Notifiable Diseases Information System Research Articles

Temporal patterns, spatial risks, and characteristics of tegumentary leishmaniasis in Brazil in the first twenty years of the 21st Century.

Tegumentary leishmaniasis (TL) is a significant public health issue in Brazil. The present ecological study describes the clinical and epidemiological characteristics of TL cases reported in the country, and analyzes the spatial and temporal patterns of the incidences and risks of occurrence across the five geopolitical regions and 27 federative units. Data regarding new cases of TL notified between 2001 and 2020 were obtained from the Information System for Notifiable Diseases of the Brazilian Ministry of Health. Joinpoint and spatial and temporal generalized additive models were used to establish trends in the evolution of TL during the target period. The incidence rate for the entire period was 226.41 cases/100,000 inhabitants. All regions of Brazil showed trends of decreasing incidence rates, albeit with fluctuations at specific times, with the exception of the Southeast where rates have increased since 2014, most particularly in Minas Gerais state. The disease was concentrated predominantly in the North region, with Acre state leading the incidence rank in the whole country, followed by Mato Grosso (Midwest), Maranhão and Bahia (Northeast) states. The spatial distribution of the risk of TL occurrence in relation to the annual averages was relatively stable throughout the period. The cutaneous form of TL was predominant and cases most frequently occurred in rural areas and among men of working age. The ages of individuals contracting TL tended to increase during the time series. Finally, the proportion of confirmations by laboratory tests was lower in the Northeast. TL shows a declining trend in Brazil, but its widespread occurrence and the presence of areas with increasing incidence rates demonstrate the persistent relevance of this disease and the need for constant monitoring. Our findings reinforce the importance of temporal and spatial tools in epidemiologic surveillance routines and are valuable for targeting preventive and control actions.

COVID-19 DEATHS AMONG THE ELDERLY IN A MUNICIPALITY IN NORTHWESTERN PARANÁ, BETWEEN THE YEARS 2020 AND 2021

In December 2019, a new virus called SARS-CoV-2 was identified. The World HealthOrganization (WHO) named the disease caused by the new virus COVID-19 (coronavirusdisease, year 2019), and in March 2020, it was declared a pandemic. Since then, there hasbeen a global effort to produce information in order to unravel the clinical, epidemiological,and prognostic factors of the disease. By identifying the main risk factors, it is possible tocarry out early monitoring of the most vulnerable groups, reducing the chance of unfavorableclinical outcomes. It is a consensus that advanced age is associated with an increase inmorbidity and mortality. This study aimed to verify the occurrence of COVID-19 deathsamong the elderly in the city of Maringá, Paraná, in the years 2020 and 2021, as well as theirassociation with gender. This research is characterized as a retrospective quantitative study.The data were obtained from the Notifiable Diseases Information System (Sinan). Thedependent variable was the occurrence of death in elderly patients, and the independentvariables were gender and year of occurrence. Descriptive and inferential statistics were usedto analyze the data. Results showed that in 2020, there were 514 deaths (40.5% female and59.5% male). In 2021, the number of deaths increased exponentially, reaching 2025 cases(39.6% female and 60.4% male). The highest occurrence of COVID-19 deaths among theelderly occurred in 2021 and in males. Based on this profile, specific strategies and care linesshould be studied for this more vulnerable population in times of pandemics.

Epidemiological characteristics of leprosy from 2000 to 2019 in a state with low endemicity in southern Brazil

BackgroundLeprosy is an infectious and contagious disease caused by Mycobacterium leprae and is mainly characterized by lesions in the skin and peripheral nerves. In Brazil, it is a public health problem due to its high endemicity. However, the state of Rio Grande do Sul presents low endemicity of this disease. ObjectiveTo characterize the epidemiological profile of leprosy in the state of Rio Grande do Sul from 2000 to 2019. MethodsThis was a retrospective observational study. Epidemiological data were collected from the Notifiable Diseases Information System (SINAN, Sistema de Informação de Agravos de Notificação). ResultsAmong the 497 municipalities in the state, 357 (71.8%) registered cases of leprosy in the assessed period, with an average of 212 (81.5%) new cases per year. The average detection rate was 1.61 new cases per 100,000 inhabitants. The male sex was predominant (51.9%) and the mean age was 50.4 years. Regarding the epidemiological clinical profile; 79.0% of the patients were multibacillary; 37.5% presented the borderline clinical form; 16% had grade 2 physical disability at diagnosis and bacilloscopy was positive in 35.4% of cases. As for treatment, 73.8% of the cases were treated with the standard multibacillary therapeutic regimen. Study limitationsThere were missing/inconsistent data in the database available. ConclusionsThe findings observed in this study indicate that the state presents a low endemicity profile of the disease and these results can support adequate health policies relevant to the reality of Rio Grande do Sul, inserted in a national scenario of highly endemic leprosy.

EPIDEMIOLOGY OF ROCKY MOUNTAIN SPOTTED FEVER IN BRAZIL, 2010-2020

Rocky Mountain spotted fever is a tick-borne rickettsiosis. The main clinical signs and symptoms are fever, severe headache, rashes and myalgia. It is considered difficult to diagnose and underreported. The study aims to descriptively analyze the epidemiology of cases of Rocky Mountain spotted fever in Brazil from 2010 to 2021. This is a retrospective cohort study that statisticall analyzes the cases of spotted fever in Brazil between 2010 and 2020 through data obtained by the Information System of Notifiable Diseases. The proportions of spotted fever cases were calculated according to: sex, age, race/color, infection environment and evolution. There are 1967 cases were confirmed. The regions with the most cases were the Southeast (n%=72.24) and the South (n%=24). However, there are 4 deaths in the south while the lethality coefficient from the southeast is 47.78%. The most affected age group was 40-59 years old (n%=34.87), and 20-39 years old (n%=28.98). 71.17% of the cases are male. As for color/race, 60% of the cases are in whites. As for the infection environment, 35.23% are at home, 15.3% are at work, 26.13% are leisure places. The prevalence in males and the predominant age group 20-59 years can be linked to work activity, which leaves hem more exposed to ticks. The high numbers in adulthood can also be related to ecotourism. The lethality of the disease differs between the South and Southeast regions. One explanation for this phenomenon would be the different etiological agents, R. rickettsi, predominant in the Southeast, generating more severe clinical conditions.

Epidemiological aspects of visceral leishmaniasis in Rio Grande do Norte, Brazil

Visceral Leishmaniasis (VL) is a parasitic disease caused by Leishmania protozoa and transmitted by the bite of sand fly insects. This study aimed to describe the epidemiological aspects of VL in Rio Grande do Norte (RN), using variables inserted in the Information System for Notifiable Diseases, for the period from 2013 to 2019. The chi-square test of independence was used with p<0.05 considered statistically significant. 635 cases of VL were reported in RN, with stability of new cases in the analyzed period. 60% of cases were autochthonous, 84 (50.2%) municipalities in RN had autochthonous cases, with 70 (18.2%) cases in Natal and 58 (15.1%) in Mossoró. The most affected age group was 20-59 year old (57.3%) followed by 0-9 year old (23.8%), 10-19 year old (10.4%) and 60 year old or older (8.5%). There was a positive association between the 0-9 and 10-19 ranges with females and 20-59 with males (p=0.0001). Among the 532 individuals, 54.5% had a low level of education, and these, as well as the illiterate, associated with males (p=0.001). 85.3% of 612 cases were in black/brown group and 77.1% of 632 in urban/periurban residents. 27.6% of 500 were co-infected with HIV, 77.5% in males and 89.8% in adults. 70.7% progressed to cure and 6.8% died from VL. The study shows that the control measures adopted within the scope of the National Program for the Control of Leishmaniasis should be reassessed since there has been no decrease in cases, even though it has had stability over the years in Natal and a tendency to growth in Mossoró, the most affected areas. KEY WORDS: Visceral leishmaniasis; Leishmania; epidemiology.

Epidemiological profile of pesticide poisoning cases in the State of Sergipe, Brazil: a retrospective analysis from 2007 to 2021

We aimed to characterize the epidemiological profile of reported cases of pesticide poisoning in the state of Sergipe between 2007 and 2021. Secondary data were obtained from the National Database of Notifiable Diseases Information System (SINAN) and National Toxicological Information System (SINITOX), through the Department of Informatics of the Unified Health System (DATASUS) and analysis performed using the free tool Google Sheets. During the studied period, 960 cases of exogenous pesticide poisoning were registered in the state. The municipality of Aracaju had the highest percentage of the number of cases. The incidence prevailed in females, in the 20-39 age group, in the brown race and among those with incomplete primary education. The most used toxic agent was rodenticide, suicide attempt predominated as a circumstance of use. Most cases resulted from a single acute exposure, confirmed by the clinical-epidemiological method, and evolved to a cure without sequelae. This study traced the epidemiological profile of the State of Sergipe with regard to the intoxication of the population and, in addition, brought little explored data and information that directly impacts policies aimed at reducing morbidity and mortality resulting from the use of pesticides.

Spatial distribution of leprosy in municipalities of the state of Goiás in the year 2020

Leprosy is a chronic infectious disease caused by an acid-resistant bacillus called Mycobacterium leprae and the disease is characterized by its slow multiplication, with an excessively long incubation period. The objective of the research was to evaluate the spatial distribution of leprosy cases among the municipalities of the State of Goiás in 2020. This is a descriptive study and the data collection took place from the Notifiable Diseases Information System (SINAN) in November, 2021 and it considered the diagnosis´ year and the patient’s municipality of residence. The following indicators were adopted in the analysis: a) annual prevalence rate per 10,000 inhabitants; b) annual rate of new cases detection in the general population; and c) annual rate of new cases detection in individuals under 15 years of age, these last two per 100,000 inhabitants. The analysis of the spatial occurrence pattern of leprosy in Goiás State municipalities was carried out in the free software Terraview version 4.2.2. A higher prevalence of distribution of the gross rate of the disease was observed in the Central-North and Central-West macro-regions, with a concentration of cases also in the Northeast region of the State. From the 246 Goiás municipalities, 68.7% (n = 169) had cases of leprosy, 18.3% (n = 45) were in a situation of hyperendemia and 23.2% (n = 57) had a very high detection coefficient. Considering the rate of detection in those people under 15 years of age, only 11 municipalities (4.5%) were in a situation of hyperendemia and 1.2% (n = 3) had a very high detection coefficient (5.00 to 9.99/ 10.000 inhabitants). The current investigation indicates the maintenance of leprosy hyperendemic areas in the State of Goiás, when compared to previous studies. This finding highlights the importance of readjustment of leprosy management and assistance in municipalities at greater risk of leprosy hyperendemicity in order to interrupt the M. leprae transmission chain. KEY WORDS: Leprosy; prevalence; spatial distribution; Goiás State.

Spatio-temporal relative risks and priority areas for visceral leishmaniasis control in Brazil, between 2001 and 2020

Visceral leishmaniasis (VL) is a pressing public health problem in Brazil. The proper implementation of disease control programs in priority areas is a challenge for healthcare managers. The present study aimed to analyze the spatio-temporal distribution and identify high risk areas of VL occurrence in the Brazilian territory. We analyzed data regarding new cases with confirmed diagnosis of VL in Brazilian municipalities, from 2001 to 2020, extracted from the Brazilian Information System for Notifiable Diseases. The Local Index of Spatial Autocorrelation (LISA) was used to identify contiguous areas with high incidence rates in different periods of the temporal series. Clusters of high spatio-temporal relative risks were identified using the scan statistics. The accumulated incidence rate in the analyzed period was 33.53 cases per 100,000 inhabitants. The number of municipalities that reported cases showed an upward trend from 2001 onward, although there was a decrease in 2019 and 2020. According to LISA, the number of municipalities considered a priority increased in Brazil and in most states. Priority municipalities were predominantly concentrated in the states of Tocantins, Maranhão, Piauí, and Mato Grosso do Sul, in addition to more specific areas of Pará, Ceará, Piauí, Alagoas, Pernambuco, Bahia, São Paulo, Minas Gerais, and Roraima. The spatio-temporal clusters of high-risk areas varied throughout the time series and were relatively higher in the North and Northeast regions. Recent high-risk areas were found in Roraima and municipalities in northeastern states. VL expanded territorially in Brazil in the 21st century. However, there is still a considerable spatial concentration of cases. The areas identified in the present study should be prioritized for disease control actions.

Temporal trend and factors associated with spatial distribution of congenital syphilis in Brazil: An ecological study.

The study aimed to analyze the temporal trend of congenital syphilis in Brazil in the period from 2008 to 2018 and its spatial distribution in the Immediate Regions of Urban Articulation, and to identify spatial correlations with socioeconomic factors and prenatal care. Spatial correlations between the incidence of congenital syphilis and socioeconomic conditions and access to prenatal care were assessed. This ecological study conducted a time series analysis in Brazil and spatial analysis in 482 Immediate Regions of Urban Articulation. Cases of congenital syphilis reported in the Notifiable Diseases Information System and the Live Birth Information System from January 1, 2008, to December 31, 2018 were included. Socioeconomic conditions (percentage of individuals with inadequate water supply and sanitation) were extracted from the 2010 census, whereas the Live Birth Information System provided data on access to prenatal care (percentage of live births with 1-3 prenatal care appointments). The Joinpoint Regression software performed the temporal trend analysis, while the GeoDa software assessed territorial clusters using the Moran's I and Local Spatial Association Indicator. The incidence of congenital syphilis showed an upward trend (annual percent change 1 = 26.96; 95% CI: 18.2-36.3; annual percent change 2 = 10.25; 95% CI: 2.7-28.4) and was unevenly distributed across Immediate Regions of Urban Articulation in Brazil (Moran's I = 0.264, p ≤ 0.05). It also presented a direct spatial correlation with the percentage of individuals with inadequate water supply and sanitation (Moran's I = 0.02, p ≤ 0.05) and the percentage of live births with 1-3 prenatal care appointments (Moran's I = 0.03, p ≤ 0.05). Agrowth trend of congenital syphilis in Brazil was observed between 2008 and 2018. Moreover, inequalities in socioeconomic conditions and access to prenatal care influenced the spatial distribution of this disease.

Sociodemographic and environmental factors associated with dengue, Zika, and chikungunya among adolescents from two Brazilian capitals.

Among the emerging and reemerging arboviral diseases, Zika, dengue and chikungunya deserve special attention due to their wide geographical distribution and clinical severity. The three arboviruses are transmitted by the same vector and can present similar clinical syndromes, bringing challenges to their identification and register. Demographic characteristics and individual and contextual social factors have been associated with the three arboviral diseases. However, little is known about such associations among adolescents, whose relationships with the social environment are different from those of adult populations, implying potentially different places, types, and degrees of exposure to the vector, particularly in the school context. This study aims to identify sociodemographic and environmental risk factors for the occurrence of Zika, dengue, and chikungunya in a cohort of adolescents from the Study of Cardiovascular Risks in Adolescents-ERICA-in the cities of Rio de Janeiro/RJ and Fortaleza/CE, from January 2015 to March 2019. Cases were defined as adolescents with laboratory or clinical-epidemiological diagnosis of Zika, dengue, or chikungunya, notified and registered in the Information System for Notifiable Diseases (SINAN). The cases were identified by linkage between the databases of the ERICA cohort and of SINAN. Multilevel Cox regression was employed to estimate hazard ratios (HR) as measures of association and respective 95% confidence intervals (95%CI). In comparison with adolescents living in lower socioeconomic conditions, the risk of becoming ill due to any of the three studied arboviral diseases was lower among those living in better socioeconomic conditions (HR = 0.43; 95%CI: 0.19-0.99; p = 0.047) and in the adolescents who attended school in the afternoon period (HR = 0.17; 95%CI: 0.06-0.47; p<0.001). When compared to areas whose Building Infestation Index (BII) for Aedes aegypti was considered satisfactory, a BII in the school region classified as "alert" and "risk" was associated with a higher risk of arboviral diseases (HR = 1.62, 95%CI: 0.98-2.70; p = 0.062; HR = 3.72, 95%CI: 1.27-10.9; p = 0.017, respectively). These findings indicate that living in less favored socioeconomic conditions, attending school in the morning, and having a high BII for Ae. aegypti in school's region can contribute to an increased risk of infection by Zika, dengue, or chikungunya in adolescents. The identification of residential or school areas based on those variables can contribute to the implementation of control measures in population groups and priority locations.

Epidemiological survey of human and canine visceral leishmaniasis cases in the municipality of São Luís in the period from 2019 to 2020

The objective was to describe the epidemiological profile of visceral leishmaniasis (VL) in the municipality of São Luís, Maranhão. To this end, a descriptive study was carried out from 2019 to 2020, using secondary data obtained from the Information System of Notifiable Diseases and provided by the São Luís Zoonoses Surveillance Unit. General and clinical characteristics of the disease were analyzed in cases registered in humans and dogs. The results showed that 78 cases of VL in humans were reported, with the following profile: male (74.36%), mixed race (73.08%), 20 to 29 and 40 to 49 years old (35.90%), incomplete elementary school education (37.18%), urban area (44.87%). Most were new cases (84.62%), with co-infection with the HIV virus (41.03%) and with evolution towards cure (82.50%). Among the dogs, 401 cases were reported, 49.63% male, without defined breed (56.86%), age between 1 and 3 years (38.15%). Most dogs were symptomatic (90.27%), with a prevalence of skin lesions (39.90%) and weight loss (15.96%). It is concluded that VL has a frequent occurrence in the city of São Luís, therefore it is necessary to intensify sanitary measures in particular the education of the local population to reach the desired effect.

Surveillance of invasive meningococcal disease in southern Brazil: considerations of an immunization programme.

Invasive meningococcal disease (IMD) is a major cause of meningitis and septicaemia worldwide. Changes in serogroup predominance contribute to the unpredictable nature of the disease, with significant health impact. This study aimed to determine the epidemiological profile of IMD in Rio Grande do Sul, Santa Catarina and Paraná, three states in southern Brazil. We analysed 1024 IMD cases that had been confirmed by clinical and/or laboratory criteria and reported to the national information system for notifiable diseases between 2015 and 2019. Additionally, we calculated the proportions of serogroup and incidence by age. Of 1024 cases, 562 (55 %) were caused by serogroup C. Furthermore, serogroup W was responsible for almost half of the cases among children younger than 5 years between 2017 and 2018, with an overall incidence of 1.5 cases/100 000 infants. IMD remains a significant healthcare issue in southern Brazil despite reduced serogroup C incidence after the introduction of the meningococcal C conjugate vaccine into the childhood immunization programme. Changes in disease epidemiology were observed, and serogroup W was the most common serogroup among children younger than 5 years in 2017 and 2018. Although future cost-effectiveness studies are necessary, our results could have future implications for meningococcal vaccination programmes.

Transition of the epidemiological profile of maternal and congenital syphilis in the State of Goiás (2009-2018): a retrospective analysis

Introduction: Syphilis is a bacterial infection transmitted sexually and transplacental. In Brazil, in the last decade, there has been an increase in notifications of maternal (MS) and congenital (SC) syphilis. Aim: To analyze the epidemiological profile of reported cases of GS and CS in the historical series, from 2009 to 2018, in the state of Goiás. Outlining: Epidemiological, cross-sectional, and analytical retrospective study that describes and analyses the data on MS and CS available in the Information System for Notifiable Diseases (SINAN). Contingency tables, descriptive and inferential statistics were presented, with the application of the G Test and significance level ≤0.05. Results: The results highlighted epidemiological changes in the sociodemographic profile and in the data of the care of pregnant women with syphilis. Implications: The evidenced epidemiological transition shows that there was an improvement in prenatal care in the state of Goiás, requiring health policy measures for specific risk groups. It is fundamental to plan and implement strategic actions with the redefinition of priorities in relation to the epidemiologically affected groups.

Epidemiological profile of Visceral Leishmaniasis in Brazil between 2011-2020

The purpose of this study was to carry out an epidemiological analysis of Visceral Leishmaniasis cases registered by the Notifiable Diseases Information System (SINAN-DATASUS) in Brazil between the years 2011 and 2020. The variables verified were: year, region of notification, gender, age group, and disease progression. In the time range studied, 34,386 cases were registered in the Brazilian territory. The year 2017 stood out with the highest number of cases: 4,462, and 2020 presented the lowest number: 1,908. Such variations proved to be related to global climatic and epidemiological events: 2017 was evaluated as the 3rd hottest year in history by the North American Entity NOAA (National Oceanic Atmospheric Administration), with the consulted literature pointing to relations of growth in the incidence of high temperature climatic events. The year 2020 faced the COVID-19 pandemic break-out. There was a predominance of cases in the Northeast (54.96%), followed by the Southeast (18.67%), North (18.05%), Midwest (8.01%) and South (0.31%). The gender variable shows a predominance of incidence of 65.08% in males and 34.91% in females, which is compatible with the literature. Another parameter that remains within the literature is the age group, where the highest incidence in the 1-4 age group was 23.77%, remaining a disease that severely affects children. The percentages found are in line with the literature and the disease has changed its spread in the Northeast region of the country from about 90% to 55% in two decades, still remaining the most affected region of the country. The disease appears to be more widespread and urban in current studies. There are new and efficient multidisciplinary resources – pharmacological, geographic, climatic and environmental – which, if continued, expanded, and articulated, can strengthen the fight against this serious harm to human health.

Perfil dos acidentes de trabalho com crianças e adolescentes no Brasil, de 2011 a 2020

Abstract Objective: to describe the profile of occupational accidents involving children and adolescents aged 5 to 17 years in Brazil, in the period from 2011 to 2020. Methods: descriptive study based on data from the Sistema de Informação de Agravos de Notificação (SINAN - Notifiable Diseases Information System) and from the Sistema de Informação sobre Mortalidade (SIM - Mortality Information System). Results: from 2011 to 2020, a total of 24,909 cases of occupational accidents involving minors under 18 years of age were registered on SINAN. Most of these cases occurred with males (82.3%), aged 16 to 17 years (84.6%), whites (44.0%), mainly within “Service workers” job titles subgroup as assigned by Brazilian Classification of Occupations. Almost half of the accidents affected the hands and upper limbs (48.7%) and the main diagnosis was “fist and hand injury” (17.7%). A total of 466 deaths were registered in that time period, with 15.9% referring to deaths of children aged 5 to 13 years. Conclusion: registers show records of occupational accidents and deaths related to child labor, including those involving children under 14 years of age, a group in which work is prohibited. It is necessary to ensure the development of research and actions that contribute to the elimination of child labor.

Perfil epidemiológico da sífilis gestacional e congênita em uma área de abrangência da região Pinheirinho de São José do Rio Preto

The aim was to identify the epidemiological profile of pregnant women and newborns with syphilis in a neighborhood of São José do Rio Preto/SP. Descriptive, quantitative and retrospective study, using medical records and the database of the Information System for Notifiable Diseases of 28 pregnant women with gestational syphilis and five newborns with congenital syphilis, at the Solo Sagrado UBSF in the area covered by the Pinheirinho de Pinheirinho Region. São José do Rio Preto/SP in the period 2019/2020. In 2019, 268 pregnant women underwent prenatal care and 21 of them were notified with a diagnosis of gestational syphilis, only four babies with congenital syphilis tested positive in the treponemal/non-treponemal test at delivery/curettage and two of them evolved to miscarriage. In 2020, 275 pregnant women underwent prenatal care and seven were diagnosed and notified with gestational syphilis and only one baby with congenital syphilis tested positive in the treponemal/non-treponemal test at delivery. Considering that the main difficulties encountered in reducing vertical transmission are associated with late diagnosis or non-treatment, or inadequate treatment of pregnant women, in addition, socioeconomic, demographic and care factors contribute to the increase in its incidence.

Tuberculosis in the Brazilian prison system: scenarios via Joinpoint, from 2007 to 2019

This study describes and compares tuberculosis (TB) data among persons deprived of liberty and the general Brazilian population, from 2007 to 2019, using the Joinpoint tool to observe changes in trends. This study focuses on women and older adults, for HIV testing, and on the number of detainees according to prison capacity. This is a retrospective, quantitative, and analytical study, which uses methods of regression of time series data from secondary data of unrestricted access collected from the Brazilian Information System for Notifiable Diseases (SINAN), Brazilian Institute of Geography and Statistics (IBGE), and from analytical reports made available by the Brazilian National Penitentiary Department (DEPEN). The results show a considerably higher increase in the prevalence of TB in persons deprived of liberty in all perspectives analyzed; increased HIV testing; and a debatable trend of stability in the number of detainees according to prison capacity. When analyzing trends in prevalence, services, and determinants, it is curious to see the temporal non-coincidence in most cases. Clearly, national policies against TB do not have the same effect within prisons and even the National Policy for Comprehensive Health Care for People Deprived of Liberty in the Prison System (PNAISP) showed restricted effects in view of the health situation herein analyzed. Despite working with secondary data of variable reliability, comparisons were reached that can impact health decisions and actions. Although lacking complete and definitive answers, it was possible to launch a new point-of-view on the evolution of questions for which reflection is essential.

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.

Situational analysis of syphilis cases taking place between 2015 and 2021 in the state of Rio Grande do Norte - Brazil

Introduction: Syphilis is a sexually transmitted infection that represents a severe public health problem worldwide and in Brazil it has not been different. The national compulsory notifications regarding syphilis cases are significantly increasing, and therefore, this fact alone justifies the study of such a relevant subject. Objective: This work presents a situational analysis of syphilis cases in the state of Rio Grande do Norte, Brazil, between 2015 and 2021, aiming primarily at assisting public healthcare authorities in decision-making processes to cope with the disease. Concomitantly, this research aims to build knowledge as well as to provide awareness to the population. Methods: This study analyzed data from compulsory notifications reports from 2015 to 2021, available in the database of the Brazilian Unified Health System’s Informatics Department, in the Brazilian Information System of Notifiable Diseases and in the Brazilian Health Surveillance Secretariat. Results: In the state, 70% of patients with syphilis are aged 15 to 39 years. The rate of patients affected with acquired syphilis that have low education is 48%, and for pregnant women, this value rises to 77%. The declared mixed-race patients represent 48% of notifications for acquired syphilis, and for mixed-race pregnant women, this value increases to 60%. In congenital syphilis, 98% of compulsory notifications occurred for children aged up to 7 days of birth. Conclusion: Syphilis in Rio Grande do Norte is a public health problem that mainly affects the vulnerable population, predominantly the groups at risk with low education, mixed race, and young-adult people, being of paramount importance to combat the disease through population awareness, as well as through constant and adequate compulsory notification.

COVID-19 EM TRABALHADORES DA SAÚDE: UM ESTUDO ECOLÓGICO A PARTIR DE DADOS DO SINAN, 2020-2021

ABSTRACT Objective: to analyze the epidemiological and occupational profile of health workers notified for COVID-19 in Brazil, in the years 2020 and 2021. Method: this is an ecological study, which used data from the Information System of Notifiable Diseases (SINAN) and the Annual Social Information List (RAIS), from the years 2020 and 2021. Sociodemographic and occupational variables were analyzed. The prevalence rates of COVID-19 in health workers were calculated, modeled by Poisson regression in the Stata 14 software. Results: in 2020 and 2021, 35,545 health workers were affected by COVID-19. A higher prevalence of the disease was observed in females (79.0%), between 30 and 49 years (65.5%) and in blacks and browns (41.4%). Higher rates were observed in women (793.9/100,000 in 2020), young workers (839.9/100,000 in 2020), non-whites (1,497.4/100,000 in 2020) and in northern Brazil, with 1,688.1 cases per 100,000 workers in 2020. Nursing professionals, physicians and physical therapists had the highest rates of the disease in 2020 and 2021. Conclusion: there was a difference between the sexes, as well as social, racial and occupational inequities that reflect the need to expand health surveillance measures in order to ensure greater prevention, protection and assistance to health workers.