Spatial distribution of malaria and primary healthcare in Cametá and Tucuruí, Pará state, Brazil

INTRODUCTION

Malaria cases in Brazil are concentrated in the Amazon region. In the state of Pará, malaria is considered an endemic disease, and the population has different levels of exposure, which contributes to different types of occurrence in the municipalities.

METHODOLOGY

A descriptive, cross-sectional, and ecological study was conducted using data from the Malaria Epidemiological Surveillance System of the municipalities of Cametá and Tucuruí, PA, Brazil, from 2014 to 2018; the Brazilian Institute of Geography and Statistics; and the National Registry of Health Institutions of the Ministry of Health. Statistical and spatial analyses of epidemiological, laboratory and public health service coverage variables were performed using the Bioestat 5.0 and ArcGis 10.5 software.

RESULTS

11,381 Malaria cases were reported in the two municipalities. The highest percentage of case notifications was reported in brown-skinned men aged from 19 and 59 years, and who had primary education levels. The predominant occupations were farming and livestock in Cametá and domestic activity in Tucuruí. The most common diagnostic examination used was a thick blood smear, and Plasmodium vivax was the species most often encountered. The percentage of primary care coverage increased during the study period. The spatial distribution of the disease was not homogeneous, and there were clusters of cases with different densities in Cametá and Tucuruí.

CONCLUSIONS

Malaria is a public health problem in the municipalities of Cametá and Tucuruí, because of its transmission dynamics and variable spatial distribution as well as the coexistence of factors that favor the exposure of resident populations to epidemiological situations, thus reflecting health inequities.

Spatial distribution of human visceral leishmaniasis cases in Cametá, Pará, Eastern Amazon, Brazil

INTRODUCTION:

Human visceral leishmaniasis is considered a major public health problem in the municipality of Cametá, Pará, Brazil.

METHODS:

This ecological study was conducted using data obtained from official Brazilian agencies. Spatial analysis of the variables was performed using the kernel interpolation technique and the bivariate Global Moran’s Index.

RESULTS:

The spatial distribution of the disease was not homogeneous, and it was associated with socio-environmental risk factors and public policies.

CONCLUSIONS:

Different relationships were observed between the variables studied and disease occurrence.

A importância da liga acadêmica na promoção do envelhecimento saudável

Objetivo: Relatar a experiência de discentes de uma liga acadêmica de Fisioterapia em gerontologia em uma ação para promoção do envelhecimento saudável. Síntese dos dados: Trata-se da descrição da experiência de discentes de Fisioterapia em uma ação organizada pela Liga Acadêmica de Fisioterapia em Gerontologia (LAFIGE), vinculada à Universidade do Estado do Pará, na IV ação de extensão da liga, intitulada “Promoção do envelhecimento saudável”, vivenciada em uma praça pública de Belém, Pará, Brasil. Nessa ação, participaram da organização: 13 membros da LAFIGE, sendo 12 acadêmicos e um orientador, e 50 participantes com idade igual ou superior a 20 anos. Antes da ação, o coordenador repassou as orientações aos discentes acerca de orientações (sob supervisão profissional) de condicionantes do envelhecimento saudável, avaliações físico-funcionais, exercícios físicos e incentivo à alimentação saudável. Tal experiência da ação possibilitou a troca de informações entre a comunidade e a academia, além de favorecer a educação em saúde da população acerca do processo de envelhecimento e da importância de preservar a capacidade funcional. Ademais, incentivou-se a construção de aprendizados científicos e interpessoais de forma bidirecional, entre os acadêmicos e participantes, enfatizando a importância da inserção da fisioterapia em gerontologia na promoção da saúde no envelhecimento. Conclusão: Observou-se a essencialidade da prática de educação em saúde em busca de uma velhice saudável, com a conscientização da população sobre o processo de envelhecimento, além de uma adequada capacitação dos ligantes envolvidos, incentivando ações que visem à promoção da saúde dos idosos.

Leprosy in elderly people and the profile of a retrospective cohort in an endemic region of the Brazilian Amazon

Background

Leprosy has a global presence; more than 180 thousand new cases were registered in 2013, 15% of which were found in the Americas. The elderly are a very susceptible demographic in terms of developing illnesses, mainly because of characteristics natural to the senescence of the human organism. This study’s goals were to analyze leprosy in an elderly population from a hyperendemic region of the Brazilian Amazon in a historical series from 2004 to 2013 and to determine the clinical and epidemiological profile of a series of leprosy cases of elderly people in the period spanning from 2009 to 2013.

Methods

To achieve these goals, an observational, longitudinal, retrospective and descriptive study was put together to analyze leprosy in elderly people from data acquired from the Notification Aggravations Information System. Furthermore, a profile of the disease from a retrospective cohort based on data collected from medical records was developed.

Results

The number of new cases and the leprosy detection rate decreased across the observed period but remained stable among the elderly. The trend for the next ten years indicates decreases in the number of cases and in the detection rate in the general population and an increase in only the elderly. The overall profile was characterized by a predominance of males (64.32%), the multibacillary clinical form (87.57%), Type 1 reaction episodes (37.50%) and some physical incapacity at diagnosis (49.19%). The risk of reaction was greater in the first six months of multidrug therapy, and the positive result from the skin smear was associated with the greater chance of reactional condition development.

Conclusions

The resulting data demonstrate that leprosy amongst the elderly deserves attention because of the increased susceptibility to disability in this age group, with their higher risk of reaction and their greater level of co-morbidity.

Leprosy, despite being an ancient disease, still represents a challenge to public health systems today. There are still just a few studies about it, particularly among the elderly. It is known that they constitute a very heterogeneous group in terms of immune response to infections, alterations to the peripheral nervous system and predisposition to situations of vulnerability and functional dependency. The Amazon region is a hyperendemic region for leprosy and has been trying to address, along with the rest of Brazil, a rapid increase in the population’s life expectancy. This article surveys medical records from elderly people diagnosed with leprosy in a five-year period at the metropolitan region of Belém, state of Pará (Brazil), identifying a predominance of the multibacillary forms of the disease, a high prevalence of leprosy reactions mainly during treatment with multidrug therapy, and the presence of some physical incapacity in most of the people evaluated. It is expected that this study will contribute to knowledge about the clinical and epidemiological characteristics of leprosy among the elderly and stimulate the making of new studies on the theme.