Impact of COVID-19 on the indigenous population of Brazil: a geo-epidemiological study

Burnout syndrome in higher education health professionals working in indigenous health in Brazil

Abstract The aim of this study was to investigate the prevalence of burnout syndrome in higher education health professionals working in indigenous health in Brazil, and to identify associated factors. This is an observational, analytical, and cross-sectional study. Data collection was based on the application of a questionnaire (personal profile and MBI-HSS) and included 513 professionals. The prevalence of burnout was 65%. Greater likelihood of emotional exhaustion was observed among younger professionals, who had worked in indigenous health for longer time, in the care function and with lower level of tranquility when working during the pandemic. Lower likelihood of having low personal accomplishment at work was observed among older professionals, professionals who had worked in indigenous health for shorter time, who worked in clinical care during the pandemic and those with lower level of tranquility when working during the pandemic. Greater likelihood of depersonalization was found among married professionals, who worked in clinical care during the pandemic and those with lower level of tranquility when working during the pandemic. This study contributes with an important assessment of the existence of BS predictors in health professionals working in indigenous health.

Burnout syndrome in higher education health professionals working in indigenous health in Brazil

The aim of this study was to investigate the prevalence of burnout syndrome in higher education health professionals working in indigenous health in Brazil, and to identify associated factors. This is an observational, analytical, and cross-sectional study. Data collection was based on the application of a questionnaire (personal profile and MBI-HSS) and included 513 professionals. The prevalence of burnout was 65%. Greater likelihood of emotional exhaustion was observed among younger professionals, who had worked in indigenous health for longer time, in the care function and with lower level of tranquility when working during the pandemic. Lower likelihood of having low personal accomplishment at work was observed among older professionals, professionals who had worked in indigenous health for shorter time, who worked in clinical care during the pandemic and those with lower level of tranquility when working during the pandemic. Greater likelihood of depersonalization was found among married professionals, who worked in clinical care during the pandemic and those with lower level of tranquility when working during the pandemic. This study contributes with an important assessment of the existence of BS predictors in health professionals working in indigenous health.

Syndemic aspects between COVID-19 pandemic and social inequalities

Although the coronavirus disease 2019 (COVID-19) pandemic has reached all over the world population, it has demonstrated a heterogeneous impact on different populations. The most vulnerable communities which coexist daily with the social inequalities like low access to hygiene and personal protection products, crowded residences, and higher levels of chronic diseases have a higher risk of contact and the spread of infection, beyond unfavorable clinical outcomes. The elevation of the risk of infection exposure can be related to gender due to the presence of a larger contingent of women in essential services, as well as frontline and cleaning professionals who regardless of gender have the greatest exposure to the virus. Such exposures can contribute to the development of fear of contaminating themselves or their family members associated also with the work stress, both of which are related to the emergence of mental disturbances in these populations. Furthermore, conditions of unsanitary living and low socioeconomic status, populations at war, pre-existing social barriers, and ethnicity have contributed to more impact of the pandemic both in the exposure to the virus and access to health services, COVID-19 management, and management of other pathologies. At the same time, factors such as the closing of non-essential services, the loss of jobs, and the increase in household spending aggravated the social vulnerabilities and impacted the family economy. Lastly, the COVID-19 pandemic contributed still more to the impact on women's health since it propitiated a favorable environment for increasing domestic violence rates, through the segregation of women from social life, and increasing the time of the victims with their aggressors.

Methods Used in the Spatial and Spatiotemporal Analysis of COVID-19 Epidemiology: A Systematic Review

The spread of the COVID-19 pandemic was spatially heterogeneous around the world; the transmission of the disease is driven by complex spatial and temporal variations in socioenvironmental factors. Spatial tools are useful in supporting COVID-19 control programs. A substantive review of the merits of the methodological approaches used to understand the spatial epidemiology of the disease is hardly undertaken. In this study, we reviewed the methodological approaches used to identify the spatial and spatiotemporal variations of COVID-19 and the socioeconomic, demographic and climatic drivers of such variations. We conducted a systematic literature search of spatial studies of COVID-19 published in English from Embase, Scopus, Medline, and Web of Science databases from 1 January 2019 to 7 September 2021. Methodological quality assessments were also performed using the Joanna Briggs Institute (JBI) risk of bias tool. A total of 154 studies met the inclusion criteria that used frequentist (85%) and Bayesian (15%) modelling approaches to identify spatial clusters and the associated risk factors. Bayesian models in the studies incorporated various spatial, temporal and spatiotemporal effects into the modelling schemes. This review highlighted the need for more local-level advanced Bayesian spatiotemporal modelling through the multi-level framework for COVID-19 prevention and control strategies.

Spatiotemporal pattern of Covid-19 outbreak in Turkey

The earliest case of Covid-19 was documented in Wuhan city of China and since then the virus has been spreading throughout the globe. The aim of this study is to evaluate the clusters of Covid-19 among the provinces in Turkey and to examine whether the clustering pattern has changed after the country's lockdown strategy. The spatial dependence of Covid-19 in 81 provinces of Turkey was examined by spatial analysis between February 8 and June 28, 2021. Global and Local Moran's I and Gi* were employed to measure the global and local spatial autocorrelation degrees. The geographical distribution of Covid-19 in the provinces of Turkey showed a strong spatial autocorrelation while the spatial structure of the clusters varied by weeks. The findings of the study show that the complete lockdown carried out in Turkey has been quite effective in mitigating Covid-19. The importance of spatial relations in preventing the spread of the disease in Turkey has also been demonstrated in this context.

Spatial Analysis of Inequality in Thailand: Applications of Satellite Data and Spatial Statistics/Econometrics

To formulate and monitor the progress of development policies, acquiring data with sufficient spatiotemporal details is inevitable. With the increasing availability of open remote-sensing data and open-source software packages, this research suggested the novelty integration of satellite data and spatial analytical methods, enabling a timely and costless framework for assessing the nationwide socioeconomic condition. Specifically, the spatial statistical and spatial econometrical methods were applied to geospatial data to identify the clustering patterns and the localized associations of inequality in Thailand. The spatial statistical results showed that Bangkok and its vicinity had been a cluster of high socioeconomic conditions, representing the spatial inequality of development. In addition, results of the spatial econometrical models showed that the satellite-based indicators could identify the socioeconomic condition (with p-value < 0.010 and R-squared ranging between 0.345 and 0.657). Inequality indicators (i.e., Gini, Thiel and Atkinson) were then constructed by using survey-based and satellite-based data, informing that spatial inequality has been slowly declining. These findings recommended the new establishment of polycentric growth poles that offer economic opportunities and reduce spatial inequality. In addition, in accordance with Sustainable Development Goal 10 (reduced inequalities), this analytical framework can be applied to country-specific implications along with the global scale extensions.

Impact of the COVID-19 Pandemic on Infectious Diseases in Brazil: A Case Study on Dengue Infections

Brazil is known for being a breeding ground for emerging infectious diseases (EIDs), such as Zika, dengue, and chikungunya. Given that it has been one of the countries most affected by the SARS-CoV-2 pandemic, this article aims to analyze the impact that the COVID-19 pandemic has had on the burden of infectious diseases in Brazil, especially that of dengue. Brazil is a unique territory with a heterogeneous population living in a tropical, wet climate favorable to infectious diseases. In addition, despite being one of the largest emerging economies in the world, the country has been exposed to political instability and a public health system that suffers from large funding shortfalls and a lack of coherent regulation. The findings from this study are multilayered. Firstly, as cases of COVID-19 rose at the start of the pandemic, cases of dengue declined drastically. This may be due, in part, to factors such as seasonal climate and distancing measures. Furthermore, the findings indicate that the diversion of resources away from dengue and other infectious diseases, and mobilization for COVID-19 testing and treatment, likely resulted in a serious underreporting of dengue. While Brazil has incorporated some of the lessons learned from past EID experience in responding to the COVID-19 pandemic, the analysis highlights how the country's structural problems present pitfalls in the epidemiological fight. It was concluded that in a country such as Brazil, where infectious disease outbreaks are only a matter of time, pandemic preparedness should be prioritized over pandemic response.

Epidemiological characteristics and temporal-spatial analysis of overseas imported dengue fever cases in outbreak provinces of China, 2005–2019

Background

Overseas imported dengue fever is an important factor in local outbreaks of this disease in the mainland of China. To better prevent and control such local outbreaks, the epidemiological characteristics and temporal-spatial distribution of overseas imported dengue fever cases in provincial-level administrative divisions (PLADs) where dengue fever is outbreak in the mainland of China were explored.

Methods

Using the Chinese National Notifiable Infectious Disease Reporting Information System (CNNDS), we identified overseas imported dengue fever cases in dengue fever outbreak areas in the mainland of China from 2005 to 2019 to draw the epidemic curve and population characteristic distribution of overseas imported cases in each PLAD. Based on spatial autocorrelation analysis of ArcGIS 10.5 and temporal-spatial scanning analysis of SaTScan 9.5, we analyzed the temporal-spatial distribution of overseas imported dengue fever in dengue fever outbreak areas in the mainland of China.

Results

A total of 11,407 imported cases, mainly from Southeast Asia, were recorded from 2005 to 2019 in these 13 PLADs. Of which 62.1% were imported into Yunnan and Guangdong Provinces. Among the imported cases, there were more males than females, mainly from the 21–50 age group. The hot spots were concentrated in parts of Yunnan, Guangdong and Fujian Provinces. We found the cluster of infected areas were expanding northward.

Conclusions

Based on the analysis of overseas imported dengue cases in 13 PLADs of the mainland of China from 2005 to 2019, we obtained the epidemiological characteristics and spatial distribution of imported dengue cases. Border controls need to pay attention to key population sectors, such as 21–50 years old men and education of key populations on dengue prevention. There is a need to improve the awareness of the prevention and control of imported cases in border areas. At the same time, northern regions cannot relax their vigilance.

Graphical Abstract