Manaus Metropolitan Region Research Articles

Use of health services among adults living in Manaus Metropolitan Region, Brazil: population-based survey, 2015.

to describe the use of health services in adults living in Manaus Metropolitan Region, Amazonas, Brazil. a population-based cross-sectional study was carried out with adults (≥18 years) living in Manaus Metropolitan Region in 2015; probabilistic sampling with three-stage clusters was used; data were collected at the participants' households. 4,001 adults participated, 52.8% were women, 49.7% aged 18-34 years; 80% rated their health status as good/regular; in the fortnight previous to the survey, 20.9% (95%CI 19.7;22.2%) had used a health service, 44.4% of those visited a primary health care unit; 2.9% (95%CI 2.4;3.4%) never used a health service; among those who already visited a doctor (n=3,886), most gave positive feedback about the last visit. health situation and last medical visit were positively assessed; one fifth of the population had used a health service in the two weeks prior to the interview, primary health care units were the main services used.

Prevalence of health services usage and associated factors in the Amazon region of Brazil: a population-based cross-sectional study

ObjectivesTo estimate the prevalence of healthcare use and associated factors in the Manaus metropolitan region and to describe the reasons for lack of access.DesignCross-sectional population-based study.SettingA survey conducted between May...

Elemental Mixing State of Aerosol Particles Collected in Central Amazonia during GoAmazon2014/15

Two complementary techniques, Scanning Transmission X-ray Microscopy/Near Edge Fine Structure spectroscopy (STXM/NEXAFS) and Scanning Electron Microscopy/Energy Dispersive X-ray spectroscopy (SEM/EDX), have been quantitatively combined to characterize individual atmospheric particles. This pair of techniques was applied to particle samples at three sampling sites (ATTO, ZF2, and T3) in the Amazon basin as part of the Observations and Modeling of the Green Ocean Amazon (GoAmazon2014/5) field campaign during the dry season of 2014. The combined data was subjected to k-means clustering using mass fractions of the following elements: C, N, O, Na, Mg, P, S, Cl, K, Ca, Mn, Fe, Ni, and Zn. Cluster analysis identified 12 particle types across different sampling sites and particle sizes. Samples from the remote Amazon Tall Tower Observatory (ATTO, also T0a) exhibited less cluster variety and fewer anthropogenic clusters than samples collected at the sites nearer to the Manaus metropolitan region, ZF2 (also T0t) or T3. Samples from the ZF2 site contained aged/anthropogenic clusters not readily explained by transport from ATTO or Manaus, possibly suggesting the effects of long range atmospheric transport or other local aerosol sources present during sampling. In addition, this data set allowed for recently established diversity parameters to be calculated. All sample periods had high mixing state indices (χ) that were >0.8. Two individual particle diversity (Di) populations were observed, with particles <0.5 µm having a Di of ~2.4 and >0.5 µm particles having a Di of ~3.6, which likely correspond to fresh and aged aerosols, respectively. The diversity parameters determined by the quantitative method presented here will serve to aid in the accurate representation of aerosol mixing state, source apportionment, and aging in both less polluted and more developed environments in the Amazon Basin.

Health-related quality of life in the Brazilian Amazon: a population-based cross-sectional study

BackgroundTo analyze perceptions of health-related quality of life and associated factors in populations from the Manaus Metropolitan Region.MethodsWe conducted a population-based cross-sectional study from May to August 2015. Adults aged 18 years and older were selected using probabilistic three-phase cluster sampling and stratified by sex and age, based on official estimates. Quality of life data were collected using the European Quality of Life 5-Dimensions 3-Levels (EQ-5D-3L) along with socioeconomic, demographic, and health perception data. Utility scores were calculated using the Brazilian version of the EQ-5D-3L. Descriptive statistics were derived, and a multivariate Tobit regression model with correction for complex sampling was performed to identify the variables that influence utility levels.ResultsA total of 4001 participants were included. The average utility score was 0.886 (95% confidence interval [CI]: 0.881–0.890) with significant differences according to living area (the capital (0.882 ± 0.144) or inner cities (0.908 ± 0.122; p < 0.001)). The dimension for which the highest proportion of people reported moderate to severe problems was pain/discomfort (39%), followed by anxiety/depression (18%). Men had a higher quality of life than women (β = 0.041, p < 0.001). Not working was a factor that increased quality of life compared with being formally employed (β = 0.031, p = 0.037). The poorest people had a lower quality of life than the richest people (β = −0.118, p < 0.001). Better health perceptions increased utility scores (p < 0.001), while being separated decreased the scores (β = −0.052, p = 0.001).ConclusionHealth-related quality of life in the Manaus Metropolitan Region was high, as expected for the general population, and was higher among individuals who lived in the inner cities, men and those in higher social classes. Gender discrepancies and differences in quality of life between the capital and inner cities should be further investigated.

Pent-up demand for surgery in the Manaus metropolitan region: A population-based cross-sectional study.

Waiting lines in healthcare reflect an imbalance between the availability and the demand for medical services. This study aimed to analyze the prevalence and factors associated with the pent-up demand for surgical procedures in the Manaus metropolitan region.We performed a population-based cross-sectional study in 2015. Pent-up demand was based on self-report by the participants; those who reported waiting were contacted by phone to clarify the nature and reasons for the experienced delay.We interviewed 4001 adults in their households. The pent-up demand for surgical procedures in the Manaus metropolitan region was 14% (95% confidence interval: 13-15%). The surgical specialties with the highest demand included orthopedics (18.1%), gynecology (17.0%), ophthalmology (12.4%), neurosurgery (10.8%), and general surgery (10.2%). The main reason for not accessing services was their lack of availability in the public health system, leading some patients to pay for procedures in private facilities. The populations most affected by pent-up demand included elderly individuals, women, and housewives.Pent-up demand for surgical procedures is a common problem in the Manaus metropolitan region and thus requires coordinated actions to optimize access to and capacity of the healthcare system.

Prevalence and correlates of depressive symptoms among adults living in the Amazon, Brazil: A population-based study

BackgroundDepression is an affective disorder and one of the main contributors to the burden of disease worldwide. Our purpose is to estimate the prevalence of depressive symptoms and associated factors in the population of the Manaus Metropolitan Region. MethodsWe conducted a population-based, cross-sectional study with a probabilistic three-phase sampling in 2015, based on a previously calculated sample size. Adults living in Manaus and seven inner cities of the metropolitan region were surveyed for depressive symptoms using the Patient Health Questionnaire (PHQ-9) and a cutoff score of ≥ 9. We performed a Poisson regression with robust variance using a hierarchical approach to calculate the prevalence ratio (PR) of depression and 95% confidence intervals (CIs). ResultsAmong 4001 participants (response rate 76%), the prevalence of current depressive symptoms was 7% (95% CI: 6–8%). Depressive symptoms were more frequent in inhabitants of Manaus than in those from the countryside (PR = 6.13, 95% CI: 2.91–12.91); in women than in men (PR = 2.55, 95% CI: 1.96–3.33); in indigenous than in white people (PR = 2.56, 95% CI: 1.24–5.30); and in those with hypertension (PR = 1.47, 95% CI: 1.13–1.92), cardiac disease (PR = 1.62, 95% CI: 1.12–2.33), and poor health status (fair: PR = 5.10, 95% CI: 2.50–10.37; bad: PR = 10.27, 95% CI: 4.92–21.44 very bad: PR = 21.14, CI 95%: 10.16–43.99). High school education (PR = 0.55, 95% CI: 0.32–0.95) and middle class economic status (PR = 0.33, 95% CI: 0.12–0.89) were protective factors. LimitationsLimitations include the lack of measurement of physical activity, religious beliefs, leisure time, and use of alcohol and other drugs since these factors can affect depression and health status. ConclusionSeven out of every 100 adults from the Manaus Metropolitan Region have depressive symptoms. This rate is higher in women, individuals living in Manaus, indigenous people, people with hypertension or chronic cardiac disease, and those with a poor health status.

American cutaneous leishmaniasis cases in the metropolitan region of Manaus, Brazil: association with climate variables over time.

A temporal series of the normalized difference vegetation index (NDVI) and other environmental parameters covering the years 2002- 2009 was used for the study of the potential association between the climate and the number of cases of American cutaneous leishmaniasis (CL) in Manaus Metropolitan Region (MMR), State of Amazonas, Brazil. The results show that CL has a marked seasonality and a strong linkage with local climate conditions. Dry and warm conditions favor the vector, while the maximum number of CL cases occurs during the following wet season. This has a clear relation to the El Niño/La Niña Southern Oscillation (ENSO) and the results presented here show that uncharacteristic dry conditions in the MMR follow El Niño after a lag period of 3 months, while wet conditions follow La Niña, again after a lag period of 3 months. El Niño brings dry conditions with warming of the land surface leading to increased growth of trees and bushes as indicated by rising NDVI values, eventually producing increased numbers of CL cases, with a peak of new cases occurring 4 to 5 months later. La Niña, on the other hand, produces wet and cool weather, which is less favorable for the leishmaniasis vector and therefore results in comparatively lower number of CL cases. Since these seasonal climate changes affect the dynamics of the CL vector, and thus the number of CL cases, a close watch of the ENSO phenomenon and the weather type it brings should be useful for monitoring and control of CL in the MMR.

Capital of the Amazon Rainforest: Constructing a Global City-region for Entrepreneurial Manaus

This paper fosters dialogue between neoliberal urbanism and post-colonial research, drawing attention to city-regional formation in the global South. It critiques the Manaus Metropolitan Region (RMM) initiative as a state-space remapping guided by ecological entrepreneurialism. In 2007, Amazonas state created the framework to spearhead growth in an extensive territory construed as both urban and pristine. RMM mobilises infrastructure investments and forceful zoning to reconcile the expansion of tax-exempted manufacturing, with exclusive ‘global city’ redevelopment, and heightened conservation measures seeking to leverage both the symbolic value of peri-urban rainforests and their potential to generate carbon-credit revenues. Focusing on the Manaus–Iranduba Bridge and its socio-spatial impacts, the paper problematises visions of sustainable urbanisation that circulate transnationally and exacerbate territorialised patterns of geographically uneven development. Hence, top–down global city-regional construction spearheads political reactions, social mobilisation and territorial conflicts of complex resolution and important implications for translocal activism and coalition building.

As artimanhas do capital: um estudo das estratégias empresariais no polo oleiro-cerâmico da Região Metropolitana de Manaus

This article analyzes the strategies of capital over labor in the Pottery Pole of Metropolitan Region of Manaus (RMM), a sector that produces 80% of bricks and tiles consumed in the state of Amazonas. These strategies are related to the reorganization of the global process of capital accumulation based on the requirements of the new paradigms of manufacturing: flexibility, organizational innovations, new technologies, etc. The first of this work will show the insertion and the importance of production of bricks in the economic scenario of Amazonas. In the second part we will bring the contribution to the sociological understanding of the wiles of capital over labor, helping us to write, so the third section, where we will identify and problematize the organizing ways of capital in the Pottery Pole of the RMM.