Risk assessment and vulnerability analyses are common practices in epidemiology (Avanzi et al., 2018;Gullón et al., 2017; WHO, 2014). Evidence from around the world confirms that climate change can affect distribution and occurrence of diseases, a major concern for policy making and healthcare facilities (UN, 2007). The health of human populations is sensitive to shifts in weather patterns and other aspects of climate change (Smith et al., 2015). Weather events and climate change are important drivers of the Abstract Hepatitis-A is a waterborne infectious disease transmitted by the eponymous hepatitis-A virus (HAV). Due to the disease's sociodemographic and environmental characteristics, this study applied public census and remote sensing data to assess risk factors for hepatitis-A transmission. Municipalitylevel data were obtained for the state of Pará, Brazil. Generalized linear and nonlinear models were evaluated as alternative predictors for hepatitis-A transmission in Pará. The Histogram Gradient Boost (HGB) regression model was deemed the best choice (RMSE= 2.36, and higher 2 R = 0.95) among the tested models. Partial dependence analysis and permutation feature importance analysis were used to investigate the partial dependence and the relative importance values of the independent variables in the disease transmission prediction model. Results indicated a complex relationship between the disease transmission and the sociodemographic and environmental characteristics of the study area. Population size, lack of sanitation, urban clustering, year of notification, insufficient public vaccination programs, household proximity to open-air dumpsites and storm-drains, and lack of access to healthcare facilities and hospitals were sociodemographic parameters related to HAV transmission. Turbidity and precipitation were the environmental parameters closest related to disease transmission. Based on HGB model, a hepatitis-A risk map was built for Pará state. The obtained risk map can be thought of as an auxiliary tool for public health strategies. This study reinforces the need to incorporate remote sensing data in epidemiological modelling and surveillance plans for the development of early prevention strategies for hepatitis-A.

Neste trabalho, objetivou-se o avaliar ecotoxicidade potencial do sedimento do Reservatório Guarapiranga da cidade de São Paulo (Brasil) frente a contaminação por metais, a fim de discutir sua qualidade e sua atual política de gerenciamento ambiental. Os metais analisados foram: Al, Cd, Cr, Cu, Fe, Mn, Pb e Zn. Utilizou-se das ferramentas de sistema de informação geográfica, geoprocessamento de imagens e da geoestatística para avaliação da dispersão espacial dos metais ao longo do sedimento do Reservatório, este considerado como aquela região de maior implicação ecotoxicológica para contaminantes metálicos. Analisaram-se também as variáveis granulometria, matéria orgânica, nitrogênio total, fósforo total e umidade do sedimento, a fim de se estudar quimiometria do sedimento, a fim de melhor compreender as distribuições dos contaminantes ao longo do sedimento. Observaram-se grande variabilidade quantitativa e espacial entre os metais analisados, denotando que o Reservatório Guarapiranga sofre contaminação por diferentes vias no sistema. Observou-se falta de correlação quimiométrica entre os parâmetros estruturais do sedimento com os contaminantes metálicos, denotando grande variabilidade interna desse sistema. Referente a política de manejo do Reservatório, especialmente relativa ao controle algal e cianofítico, observou-se um gerenciamento de grande impacto ecossistêmico, focado mais no custo imediato do que em planejamentos de longo prazo. Tal gerenciamento, hoje, traz risco ecotoxicológico ao reservatório, mas também à própria população tanto abastecida pelo reservatório quanto aquela exposta diretamente (recreação, esportes náuticos, alimentação).

The hepatitis-A virus (HAV) is a worldwide healthcare problem, mainly affecting countries with poor sanitation and socioeconomic conditions. Spatio-temporal analyses have become an important scientific asset for identifying the clustering of disease infection, providing support for planning interventions and control strategies. This study aims to determine the spatio-temporal variability of HAV infection and related population-based demographic factors in a endemic region. The selected area of study was Pará state, Brazil. Brazilian Ministry of Health Notifiable Diseases Information System (SINAN) epidemiological report, MS vaccination coverage and Brazilian National Sanitation System (SNIS) sanitation condition datum have been analyzed. Spatial (Moran and Local Moran index)and space-time scan statistics techniques have been applied over Pará state using SINAN database for the assessment of the hepatitis-A incidence for a period of 10 years (from 2008 up to 2017). A total of 5500 cases has been reported. Gender specific incidence analysis indicated that men have higher risk of contamination than women. Sociodemographic (lack of sanitation), socioeconomic (municipality governments investments in infra-structure) presented relationship with the disease incidence. There have been evidences that extreme events of severe precipitation and severe droughs were also related to increase in hepatitis-A notification cases. Spatial statistics denoted a heterogeneous geographical structure in the disease`s incidence: isolated high and low HAV incidence clusters through the years, implying in a complex disease outbreak system that is partially controlled by public vaccination actions. Space-time scan statistics denoted that hepatitis-A incidence is highly attached to the public HAV vaccination program and to municipality specific social infrastructure.Lower incidence risk were majorly aggregated over the Nordeste Paraense and Metropolitana de Belém meso-regions. Distinct clusters of hepatitis-A incidence have been found over the studied area (Pará state), and these clusters varied over the years centered at northwest and northeast mesoregions, mainly time-located prior to the national vaccination program start (prior to 2014). National public vaccination program has not been capable of erradicating the disease in the state. Further studies are required to better assess the relationship between climate change efffects over weather events and their relation to HAV transmission outbreaks.

Hepatitis-A virus is a worldwide healthcare problem, mainly affecting countries with poor sanitary and socioeconomic conditions. This communication evaluates the spatiotemporal variability of the disease’s socioepidemiological profile in one of the endemic Brazilian regions (Pará State) prior to (2008-2013) and after (2014-2017) the launch of the national public vaccination programme. Hepatitis-A epidemiological reports concerning Pará State - Brazil - were used for this study including municipalitylevel data of the disease’s reported positive notification cases (PNCs). The analyses involved socioepidemiological profiling and space-time scan statistics. A total of 5500 PNCs were reported in the study period. On average, PNCs decreased over time throughout the state, with strongest drops after 2015. The PNCs were specific for gender, race/ethnic origin and age group. The predominant gender and race/ethnic groups was male and brown, respectively. While children were the most susceptible age group prior to 2015, there was a shift towards older ages (young and adults) in later years. Those found to be the most affected by the disease, as shown by space-time scan statistics, were people in densely populated municipalities with unsatisfactory sanitary conditions and also less well covered by the public vaccination programme. Despite drops in the number of hepatitis-A PNCs, thanks to the national vaccination programme, the disease still persists in Pará State and elsewhere in Brazil. The present study reinforces the need of continuous prevention and control strategies for effective control and erradication of hepatitis-A.

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