Determinantes das exportações de frutas da região Nordeste brasileira (2000 – 2018): uma análise sob a ótica do modelo gravitacional

Despite visceral leishmaniasis (VL) being epidemic in most Brazilian regions, the Northeast region is responsible for the highest morbidity and mortality outcomes within the country. To analyse the spatiotemporal dynamics of VL cases to identify the temporal trends and high-risk areas for VL transmission, as well as the association of the disease with social vulnerability in Brazilian Northeast. We carried out an ecological time series study employing spatial analysis techniques using all VL confirmed cases of 1,794 municipalities of Brazilian Northeast between the years 2000 to 2017. The Social Vulnerability Index (SVI) was used to represent the social vulnerability. Incidence rates were standardized and smoothed by the Local Empirical Bayesian Method. Time trends were examined through segmented linear regression. Spatiotemporal analysis consisted of uni- and bivariate Global and Local Moran indexes and space-time scan statistics. Incidence rate remained stable and ranged from 4.84 to 3.52 cases/100,000 inhabitants. There was higher case prevalence between males (62.71%), children and adolescents (63.27%), non-white (69.75%) and urban residents (62.58%). Increasing trends of new cases were observed among adult male subjects (≥ 40 years old) and urban residents. Importantly, VL incidence showed a direct spatial dependence. Spatial and space-time clusters were identified in sertão and meio-norte sub-regions, overlapping with high social vulnerability areas. VL is a persistent health issue in Brazilian Northeast and associated with social vulnerability. Space-time clustering of VL cases in socially vulnerable municipalities demands intersectoral public policies of surveillance and control, with focus on reducing inequalities and improving living conditions for regional inhabitants.

The Northeast region of Brazil (NRB) is the most populous semiarid area in the world and is extremely susceptible to droughts. The severity and duration of these droughts depend on several factors, and they do not necessarily follow the same behavior. The aim of this work is to evaluate the frequency of droughts in the NRB and calculate the return period of each drought event using the copula technique, which integrates the duration and severity of the drought in the NRB in a joint bivariate distribution. Monthly precipitation data from 96 meteorological stations spatially distributed in the NRB, ranging from 1961 to 2017, are used. The copula technique is applied to the Standardized Precipitation Index (SPI) on the three-month time scale, testing three families of Archimedean copula functions (Gumbel–Hougaard, Clayton and Frank) to reveal which model is best suited for the data. Averagely, the most frequent droughts observed in the NRB are concentrated in the northern sector of the region, with an observed duration varying from three and a half to five and a half months. However, the eastern NRB experiences the most severe droughts, lasting for 14 to 24 months. The probability distributions that perform better in modeling the series of severity and duration of droughts are exponential, normal and lognormal. The observed severity and duration values show that, for average values, the return period across the region is approximately 24 months. Still in this regard, the southernmost tip of the NRB stands out for having a return period of over 35 months. Regarding maximum observed values of severity and duration, the NRB eastern strip has the longest return period (>60 months), mainly in the southeastern portion where a return period above 90 months was observed. The northern NRB shows the shortest return period (~45 months), indicating that it is the NRB sector with the highest frequency of intense droughts. These results provide useful information for drought risk management in the NRB.

BackgroundPycnodysostosis is an autosomal recessive skeletal dysplasia, the prevalence of which is estimated to be low (1 per million). Nevertheless, in recent years we have found 27 affected individuals from 22 families in Ceará State, a region of the Brazilian Northeast, giving a local prevalence of 3 per million. This local prevalence associated with a high parental consanguinity, suggesting a possible founder effect, prompted us to perform a molecular investigation of these families to test this hypothesis.MethodsThe CTSK gene was sequenced by the Sanger method in the patients and their parents. In addition to 18 families from Ceará, this study also included 15 families from other Brazilian regions. We also investigated the origin of each family from the birthplace of the parents and/or grandparents.ResultsWe have studied 39 patients, including 33 probands and 6 sibs, from 33 families with pycnodysostosis and identified six mutations, five previously described (c.436G>C, c.580G>A, c.721C>T, c.830C>T and c.953G>A) and one novel frameshift (c.83dupT). This frameshift variant seems to have a single origin in Ceará State, since the haplotype study using the polymorphic markers D1S2344, D1S442, D1S498 and D1S2715 suggested a common origin. Most of the mutations were found in homozygosity in the patients from Ceará (83.3 %) while in other states the mutations were found in homozygosity in half of patients. We have also shown that most of the families currently living outside of Ceará have northeastern ancestors, suggesting a dispersion of these mutations from the Brazilian Northeast.ConclusionsThe high frequency of pycnodysostosis in Ceará State is the consequence of the high inbreeding in that region. Several mutations, probably introduced a long time ago in Ceará, must have spread due to consanguineous marriages and internal population migration. However, the novel mutation seems to have a single origin in Ceará, suggestive of a founder effect.Electronic supplementary materialThe online version of this article (doi:10.1186/s40001-016-0228-7) contains supplementary material, which is available to authorized users.

Climate change and its potentially harmful effects on agricultural production, income, and subsistence might change the incentive and capability of the population to remain in rural areas or to migrate to urban locations. Using census micro-data in combination with high-resolution climate information, we explore the impacts of climate change on rural–urban migration in the Brazilian Northeast region. Results from a gravity model estimation reveal that the climate–migration relationship depends on the agricultural income levels of rural origin areas and the educational attainment of the rural population. Specifically, our results indicate that the intensification of climate adversities may have contributed to boosting migration from rural areas with lower socioeconomic vulnerability. In contrast, in the most deprived rural areas, harmful climate effects may have resulted in the reduction of this type of migration flow. Nevertheless, our findings suggest that education might attenuate the suppressing effects of adverse climate conditions on migration in highly vulnerable rural areas, suggesting a viable pathway to overcome mobility constraints. Our findings emphasize the complexity of climate–migration linkages and conclude that the debate on climate change and migration should no longer consider that climate change invariably results in migration, but also should investigate who is able to implement and take advantage of migration as an adaptation strategy. Policies to address issues related to climate-induced migration must focus on both facilitating migration and assisting vulnerable segments of the population who remain in place, as the less-educated rural population whose livelihoods depend on the agricultural activity.

BackgroundDespite visceral leishmaniasis (VL) being epidemic in most Brazilian regions, the Northeast region is responsible for the highest morbidity and mortality outcomes within the country.ObjectiveTo analyse the spatiotemporal dynamics of VL cases to identify the temporal trends and high-risk areas for VL transmission, as well as the association of the disease with social vulnerability in Brazilian Northeast.MethodsWe carried out an ecological time series study employing spatial analysis techniques using all VL confirmed cases of 1,794 municipalities of Brazilian Northeast between the years 2000 to 2017. The Social Vulnerability Index (SVI) was used to represent the social vulnerability. Incidence rates were standardized and smoothed by the Local Empirical Bayesian Method. Time trends were examined through segmented linear regression. Spatiotemporal analysis consisted of uni- and bivariate Global and Local Moran indexes and space-time scan statistics.ResultsIncidence rate remained stable and ranged from 4.84 to 3.52 cases/100,000 inhabitants. There was higher case prevalence between males (62.71%), children and adolescents (63.27%), non-white (69.75%) and urban residents (62.58%). Increasing trends of new cases were observed among adult male subjects (≥ 40 years old) and urban residents. Importantly, VL incidence showed a direct spatial dependence. Spatial and space-time clusters were identified in sertão and meio-norte sub-regions, overlapping with high social vulnerability areas.ConclusionsVL is a persistent health issue in Brazilian Northeast and associated with social vulnerability. Space-time clustering of VL cases in socially vulnerable municipalities demands intersectoral public policies of surveillance and control, with focus on reducing inequalities and improving living conditions for regional inhabitants.

Abstract. The regional analysis of extreme hydrological events is connected with the availability of a dense network of rainfall data that is absent or inaccessible in Brazil, especially for sub-daily information. In engineering, extreme events rainfall information is represented by intensity–duration–frequency (IDF) relationships which are the most commonly used tools in water resources engineering for planning and design. Even if the sub-daily information that is included in the relationships is not available, the extreme rainfall information rest in the fundamentals of the IDF. This paper analyzes spatial distribution and track changes in sub-daily precipitation over Northeastern (NE) Brazil. Precipitation was estimated from IDF relationships information in Brazil based in rainfall measured from 1920's to 1950's (but still used in engineering projects) and information from the last half of the 20th century obtained from several IDFs gathered from municipalities' manuals, local symposia and books in many cases not easily obtainable. Results showed an intensification of extreme events in recent years, especially in shorter duration rainfall (less than 12 h). Hourly rainfall is bigger in almost all the Brazilian region, but especially in littoral and Northern portion, however, 12 and 24 h rainfall exhibit increases in the North, but, lower values in the Southern half of the region in concordance with flood changes reported by Milly et al. (2005). Analyzing the ratio between 1 and 24 h rainfall is possible to confirm its increase in all the region, with up to 35% in some areas. These results were able to show insight of sub-daily extreme events changes during 20th century in NE Brazil were previous reports were not found. The results also alerts for the necessity of engineering projects review, as outdated information is still being used for design purposes.

Market-led economic reforms are usually viewed as being in conflict with government-stimulated socioeconomic development for disadvantaged groups. Nevertheless, Ceará, a poor state in the Northeast of Brazil, has since 1987 pursued both of those strategies simultaneously. One part of that approach has been a program of nurse-directed auxiliary health workers serving about 5 million people--almost all the persons outside the capital city and half of those in the capital. The system requires that the auxiliaries, called agentes de saúde, live in the local communities that they serve. The health agents visit each home once a month to carry out a small number of priority health activities. While health agent positions are in high demand, the minimum-wage salary that the agents receive makes up only a small portion of the state budget. A key aspect of the system is timely and comprehensive information, which is based on agent visits and is managed by trained nurses. Since the health agents system was launched, there has been a rapid decline in infant mortality, a rapid rise in immunization, identification of bottlenecks limiting the utilization of other medical resources, and timely interventions in times of crisis. The health agents system has combined administrative decentralization with financial centralization during a period of electoral democratization. The system has strengthened Ceará's commitment to primary care even as market-oriented changes have reduced the overall role of government. The Ceará program is being copied throughout the Northeast and other regions of Brazil. The key role that nurses play in the Ceará program in organizing and leading a system of basic primary care in poor neighborhoods and rural areas may provide useful lessons for other countries. In addition, Ceará does not have many of the favorable characteristics of other countries that have successfully invested in primary health care. Ceará thus represents a more achievable model for other countries, where, like Brazil, income, educational levels, and land tenure equity are limited.

Urban rainfall in the Capitals of Brazil: Variability, trend, and wavelet analysis

Mixture distribution and multifractal analysis applied to wind speed in the Brazilian Northeast region

Cancer is the second leading cause of death in children from 2001 to 2005 in Brazil. This study aimed to describe the pattern of mortality from central nervous system (CNS) tumors in children in Brazil from 1979 to 2019. A descriptive study was carried out using data from the Mortality Information System (SIM) of the Ministry of Health, according to the International Classification of Diseases (ICD-9 and ICD-10), between 1979 and 2019. The frequencies of the distribution of available variables were calculated: age (0 - 19years), s skin color, tumor behavior, year and place of death (by region), ICD-10, and all of these, excluding skin color (by ICD-9). Mortality rates in general, mortality from neoplasms, and specific rates of CNS tumors were calculated considering the variables described above. In 40years (1979 - 2019), there were 21,940 deaths due to brain tumors in children. A different pattern of the mortality rate of brain tumors was shown in children per age (increasing until age 5 - 9years (28.9%) and then decreasing until age 15 - 19years (20.2%)). The Southeast (44.3%), Northeast (23.4%), and South (17.5%) regions of Brazil had the highest rates; 94.7% of tumors were malignant, and 91.1% of deaths were observed in hospitals. To our knowledge, this is the first description of the mortality rate epidemiology of brain/CNS tumors in children in Brazil over 40years. Furthermore, tumor malignancy, hospitals, and the Southeast and Northeast region of Brazil are factors associated with a higher mortality rate.

The advanced degradation and desertification processes, resulting from the anthropization of the semi-arid region of Brazil has led to an increasing need for research on the status of the occurrence of plant species. Schinopsis brasiliensis Engler, popularly known as "barauna", is recognized both for its exuberance and the use of its wood for different purposes. This species occurs in the Northeast and Midwest regions of Brazil and can be found in the Cerrado and Caatinga phytogeographic domains. This study aimed to analyze the local and regional distribution and abundance of S. brasiliensis in six municipalities in different regions of Paraíba State, as well as to perform the current and predictive modeling of the ecological niche of this species in the northeast region of Brazil, considering bioclimatic variables. On a state scale, this research was conducted in six rural communities, previously selected from studies already carried out by the Ethnobiology and Environmental Sciences Laboratory of the Federal University of Paraíba. On a regional scale, current and predictive modeling of the species' ecological niche was used, considering bioclimatic variables, based on data obtained from the WorldClim database (www.worldclim.org). The data showed a heterogeneous distribution in the populations of S. brasiliensis. The high number of adult specimens may indicate low resource extraction. Climate change, in different scenarios, does not significantly affect the distribution of the study species in the Northeastern Region of Brazil.

The northeast (NE) region of Brazil commonly goes through drought periods, which favor cyanobacterial blooms, capable of producing neurotoxins with implications for human and animal health. The most severe dry spell in the history of Brazil occurred between 2012 and 2016. Coincidently, the highest incidence of microcephaly associated with the Zika virus (ZIKV) outbreak took place in the NE region of Brazil during the same years. In this work, we tested the hypothesis that saxitoxin (STX), a neurotoxin produced in South America by the freshwater cyanobacteria Raphidiopsis raciborskii, could have contributed to the most severe Congenital Zika Syndrome (CZS) profile described worldwide. Quality surveillance showed higher cyanobacteria amounts and STX occurrence in human drinking water supplies of NE compared to other regions of Brazil. Experimentally, we described that STX doubled the quantity of ZIKV-induced neural cell death in progenitor areas of human brain organoids, while the chronic ingestion of water contaminated with STX before and during gestation caused brain abnormalities in offspring of ZIKV-infected immunocompetent C57BL/6J mice. Our data indicate that saxitoxin-producing cyanobacteria is overspread in water reservoirs of the NE and might have acted as a co-insult to ZIKV infection in Brazil. These results raise a public health concern regarding the consequences of arbovirus outbreaks happening in areas with droughts and/or frequent freshwater cyanobacterial blooms.

Desertification is defined as land degradation in arid, semiarid, and dry sub-humid regions, and it is caused primarily by human activities and climate change. The semiarid region of Northeast (NE) Brazil is a very large, populous region, and thus, it is hard to monitor the dynamics of its desertified areas; therefore, the present study aimed to develop a minimum set of biophysical indicators to qualify and monitor desertification in this region. This approach included sampling a pair of preserved forested areas and nearby degraded, non-forested areas which had no vegetation growth in the previous years. The study was developed in four stages: (a) pilot site selection; (b) quantification and analysis of soil and vegetation biophysical indicators; (c) biophysical indicator selection; and (d) elaboration of the minimum set of biophysical indicators and desertification levels. Of the analyzed 24 biophysical indicators, 11 were retained and subjected to factor analysis by its principal components. This yielded the minimum set of indicators used to estimate the desertification levels of the pilot sites, which consisted of four soil characteristics: Total Organic Carbon (TOC), cation exchange capacity, clay content, and magnesium content. Regressions were conducted using the SQI, and these indicators showed that the TOC had the highest coefficient of determination. In an exploratory analysis, high SQI (low desertification) showed a positive correlation with the normalized difference vegetation index (R = 0.70) and Aridity Index (R = 0.97). This methodological approach could form the basis of a dynamic monitoring system that is capable of supplying objective, quantitative, and easy to obtain information to decision-makers in NE Brazil and other dry ecosystems around the globe.

To characterise the epidemiological patterns and the spatial-temporal distribution of schistosomiasis-related mortality in Brazil from 2003 to 2018. A national population-based ecological study that used official data from the Mortality Information System. The data included all deaths recorded in Brazil from 2003 to 2018 in which schistosomiasis was mentioned in the death certificate as an underlying or associated cause of death (multiple causes). The municipalities of residence were used as units of geographic analysis, and standardised and smoothed mortality rates (per 100000 inhabitants) were calculated using the local empirical Bayes method. Spatial autocorrelation was evaluated using global and local Moran indexes. To analyse the spatial dependence, the Getis-Ord G and Gi* statistics were used. During the study period, 18421113 deaths were recorded in Brazil. Schistosomiasis was mentioned in 11487 deaths (proportional mortality: 0.06%); for 8141 deaths (70.87%), it was listed as the underlying cause, and for 3346 deaths (29.13%), it was listed as an associated cause. The mean mortality rate was 0.38 deaths/100000 inhabitants. Individuals≥70years of age (RR: 115.34, 95% CI: 68.56-194.03) and residents in the Northeast region (RR: 10.81, 95% CI: 5.95-19.66) presented higher risks related to schistosomiasis. Municipalities with high mortality rates were identified in all regions, and high-risk clusters were found in municipalities located in the Northeast and Southeast regions of the country. Schistosomiasis remains an important cause of death in persistently endemic areas in Brazil, particularly in those with a high prevalence of the disease and a marked parasite load.

Background: Spina bifida is a congenital anomaly caused by failures in the neural tube closure mechanism during the fourth week of gestation. This condition can affect the spinal cord and meninges, leading to a range of neurological and orthopedic complications. The Northeast is the Brazilian region with the highest prevalence of hospitalizations due to this congenital malformation in the past ten years. Objective: To delineate the epidemiological profile of hospitalizations of patients with spina bifida in Northeast Brazil over the last ten years. Methods: This is a retrospective study using data obtained through the Department of Informatics of the Unified Health System (DATASUS), regarding hospitalizations for spina bifida in Northeast Brazil, between January 2014 and December 2023. Results: From the analysis of this period, a total of 4285 hospitalizations and 108 deaths were recorded in the Northeast region, representing 40.4% of hospitalizations and 44.8% of deaths due to spina bifida in Brazil. Among the states in the region, Bahia accounted for 29.1% of hospitalizations, followed by Maranhão with 20.8%. The highest number of hospitalizations occurred in 2015, with 15% of the total, showing a gradual decrease in the following years. Regarding age groups, individuals under 1 year old represented the age group with the highest number of hospitalizations (62.5%) and deaths (74.0%). Concerning sex, males predominated with 50.8% of hospitalizations and 55.5% of deaths. In terms of mortality rate, Alagoas had the highest rate (6.03), followed by Maranhão (4.36). The white race/color group was the most affected, with a mortality rate of 4.17. Conclusion: The data on hospitalizations and deaths reveal regional inequalities and vulnerabilities in the country. It is necessary to implement public policies with investments focused on improving health infrastructure and technologies for early detection and treatment of spina bifida, as well as on training health professionals for the proper management of patients from birth, in order to reduce the impact of hospitalizations and mortality in individuals under 1 year old.