrente do desmatamento nos meses de seca. No entanto, os efeitos à saúde humana decorrentes da poluição atmosférica derivada das queimadas são pouco estudados. OBJETIVOS: Descrever o método de seleção dos municípios prioritários, orientado pelos indicadores de morbidade e mortalidade por doenças respiratórias para o estudo da "avaliação do efeito das queimadas do desmatamento à saúde humana" na região da Amazônia. MATERIAL E MÉTODOS: Estudo ecológico dos indicadores de morbidade hospitalar e mortalidade por doenças do aparelho respiratório em menores de cinco de idade no período de 2000 a 2004. Análise de: proporção de óbitos; taxa de internação e proporção de internações por doença do aparelho respiratório em menores de 5 anos para o cálculo dos escores e definição do ranking dos municípios. Foi considerada a localização geográfica dos municípios, tipo de bioma, estrutura da rede de serviços de saúde, número de habitantes, registros de dados ambientais prévios sobre poluentes atmosféricos e de dados meteorológicos. RESULTADOS: Foram selecionados os municípios de Alta Floresta e de Tangará da Serra no Estado de Mato Grosso para o desenvolvimento da pesquisa em razão destes alcançarem as piores classificações em termos de morbimortalidade. CONCLUSÃO: Os indicadores de saúde mostram consistência e orientam a análise integrada de saúde e ambiente.