Ecological Time Research Articles

Correlation between the Implementation of Psychosocial Care Centers and the Rates of Psychiatric Hospitalizations and Suicide in Porto Alegre-RS from 2008 to 2018.

The Brazilian psychiatric reform has revolutionized the way that mental health care is provided throughout the country, introducing the Psychosocial Care Centers (CAPS) and encouraging care in freedom. The CAPS have a lot of objectives, such as the prevention of hospitalizations and crisis or suicide intervention. This paper aims to describe the correlation between the implementation of the CAPS and the rates of psychiatric hospitalizations as well as suicide from 2008 to 2018. This study has an ecological time series design and included residents in the city of Porto Alegre-RS and users hospitalized in the SUS (Sistema Único de Saúde - Unified Health System). The data were obtained from official database (DATASUS, CNES and IBGE), after calculating the indicators (the CAPS offer, hospitalization rate and suicide rate). Associations between the indicators were tested using Pearson's correlation. We found a negative correlation between the provision of the CAPS and psychiatric hospitalizations (r= -0.607 p=0.048). These results support the hypothesis that there is a negative correlation between the implementation of the CAPS and psychiatric hospitalizations. This reinforces the importance of implementing policies related to improving psychiatric reform.

Temporal trend of congenital syphilis in the most populous municipality of metropolitan region II of Rio de Janeiro state.

This study aimed to explore the temporal trend in congenital syphilis, according to sociodemographic and prenatal care in the city of São Gonçalo - Rio de Janeiro, from 2007 to 2018. Ecological time series study, with data from SINAN (Information System for Notifiable Diseases) and SINASC (Information System on Live Births databases). We calculated annual incidence (per 1,000 live births) according to sociodemographic and prenatal variables. For the same variables, we calculated trends by logarithmic regression (Joinpoint Regression), estimating the annual percentage change. A total of 2,420 cases were reported from 2007 to 2018, with an increasing trend: 64.9% per year (2010-2013) and 24.9% (2013-2018). In 2018, the highest rates were in adolescents (90.6/1,000 live births), black women (87.6/1,000 live births), low-educated women (122.8/1,000 live births), and those without prenatal care (677.4/1,000 live births). The annual percentage change of these categories was, respectively, 37.3% (2010-2018), 33.5% (2012-2018), 39.9% (2014-2018), and 85.0% (2011-2015), but all categories showed a crescent trend. We identified high congenital syphilis incidences and crescent trends, especially in more vulnerable groups, pointing to social and healthcare inequalities. Prenatal care needs to be more comprehensive and qualified, primarily for young, low-educated, and black women.

Elderly Mortality due to Ambulatory Care Sensitive Conditions and Primary Health Care Coverage in the Federal District.

To describe the mortality coefficients of elderly due to primary care sensitive conditions, from 2008 to 2018, and determine its association with the coverage of the Primary Health Care (Family Health Strategy and Basic Care models) in the Federal District. Ecological time series of mortality in Federal District elderly, from 2008 to 2018. The Poisson regression model was applied, considering as significant those with p<0.05, with a CI of 95%. There were 70,503 deaths. There was a decrease in the risk of death of elders due to cardiovascular diseases and diabetes. Higher primary care coverage decreased the chance of death by sensitive conditions, both in Basic Care (OR: 0.994, CI: 0.990-0.998) and in the Family Health Strategy (OR: 0.997, CI: 0.995-0.999). Primary Care coverage was associated with a lower chance of death of the elderly due to Ambulatory Care Sensitive Conditions, especially in Basic Care.

Warm Soil, Westerly Wind, and Wet Feet: Feeling and Measuring Ecological Time in the Roman World

Although climate change, pollution, and environmental degradation are contemporary problems, these are also challenges with deep historic roots in antiquity. 2,000years ago, during the Roman Climate Optimum, a period of unusually warm, wet, and stable temperatures in the Mediterranean from roughly 200 BCE to 150 CE, the Romans altered the natural environment so greatly that they produced a level of pollution that was unparalleled until the Industrial Revolution. It is precisely in this contradictory time of unusually productive growth and destruction that we discover a blossoming of textual and visual ecological calendars illustrating how the Romans experienced the changing Mediterranean seasons. Roman agricultural treatises instruct us on specific agricultural tasks based on celestial movement, the arrival of particular winds, and on corporeal sensations, such as the warmth of the soil. Literary texts from the period portray kinship and shared corporeality between farmers and plants, with parent farmers listening to and assisting plant-children in achieving their desires. The concept of measuring time by means of the human body and its sensations is most explicit in the agricultural mosaics of the Late Roman period, which depict enslaved workers laboring, sweating, stomping, plowing, and performing seasonal tasks. While much of the conceptualization of indigenous ecological calendars is framed within the context of modern states, juxtaposing ancient predecessors and contemporary practices offers a new perspective on this topic.

Tendência e correlação de obesidade e aleitamento materno continuado em crianças de seis a 23 meses

Abstract Objectives: to analyze the trend and correlation of obesity and the increase in continued breastfeeding in children aged six to 23 months in Brazil, from 2015-2019. Methods: ecological time series study with data from the Sistema de Vigilância Alimentar e Nutricional (Food and Nutritional Surveillance System). The dependent variable was the prevalence of obesity. Prais-Winsten linear regression was used to verify the trend. Spearman’s correlation was used to verify the relationship between the prevalence of obesity and the increase in continued breastfeeding. Results: there was a trend towards a reduction in the prevalence of obesity in all regions in Brazil (Annual Percentage Variation [APV]: -4.14; CI95%=-4.50; -3.79). The prevalence of continued breastfeeding showed an upward trend in the North (APV=4.89; CI95%=2.92; 6.90), Southeast (APV=3.36; CI95%=2.32; 4 .41) and South (APV=2.67; CI95%=0.98; 4.38). There was a negative and significant correlation between obesity and continued breastfeeding in the North, Northeast, Southeast and South regions. Conclusion: the reduction in the prevalence of obesity and the increase in continued breastfeeding occurred only in some regions, requiring the implementation of effective strategies to be present throughout the country. Actions to promote, protect and support continued breastfeeding and healthy eating should be more prioritized to promote the child’s healthy growth.

NEW CONCEPT OF CHEMOMETRICS

The parametric statistical methods of the research experimental data most often use presently in chemometrics. If experimental data do not correspond to the normal probabilistic distribution that in this case it is impossible prodice adequate data processing. At recently in chemometrics more often started to use the classical nonparametric methods. The classical nonparametric methods do not handle the raw datas probabilistic distribution. But these methods when undertakind the real calculations don’t care use that or other types of the distributions. The classical nonparametric methods under its realization usually requare referencing to corresponding statistical tables. Its own table is used for each such method. Chemometrics to presently presents itself many not bound between itself statistical methods of the investigations. The huge defect of the classical methods of chemometrics (parametric and nonparametric) in absence of the united approach to processing the raw datas. In this article is offered in fundamentally new approach to statistical investigations of the datas. If use the method of nonparametric bootstrap that possible replace many unbound between itself methods of classical chemometrics whole one ore two universal methods. And these universal methods have not what or essential defect. With standpoint of the program realization this means presence one or two universal procedures for decision nearly all practical problems of chemometrics. One of the primary tasks of nonparametric bootstrap as follows problem of the duplication of the sample is considered in article. Herewith simulated that was organized not one series of experiment but well over (for example 1000 … 10000). On example is shown use the method of nonparametric bootstrap with finding confidential interval for average and median for ecological time series. On programming language MATLAB is brought code corresponding bootstrap procedure.

Temporal trend of the dropout rate and vaccination coverage of the triple viral vaccine in Brazil, 2014-2021.

Annual vaccination coverage was below 95% in Brazil. The second dose of the vaccine showed stationary and decreasing trends in the country's Federative Units. The dropout rate varied greatly throughout the study period. The results found regarding the trends serve to inform and point to the urgency of planning actions aimed at improving coverage of the triple viral vaccine nationally in Brazil. Investments in enhanced training of epidemiological surveillance professionals and enhanced computerized systems are necessary, with a view to continuous monitoring, to support actions to promote better and timely vaccine coverage. to analyze the temporal trend of coverage and dropout rate for triple viral vaccine in Brazil, according to the country's Federative Units and Macro-Regions, between 2014 and 2021. this was an ecological time series study, using data from the National Immunization Program Information System and the Live Birth Information System; joinpoint regression models were used. in Brazil as a whole annual vaccination coverage was below 95% and ranged from 92.3% (2015) to 54.4% (2021); the second dose of the vaccine showed a decreasing temporal trend in the period (average change over the period = -5.8; 95%CI -10.5;-0.8); the temporal trends were stationary and decreasing in the country's Federative Units; the dropout rate ranged from 22.2% (2014) to 37.4% (2021). there was a downward trend in vaccination coverage and an increase in the dropout rate in Brazil as a whole and in the country's Federative Units.

Temporal and spatial distribution of polio vaccine coverage in Brazil between 1997 and 2021.

To analyze the temporal and spatial distribution of polio vaccine coverage in Brazilian states. An ecological time series study was conducted using data from the National Immunization Program Information System. The analyzed period was from 1997 to 2021. Joinpoint software was used to calculate the annual percentage change and average annual percentage change through regressions. QGIS 3.10.7 software was used to construct thematic maps. GeoDa 1.20.0.10 software was used to estimate spatial autocorrelation using the Global Moran's Index and Local Moran's Index. National vaccine coverage in 1997 was 89.27%, decreasing to 61.32% in 2021. The trend analysis indicated an average annual decrease of 1.5% in polio vaccine coverage in Brazil. Across the country, 17 states showed a statistically significant reduction in the average annual percentage change rate. The highest average reduction rates in vaccine coverage among Brazilian states were observed in Amapá (-3.7%; 95%CI -6.0; -1.4) and Pernambuco (-3.3%; 95%CI -4.0; -2.5). In the spatial analysis, in Moran Global, a positive autocorrelation was identified in the years 2012 to 2021 (p<0.02), with an index value of 0.361, which means that geographically close areas tended to have similar levels of vaccination coverage. There was significant heterogeneity in coverage among states and a strong decrease trend in vaccination rates, which could facilitate the circulation of the poliovirus and pose a threat to the susceptible population.

Sick leave due to occupational mental disorders in Brazil Northeastern states: an ecological study.

Although work provides many benefits, occupational mental disorders, such as mental distress, depression, and stress-related illnesses have significantly increased. This study aims to identify and present the spatial distribution of the major mental and behavioral disorders that lead to sick leave in Brazil Northeastern states. This descriptive study with an ecological time series design aimed to identify the distribution of occupational mental and behavioral disorders in Brazil Northeastern states. Data collection included downloading information from the Observatório de Segurança e Saúde no Trabalho (SmartLab, Occupational Health and Safety Observatory) from 2012 to 2018. Data were analyzed using Python. Grants of sick leave according to the type of illness were recorded for nonaccident-related leave (B31) and accident-related leave (B91). Bahia had the highest number of cases reported for B31, as did Rio Grande do Norte for B91. Rio Grande do Norte and Alagoas stood out with the highest rates of sick leave due to mental and behavioral disorders. Phobic-anxiety disorders had the highest number of notifications. The building construction industry had the highest number of work-related notifications. This study has contributed to identifying the main occupational disorders. Public policies need to be implemented to tackle the public health crisis which directly impacts on domestic social and economic conditions.

Indicators of the National Immunization Program for children under one year old: time trend in Maranhão, Brazil, 2010 to 2021.

We aimed to analyze the trend of indicators of the National Immunization Program (acronym in Portuguese. PNI) in children under one-year-old and classify municipalities regarding the risk of transmission of vaccine-preventable diseases (RTVPD) in Maranhão from 2010 to 2021. This ecological time series study was based on secondary data on vaccination coverage (VC). vaccination coverage homogeneity (VCH). proportion of abandonment (PA). and RTVPD. with state coverage for vaccines in the national children's calendar. Prais-Winsten regression estimated trends (α=5%) and the indicators' annual percentage change (APC). We identified fluctuating and discrepant VC between vaccines. with a decreasing trend (p < 0.01). except those against Hepatitis B (p = 0.709) and oral human rotavirus (p = 0.143). The sharpest falls were for Yellow Fever (APC = 12.24%) and BCG (APC = 12.25%) vaccines. All VCH rates were lower than expected. with a drop from 2014 and APC between 5.75% (Pneumococcal 10; p = 0.033) and 14.02% (Poliomyelitis; p < 0.01). We observed an increasing trend in PA for Pentavalent (APC = 4.91%; p < 0.01) and Poliomyelitis (APC = 3.55%; p < 0.01). We identified an increase of 52.54% in the proportion of municipalities in Maranhão from 2015 to 2021. with extremely high (p = 0.025) and high (p = 0.028) RTVPD. The PNI indicators deteriorated. reaffirming the susceptibility to the emergence of vaccine-preventable diseases.

The New Coronavirus Pandemic and the Trend of Breast Cancer Diagnosis according to Age-Group: Total and Interrupted Time Series Study

Objective: There is a lack of studies evaluating the COVID-19 pandemic effect on breast cancer detection according to age-group. This study aimed to assess the pandemic impact on the trend of mammograms, breast biopsies, and breast cancer stage at diagnosis according to age-group. Methods: This was an ecological time series study by inflection point regression model. We used data from women aged between 30 and 49, 50 and 69, and 70 years or more available in an open-access dataset of the Brazilian public healthcare system (2017–2021). We analyzed the trend of the variables in the pre-pandemic and the pandemic effect on the total time series. Results: The decreasing or stationary trend of mammograms in the pre-pandemic has changed to a decreasing trend in the total time series in all age-groups. Before the pandemic, the increasing trend of breast biopsies has changed to stationary in the total time series in all age-groups. The increasing trend of tumors at stages 0 to II in the pre-pandemic has changed to decreasing or stationary in the total time series. Finally, the increasing trend of tumors at stage III or IV remained increasing in the total time series in all age-groups. Conclusion: The pandemic has changed the stationary or increasing trend to a decreasing or stationary trend of mammograms, breast biopsies, and tumors at stages 0 to II but has not influenced the increasing trend of tumors at stages III and IV in all age-groups.

Indicadores do Programa Nacional de Imunizações em menores de um ano: tendência temporal no Maranhão, Brasil, 2010 a 2021

Abstract We aimed to analyze the trend of indicators of the National Immunization Program (acronym in Portuguese. PNI) in children under one-year-old and classify municipalities regarding the risk of transmission of vaccine-preventable diseases (RTVPD) in Maranhão from 2010 to 2021. This ecological time series study was based on secondary data on vaccination coverage (VC). vaccination coverage homogeneity (VCH). proportion of abandonment (PA). and RTVPD. with state coverage for vaccines in the national children’s calendar. Prais-Winsten regression estimated trends (α=5%) and the indicators’ annual percentage change (APC). We identified fluctuating and discrepant VC between vaccines. with a decreasing trend (p &lt; 0.01). except those against Hepatitis B (p = 0.709) and oral human rotavirus (p = 0.143). The sharpest falls were for Yellow Fever (APC = 12.24%) and BCG (APC = 12.25%) vaccines. All VCH rates were lower than expected. with a drop from 2014 and APC between 5.75% (Pneumococcal 10; p = 0.033) and 14.02% (Poliomyelitis; p &lt; 0.01). We observed an increasing trend in PA for Pentavalent (APC = 4.91%; p &lt; 0.01) and Poliomyelitis (APC = 3.55%; p &lt; 0.01). We identified an increase of 52.54% in the proportion of municipalities in Maranhão from 2015 to 2021. with extremely high (p = 0.025) and high (p = 0.028) RTVPD. The PNI indicators deteriorated. reaffirming the susceptibility to the emergence of vaccine-preventable diseases.

Tendência da incompletude das variáveis escolaridade e raça/cor da pele da mãe no Sistema de Informações sobre Nascidos Vivos do Brasil, 2012-2020

to analyze the trend of incompleteness of the maternal schooling and race/skin color variables held on the Brazilian Live Birth Information System (SINASC) between 2012 and 2020. this was an ecological time series study of the incompleteness of maternal schooling and race/skin color data for Brazil, its regions and Federative Units, by means of joinpoint regression and calculation of annual percentage change (APC) and average annual percentage change. a total of 26,112,301 births were registered in Brazil in the period; incompleteness of maternal schooling data decreased for Brazil (APC = -8.1%) and the Southeast (APC = -19.5%) and Midwest (APC = -17.6%) regions; as for race/skin color, there was a downward trend for Brazil (APC = -8.2%) and all regions, except the Northeast region, while nine Federative Units and the Federal District showed a stationary trend. there was an improvement in filling out these variables on the SINASC, but with regional disparities, mainly for race/skin color.

Gênero, Raça, Desigualdades Sociais e Território como Fatores Relacionados a Homicídios de Crianças Brasileiras: Uma Análise Ecológica de 2014 a 2018

The article aims to analyze the homicides of Brazilian children aged 0 to 14 years from 2014 to 2018. The methodology included an ecological time series study, in which child murders were analyzed according to the following variables: region, state, age, sex, race/color, place of death, causes of death, human development index (HDI) and Gini coefficient. Data analysis was performed using SPSS® and QGIS software. As a result, we point out that the proportional homicide rate among children aged 0 to 14 in Brazil is 2.07 homicides per100,000 children, with higher rates in the North region (3.02/100,000), in the state of Roraima (19.34 /100,000) and Indigenous race/ethnicity (15.68/100,000). Regarding the causes of homicide, the most prevalent was the shooting of firearms (58.84%). The results also show that the male homicide rate, in addition to its correlations with the rate by state, showed a very strong association with age with 86% for the age group from 10 to 14 years (p&lt;0.001; rs=0.928). It also showed a strong correlation with mixed race/color, 80% (p&lt;0.001; rs=0.893), and a moderate correlation of 43% with the Gini index (p&lt;0.001; rs=0.658). Conclusion: Male gender, mixed race, states in the North, Northeast and Central­West regions and higher values in the Gini index appear as factors of association with higher child homicide rates in Brazil, confirming the country's inequality issues as greater risks to life.

Trends in suicide rates in Brazil from 2011 to 2020: special focus on the COVID-19 pandemicTendencia de las tasas de suicidio en Brasil, 2011-2020, con especial atención a la pandemia de COVID-19

To describe the trends in suicide rates in Brazil from 2011 to 2020 and determine whether these rates are associated with COVID-19 pandemic-related variables. This ecological time series study analyzed mortality from suicide with a focus on 2020, the first year of the COVID-19 pandemic. The suicide mortality rate per 100,000 population was the primary outcome. The trends in suicide rates were estimated using generalized Prais-Winsten regression. An autoregressive integrated moving average (ARIMA) model was used to predict suicide rates in 2020. The association between suicide rates and death rates from COVID-19, unemployment, receiving emergency financial aid, and rates of social distancing was investigated. From 2011 to 2020, 115 469 deaths by suicide were recorded in Brazil (60.5 deaths/100 000 population). The suicide rate in 2020 was 6.68/100 000 population. An increasing trend in suicide rates was observed from 2011 to 2020 in both sexes, with annual percent change of 0.23 (95%CI: 0.141; 0.322) in women; and 1.19 (95%CI: 0.714; 1.810) in men. Mortality by suicide increased in all regions, with the highest increase recorded in the South. There was no evidence of increase in deaths by suicide in relation to the expected number during the first year of the COVID-19 pandemic. Suicide rates increased for both sexes and in all Brazilian states. In the first pandemic year, the number of deaths by suicide did not increase in relation to the expected number, with a stability trend during the months of 2020.

The associations of tobacco use, sexually transmitted infections, HPV vaccination, and screening with the global incidence of cervical cancer: an ecological time series modeling study.

We aimed to quantify the temporal associations between cervical cancer incidence and cervical cancer-related factors and to predict the number of new cervical cancer cases averted under counterfactual scenarios compared to the status quo scenario. We described temporal trends in cervical cancer and associated factors globally from 1990 to 2019. We then used generalized linear mixed models to explore the impact of tobacco use, sexually transmitted infections (STIs), human papillomavirus (HPV) vaccination, and cervical screening on cervical cancer incidence. A counterfactual analysis was performed to simulate the most effective scenario for reducing cervical cancer incidence. The worldwide incidence of cervical cancer showed a downward trend over the past 3 decades (estimated annual percentage change, -0.72%), although the incidence remained high (>30 cases per 100,000 persons) in sub-Saharan Africa, Latin America, and the Caribbean. Higher smoking and STI prevalence showed significant direct associations with the incidence of cervical cancer, whereas HPV vaccination and screening coverage showed significant inverse associations. If the strategic goals for accelerating the elimination of cervical cancer and tobacco control programs had been achieved in 2019, the largest decrease in the number of new cervical cancer cases would have been observed, with 54,169 fewer new cases of cervical cancer in 2019. Our counterfactual analysis found that a comprehensive intervention program emphasizing scaled-up cervical screening coverage (70%), HPV vaccination coverage (90%), and tobacco control (30% relative reduction) would be the most effective program for reducing cervical cancer incidence.

High association strengths are linked to phenotypic similarity, including plumage color and patterns, of participants in mixed-species bird flocks of southwestern China.

Participants in mixed-species bird flocks (MSFs) have been shown to associate with species that are similar in body size, diet, and evolutionary history, suggesting that facilitation structures these assemblages. In addition, several studies have suggested that species in MSFs resemble each other in their plumage, but this question has not been systematically investigated for any MSF system. During the nonbreeding season of 2020 and 2021, we sampled 585 MSFs on 14 transects in 2 habitats of Tongbiguang Nature Reserve in western Yunnan Province, China. We performed social network analysis and the Multiple Regression Quadratic Assignment Procedure to evaluate the effect of 4 species traits (body size, overall plumage color, distinctive plumage patterns, and diet) and evolutionary history on species association strength at the whole-MSF and within-MSF levels. All 41 significant relationships showed that species with stronger associations were more similar in their various traits. Body size had the strongest effect on association strength, followed by phylogeny, plumage patterns, and plumage color; diet had the weakest effect. Our results are consistent with the hypotheses that the benefits of associating with phenotypically similar species outweigh the potential costs of interspecific competition, and that trait matching can occur in plumage characteristics, albeit more weakly than in other traits. Several explanations exist as to why similarities in plumage may occur in MSFs, including that they could reduce predators' ability to target phenotypically "odd" individuals. Whether trait matching in plumage occurs through assortative processes in ecological time or is influenced by co-evolution requires further study.

The trend and direct costs of screening and chemotherapy treatment of breast cancer in the new coronavirus pandemic: total and interrupted time series study

BackgroundThe COVID-19 pandemic has overloaded the healthcare systems of many countries and reduced the population’s access to treatment and prevention of other diseases. This study aims to assess whether the COVID-19 pandemic has negatively interfered with the trend and the direct costs of screening and chemotherapy treatment of breast cancer in a public and universal healthcare system.MethodThis was an ecological time series study using an open database of a public and universal health system from 2017 to 2021.ResultsIn 2020, there was a 41% reduction in the coverage rate of breast cancer screening in women aged 50 to 69 years (about 1 million mammograms missed). The total direct cost of breast cancer screening reduced proportionally to the number of tests (BRL 67 million). On the other hand, the cost of chemotherapy treatment was higher in 2020, both in advanced (BRL 465 million) and localized (BRL 113 million) diseases. In the time series, mammograms’ trend and direct costs changed from stationary to decreasing after the COVID-19 pandemic. The trend of direct costs with chemotherapy treatment for the advanced disease has been increasing and has not changed after the COVID-19 pandemic. On the other hand, in the case of localized disease, there was a trend toward reducing direct costs after the pandemic.ConclusionAfter COVID-19, there was a downward trend in breast cancer screening and its direct costs, an upward trend in chemotherapy costs for advanced disease, and a downward trend in chemotherapy costs for localized disease.

Population regulation and adaptive dynamics of cross-feeding.

The particular importance of evolutionary studies in microbial experimental systems is that starting from the level of the metabolism of individual cells, the adaptive dynamics can be followed step by step by biochemical, genetic, and population dynamical tools. Moreover, the coincidence of evolutionary and ecological time scales helps to clarify the mutual role of ecological and evolutionary principles in predicting adaptive dynamics in general. Ecological principles define the ecological conditions under which adaptive branching can occur. This paper overviews and interprets the results of empirical and modeling studies of the evolution of metabolic cross-feeding in glucose-limited E.coli chemostats and batch cultures in the context of theories of robust coexistence and adaptive dynamics. Empirical results consistently demonstrate that the interactions between cells are mediated by the changing metabolite concentrations in the cultures and modeling confirms that these changes may control the adaptive dynamics of the clones. In consequence, the potential results of evolution can be predicted at the functional level by evolutionary flux balance analysis (evoFBA), while the genetic changes are more contingent. evoFBA follows the scheme of adaptive dynamics theory by calculating the feedback environment that changes during the evolutionary process and provides a promising tool to further investigate adaptive divergence in small microbial communities. Three general conclusions close the paper.

Analysis of health care in prisons of Pará state, Brazil.

This study aimed to describe Pará's Prison Health. This ecological time series study was based on secondary data with unrestricted access from Institutional Reports of the Penitentiary System and information from the Pará Transparency Web Portal, the National Register of Health Facilities (CNES), and the Notifiable Diseases Information System (SINAN). As a result, we observed a population with a majority of less-educated young black and brown males. In absolute numbers, we observed an increase of health professionals who did not follow the prison population hike. When entered into statistical control charts, the number of medical, dental, and psychological visits varied randomly and outside the limits. The potential coverage of prison health teams linked to the SUS achieved a maximum of 45.77%. Health task forces did not increase the number of visits. The incidence of tuberculosis was much higher than the mean for the state population, and its notification is adequate. Even with restricted secondary data, we could broadly look at the state's prison health, raising issues managers and professionals should consider.