Notifiable Diseases Information System Research Articles

Epidemiological profile of tuberculosis cases in Belém - PA from 2016 to 2019

Introduction: Tuberculosis is a chronic and progressive infection, often with a latency period following the initial infection. Clinical manifestations include productive cough, hyperthermia, weight loss and malaise. Method: This is a quantitative research, data were collected from the database of the Notifiable Diseases Information System (SINAN)[14] database, the analyzed variables: schooling; breed; sex; age range and type of entry. Result and Discussion: Males have the highest percentage, representing 67.1%. The age range was between 20 and 39 years old, totaling 43.5%. There is a high prevalence of notification of new cases among the types of entry, totaling 83.1%. The predominance of cases is found in the brown race with a percentage of 81.2% and when related to education the highest number is of those who have completed high school, with 29.4%. Conclusion: In view of this, there is a need for government intervention for more exposed groups, application of public policies aimed at this vulnerable public and the entire population of the municipality, aiming at the prevention, treatment and recovery of the disease.

Epidemiological profile of gestational and congenital syphilis in the state of Mato Grosso, Brazil

Introduction: Syphilis is a disease transmitted mainly sexually and vertically. Congenital syphilis is preventable when a pregnant woman is treated, warning about the importance of prenatal screening. Objective: To describe the epidemiological profile of gestational and congenital syphilis in the state of Mato Grosso - Brazil. Methodology: A descriptive cross-sectional study with a quantitative approach, using secondary data from the Notifiable Diseases Information System (SINAN), from 2011 to 2020. Results: 5120 cases of gestational syphilis and 2320 cases of syphilis were reported congenital in the state of Mato Grosso. The induced cases increased over the years, with notification peak of gestational syphilis in the year 2019 with 942 (18%) cases and congenital syphilis in the year of 2018 with 322 (14%) cases. Most women affected by gestational syphilis were young, with low education, mixed race, who underwent prenatal care, did not have their partners treated concomitantly and had a late diagnosis after the first trimester. Patients with congenital syphilis were mostly diagnosed early. Conclusion: The findings change flaws in prenatal care and the need for greater investments in innovative actions in order to reduce vertical transmission of syphilis.

HIV epidemic in a province of the Brazilian Amazon region: Temporal trend analysis.

BackgroundAlthough considerable progress has been made over the last decades, human immunodeficiency virus (HIV) incidence and acquired immunodeficiency syndrome (AIDS) mortality rates have remarkably increased in the Brazilian Amazon region. Here, we employed temporal analysis to determine the impact of public policies on the HIV epidemic in the state of Pará, Brazil, which has the second highest HIV incidence rate in the Amazon region.Design and methodsThis is an ecological study conducted in the state of Pará, employing secondary data of HIV/AIDS cases notified to the Information System for Notifiable Diseases, 2007– 2018. The following epidemiological variables were collected: year of notification, municipality of residence, age, sex, education, exposure category, and HIV/AIDS diagnostic criteria. The study population was composed of 21,504 HIV/AIDS cases. The HIV/AIDS incidence rates were analyzed employing the temporal trend analysis (TTA) followed by the chi-square test and residue analysis to determine the association between the epidemiological variables and time series periods.ResultsA total of 50% of the notifications were composed of AIDS cases. TTA identified two periods in HIV/AIDS incidence, with stabilization of cases in the first period (G1, 2007–2012) and an upward trend in the second period (G2, 2012–2018). The most prevalent epidemiological characteristics in G2 (versus G1) were as follows: young people, brown skin color, higher schooling, and homosexuals.ConclusionsPublic policy to control HIV infection in the Brazilian Amazon region has been partially effective. HIV screening tests and treatment should be made widely available to eradicate HIV infection in the Amazon region by 2030.

Incidence of syphilis in pregnant women in the countryside of são paulo from 2018 to 2020

Syphilis is caused by the bacterium Treponema pallidum and is transmitted sexually, hematogenously or vertically, and may occur in any time of pregnancy. It is one of the major concerns and high rates of pregnant women with syphilis, which leads to congenital syphilis. The aim of this study was to investigate the incidence of syphilis in pregnant women in the state of São Paulo from 2018 to 2020 in epidemiological surveillance. The study is an epidemiological, descriptive observational research of quantitative analysis with secondary data, notified in the Notifiable Diseases Information System (SINAN), which is the database of the Department of Informatics of the Unified Health System (DATASUS), of pregnant women with syphilis, between 2018-2020. The collection of secondary data was authorized of São Paulo State. We found 50 women with unspecified syphilis in the last 3 years, of these 36 are pregnant women with syphilis and 7 cases of congenital syphilis. There has been a large increase in pregnant women with syphilis in the last year, however, there has been an eradication of congenital syphilis during this period. With this, it can be emphasized the importance of screening and early treatment of pregnant women in the Primary Health Care Network to promote health promotion and to offer quality of health services to mothers.

Epidemiological evaluation of notified cases of tuberculosis in Minas Gerais, Brasil / Avaliação epidemiológica de casos notificados de tuberculose em Minas Gerais, Brasil

Due to the situation of growing poverty in the state of Minas Gerais and the tuberculosis’ severity, a pathology associated with poor living conditions, it is necessary to study the incidence of new cases of this pathology so that public health measures can be taken to revert this scenario. So, the objective of this study is to evaluate the incidence of notified cases of tuberculosis in the state of Minas Gerais between 2015 and 2020. The number of confirmed and notified cases of tuberculosis in the state of Minas Gerais from 2015 to 2020 was collected in the Information System of Notifiable Diseases of the IT department of the Brazilian Unified Health System (DATASUS), through the Tabnet system. Between 2015 and 2020, 24717 new cases of tuberculosis were reported in the Brazilian state of Minas Gerais. Regarding the year, 4053 occurred in 2015, 4071 in 2016, 4055 in 2017, 4214 in 2018, 4349 in 2019 and 3975 in 2020. For all of the foregoing, the great significance and need for attention focused on the prevention and treatment of Tuberculosis is highlighted.

The effect of incarceration on TB treatment outcomes.

BACKGROUND: TB notifications in Latin American prisons have more than doubled over the past two decades; however, treatment outcomes and their determinants among incarcerated individuals in this region are not well understood.METHODS: Newly diagnosed drug-susceptible TB cases reported to Brazil´s Information System for Notifiable Diseases (Sistema de Informação de Agravos de Notificação, SINAN) between January 2015 and December 2017 were included. Multivariate logistic regression was used to assess socio-economic and clinical factors associated with treatment success among incarcerated individuals.RESULTS: Incarcerated individuals (n = 17,776) had greater treatment success than non-incarcerated individuals (n = 160,728; 82.2% vs. 75.1%; P < 0.0001), including after adjusting for demographic and clinical risk factors (adjusted odds ratio aOR 1.27, 95% CI 1.19-1.34). These differences were partially mediated by increased use of directly observed therapy among incarcerated individuals (DOT) (61% vs. 47%; P < 0.001), which was associated with greater efficacy in the incarcerated population (aOR 2.56 vs. aOR 2.17; P < 0.001). DOT was associated with improved treatment success among incarcerated subpopulations at elevated risk of poor outcomes.CONCLUSION: TB treatment success among incarcerated individuals in Brazil is higher than non-incarcerated individuals, but both fall below WHO targets. Expanding the use of DOT and services for socially and medically vulnerable individuals may improve outcomes in carceral settings.

Detection of areas vulnerable to scorpionism and its association with environmental factors in São Paulo, Brazil

Accidents caused by scorpions are considered a neglected condition and represent a major health problem in most tropical countries, especially for children and elderly people. In Brazil, scorpionism is recurrent in the southeast region, mainly in the state of São Paulo, due to the progressive increase in scorpions found in urban habitats. Thus, our study aimed to provide better insights into the geographic and epidemiological characteristics of scorpion envenomation in São Paulo state and identify the environmental factors that are associated with these accidents. This is an ecological and retrospective study with secondary data on scorpion accidents in the state of São Paulo from 2008 to 2018 obtained from the Notifiable Disease Information System. The SatScan software was used to identify the higher- and lower-risk spatiotemporal clusters. A total of 145,464 scorpion sting cases were recorded in the state of São Paulo, between 2008 and 2018; there was a four-fold increase in the incidence rate. Accidents occurred more frequently in the spring season, wherein higher-risk clusters were in the north and northwest regions of the state. High temperatures, low precipitation, and poor natural vegetation are associated with higher risk areas. Our study mapped vulnerable areas for scorpion accidents that can aid in the design of efficient public health policies, which should be intensified during the spring season.

Abandonment of tuberculosis treatment in Brazil, 2012-2018: trend and spatiotemporal distribution

Ecological study that analyzes the trend and the spatiotemporal distribution of new cases of tuberculosis (TB) that abandoned treatment in Brazil, notified in the Notifiable Diseases Information System, in the period from 2012 to 2018. For the study of the trend used the Prais-Winsten generalized linear regression model was used and the Moran Global and Local indices for spatial analysis. The mean and median proportion of TB treatment dropout in Brazil was 10.4%. The highest averages of the indicator were concentrated in the Southeast (10.78 ± 1.38), South (10.70 ± 2.94) and North (10.35 ± 1.13), and; in the states of Rondônia (14.35 ± 2.34), Rio Grande do Sul (13.60 ± 4.23) and Rio de Janeiro (12.64 ± 1.73), only Acre and Piauí showed this indicator below 5%. In Brazil, there was a tendency towards stability in the proportion of abandonment of TB treatment, a decrease in the North, Northeast and South regions and only in the Federal District there was growth. There was a heterogeneous and non-random distribution, with five capitals comprising the High-Risk cluster. We conclude that the proportion of TB treatment abandonment in Brazil is above what is acceptable and that the identification of high-risk areas can contribute to the elaboration and strengthening of more specific control actions.

Spotted Fever in the Morphoclimatic Domains of Minas Gerais State, Brazil

In Brazil, the tick-borne rickettsiosis known as Spotted Fever (SF) has been recorded from 59% of the Federative Units, however, the knowledge of the epidemiology and dynamics of human infection remains incipient in certain areas, complicating appropriate public health actions to inform the general population and control the disease. Here, we improved the interpretation of epidemiological information of SF cases recorded for an important endemic area. A descriptive epidemiological study was carried out based on records in the SINAN (Notifiable Diseases Information System) SF case databases. Data analysis was performed using Python programming language, Pandas library and Qgis map making. To evaluate the sociodemographic, clinical, assistance, laboratory and epidemiological characteristics, simple and relative nominal values of occurrences, means and standard deviations, and molecular analyzes were performed to identify the bioagent present in biological samples collected during each case investigation. Of the 298 confirmed cases, 98 resulted in death, the number of cases increased from 2011, and the disease scenario had 32.8% lethality. Overall, 207 cases involved men, and lethality was higher in this group. The most affected age group was 30 to 59 years old. The majority of patients reported having had contact with animals such as ticks, capybara and domestic animals such as dogs and cats. The results corroborate existing studies in areas of severe SF cases in Brazil. Despite reports of SF cases from the Cerrado Biome, analyses show that serious cases occur in anthropized areas of the Atlantic Forest biome, and in a transition area between this and the Cerrado. Complex, longitudinal, multidisciplinary studies, with an eco-epidemiological focus, should be carried out to allow the construction of algorithms capable of predicting, in time and space, the risk factors associated with severe cases and deaths from SF, with the aim of avoiding their expansion.

Temporal trend and spatial analysis of the HIV epidemic in young men who have sex with men in the second largest Brazilian Amazonian province

BackgroundAfter 40 years of its starting, the HIV epidemic in Brazilian Amazon region remains on an increasing trend. The young men who have sex with men (MSM) have been the most impacted by the HIV in the last decade. However, much more than attributing the risk behavior to HIV uniquely to the individual, behaviors are shaped by social determinants of health (SDH). Despite the problem, there is a scarcity of studies evaluating the impact of SDH on HIV among young MSM and none of them were done in the Northern of Brazil. Therefore, the main goal of this study was to analyse the HIV epidemic among Brazilian Amazonian young MSM using temporal trends and spatial analysis.MethodsWe conducted an ecological study using reported cases of HIV/AIDS in young MSM living in Pará, the second larger Brazilian Amazonian province, between 2007 and 2018. Data were obtained from the Information System for Notifiable Diseases. For the temporal analysis, we employed a Seasonal and Trend decomposition using Loess Forecasting model (STLF), which is a hybrid time-series forecast model, that combines the Autoregressive-Integrated Moving Average (ARIMA) forecasting model with the Seasonal-Trend by Loess (STL) decomposition method. For the spatial analysis, Moran’s spatial autocorrelation, spatial scan, and spatial regression techniques were used.ResultsA total of 2192 notifications were included in the study. Greater variabilities in HIV/AIDS population-level diagnosis rates were found in the festive months. The HIV/AIDS population-level diagnosis rates exhibited an upward trend from 2013 and this trend is forecasted to continue until 2022. Belém, the capital of Pará, presented the highest spatial risk for HIV/AIDS and was the only city to present spatiotemporal risk from 2014 to 2018. The geographic variation of the HIV epidemic was associated with the number of men with formal jobs, the average salary of men, and the percentage of people over 18 years old with elementary education.ConclusionThe upward trend of HIV/AIDS population-level diagnosis rate forecasted until 2022 and the variability of the epidemic promoted by the SDH brings an alert and subsidies to health authorities to implement more efficient and focalized public policies against HIV among young MSM in Pará.

Spatio-temporal analysis of leprosy risks in a municipality in the state of Mato Grosso-Brazilian Amazon: results from the leprosy post-exposure prophylaxis program in Brazil

BackgroundLeprosy post-exposure prophylaxis (LPEP) with single dose rifampicin (SDR) can be integrated into different leprosy control program set-ups once contact tracing has been established. We analyzed the spatio-temporal changes in the distribution of index cases (IC) and co-prevalent cases among contacts of leprosy patients (CP) over the course of the LPEP program in one of the four study areas in Brazil, namely the municipality of Alta Floresta, state of Mato Grosso, in the Brazilian Amazon basin.MethodsLeprosy cases were mapped, and socioeconomic indicators were evaluated to explain the leprosy distribution of all leprosy cases diagnosed in the period 2016–2018. Data were obtained on new leprosy cases [Notifiable diseases information system (Sinan)], contacts traced by the LPEP program, and socioeconomic variables [Brazilian Institute of Geography and Statistics (IBGE)]. Kernel, SCAN, factor analysis and spatial regression were applied to analyze changes.ResultsOverall, the new case detection rate (NCDR) was 20/10 000 inhabitants or 304 new cases, of which 55 were CP cases among the 2076 examined contacts. Changes over time were observed in the geographic distribution of cases. The highest concentration of cases was observed in the northeast of the study area, including one significant cluster (Relative risk = 2.24; population 27 427, P-value < 0.001) in an area characterized by different indicators associated with poverty as identified through spatial regression (Coefficient 3.34, P-value = 0.01).ConclusionsThe disease distribution was partly explained by poverty indicators. LPEP influences the spatial dynamic of the disease and results highlighted the relevance of systematic contact surveillance for leprosy elimination.Graphical

Stochastic Petri net model describing the relationship between reported maternal and congenital syphilis cases in Brazil

IntroductionSyphilis is a sexually transmitted disease (STD) caused by Treponema pallidum subspecies pallidum. In 2016, it was declared an epidemic in Brazil due to its high morbidity and mortality rates, mainly in cases of maternal syphilis (MS) and congenital syphilis (CS) with unfavorable outcomes. This paper aimed to mathematically describe the relationship between MS and CS cases reported in Brazil over the interval from 2010 to 2020, considering the likelihood of diagnosis and effective and timely maternal treatment during prenatal care, thus supporting the decision-making and coordination of syphilis response efforts.MethodsThe model used in this paper was based on stochastic Petri net (SPN) theory. Three different regressions, including linear, polynomial, and logistic regression, were used to obtain the weights of an SPN model. To validate the model, we ran 100 independent simulations for each probability of an untreated MS case leading to CS case (PUMLC) and performed a statistical t-test to reinforce the results reported herein.ResultsAccording to our analysis, the model for predicting congenital syphilis cases consistently achieved an average accuracy of 93% or more for all tested probabilities of an untreated MS case leading to CS case.ConclusionsThe SPN approach proved to be suitable for explaining the Notifiable Diseases Information System (SINAN) dataset using the range of 75–95% for the probability of an untreated MS case leading to a CS case (PUMLC). In addition, the model’s predictive power can help plan actions to fight against the disease.

Impact of the COVID-19 pandemic on compulsory notification of meningitis during the first wave of the pandemic in Brazil: an ecological study using P-score

Meningitis is listed as one of the diseases requiring compulsory notification in Brazil. It can affect all age groups and also has no seasonality. Cases can be recorded in all months of the year and in all states of Brazil. Despite its importance, the obligation of immediate notification may have been compromised by the coronavirus disease 2019 (COVID-19) pandemic. To analyze the immediate impact of the COVID-19 pandemic on compulsory notifications of meningitis in Brazil and its states during the first wave of the pandemic. This was an ecological study involving all confirmed cases of meningitis in Brazil, in its regions and in its states. Data for the months from 2015 to 2020 were obtained from the database of the Notifiable Diseases Information System (Sistema de Informação de Agravos de Notificação, SINAN), in the Department of Informatics of the National Health System (Departamento de Informática do Sistema Único de Saúde, DATASUS). The P-score was used to obtain the percentage change in the numbers of cases reported in 2020. A 45.7% reduction in notifications of meningitis in Brazil was observed. Regarding the regions and the states, with the exception of Roraima, all of them showed a negative P-score, with decreasing curves each month. The pandemic caused a negative impact on meningitis notifications in Brazil.

Epidemiological aspects of Chagas disease in the state of Piauí (Northeast Brazil) in the period 2010–2019

Chagas disease (ChD), caused by the hemoflagellate protozoan Trypanosoma cruzi, is an important morbidity that affects approximately six million people in the American continent. T. cruzi parasites are mainly transmitted to human by the infected feces of blood-sucking triatomine insects. The persistent disease is endemic in many regions of South America, mostly affecting residents of rural areas. The aim of this study was to evaluate epidemiological aspects of ChD in the state of Pi-auí located in northeastern Brazil. This is an analytical cross-sectional study carried out from the collection of data of the Notifiable Diseases Information System (SINAN, in Portuguese, Sistema de Informações de Agravos de Notificação) of suspected and confirmed cases of acute ChD in the state of Piauí, in the period 2010–2019. Associations between T. cruzi positivity and the study variables were determined by the chi-square test or Fisher's exact test and were raised as prevalence ratios (PR) with 95% confidence interval. According to this survey, 517 suspected cases of acute ChD were reported in Piauí, with 70 cases (13.5%) confirmed. In 88.5% of confirmed cases, confirmation occurred by laboratory diagnosis. Most of the confirmed cases occurred in municipalities located in the semiarid region, with the municipality of São João do Piauí presenting the highest number of cases. Regarding sociodemographic data, females represent 55.7% of cases, people over 50 years of age (55.7%), being three cases in people up to 18 years of age, and less than 8 years of schooling (67.1%). 77.9% of confirmed cases had vector transmission as the probable form of infection. The data available in this study conclude that vectorial transmission of ChD in the state of Piauí remains active. This fact is corroborated by the number of notified and confirmed cases of acute ChD, requiring housing improvement programs and more effective epidemiological surveillance to control the transmission of the disease in the state.

Prevalence and Clinical Profiling of Dysglycemia and HIV Infection in Persons With Pulmonary Tuberculosis in Brazil.

BackgroundThere are scarce data on the prevalence and disease presentation of HIV in patients with tuberculosis (TB) and dysglycemia (diabetes [DM] and prediabetes [PDM]), especially in TB-endemic countries.MethodsWe assessed the baseline epidemiological and clinical characteristics of patients with culture-confirmed pulmonary TB, enrolled in a multicenter prospective cohort in Brazil (RePORT-Brazil) during 2015–2019. Dysglycemia was defined by elevated glycated hemoglobin and stratified as PDM or DM. Additionally, we used data from TB cases obtained through the Brazilian National Notifiable Diseases Information System (SINAN), during 2015–2019. In SINAN, diagnosis of diabetes was based on self-report. Logistic regression models were performed to test independent associations between HIV, dysglycemia status, and other baseline characteristics in both cohorts.ResultsIn the RePORT-Brazil cohort, the prevalence of DM and of PDM was 23.7 and 37.8%, respectively. Furthermore, the prevalence of HIV was 21.4% in the group of persons with TB-dysglycemia and 20.5% in that of patients with TBDM. In the SINAN cohort, the prevalence of DM was 9.2%, and among the TBDM group the prevalence of HIV was 4.1%. Logistic regressions demonstrated that aging was independently associated with PDM or DM in both the RePORT-Brazil and SINAN cohorts. In RePORT-Brazil, illicit drug use was associated with PDM, whereas a higher body mass index (BMI) was associated with DM occurrence. Of note, HIV was not associated with an increased risk of PDM or DM in patients with pulmonary TB in both cohorts. Moreover, in both cohorts, the TBDM-HIV group presented with a lower proportion of positive sputum smear and a higher frequency of tobacco and alcohol users.ConclusionThere is a high prevalence of dysglycemia in patients with pulmonary TB in Brazil, regardless of the HIV status. This reinforces the idea that DM should be systematically screened in persons with TB. Presence of HIV does not substantially impact clinical presentation in persons with TBDM, although it is associated with more frequent use of recreational drugs and smear negative sputum samples during TB screening.

Cryptoccoccal meningitis in post-covid 19 patient in the city of manaus: Case report

Cryptococcosis is a cosmopolitan and opportunistic mycosis, caused mainly by the etiological agent Cryptococcus neoformans, through the inhalation of fungal structures, especially in bird feces. The aim of this study was to report a reported case of cryptococcal meningitis in an immunosuppressed patient due to previous COVID-19 infection in the city of Manaus-AM, as well as to implement health education actions to prevent cryptococcosis in the region of the disease. Information about the case was obtained through access to the database of the Information System for Notifiable Diseases (SINAN), made available by the Center for Control of Zoonoses Dr. Carlos Durand (CCZ), an agency belonging to the Municipal Health Department of Manaus (SEMSA). The case patient, male, presented symptoms such as headache, fever, vomiting, seizures, neck stiffness, petechiae and hemorrhagic suffusions, hearing loss and signs of Kernig and Brudzinski. In a zoosanitary visit to the site of the injury, the presence of pigeon excreta on the walls of the residence was found, and cleaning was carried out without the use of personal protective equipment (PPE’s). The contact with the residents evidenced the lack of information about the zoonosis addressed, including the risk of transmission of cryptococcosis by pigeons, facts that make necessary more sanitary actions on zoonoses among the population of Manaus.

Clinical outcomes of dengue virus infection in pregnant and non-pregnant women of reproductive age: a retrospective cohort study from 2016 to 2019 in Paran\xe1, Brazil

BackgroundThe increasing number of dengue cases worldwide implies a greater exposure of at-risk groups, such as pregnant women. DENV infection during pregnancy has been increasingly associated with unfavorable outcomes, but the evolution of the disease and its clinical outcomes remain unclear. The objective of this study was to characterize dengue cases in reproductive aged women by comparing the development of the disease in pregnant and non-pregnant women.MethodsA population based retrospective cohort study that used data reported in the Brazilian Mandatory Notifiable Diseases Information System from 2016 to 2019 in Paraná, Brazil. We compared sociodemographic, clinical, and laboratory variables between pregnant and non-pregnant women. Hospitalization and disease severity classification (Dengue, Dengue with warning signs, Severe Dengue) were considered outcome variables.ResultsThe two groups had differences in the year of notification, age distribution, and region of residence. Laboratory investigation was more frequent among pregnant women, and DENV-2 prevailed in both groups. The risks of hospitalization and development of Severe Dengue were higher in pregnant women. There were no deaths observed among pregnant women.ConclusionThis study identified pregnancy as a risk factor for an increase in the severity of DENV infection. It reinforces the importance of identifying early signs of complication, close monitoring, and adequate treatment for pregnant women.

Epidemiologia de acidentes ofídicos no estado do Amazonas entre 2010-2020

Epidemiological studies can improve knowledge of the profile of snakebites in a given region and help identify opportunities for improving health care and preventing this type of disease. Thus, the objective of this work was to carry out a survey of data regarding the epidemiological aspects of snakebites in municipalities belonging to the State of Amazonas. The study was carried out through a documentary survey through the electronic search of articles, thesis, dissertation and monographs, in academic Google databases and database of the Information System of Notifiable Diseases (SINAN). The final work included a total of 09 scientific articles. Regarding the data obtained through the consultation of data in the Information System of Notifiable Diseases (SINAN), 16,868 cases of snakebite accidents were reported for the state of Amazonas in the period corresponding to the years 2010-2020, where the cases with the highest number of cases were contacted. records of accidents affected by species belonging to the genus Bothrops, followed by the genus Lacheses. In view of the results, it is important to promote educational campaigns, being necessary the implementation of programs that can increase the knowledge of the residents about the forms of adequate treatment and prevention of these accidents, mainly by rural workers, in order to reduce the accident cases.

PREVALÊNCIA E FATORES ASSOCIADOS AO DIAGNÓSTICO TARDIO DA INFECÇÃO PELO HIV EM UM MUNICÍPIO PAULISTA

ABSTRACT Objective: to identify the prevalence and factors associated with late diagnosis of the infection by the Human Immunodeficiency Virus (HIV), in a municipality of São Paulo. Method: an epidemiological, analytical and retrospective study that analyzed the HIV and AIDS cases notified by the health services in the period from 2015 to 2017 using data from the notifications of the Information System for Notifiable Diseases (SINAN Net) corresponding to the users recently diagnosed with HIV/AIDS infection in the municipality of Ribeirão Preto/SP, Brazil. Data collection was in May 2018. The chi-square test was performed, as well as binary logistic regression, where the dependent variable was the AIDS criterion at the moment of notifying infection by HIV. A p-value&lt;0.05 was considered for the association between the variables studied in relation to late diagnosis. Results: of the 829 (100%) new HIV cases, 290 (35.0%) were diagnosed in the condition of AIDS. Most of the population was male and aged between 15 and 34 years old. Oral candidiasis and weight loss greater than 10% were the main symptoms associated with AIDS. It was observed that people with lower schooling levels and older were more prone to late diagnoses. Conclusion: it is necessary to devise strategies that favor timely diagnosis in the municipality under study, particularly among the individuals aged over 45 years old and with lower schooling levels.

Spatio-temporal analysis of tuberculosis and its correlation with the Living Conditions Index in an elderly population in Brazil.

The aim of this study was to analyze the spatio-temporal distribution of tuberculosis (TB) in the elderly population in the city of Belém, PA from 2011 to 2015 according to the Living Conditions Index (LCI). This was an epidemiological, descriptive, ecological, and retrospective study involving 1,134 cases. Data were collected through the Information System of Notifiable Diseases (SINAN). For data analysis, we used the incidence coefficient, global and local empirical Bayesian model, Kernel density, and Kernel ratio. The construction of the LCI was based on the United Nations Development Program (UNDP) method. The incidence of TB remained the same over the five years studied. No neighborhood was found to have a high incidence of TB and a high LCI, but most of the cases occurred in the south of the city where the neighborhoods with the most precarious conditions are located. Moreover, the lowest incidence was in neighborhoods that historically had better infrastructure. Spatial analysis tools facilitate studies on the dynamics of disease transmission such as TB. In this study, it was shown that TB is heterogeneously distributed throughout the municipality. Living conditions, especially in slums, influenced TB incidence.