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Queiroz AM, Estrázulas JA, Garnelo L, Siqueira JH, Fonseca FR, Herkrath FJ. Association of physical performance and sarcopenia with use of health services in elderly people living in rural riverside areas in the Amazon: a cross-sectional study. Rural Remote Health 2023; 23:7957. [PMID: 37806667 DOI: 10.22605/rrh7957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023] Open
Abstract
INTRODUCTION Access is considered one of the necessary conditions for achieving effectiveness and quality in health services. However, it represents a complex construct, with several interpretations, and can be understood as the ease or degree of difficulty with which people obtain effective and timely care. Barriers to access can be related to individual characteristics and those of health systems and services. Regarding elderly people living in rural riverine localities, these limitations are exacerbated due to the territorial dispersion of households and the difficulty of obtaining the necessary care near their homes. The aim of this study was to describe and test the association of sarcopenia and physical performance with primary healthcare attributes and the use of health services by elderly people living in rural riverside areas in the Amazon, Brazil. METHODS This cross-sectional observational study was carried out in households with individuals aged 60 years or older living in nine communities located on the left bank of the Negro River, in the rural riverside area of the municipality of Manaus, Amazonas, Brazil. The study evaluated socioeconomic and demographic conditions, health services utilization and the primary care attributes related to the use of and access to services, assessed by components of the Primary Care Assessment Tool instrument (PCATool-Brazil), a reduced version validated for Brazilian adult users. Physical performance was assessed using the Short Physical Performance Battery scale, and handgrip strength was also assessed, according to a dynamometer. The Sarcopenia Formulary (SARC-F) and calf circumference (CC) were used to assess sarcopenia (SARC-CalF). The association of sarcopenia and physical performance with the study outcomes was evaluated using hierarchical logistic regression for health services utilization (having had a medical consultation in the last year), and hierarchical linear regression for the continuous outcomes of the PCATool-Brazil (total score and each of the domains). The sociodemographic variables were inserted in model 1 and the clinical variables in model 2. Variables with p<0.20 were kept in the models. RESULTS A total of 98 elderly people (55.1% men; mean age 70±7.4 years) were included in the study. Low physical performance and suggestive signs of sarcopenia were observed in 52.5% and 28.9% of the study participants, respectively. Elderly with better physical performance reported more health services utilization (odds ratio (OR)=1.37; 95% confidence interval (CI)=1.03-1.81) and higher scores in the affiliation (β=1.67; 95%CI=0.37-2.98), utilization (β=1.19; 95%CI=0.06-2.33) and longitudinality (β=0.99; 95%CI=0.09-1.90) domains of the PCATool-Brazil. CONCLUSION The study findings showed high prevalence of impairment in physical performance and suggestive signs of sarcopenia in elderly people living in the studied rural riverside localities. Better physical performance was associated with use of health services in the previous year and with better evaluation of some primary care attributes.
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Affiliation(s)
- Aline Melo Queiroz
- Instituto Leônidas e Maria Deane, Fiocruz Amazônia, Manaus, Amazonas, Brazil
| | | | - Luiza Garnelo
- Instituto Leônidas e Maria Deane, Fiocruz Amazônia, Manaus, Amazonas, Brazil
| | | | | | - Fernando J Herkrath
- Instituto Leônidas e Maria Deane, Fiocruz Amazônia, Manaus, Amazonas, Brazil; and Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil
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Delevatti RS, Danielevicz A, Sirydakis ME, de Melo PUG, de la Rocha Freitas C, Rech CR, Guglielmo LGA, Speretta GFF, Hansen F, Fonseca FR, Starke AC, de Lucas RD, de Melo Junior JT, Maurici R, Gerage AM. Effects of physical training on functional, clinical, morphological, behavioural and psychosocial outcomes in post-COVID-19 infection: COVID-19 and REhabilitation study (CORE-study)-a study protocol for a randomised controlled clinical trial. Trials 2023; 24:39. [PMID: 36658592 PMCID: PMC9850322 DOI: 10.1186/s13063-022-07055-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 12/27/2022] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic remains ongoing, with a significant number of survivors who have experienced moderate to severe clinical conditions and who have suffered losses of great magnitude, especially in functional capacity, triggering limitations to daily autonomy and quality of life. Among the possibilities of intervention for disease rehabilitation, physical exercise training stands out, which can benefit several health outcomes and favours the adoption of healthier behaviours. Therefore, the aim of the study will be to analyse the effects of physical training on the functional, clinical, morphological, behavioural and psychosocial status in adults and the elderly following COVID-19 infection. METHODS A randomised controlled clinical trial is to be conducted in parallel, with the experimental group undergoing an intervention involving a multicomponent physical rehabilitation programme, carried out at the Sports Center in partnership with the Academic Hospital of the Federal University of Santa Catarina, in Florianópolis, Brazil. Participants will be adults and the elderly, of both sexes, in a post-COVID-19-infection state, who were hospitalised during the infection. The intervention will have a total duration of 24 weeks and will include a multicomponent physical training programme, which will have gradual progression in frequency, duration and intensity over time. Regarding the outcomes, before, at the 12th and after 24 weeks of intervention, functional (primary outcome = functional index of aerobic capacity), clinical, morphological, behavioural and psychosocial outcomes will be assessed. DISCUSSION This study will contribute to a greater understanding of the safety, adherence and benefits of physical training in the rehabilitation of post-COVID-19 patients. The results of this study will be disseminated through presentations at congresses, workshops, peer-reviewed publications and local and international conferences, especially with a view to proposing a post-COVID-19 rehabilitation care protocol. TRIAL REGISTRATION ReBEC, RBR-10y6jhrs . Registered on 22 February 2022. 2015.
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Affiliation(s)
- Rodrigo Sudatti Delevatti
- grid.411237.20000 0001 2188 7235Department of Physical Education, Sports Center, Federal University of Santa Catarina, University Campus, Trindade, Florianópolis, Santa Catarina 88040-900 Brazil
| | - Angelica Danielevicz
- grid.411237.20000 0001 2188 7235Department of Physical Education, Sports Center, Federal University of Santa Catarina, University Campus, Trindade, Florianópolis, Santa Catarina 88040-900 Brazil
| | - Maria Eduarda Sirydakis
- grid.411237.20000 0001 2188 7235Department of Physical Education, Sports Center, Federal University of Santa Catarina, University Campus, Trindade, Florianópolis, Santa Catarina 88040-900 Brazil
| | - Paulo Urubatan Gama de Melo
- grid.411237.20000 0001 2188 7235Department of Physical Education, Sports Center, Federal University of Santa Catarina, University Campus, Trindade, Florianópolis, Santa Catarina 88040-900 Brazil
| | - Cíntia de la Rocha Freitas
- grid.411237.20000 0001 2188 7235Department of Physical Education, Sports Center, Federal University of Santa Catarina, University Campus, Trindade, Florianópolis, Santa Catarina 88040-900 Brazil
| | - Cassiano Ricardo Rech
- grid.411237.20000 0001 2188 7235Department of Physical Education, Sports Center, Federal University of Santa Catarina, University Campus, Trindade, Florianópolis, Santa Catarina 88040-900 Brazil
| | - Luiz Guilherme Antonacci Guglielmo
- grid.411237.20000 0001 2188 7235Department of Physical Education, Sports Center, Federal University of Santa Catarina, University Campus, Trindade, Florianópolis, Santa Catarina 88040-900 Brazil
| | - Guilherme Fleury Fina Speretta
- grid.411237.20000 0001 2188 7235Department of Physical Education, Sports Center, Federal University of Santa Catarina, University Campus, Trindade, Florianópolis, Santa Catarina 88040-900 Brazil
| | - Fernanda Hansen
- grid.411237.20000 0001 2188 7235Department of Nutrition, Health Sciences Center, Federal University of Santa Catarina, University Campus, Trindade, Florianópolis, Santa Catarina 88040-900 Brazil
| | - Fernanda Rodrigues Fonseca
- grid.411237.20000 0001 2188 7235Health Sciences Center/NUPAIVA, Federal University of Santa Catarina, University Campus, Trindade, Florianópolis, Santa Catarina 88040-900 Brazil
| | - Ana Carolina Starke
- grid.411237.20000 0001 2188 7235Health Sciences Center/NUPAIVA, Federal University of Santa Catarina, University Campus, Trindade, Florianópolis, Santa Catarina 88040-900 Brazil
| | - Ricardo Dantas de Lucas
- grid.411237.20000 0001 2188 7235Department of Physical Education, Sports Center, Federal University of Santa Catarina, University Campus, Trindade, Florianópolis, Santa Catarina 88040-900 Brazil
| | - José Tavares de Melo Junior
- grid.411237.20000 0001 2188 7235Health Sciences Center/NUPAIVA, Federal University of Santa Catarina, University Campus, Trindade, Florianópolis, Santa Catarina 88040-900 Brazil
| | - Rosemeri Maurici
- grid.411237.20000 0001 2188 7235Health Sciences Center/NUPAIVA, Federal University of Santa Catarina, University Campus, Trindade, Florianópolis, Santa Catarina 88040-900 Brazil
| | - Aline Mendes Gerage
- grid.411237.20000 0001 2188 7235Department of Physical Education, Sports Center, Federal University of Santa Catarina, University Campus, Trindade, Florianópolis, Santa Catarina 88040-900 Brazil
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Queiroz AM, Estrázulas JA, Garnelo L, Mainbourg EMT, Fonseca FR, Herkrath FJ. Self-reported chronic back pain in the elderly living in rural riverine areas in the Amazon. Rural Remote Health 2022; 22:6911. [PMID: 34982939 DOI: 10.22605/rrh6911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION The present study aimed to estimate the prevalence of self-reported chronic low back pain and to identify the associated factors in elderly people living in rural riverside areas in the Amazon. METHODS Data from a cross-sectional home-based survey performed in 38 riverside rural locations along the left bank of the Negro River, in the municipality of Manaus, Amazonas, Brazil, were analyzed. The selected elderly people answered a questionnaire comprising items related to the living conditions, socioeconomic and demographic characteristics, health status and utilization of health services. The outcome was self-reported chronic back pain or problem. The association between the outcome and the independent variables was assessed using logistic regression, estimating the odds ratios and respective 95% confidence intervals (CIs). RESULTS One hundred and six residents aged 60 years or older out of a total of 277 were included in the study. The prevalence of chronic back pain among the elderly residents was 57.5% (63.3% among men and 50.0% among women). Most of them did not have any treatment related to their chronic condition (77.0%). Occupation in activities other than agricultural activities was protective for the outcome (odds ratio (OR)=0.1, 95%CI=0.0-0.9). The chronic low back pain was also associated with worse self-perceived health (OR=10.3, 95%CI=1.6-67.5). CONCLUSION The high prevalence of chronic low back pain in elderly people living in rural riverside areas, along with limited access to treatment and the different impacts on the performance of daily activities and the quality of life, reveals the relevance of this condition as a public health problem.
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Affiliation(s)
- Aline Melo Queiroz
- Instituto Leônidas e Maria Deane, Fiocruz Amazônia, Manaus, Amazonas, Brazil
| | | | - Luiza Garnelo
- Instituto Leônidas e Maria Deane, Fiocruz Amazônia, Manaus, Amazonas, Brazil
| | | | | | - Fernando J Herkrath
- Instituto Leônidas e Maria Deane, Fiocruz Amazônia, Manaus, Amazonas, Brazil; and Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil
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Achilles GR, Kautzmann RP, Chagas HDF, Pereira-Silva JW, Almeida JF, Fonseca FR, da Silva MNF, Pessoa FAC, Nava AFD, Ríos-Velásquez CM. Presence of trypanosomatids, with emphasis on Leishmania, in Rodentia and Didelphimorphia mammals of a rural settlement in the central Amazon region. Mem Inst Oswaldo Cruz 2021; 116:e200427. [PMID: 34259735 PMCID: PMC8279123 DOI: 10.1590/0074-02760200427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 06/11/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Trypanosomatids are widespread and cause diseases - such as trypanosomiasis, sleeping sickness, Chagas disease, and cutaneous and visceral leishmaniasis - in animals and humans. These diseases occur in both rural and urban regions due to unplanned growth and deforestation. Thus, wild and synanthropic reservoir hosts living in residential areas are risk factors. OBJECTIVE We aimed to evaluate the diversity of small mammals (rodents and marsupials), and the occurrence of trypanosomatids, especially Leishmania, in the rural settlement of Presidente Figueiredo, Amazonas. METHODS Animals were collected using Sherman, Tomahawk, and Pitfall traps along 16 trails in four landscapes: continuous forest, forest with planting, planting, and peridomiciliar. Leishmania sp. was detected in liver samples by polymerase chain reaction targeting kDNA. FINDINGS Diversity was higher in forests with planting and lower around residences. In total, 135 mammals (81 rodents and 54 marsupials covering 14 genera) were captured. Rodents presented infection rates (IR) of 74% and marsupials of 48%. Rodents in domicile landscapes presented a higher IR (92.9%), while marsupials showed a higher IR in forests (53.3%). MAIN CONCLUSIONS The results suggest high prevalence of trypanosomatids across 12 mammalian genera possibly involved as reservoir hosts in the enzootic transmission of leishmaniasis in the Amazon’s rural, peridomiciliar landscape.
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Affiliation(s)
- Genevere Reis Achilles
- Fundação Oswaldo Cruz-Fiocruz, Instituto Leônidas e Maria Deane, Programa de Pós-Graduação em Condições de Vida e Situações de Saúde na Amazônia, Manaus, AM, Brasil.,Fundação Oswaldo Cruz-Fiocruz, Instituto Leônidas e Maria Deane, Laboratório de Ecologia de Doenças Transmissíveis na Amazônia, Manaus, AM, Brasil
| | - Rafael Pinto Kautzmann
- Universidade Federal do Amazonas, Programa de Pós-Graduação em Zoologia, Manaus, AM, Brasil
| | - Haile Dean Figueiredo Chagas
- Fundação Oswaldo Cruz-Fiocruz, Instituto Leônidas e Maria Deane, Laboratório de Ecologia de Doenças Transmissíveis na Amazônia, Manaus, AM, Brasil
| | - Jordam William Pereira-Silva
- Fundação Oswaldo Cruz-Fiocruz, Instituto Leônidas e Maria Deane, Laboratório de Ecologia de Doenças Transmissíveis na Amazônia, Manaus, AM, Brasil
| | - Jéssica Feijó Almeida
- Fundação Oswaldo Cruz-Fiocruz, Instituto Leônidas e Maria Deane, Programa de Pós-Graduação em Condições de Vida e Situações de Saúde na Amazônia, Manaus, AM, Brasil.,Fundação Oswaldo Cruz-Fiocruz, Instituto Leônidas e Maria Deane, Laboratório de Ecologia de Doenças Transmissíveis na Amazônia, Manaus, AM, Brasil
| | - Fernanda Rodrigues Fonseca
- Fundação Oswaldo Cruz-Fiocruz, Instituto Leônidas e Maria Deane, Laboratório de Ecologia de Doenças Transmissíveis na Amazônia, Manaus, AM, Brasil
| | | | - Felipe Arley Costa Pessoa
- Fundação Oswaldo Cruz-Fiocruz, Instituto Leônidas e Maria Deane, Laboratório de Ecologia de Doenças Transmissíveis na Amazônia, Manaus, AM, Brasil
| | - Alessandra Ferreira Dales Nava
- Fundação Oswaldo Cruz-Fiocruz, Instituto Leônidas e Maria Deane, Laboratório de Ecologia de Doenças Transmissíveis na Amazônia, Manaus, AM, Brasil
| | - Claudia María Ríos-Velásquez
- Fundação Oswaldo Cruz-Fiocruz, Instituto Leônidas e Maria Deane, Laboratório de Ecologia de Doenças Transmissíveis na Amazônia, Manaus, AM, Brasil
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Rê AD, Fonseca FR, Queiroz AP, Reis CMD, Bahl MM, Kocks J, Molen TVD, Maurici R. Brazilian version of the Clinical COPD Questionnaire, administered by interview: reliability and validity measurement properties. ACTA ACUST UNITED AC 2021; 47:e20200371. [PMID: 34076173 PMCID: PMC8332715 DOI: 10.36416/1806-3756/e20200371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 02/06/2021] [Indexed: 11/22/2022]
Abstract
Objective: To test the reliability, validity, and interpretability of the Brazilian version of the Clinical COPD Questionnaire (CCQ) in patients with COPD. Methods: Fifty patients with COPD completed the CCQ by interview on two occasions. At the first visit, the CCQ was administered twice, by two different raters, approximately 10 min apart; the patients also underwent spirometry and were administered the COPD Assessment Test, the modified Medical Research Council scale, and Saint George’s Respiratory Questionnaire (SGRQ). At the second visit (1-2 weeks later), the CCQ was readministered. We tested the hypothesis that the CCQ total score would correlate positively with the total and domain SGRQ scores (r ≥ 0.5). Results: Of the 50 patients, 30 (60%) were male. The mean age was 66 ± 8 years, and the mean FEV1 was 44.7 ± 17.9% of the predicted value. For all CCQ items, Cronbach’s alpha coefficient (95% CI) was 0.93 (0.91-0.96). To analyze the interrater reliability and test-retest reliability of the CCQ, we calculated the two-way mixed effects model/single measure type intraclass correlation coefficient (0.97 [95% CI: 0.95-0.98] and 0.92 [95% CI: 0.86-0.95], respectively); the agreement standard error of measurement (0.65 for both); the smallest detectable change at the individual level (1.81 and 1.80, respectively) and group level (0.26 and 0.25, respectively); and the limits of agreement (−0.58 to 0.82 and −1.14 to 1.33, respectively). The CCQ total score correlated positively with all SGRQ scores (r ≥ 0.70 for all). Conclusions: The Brazilian version of the CCQ showed an indeterminate measurement error, as well as satisfactory interrater/test-retest reliability and construct validity.
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Affiliation(s)
- Alexânia de Rê
- . Programa de Pós-Graduação em Ciências Médicas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil.,. Núcleo de Pesquisa em Asma e Inflamação das Vias Aéreas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil
| | - Fernanda Rodrigues Fonseca
- . Programa de Pós-Graduação em Ciências Médicas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil.,. Núcleo de Pesquisa em Asma e Inflamação das Vias Aéreas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil
| | - Ana Paula Queiroz
- . Programa de Pós-Graduação em Ciências Médicas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil.,. Núcleo de Pesquisa em Asma e Inflamação das Vias Aéreas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil
| | - Cardine Martins Dos Reis
- . Programa de Pós-Graduação em Ciências Médicas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil
| | - Marina Mônica Bahl
- . Programa de Pós-Graduação em Ciências Médicas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil
| | - Janwillem Kocks
- . General Practitioners Research Institute, Groningen, The Netherlands.,. University of Groningen, University Medical Center Groningen, GRIAC Research Institute, Groningen, The Netherlands.,. Observational and Pragmatic Research Institute, Singapore
| | - Thys van der Molen
- . Department of General Practice, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Rosemeri Maurici
- . Programa de Pós-Graduação em Ciências Médicas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil.,. Núcleo de Pesquisa em Asma e Inflamação das Vias Aéreas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil.,. Departamento de Clínica Médica, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil.,. Hospital Universitário, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil
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Queiroz APA, Fonseca FR, Rê AD, Maurici R. Clinical, laboratory, and functional characteristics of asthma-COPD overlap in patients with a primary diagnosis of COPD. ACTA ACUST UNITED AC 2020; 47:e20200033. [PMID: 33174971 PMCID: PMC7889314 DOI: 10.36416/1806-3756/e20200033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 08/29/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To evaluate the frequency of asthma-COPD overlap (ACO) in patients with COPD and to compare, from a clinical, laboratory, and functional point of view, patients with and without ACO, according to different diagnostic criteria. METHODS The participants underwent evaluation by a pulmonologist, together with spirometry and blood tests. All of the patients were instructed to record their PEF twice a day. The diagnosis of ACO was based on the Proyecto Latinoamericano de Investigación en Obstrucción Pulmonar (PLATINO, Latin American Project for the Investigation of Obstructive Lung Disease) criteria, the American Thoracic Society (ATS) Roundtable criteria, and the Spanish criteria. We investigated patient histories of exacerbations and hospitalizations, after which we applied the COPD Assessment Test and the modified Medical Research Council scale, to classify risk and symptoms in accordance with the GOLD criteria. RESULTS Of the 51 COPD patients, 14 (27.5%), 8 (12.2%), and 18 (40.0) were diagnosed with ACO on the basis of the PLATINO, ATS Roundtable, and Spanish criteria, respectively. The values for pre-bronchodilator FVC, post-bronchodilator FVC, and pre-bronchodilator FEV1 were significantly lower among the patients with ACO than among those with COPD only (1.9 ± 0.4 L vs. 2.4 ± 0.7 L, 2.1 ± 0.5 L vs. 2.5 ± 0.8 L, and 1.0 ± 0.3 L vs. 1.3 ± 0.5 L, respectively). When the Spanish criteria were applied, IgE levels were significantly higher among the patients with ACO than among those with COPD only (363.7 ± 525.9 kU/L vs. 58.2 ± 81.6 kU/L). A history of asthma was more common among the patients with ACO (p < 0.001 for all criteria). CONCLUSIONS In our sample, patients with ACO were more likely to report previous episodes of asthma and had worse lung function than did those with COPD only. The ATS Roundtable criteria appear to be the most judicious, although concordance was greatest between the PLATINO and the Spanish criteria.
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Affiliation(s)
- Ana Paula Adriano Queiroz
- . Programa de Pós-Graduação em Ciências Médicas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil.,. Núcleo de Pesquisa em Asma e Inflamação das Vias Aéreas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil
| | - Fernanda Rodrigues Fonseca
- . Programa de Pós-Graduação em Ciências Médicas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil.,. Núcleo de Pesquisa em Asma e Inflamação das Vias Aéreas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil
| | - Alexânia de Rê
- . Programa de Pós-Graduação em Ciências Médicas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil.,. Núcleo de Pesquisa em Asma e Inflamação das Vias Aéreas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil
| | - Rosemeri Maurici
- . Programa de Pós-Graduação em Ciências Médicas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil.,. Núcleo de Pesquisa em Asma e Inflamação das Vias Aéreas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil.,. Departamento de Clínica Médica, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil
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Fonseca FR, Biscaro RRM, de Rê A, Junkes-Cunha M, dos Reis CM, Bahl MM, Yohannes AM, Maurici R. The Brazilian Portuguese-language version of the Manchester Respiratory Activities of Daily Living questionnaire: construct validity, reliability, and measurement error. J Bras Pneumol 2019; 46:e20180397. [PMID: 31851219 PMCID: PMC7462675 DOI: 10.1590/1806-3713/e20180397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 03/31/2019] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To test the construct validity, reliability, and measurement error of the Brazilian Portuguese-language version of the Manchester Respiratory Activities of Daily Living (MRADL) questionnaire in patients with COPD. METHODS We evaluated 50 patients with COPD, among whom 30 were men, the mean age was 64 ± 8 years, and the median FEV1 as a percentage of the predicted value (FEV1%predicted) was 38.4% (interquartile range, 29.1-57.4%). Pulmonary function and limitations in activities of daily living (ADLs) were assessed by spirometry and by face-to-face application of the MRADL, respectively. For the construct validity analysis, we tested the hypothesis that the total MRADL score would show moderate correlations with spirometric parameters. We analyzed inter-rater reliability, test-retest reliability, inter-rater measurement error, and test-retest measurement error. RESULTS The total MRADL score showed moderate correlations with the FEV1/FVC ratio, FEV1 in liters, FEV1%predicted, and FVC%predicted, all of the correlations being statistically significant (r = 0.34, r = 0.31, r = 0.42, and r = 0.38, respectively; p < 0.05 for all). For the reliability and measurement error of the total MRADL score, we obtained the following inter-rater and test-retest values, respectively: two-way mixed-effects model intraclass correlation coefficient for single measures, 0.92 (95% CI: 0.87-0.96) and 0.89 (95% CI: 0.81-0.93); agreement standard error of measurement, 1.03 and 0.97; smallest detectable change at the individual level, 2.86 and 2.69; smallest detectable change at the group level, 0.40 and 0.38; and limits of agreement, -2.24 to 1.96 and -2.65 to 2.69. CONCLUSIONS In patients with COPD in Brazil, this version of the MRADL shows satisfactory construct validity, satisfactory inter-rater/test-retest reliability, and indeterminate inter-rater/test-retest measurement error.
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Affiliation(s)
- Fernanda Rodrigues Fonseca
- . Programa de Pós-Graduação em Ciências Médicas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil
- . Núcleo de Pesquisa em Asma e Inflamação das Vias Aéreas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil
| | | | - Alexânia de Rê
- . Programa de Pós-Graduação em Ciências Médicas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil
- . Núcleo de Pesquisa em Asma e Inflamação das Vias Aéreas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil
| | - Maíra Junkes-Cunha
- . Departamento de Fisioterapia, Centro de Ciências da Saúde, Universidade do Estado de Santa Catarina, Florianópolis (SC) Brasil
| | - Cardine Martins dos Reis
- . Programa de Pós-Graduação em Ciências Médicas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil
| | - Marina Mônica Bahl
- . Programa de Pós-Graduação em Ciências Médicas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil
| | | | - Rosemeri Maurici
- . Programa de Pós-Graduação em Ciências Médicas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil
- . Núcleo de Pesquisa em Asma e Inflamação das Vias Aéreas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil
- . Departamento de Clínica Médica, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil
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8
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Teles GDC, Fonseca FR, Gonçalves MJF. American Tegumentary Leishmaniasis in the Brazilian Amazon from 2010 to 2014. Rev Inst Med Trop Sao Paulo 2019; 61:e22. [PMID: 30970050 PMCID: PMC6466847 DOI: 10.1590/s1678-9946201961022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 03/12/2019] [Indexed: 11/23/2022] Open
Abstract
American tegumentary leishmaniasis (ATL) is one of the most important but
neglected infectious diseases, and can cause severe deformities. ATL incidence
remains high in forest regions, such as in the Amazonas State, Brazil. However,
differences within the State and over time have been observed, since infection
patterns are not homogeneous, and these aspects need to be clarified. This study
aimed to identify the epidemiological profile of ATL and its spatial and
temporal distribution in the Brazilian Amazon, from 2010 to 2014. Data were
extracted from the Information System for Notifiable Diseases, which
descriptively evaluates the incidence rate, as well as the temporal and spatial
distribution of the disease. The highest prevalence of ATL was found in men and
in the age group of 20-40 years. Approximately 95% of the cases were of
cutaneous ATL and they were identified through direct examination. The spatial
analysis has shown that ATL was widely distributed, both in rural and urban
areas, and more concentrated in the Southern part of the State. Moreover,
although there was an expansion in the spatial distribution and an increasing
incidence of ATL in Amazonas, the epidemiological profile remained unchanged,
suggesting that other factors must be responsible for its widespread
distribution and increasing incidence.
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Affiliation(s)
- Giovana da Costa Teles
- Universidade Federal do Amazonas, Escola de Enfermagem de Manaus, Manaus, Amazonas, Brazil
| | | | - Maria Jacirema Ferreira Gonçalves
- Universidade Federal do Amazonas, Escola de Enfermagem de Manaus, Manaus, Amazonas, Brazil.,Fundação Oswaldo Cruz, Instituto Leônidas e Maria Deane, Manaus, Amazonas, Brazil
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Fonseca FR, Karloh M, Araujo CLPD, Reis CMD, Mayer AF. Validation of a bioelectrical impedance analysis system for body composition assessment in patients with COPD. ACTA ACUST UNITED AC 2019; 44:315-320. [PMID: 30328930 PMCID: PMC6326721 DOI: 10.1590/s1806-37562017000000121] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Accepted: 12/15/2017] [Indexed: 12/13/2022]
Abstract
Objective: To investigate the validity of an eight-contact electrode bioelectrical impedance analysis (BIA) system within a household scale for assessing whole body composition in COPD patients. Methods: Seventeen patients with COPD (mean age = 67 ± 8 years; mean FEV1 = 38.6 ± 16.1% of predicted; and mean body mass index = 24.7 ± 5.4 kg/m2) underwent dual-energy X-ray absorptiometry (DEXA) and an eight-contact electrode BIA system for body composition assessment. Results: There was a strong inter-method correlation for fat mass (r = 0.95), fat-free mass (r = 0.93), and lean mass (r = 0.93), but the correlation was moderate for bone mineral content (r = 0.73; p < 0.01 for all). In the agreement analysis, the values between DEXA and the BIA system differed by only 0.15 kg (−6.39 to 6.70 kg), 0.26 kg (−5.96 to 6.49 kg), −0.13 kg (−0.76 to 0.50 kg), and −0.55 kg (−6.71 to 5.61 kg) for fat-free mass, lean mass, bone mineral content, and fat mass, respectively. Conclusions: The eight-contact electrode BIA system showed to be a valid tool in the assessment of whole body composition in our sample of patients with COPD.
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Affiliation(s)
- Fernanda Rodrigues Fonseca
- . Programa de Pós-Graduação em Fisioterapia, Universidade do Estado de Santa Catarina - UDESC - Florianópolis (SC) Brasil.,. Núcleo de Assistência, Ensino e Pesquisa em Reabilitação Pulmonar, Universidade do Estado de Santa Catarina - UDESC - Florianópolis (SC) Brasil
| | - Manuela Karloh
- . Núcleo de Assistência, Ensino e Pesquisa em Reabilitação Pulmonar, Universidade do Estado de Santa Catarina - UDESC - Florianópolis (SC) Brasil.,. Programa de Pós-Graduação em Ciências do Movimento Humano, Universidade do Estado de Santa Catarina - UDESC - Florianópolis (SC) Brasil
| | - Cintia Laura Pereira de Araujo
- . Núcleo de Assistência, Ensino e Pesquisa em Reabilitação Pulmonar, Universidade do Estado de Santa Catarina - UDESC - Florianópolis (SC) Brasil
| | - Cardine Martins Dos Reis
- . Programa de Pós-Graduação em Fisioterapia, Universidade do Estado de Santa Catarina - UDESC - Florianópolis (SC) Brasil.,. Núcleo de Assistência, Ensino e Pesquisa em Reabilitação Pulmonar, Universidade do Estado de Santa Catarina - UDESC - Florianópolis (SC) Brasil
| | - Anamaria Fleig Mayer
- . Programa de Pós-Graduação em Fisioterapia, Universidade do Estado de Santa Catarina - UDESC - Florianópolis (SC) Brasil.,. Núcleo de Assistência, Ensino e Pesquisa em Reabilitação Pulmonar, Universidade do Estado de Santa Catarina - UDESC - Florianópolis (SC) Brasil.,. Programa de Pós-Graduação em Ciências do Movimento Humano, Universidade do Estado de Santa Catarina - UDESC - Florianópolis (SC) Brasil
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Reis LLD, Balieiro AADS, Fonseca FR, Gonçalves MJF. Leishmaniose visceral e sua relação com fatores climáticos e ambientais no Estado do Tocantins, Brasil, 2007 a 2014. CAD SAUDE PUBLICA 2019; 35:e00047018. [DOI: 10.1590/0102-311x00047018] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 10/01/2018] [Indexed: 01/28/2023] Open
Abstract
Resumo: A leishmaniose visceral (LV) pode ser influenciada por fatores climáticos e ambientais. Tocantins é o estado com mais incidência no Brasil, contribuindo para o aumento dos casos na macrorregião Norte. Este estudo tem objetivo de identificar a correlação entre a taxa de incidência de LV e fatores climáticos e ambientais, nos municípios do Estado do Tocantins de 2007 a 2014. As correlações entre a taxa de incidência bruta de LV e as variáveis elevação, precipitação, Índice de Vegetação Melhorado (EVI - Enhanced Vegetation Index) e temperatura foram testadas por meio dos índices de Moran Global e Local, identificando também clusters de incidência de LV. A análise de variância para tendência linear foi testada entre as médias das variáveis em cada categoria da taxa. Os resultados apontam aumento nas taxas de incidência, na medida em que aumentam os valores de precipitação anual, umidade, EVI e temperatura noturna; e uma relação inversa para a elevação e temperatura diurna. Os clusters identificados evidenciam que variáveis climáticas e ambientais se relacionam à incidência de LV, devendo haver outros estudos que ajustem os fatores associados aos sujeitos, a fim de dimensionar o quanto o ambiente ou a influência do homem nele impacta na doença.
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11
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Reis CMD, Karloh M, Fonseca FR, Biscaro RRM, Mazo GZ, Mayer AF. Functional capacity measurement: reference equations for the Glittre Activities of Daily Living test. ACTA ACUST UNITED AC 2018; 44:370-377. [PMID: 30020345 PMCID: PMC6467592 DOI: 10.1590/s1806-37562017000000118] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Accepted: 12/07/2017] [Indexed: 12/03/2022]
Abstract
Objective: To develop reference equations for the Glittre Activities of Daily Living test (Glittre ADL-test) on the basis of anthropometric and demographic variables in apparently healthy individuals. A secondary objective was to determine the reliability of the equations in a sample of COPD patients. Methods: This was a cross-sectional study including 190 apparently healthy individuals (95 males; median age, 54.5 years [range, 42-65]; median FEV1 = 97% [range, 91-105.2]; and median FVC = 96% [range, 88.5-102]) recruited from the general community and 74 COPD patients (55 males; mean age, 65 ± 8 years; body mass index [BMI] = 25.9 ± 4.7 kg/m2; FEV1 = 36.1 ± 14.1%; and FVC = 62.7 ± 16.1%) recruited from a pulmonary rehabilitation center. Results: The mean time to complete the Glittre ADL-test was 2.84 ± 0.45 min. In the stepwise multiple linear regression analysis, age and height were selected as Glittre ADL-test performance predictors, explaining 32.1% (p < 0.01) of the total variance. Equation 1 was as follows: Glittre ADL-testpredicted = 3.049 + (0.015 × ageyears) + (−0.006 × heightcm). Equation 2 included age and BMI and explained 32.3% of the variance in the test, the equation being as follows: Glittre ADL-testpredicted = 1.558 + (0.018 × BMI) + (0.016 × ageyears). Conclusions: The reference equations for the time to complete the Glittre ADL-test were based on age, BMI, and height as independent variables and can be useful for predicting the performance of adult individuals. The predicted values appear to be reliable when applied to COPD patients.
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Affiliation(s)
- Cardine Martins Dos Reis
- . Núcleo de Assistência, Ensino e Pesquisa em Reabilitação Pulmonar, Centro de Ciências da Saúde e do Esporte, Universidade do Estado de Santa Catarina, Florianópolis (SC) Brasil.,. Programa de Pós-Graduação em Fisioterapia, Centro de Ciências da Saúde e do Esporte, Universidade do Estado de Santa Catarina, Florianópolis (SC) Brasil
| | - Manuela Karloh
- . Núcleo de Assistência, Ensino e Pesquisa em Reabilitação Pulmonar, Centro de Ciências da Saúde e do Esporte, Universidade do Estado de Santa Catarina, Florianópolis (SC) Brasil.,. Departamento de Fisioterapia, Centro de Ciências da Saúde e do Esporte, Universidade do Estado de Santa Catarina, Florianópolis (SC) Brasil
| | - Fernanda Rodrigues Fonseca
- . Núcleo de Assistência, Ensino e Pesquisa em Reabilitação Pulmonar, Centro de Ciências da Saúde e do Esporte, Universidade do Estado de Santa Catarina, Florianópolis (SC) Brasil.,. Programa de Pós-Graduação em Fisioterapia, Centro de Ciências da Saúde e do Esporte, Universidade do Estado de Santa Catarina, Florianópolis (SC) Brasil
| | - Roberta Rodolfo Mazzali Biscaro
- . Núcleo de Assistência, Ensino e Pesquisa em Reabilitação Pulmonar, Centro de Ciências da Saúde e do Esporte, Universidade do Estado de Santa Catarina, Florianópolis (SC) Brasil.,. Programa de Pós-Graduação em Fisioterapia, Centro de Ciências da Saúde e do Esporte, Universidade do Estado de Santa Catarina, Florianópolis (SC) Brasil
| | - Giovana Zarpellon Mazo
- . Departamento de Educação Física, Centro de Ciências da Saúde e do Esporte, Universidade do Estado de Santa Catarina, Florianópolis (SC) Brasil.,. Programa de Pós-Graduação em Ciências do Movimento Humano, Centro de Ciências da Saúde e do Esporte, Universidade do Estado de Santa Catarina, Florianópolis (SC) Brasil
| | - Anamaria Fleig Mayer
- . Núcleo de Assistência, Ensino e Pesquisa em Reabilitação Pulmonar, Centro de Ciências da Saúde e do Esporte, Universidade do Estado de Santa Catarina, Florianópolis (SC) Brasil.,. Programa de Pós-Graduação em Fisioterapia, Centro de Ciências da Saúde e do Esporte, Universidade do Estado de Santa Catarina, Florianópolis (SC) Brasil.,. Departamento de Fisioterapia, Centro de Ciências da Saúde e do Esporte, Universidade do Estado de Santa Catarina, Florianópolis (SC) Brasil.,. Programa de Pós-Graduação em Ciências do Movimento Humano, Centro de Ciências da Saúde e do Esporte, Universidade do Estado de Santa Catarina, Florianópolis (SC) Brasil
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12
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Reis LLD, Balieiro AADS, Fonseca FR, Gonçalves MJF. Changes in the epidemiology of visceral leishmaniasis in Brazil from 2001 to 2014. Rev Soc Bras Med Trop 2017; 50:638-645. [PMID: 29160510 DOI: 10.1590/0037-8682-0243-2017] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 10/05/2017] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Visceral leishmaniasis (VL) is a neglected disease, with territorial expansion and regional differences in Brazil that require explanation. This study aimed to describe changes in the epidemiology of VL in Brazil from 2001 to 2014. METHODS The incidence rates, sociodemographic and clinical data, and case evolution were subgrouped from 2001 to 2006 and from 2007 to 2014 and presented descriptively. Spatial distribution of disease incidence rates and changes in the spatial and temporal pattern were examined. RESULTS In total, 47,859 VL cases were reported in Brazil between 2001 and 2014, with predominance in the Northeast macroregion (55%), though the incidence rate in this region declined between the two study periods. The State of Tocantins had the highest crude rate (26.2/100,000 inhabitants), which was responsible for VL increasing in the North macroregion. VL predominated in the urban zone (70%), in children under 4 years (34%); however, an increase in the incidence of VL in adults older than 40 years was identified, with 12.3% and 31% in the first and second period, respectively. The mapping of crude rates and autochthonous canine cases showed territorial expansion. The temporal distribution of VL was consistent in Brazil in general, with no pattern observed, but regional differences were found. CONCLUSIONS The incidence of VL is increasing in Brazil. In addition to the State of Tocantins, which had the highest rate, new outbreaks of VL have occurred in the South macroregion of Brazil with small decreases identified in the incidence rate in the Northeast.
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Affiliation(s)
| | | | | | - Maria Jacirema Ferreira Gonçalves
- Instituto Leônidas e Maria Deane, Fundação Oswaldo Cruz, Manaus, AM, Brasil.,Escola de Enfermagem de Manaus, Universidade Federal do Amazonas, Manaus, AM, Brasil
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Guimarães RJDPS, Freitas CC, Dutra LV, Scholte RGC, Martins-Bedé FT, Fonseca FR, Amaral RS, Drummond SC, Felgueiras CA, Oliveira GC, Carvalho OS. A geoprocessing approach for studying and controlling schistosomiasis in the state of Minas Gerais, Brazil. Mem Inst Oswaldo Cruz 2011; 105:524-31. [PMID: 20721503 DOI: 10.1590/s0074-02762010000400030] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2009] [Accepted: 02/10/2010] [Indexed: 11/22/2022] Open
Abstract
Geographical information systems (GIS) are tools that have been recently tested for improving our understanding of the spatial distribution of disease. The objective of this paper was to further develop the GIS technology to model and control schistosomiasis using environmental, social, biological and remote-sensing variables. A final regression model (R(2) = 0.39) was established, after a variable selection phase, with a set of spatial variables including the presence or absence of Biomphalaria glabrata, winter enhanced vegetation index, summer minimum temperature and percentage of houses with water coming from a spring or well. A regional model was also developed by splitting the state of Minas Gerais (MG) into four regions and establishing a linear regression model for each of the four regions: 1 (R(2) = 0.97), 2 (R(2) = 0.60), 3 (R(2) = 0.63) and 4 (R(2) = 0.76). Based on these models, a schistosomiasis risk map was built for MG. In this paper, geostatistics was also used to make inferences about the presence of Biomphalaria spp. The result was a map of species and risk areas. The obtained risk map permits the association of uncertainties, which can be used to qualify the inferences and it can be thought of as an auxiliary tool for public health strategies.
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