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Santos CVBD, Cavalcante JR, Pungartnik PC, Guimarães RM. Space-time analysis of the first year of COVID-19 pandemic in the city of Rio de Janeiro, Brazil. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2021; 24:e210046. [PMID: 34730708 DOI: 10.1590/1980-549720210046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 07/21/2021] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To describe the space-time evolution of cases and deaths due to COVID-19 in the Rio de Janeiro municipality, Brazil, during the first year of the pandemic. METHODS An ecological study was carried out. The units of analysis were the neighborhoods of the city of Rio de Janeiro. Incidence and mortality rates, excess risk, Global Moran's Index (Moran's I), local indicator for spatial association, standardized incidence ratio, and standardized mortality ratio were estimated for neighborhoods in the municipality of Rio de Janeiro. RESULTS Over the first year of the pandemic, registries in the city of Rio de Janeiro included 204,888 cases and 19,017 deaths due to COVID-19. During the first three months of the pandemic, higher incidence rates were verified in the municipality compared with the state of Rio de Janeiro and Brazil, in addition to higher mortality rates compared with the state of Rio de Janeiro and Brazil from May 2020 to February 2021. Bonsucesso was the neighborhood with the highest incidence and mortality rates, and throughout the neighborhoods and months, there is no synchrony between the worst moments of the COVID-19 pandemic. CONCLUSION The authors emphasize the need for implementing more rigid control and prevention measures, increasing case detection, and accelerating the COVID-19 immunization campaign.
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Affiliation(s)
| | - João Roberto Cavalcante
- Institute of Studies in Public Health, Universidade Federal do Rio de Janeiro - Rio de Janeiro (RJ), Brazil
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Pereira TV, Nogueira MC, Campos EMS. Spatial analysis of tuberculosis and its relationship with socioeconomic indicators in a medium-sized city in Minas Gerais. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2021; 24:e210021. [PMID: 33886894 DOI: 10.1590/1980-549720210021.supl.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 11/25/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To analyze the tuberculosis spatial pattern and its relationship with socioeconomic indicators, from 2008 to 2015, in a priority city for tuberculosis control by the National Tuberculosis Control Program, Juiz de Fora, Minas Gerais. METHODS Ecological study in which the units of analysis were 81 urban regions of Juiz de Fora. Secondary data from Notifiable Diseases Information System and 2010 Demographic Census were used. Georeferenced data from 1,854 notifications were used to elaborate thematic maps in order to verify the distribution pattern of average tuberculosis rates and socioeconomic indicators within the city. Global spatial autocorrelation (Moran's I) and local (Local Indicator of Spatial Association) and multiple linear regression model were estimated to analyze the relationship between the average tuberculosis incidence rate and socioeconomic indicators. RESULTS The average tuberculosis incidence rate was 48.3 cases/100,000 inhabitants/year. It was found that the urban regions corresponding to central regions of the city had lower rates with a progressive increase toward the urban regions representative of the most peripheral neighborhoods. All variables showed significant spatial autocorrelation. The regression model showed an association between the average tuberculosis incidence rate and the proportion of poor, household density, and aging index. CONCLUSION The dynamics of tuberculosis transmission in Juiz de Fora may be explained by the maintenance of social inequality and urban space organization process.
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Affiliation(s)
- Thamiris Vilela Pereira
- Postgraduate Program in Collective Health, Universidade Federal de Juiz de Fora - Juiz de Fora (MG), Brazil
| | - Mário Círio Nogueira
- Department of Collective Health, School of Medicine, Universidade Federal de Juiz de Fora - Juiz de Fora (MG), Brazil
| | - Estela Márcia Saraiva Campos
- Department of Collective Health, School of Medicine, Universidade Federal de Juiz de Fora - Juiz de Fora (MG), Brazil
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Lima SVMA, de Araújo KCGM, Nunes MAP, Nunes C. Early identification of individuals at risk for loss to follow-up of tuberculosis treatment: A generalised hierarchical analysis. Heliyon 2021; 7:e06788. [PMID: 33981876 PMCID: PMC8085707 DOI: 10.1016/j.heliyon.2021.e06788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 03/03/2021] [Accepted: 04/09/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND We characterise the loss to follow-up (locally termed abandoned) of tuberculosis treatment with individual and ecological health determinants and to identify the predictive capacity of these risk factors. METHODS A cohort study with individual and ecological characterisation of patients diagnosed with tuberculosis in Sergipe/Brazil from 2015 to 2018 with either loss to follow-up or completion of treatment as a therapeutic outcome was performed. The examined variables were based on the social determinants of health with descriptive analysis, binary logistic regression, a generalised hierarchical model and graphical presentation using a nomogram. RESULTS The loss to follow-up accounted for 18.21% of the 2,449 studied cases. The characteristics revealed that the highest abandonment percentages were people who: were male (20.0%), had black skin colour (20.3%), were aged 20-39 years (21.8%), had 4-7 years of schooling (23.6%), re-entered treatment after abandonment (36.5%), used alcohol (31.0%), used drugs (39.3%), were smokers (26.5%) and were homeless (55.4%). The ecological characteristics showed that individuals living in municipalities with a high human development index (HDI; odds ratio [OR]: 1.91) and high-income inequality (OR: 1.81) had a greater chance of not finishing the treatment. Most of these variables were identified as predictors in the generalised hierarchical model; the receiver operating characteristic curve (ROC) curve had 0.771 precision and 84.0% accuracy. CONCLUSION The group of identified characteristics influenced the loss to follow-up of tuberculosis treatment. This data provides evidence for the early identification of individuals who are at greater risk of abandoning tuberculosis treatment.
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Affiliation(s)
- Shirley Verônica Melo Almeida Lima
- Post-Graduate Program in Health Sciences, Federal University of Sergipe, Brazil
- NOVA National School of Public Health, Universidade NOVA de Lisboa, Portugal
| | | | | | - Carla Nunes
- NOVA National School of Public Health, Universidade NOVA de Lisboa, Portugal
- Public Health Research Centre, Universidade NOVA de Lisboa, Portugal
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Sampaio VDS, Rodrigues MGDA, da Silva LCF, de Castro DB, Balieiro PCDS, Cabrinha AA, Leal Costa AJ. Social, demographic, health care and co-morbidity predictors of tuberculosis mortality in Amazonas, Brazil: a multiple cause of death approach. PLoS One 2020; 15:e0218359. [PMID: 31995562 PMCID: PMC6988942 DOI: 10.1371/journal.pone.0218359] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 01/07/2020] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVES Estimate TB mortality rates, catalogue multiple causes on death certificates in which TB was reported and identify predictors of TB from reporting on death certificates in the State of Amazonas, Brazil, based on a multiple cause of death approach. METHODS The death records of residents in the Amazonas state between 2006-2014 were analyzed and separated into three categories: TB not reported on the death certificate (TBNoR), TB reported as the underlying cause of death (TBUC) and TB reported as an associated cause of death (TBAC). Age standardized annual mortality rates for TBUC, TBAC and with TB reported (TBUC plus TBAC) were estimated for the State of Amazonas using the direct standardization method and World Health Organization 2000-2025 standard population. Mortality odds ratios (OR) for reporting of TBUC and TBAC were estimated using multinomial logistic regression. RESULTS Age standardized annual TBUC and TBAC mortality rates ranged between 5.9-7.8/105 and 2.7-4.0/105, respectively. TBUC was associated with being a resident in the State capital (OR = 0.66), of female gender (OR = 0.87), having an education level of 8 to 11, or 12 or more school years (OR = 0.67 and 0.50 respectively), non-white race/skin color (OR = 1.38) and place of death reported as in the State capital (OR = 1.69). TBAC was related to the triennium in which death occurred (OR = 1.21 and 1.22 for the years 2009-2011 and 2012-2014 respectively), age (OR = 36.1 and 16.5 for ages 15-39 and 40-64 years respectively) and when death occurred in the State capital (OR = 5.8). CONCLUSIONS TBUC was predominantly associated with predictors of unfavorable socioeconomic conditions and health care access constraints, whereas TBAC was mainly related to ages which were typical of high HIV disease incidence.
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Affiliation(s)
- Vanderson de Souza Sampaio
- Sala de Análise de Situação de Saúde, Fundação de Vigilância em Saúde do Amazonas, Manaus, Amazonas, Brazil
- Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brazil
| | | | - Leila Cristina Ferreira da Silva
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brazil
- Núcleo de Ensino e Pesquisa, Fundação de Vigilância em Saúde do Amazonas, Manaus, Amazonas, Brazil
| | - Daniel Barros de Castro
- Sala de Análise de Situação de Saúde, Fundação de Vigilância em Saúde do Amazonas, Manaus, Amazonas, Brazil
| | | | - Ana Alzira Cabrinha
- Núcleo de Sistemas de Informações, Fundação de Vigilância em Saúde do Amazonas, Manaus, Amazonas, Brazil
| | - Antonio José Leal Costa
- Área de Epidemiologia e Bioestatística, Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
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Verônica Melo Almeida Lima S, Victor Muniz Rocha J, de Araújo KCGM, Antonio Prado Nunes M, Nunes C. Determinants associated with areas with higher tuberculosis mortality rates: an ecological study. Trop Med Int Health 2019; 25:338-345. [PMID: 31755621 DOI: 10.1111/tmi.13349] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To characterise tuberculosis deaths in a region of northeast Brazil during the period from 2006 to 2017 and to identify determinants associated with areas with higher tuberculosis mortality rates. METHODS Ecological descriptive study of deaths from tuberculosis with multivariate mapping and logistic regression, carried out from 2006 to 2017 in the 75 municipalities of Sergipe, Brazil. The focus of the analysis was the mean mortality rate from tuberculosis, dichotomised according to the median. The independent variables were selected based on the conceptual model of the social determinants of health. RESULTS Mortality due to tuberculosis in Sergipe, Brazil, was most prevalent among males, mixed-race people, and people over 40 years old and with a low level of education. Multivariate logistic regression identified the mean incidence rate for tuberculosis (aOR: 1.06), the proportion of HIV testing (aOR: 7.10), people without primary education and with informal occupation (aOR: 1.26) and people living in urban households without waste collection service (aOR: 0.10) as determinants associated to municipalities with higher tuberculosis mortality rates, with area under the ROC curve of 84% (P-value 0.000). Mapping revealed evident spatial variability. CONCLUSIONS The tuberculosis epidemic in Brazil is determined by access to health services, especially the provision of HIV testing among those diagnosed with tuberculosis, accelerated urbanisation with large pockets of poverty and unsanitary housing conditions, corroborating global trends.
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Affiliation(s)
- Shirley Verônica Melo Almeida Lima
- Post-Graduate Program in Health Sciences, Federal University of Sergipe, São Cristóvão, Brazil.,NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
| | | | | | | | - Carla Nunes
- NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal.,Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
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Zille AI, Werneck GL, Luiz RR, Conde MB. Social determinants of pulmonary tuberculosis in Brazil: an ecological study. BMC Pulm Med 2019; 19:87. [PMID: 31068155 PMCID: PMC6507035 DOI: 10.1186/s12890-019-0855-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 04/26/2019] [Indexed: 11/10/2022] Open
Abstract
Background Social determinants may influence the incidence and control of tuberculosis (TB). The aim of this study was to evaluate the correlation between social determinants and pulmonary TB (PTB) incidence and treatment outcomes in different regions in Brazil. Methods In this ecological study, PTB incidence and treatment outcome rates as well as HIV incidence for all 5560 Brazilian cities as reported to the Brazilian Tuberculosis Program in 2010 were correlated with two social indicators, the Human Development Index (HDI) and Gini Index (GI). Cities were stratified into six groups based on location (metropolitan region or not) and size (small, medium, and large cities), and according to the regions of the country to which they belong. The Spearman correlation coefficient was used to assess the association between variables. Results In 2010, 68,729 new PTB cases were reported in Brazil, with an incidence rate of 36 cases per 100,000 inhabitants. Incidence rates and PTB mortality demonstrated a weak negative correlation with HDI and a positive correlation with GI. The correlation between HDI and GI with cure, relapse, and lost to follow-up of treatment greatly varied in the different groups of cities and regions of the country evaluated. Conclusions There is a weak correlation between HDI and GI and PTB incidence and mortality rate. However, there is great variation between the HDI and GI and cure, relapse, and lost to follow-up in the different groups of cities and regions of the country. This suggests that for TB determination, these outcome variables might be more related to the quality of healthcare provided by services than to social determinants in the general population.
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Affiliation(s)
- Alessandra Isabel Zille
- Instituto de Doenças do Tórax da Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil. .,Hospital Universitário Clementino Fraga Filho, Cidade Universitária, Rua, Professor Rodolpho Paulo Rocco n° 255, 6° andar, Rio de Janeiro, 21941-913, Brazil.
| | - Guilherme Loureiro Werneck
- Instituto de Estudos em Saúde Coletiva da Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Ronir Raggio Luiz
- Instituto de Estudos em Saúde Coletiva da Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Marcus Barreto Conde
- Instituto de Doenças do Tórax da Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.,Faculdade de Medicina de Petropolis/FASE, Petrópolis, RJ, Brazil
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Valente BC, Angelo JR, Kawa H, Baltar VT. A tuberculose e seus fatores associados em um município da região metropolitana do Rio de Janeiro. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2019; 22:e190027. [DOI: 10.1590/1980-549720190027] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 08/14/2017] [Indexed: 11/21/2022] Open
Abstract
RESUMO: Introdução: A ocorrência da tuberculose tem sido relacionada à organização espacial e à melhoria das condições de vida da população. Contudo, essa relação não é de forma direta, e o adoecimento por tuberculose envolve processos de diferentes níveis de organização. Método: Estudo ecológico que analisa a relação entre condições de vida e tuberculose no município de Niterói, Brasil. Foram criados dois indicadores, socioambiental e programático, por meio de análise fatorial e analisados por regressão no período de 2008 a 2012. Foram construídos mapas temáticos com os dados referentes à taxa de incidência e aos indicadores, para verificar o padrão da distribuição da taxa de incidência e desses indicadores no município. Resultados: Os resultados apontaram associação direta e significativa entre os dois indicadores com a taxa de incidência de tuberculose. O aumento em uma unidade no indicador programático esteve associado com um aumento na taxa de incidência em 7%. Já o indicador socioambiental associou-se com uma taxa de tuberculose 27% mais elevada. Discussão: Os resultados do presente trabalho foram consistentes ao constatar relação direta entre tuberculose e condições de vida no município de Niterói. Conclusão: Podemos concluir que a dinâmica da transmissão da tuberculose no município de Niterói pode ser explicada pela ocorrência da doença em áreas de periferia social consolidada e pela vulnerabilidade social de grupos específicos.
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Rocha MS, Oliveira GP, Saraceni V, Aguiar FP, Coeli CM, Pinheiro RS. Effect of inpatient and outpatient care on treatment outcome in tuberculosis: a cohort study. Rev Panam Salud Publica 2018; 42:e112. [PMID: 31093140 PMCID: PMC6385847 DOI: 10.26633/rpsp.2018.112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 05/10/2018] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To identify individual- and health services-related factors associated with deaths in subjects diagnosed with tuberculosis (TB). METHODS A nonconcurrent cohort study with passive follow-up was conducted using a probabilistic linkage method to analyze a sample of patients diagnosed and reported as having TB in 2006 and followed up until 2008. New cases, cases with previous treatment (readmission after loss to follow-up or relapse), and transfers across health services were included. Proportional hazards models were used to estimate the independent effect of covariates related to the individual and to the health services on mortality from all causes. RESULTS Age above 60 years, admission to a hospital with emergency services, HIV-associated TB, and readmission to an outpatient facility after disease relapse or loss to follow-up were identified as risk factors for death. Variables related to process and results indicators of Brazil's National TB Program were not associated with mortality from all causes. CONCLUSIONS Advanced age, previous treatment for TB, and treatment at a secondary-level outpatient facility or a hospital with emergency services on site were associated with mortality in TB patients. Better strategies to improve TB care delivered at health units are needed to prevent death from TB, especially among the elderly.
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Affiliation(s)
- Marli S. Rocha
- Universidade Federal do Rio de Janeiro, RJ, Brazil,Send correspondence to: Marli Souza Rocha,
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Yamamura M, Santos-Neto M, dos Santos RAN, Garcia MCDC, Nogueira JDA, Arcêncio RA. Epidemiological characteristics of cases of death from tuberculosis and vulnerable territories. Rev Lat Am Enfermagem 2017; 23:910-8. [PMID: 26487142 PMCID: PMC4660414 DOI: 10.1590/0104-1169.0450.2631] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Accepted: 03/11/2015] [Indexed: 11/22/2022] Open
Abstract
Objective: to characterize the differences in the clinical and epidemiological profile of
cases of death that had tuberculosis as an immediate or associated cause, and to
analyze the spatial distribution of the cases of death from tuberculosis within
the territories of Ribeirão Preto, Brazil. Method: an ecological study, in which the population consisted of 114 cases of death from
tuberculosis. Bivariate analysis was carried out, as well as point density
analysis, defined with the Kernel estimate. Results: of the cases of death from tuberculosis, 50 were the immediate cause and 64 an
associated cause. Age (p=.008) and sector responsible for the death certificate
(p=.003) were the variables that presented statistically significant associations
with the cause of death. The spatial distribution, in both events, did not occur
randomly, forming clusters in areas of the municipality. Conclusion: the difference in the profiles of the cases of death from tuberculosis, as a
basic cause and as an associated cause, was governed by the age and the sector
responsible for the completion of the death certificate. The non-randomness of the
spatial distribution of the cases suggests areas that are vulnerable to these
events. Knowing these areas can contribute to the choice of disease control
strategies.
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Affiliation(s)
- Mellina Yamamura
- Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Marcelino Santos-Neto
- Centro de Ciências Sociais, Saúde e Tecnologia, Universidade Federal do Maranhão, Imperatriz, MA, Brazil
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Lírio M, dos Santos NP, Passos LAR, Kritski A, Galvão-Castro B, Grassi MFR. Completeness of tuberculosis reporting forms for disease control in individuals with HIV/AIDS in priority cities of Bahia state. CIENCIA & SAUDE COLETIVA 2017; 20:1143-8. [PMID: 25923625 DOI: 10.1590/1413-81232015204.00672014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Accepted: 11/23/2014] [Indexed: 11/22/2022] Open
Abstract
The control of HIV / Tuberculosis (TB) co -infection remains a challenge for public health. Notification is mandatory for both diseases and the National Case Registry Database (Sinan) is responsible for the collection and processing of individual forms of reporting and monitoring. The adequate fulfillment of these fields chips (completeness) is essential to follow the dynamics of the disease and set priorities for intervention. The aim of this study was to evaluate the completeness of the notification forms of tuberculosis in the priority municipalities of Bahia (Camaçari , Feira de Santana , Ilhéus , Itabuna, Jequié, Lauro de Freitas , Porto Seguro , Teixeira de Freitas , Paulo Afonso, Barreiras and Salvador) to control the disease in individuals with HIV/AIDS using tabulations obtained from the Sinan in the period from 2001 to 2010. The results showed that despite the completeness of the field HIV be above 50 %, more than half the cases were met as "undone" or "being processed" in all municipalities assessed in the period. The low completeness of reporting forms may compromise the quality of surveillance of TB cases. The results suggest the need for greater availability of HIV testing in these individuals.
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Affiliation(s)
- Monique Lírio
- Complexo Hospitalar Professor Edgard Santos, Universidade Federal da Bahia, Salvador, BA, Brasil,
| | | | | | - Afrânio Kritski
- Faculdade de Medicina, Universidade Federal do Rio de Janeiro
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Pedro AS, Gibson G, Santos JPCD, Toledo LMD, Sabroza PC, Oliveira RMD. Tuberculosis as a marker of inequities in the context of socio-spatial transformation. Rev Saude Publica 2017; 51:9. [PMID: 28225909 PMCID: PMC5308553 DOI: 10.1590/s1518-8787.2017051006533] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 12/11/2015] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE This study aims to analyze the association between the incidence of tuberculosis and different socioeconomic indicators in a territory of intense transformation of the urban space. METHODS This is an ecological study, whose analysis units were the neighborhoods of the city of Itaboraí, state of Rio de Janeiro, Brazil. The data have been analyzed by generalized linear models. The response variable was incidence of tuberculosis from 2006 to 2011. The independent variables were the socio-demographic indicators. The spatial distribution of tuberculosis was analyzed with the elaboration of thematic maps. RESULTS The results have shown a significant association between the incidence of tuberculosis and variables that reflect different dimensions of living conditions, such as consumer goods, housing conditions and its surroundings, agglomeration of population, and income distribution. CONCLUSIONS The disproportionate incidence of tuberculosis in populations with worse living conditions highlights the persistence of socioeconomic determinants in the reproduction of the disease. Different municipal public sectors need to better articulate with local tuberculosis control programs to reduce the social burden of the disease.
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Affiliation(s)
- Alexandre San Pedro
- Departamento de Endemias Samuel Pessoa. Escola Nacional de Saúde Pública. Fundação Oswaldo Cruz. Rio de Janeiro, RJ, Brasil
| | - Gerusa Gibson
- Instituto de Estudos em Saúde Coletiva. Universidade Federal do Rio de Janeiro. Rio de Janeiro, RJ, Brasil
| | | | - Luciano Medeiros de Toledo
- Departamento de Endemias Samuel Pessoa. Escola Nacional de Saúde Pública. Fundação Oswaldo Cruz. Rio de Janeiro, RJ, Brasil
| | - Paulo Chagastelles Sabroza
- Departamento de Endemias Samuel Pessoa. Escola Nacional de Saúde Pública. Fundação Oswaldo Cruz. Rio de Janeiro, RJ, Brasil
| | - Rosely Magalhães de Oliveira
- Departamento de Endemias Samuel Pessoa. Escola Nacional de Saúde Pública. Fundação Oswaldo Cruz. Rio de Janeiro, RJ, Brasil
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Pinto ML, da Silva TC, Gomes LCF, Bertolozzi MR, Villavicencio LMM, Azevedo KMDFA, de Figueiredo TMRM. Occurrence of tuberculosis cases in Crato, Ceará, from 2002 to 2011: a spatial analisys of specific standards. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2016; 18:313-25. [PMID: 26083505 DOI: 10.1590/1980-5497201500020003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Accepted: 09/30/2014] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to analyze the spatial distribution of tuberculosis in Crato, Ceará, Brazil, from 2002 to 2011, aiming to check for a point pattern. METHODS This is an ecological, temporal trend and hybrid design study, with a quantitative approach. A total of 261 cases of tuberculosis were geo-referenced and 20 (7.1%) were considered as losses due to the lack of address. The profile of patients in 10 years of study was in accordance with the following pattern: men aged between 20 and 59 years, with low schooling, affected by the pulmonary form of tuberculosis and who were cured from the disease. RESULTS The analysis of the spatial distribution of tuberculosis points out that in the period of study, new cases of the disease were not distributed on a regular basis, indicating a clustered spatial pattern, confirmed by the L-function. The map with the density of new cases estimated by the Kernel method showed that the "hot" areas are more concentrated in the vicinity of the central urban area. CONCLUSION The study allowed pointing out areas of higher and lower concentration of tuberculosis, identifying the spatial pattern, but it also recognized that the disease has not reached all of the population groups with the same intensity. Those who were most vulnerable were the ones who lived in regions with higher population densities, precarious living conditions, and with intense flow of people.
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Affiliation(s)
| | | | | | - Maria Rita Bertolozzi
- Nursing Public Health Department, Nursing School, Universidade de São Paulo, São Paulo, SP, Brazil
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Santos Neto M, Yamamura M, Garcia MCDC, Popolin MP, Rodrigues LBB, Chiaravalloti Neto F, Fronteira I, Arcêncio RA. Pulmonary tuberculosis in São Luis, State of Maranhão, Brazil: space and space-time risk clusters for death (2008-2012). Rev Soc Bras Med Trop 2015; 48:69-76. [PMID: 25860467 DOI: 10.1590/0037-8682-0290-2014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Accepted: 02/10/2015] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION The objective was to identify space and space-time risk clusters for the occurrence of deaths in a priority city for the control of tuberculosis (TB) in the Brazilian Northeast. METHODS Ecological research was undertaken in the City of São Luis/Maranhão. Cases were considered that resulted in deaths in the population living in the urban region of the city with pulmonary TB as the basic cause, between 2008 and 2012. To detect space and space-time clusters of deaths due to pulmonary TB in the census sectors, the spatial analysis scan technique was used. RESULTS In total, 221 deaths by TB occurred, 193 of which were due to pulmonary TB. Approximately 95% of the cases (n=183) were geocoded. Two significant spatial clusters were identified, the first of which showed a mortality rate of 5.8 deaths per 100,000 inhabitants per year and a high relative risk of 3.87. The second spatial cluster showed a mortality rate of 0.4 deaths per 100,000 inhabitants per year and a low relative risk of 0.10. A significant cluster was observed in the space-time analysis between 11/01/2008 and 04/30/2011, with a mortality rate of 8.10 deaths per 100,000 inhabitants per year and a high relative risk (3.0). CONCLUSIONS The knowledge of priority sites for the occurrence of deaths can support public management to reduce inequities in the access to health services and permit an optimization of the resources and teams in the control of pulmonary TB, providing support for specific strategies focused on the most vulnerable populations.
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Affiliation(s)
- Marcelino Santos Neto
- Centro de Ciências Sociais Saúde e Tecnologia, Universidade Federal do Maranhão, Imperatriz, MA, Brazil
| | - Mellina Yamamura
- Departamento de Enfermagem Materno-Infantil e Saúde Pública, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Maria Concebida da Cunha Garcia
- Departamento de Enfermagem Materno-Infantil e Saúde Pública, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Marcela Paschoal Popolin
- Departamento de Enfermagem Materno-Infantil e Saúde Pública, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | | | | | - Inês Fronteira
- Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Ricardo Alexandre Arcêncio
- Departamento de Enfermagem Materno-Infantil e Saúde Pública, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
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14
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Hino P, Villa TCS, da Cunha TN, dos Santos CB. [Spatial patterns of tuberculosis and its association with living conditions in the city of Ribeirão Preto in the state of São Paulo]. CIENCIA & SAUDE COLETIVA 2012; 16:4795-802. [PMID: 22124919 DOI: 10.1590/s1413-81232011001300028] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2009] [Accepted: 01/23/2010] [Indexed: 11/22/2022] Open
Abstract
This study, with a hybrid, ecological and time-tendency design, sought to establish the relation between the spatial correlation in the occurrence of new cases of TB in the year 2000 and to ascertain the association between living conditions and TB distribution in Ribeirão Preto, State of São Paulo, between 2000 and 2006. The thematic maps were elaborated with the help of MapInfo 7.5 and spatial statistical analysis using Spring 4.3. For the remaining calculations, SPSS 10.0 was used. The indices with the highest factor loads were family heads earning 2 minimum wages or less and with less than 3 years of education. The comparison of the living conditions and TB maps revealed a relation between TB and poorer areas in the city, as the incidence rate in the cluster with poor living conditions was 49.9/100,000 inhabitants. The gross Chance Ratio, considering the cluster with the high living conditions as a reference, proved the association between TB and living conditions and 3.30 for the low living conditions cluster (CR=3.30; CI95%: 1.90-5.70). The city's stratification according to living conditions and incidence of TB allowed for the identification of risk areas, providing input for the local TB Control Program.
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Affiliation(s)
- Paula Hino
- Escola de Enfermagem, Universidade de São Paulo.
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15
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Santo AH. Deaths attributed to multiple causes and involving tuberculosis in the state of Rio de Janeiro Brazil between 1999 and 2001. J Bras Pneumol 2007; 32:544-52. [PMID: 17435905 DOI: 10.1590/s1806-37132006000600012] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2005] [Accepted: 03/08/2006] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To evaluate deaths attributed to multiple causes in which tuberculosis was one of the causes listed. METHODS All deaths among residents of the state of Rio de Janeiro, Brazil, occurring between 1999 and 2001 and for which the death certificate mentioned tuberculosis, were investigated. The World Health Organization guidelines were used in characterizing the underlying and associated (non-underlying) causes of death. RESULTS In deaths from tuberculosis, conditions related to its natural history were the principal associated causes, together with alcoholism and diabetes. In approximately three-fifths of all deaths for which tuberculosis was listed as an associated cause, the underlying cause of death was acquired immunodeficiency syndrome. High proportion of ill-defined causes of death, low values found for the number of causes informed per death certificate and for TB as an associated cause point towards a certain degree of underestimation of the actual number of TB-related deaths in Rio de Janeiro State. CONCLUSION The study shows that the rates of tuberculosis-related mortality in the state of Rio de Janeiro, calculated based on the number of times tuberculosis was listed as a cause of death (underlying or associated), are the highest in the country. Epidemiological studies of mortality are recommended as a means of guiding the activities of the tuberculosis control program.
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Affiliation(s)
- Augusto Hasiak Santo
- Department of Epidemiology, University of São Paulo, School of Public Health, São Paulo, Brazil.
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16
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Ferreira AADA, Queiroz KCDS, Torres KP, Ferreira MÂF, Accioly H, Alves MDSCF. Os fatores associados à tuberculose pulmonar e a baciloscopia: uma contribuição ao diagnóstico nos serviços de saúde pública. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2005. [DOI: 10.1590/s1415-790x2005000200006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJETIVO: Verificar os principais fatores associados à tuberculose pulmonar e os resultados da baciloscopia. DESENHO DO ESTUDO: Trata-se de um estudo seccional de base secundária. METODOLOGIA: A coleta de dados foi realizada com 189 prontuários de pacientes com idade acima de 25 anos atendidos no Hospital Giselda Trigueiro em Natal/RN, Brasil, no período de 2000 a 2002. Os fatores associados identificados e os resultado da baciloscopia foram apresentados através da distribuição percentual. RESULTADOS: A média de idade dos pacientes variou entre 43,5 + 18,5 anos, sendo 73% do sexo masculino. Os principais fatores associados foram etilismo e tabagismo (20,6%), tabagismo (19,8%), etilismo (16,7%), contágio direto (10,3%), diabetes mellitus (8,7%), pneumonia não tratada (6,3%), abandono de esquema (6,3%) e outros fatores (11,1%). A baciloscopia foi realizada em 84,1% dos pacientes. Em 44,7% deles, o diagnóstico foi negativo, enquanto que em 55,3% foi positivo. CONCLUSÃO: Os fatores associados contribuem para o diagnóstico da tuberculose pulmonar na medida em que a baciloscopia apresenta uma baixa sensibilidade.
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Abstract
Analisa-se o processo de transformação do padrão epidemiológico de uma população amazônica constituída para trabalhar no desenvolvimento da Mineração Rio do Norte S.A. (MRN), no município de Oriximiná (PA), na localidade de Porto Trombetas. A determinação do processo saúde-doença se desenvolveu segundo as condições particulares de reprodução social do empreendimento, bastante distintas em relação às das populações vinculadas ao desenvolvimento socioeconômico tradicional da região. As categorias particulares mais diretamente envolvidas foram a organização social do espaço e a política social: da MRN, para a população de Porto Trombetas e do país, para as demais categorias da população.
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