Urban Flood Relief Management in COVID-19 Pandemic

Introduction: Urban floods were addressed as a separate disaster after the historical 2005 Mumbai floods. Urban flood peaks are 2-8 times and volume 6 times when compared with rural floods. We are now handling multiple disasters simultaneously due to the Covid-19 Pandemic. The river plains of north India are prone to floods in the monsoon season and geographical location of Prayagraj doubles the damage because it faces wrath from two sides. Very few researches have been conducted on urban floods and evidence needs to be generated from the field. Methodology: This qualitative research was planned with an objective to identify the difficulties faced in operating an urban flood relief camp during superimposed burden of COVID-19 Pandemic and to suggest remedial measures from the public health aspect. We conducted in-depth interviews of nodal officers, health staff and beneficiaries of the identified camps. Informed consent was taken from participant after explaining them about the research. Results: The findings from the interviews were categorized into 3phases of flood relief i.e. before the floods, during floods and lastly post flood. The most crucial work before floods is to spread awareness about do’s and don’ts in detail. Next was identification of the local people actually affected by flood. The space and facilities at few centers was low for the population load. Urban flood management needs a major overhauling of public health infrastructure to handle such disasters in future. Conclusion: The officials were working hard to make the homeless feel as if they are on a picnic. The database of beneficiaries should be strengthened and should also include students and labourers, anyone who is a flood victim and not only local flood victims.

Confianza en la gestión pública del riesgo y dinámica social en caso de inundación / Trust in Public Risk Management and Social Dynamics in the Case of Flood Risk

Resumen El cambio climático está forzando a los expertos en inundaciones costeras a involucrar a los residentes en la prevención de riesgos, en particular, a través de comunicaciones oficiales que incluyen recomendaciones de comportamiento. Este estudio tiene como objetivo comprender la integración que hacen los residentes de esta información oficial en relación con el riesgo de inundación. Se realiza un estudio cualitativo sobre el postulado teórico que considera que la dinámica social que se crea entre los gestores de riesgos y los residentes ayuda a explicar la relación con el riesgo de inundación. Estas dinámicas se analizan a través del tipo de confianza que los residentes depositan en los actores públicos de la gestión y el nivel de conocimiento que afirman tener. Se realizaron 20 entrevistas semiestructuradas con residentes de una ciudad costera expuesta al riesgo de inundaciones, reclutados mediante el método de bola de nieve hasta el punto de saturación. Los resultados sugieren que los residentes que sienten tener poco conocimiento confieren confianza social a los gestores de riesgos y una visión positiva de las comunicaciones sobre este riesgo; mientras que los que sienten tener mucho conocimiento sobre las inundaciones apoyan una confianza calculadora sobre los aspectos técnicos de la gestión y una visión negativa de las comunicaciones. Estos tipos de confianza reflejan una relación con el riesgo de inundación anclado en el espacio social donde los grupos toman posición en la dinámica social. En este sentido, para ser eficaz, la comunicación preventiva debería tener en cuenta no solo el contenido real del mensaje sino también los mecanismos sociales que apoyan su interpretación, en particular la confianza entre el mensajero y el destinatario.

Abstract Climate change forces coastal communities exposed to floods to involve residents more actively in risk prevention, notably through official communication including behavioral recommendations. In order to improve prevention impact, this study aims to understand how inhabitants deal with this official information and integrate it into their relation to flood risk. This qualitative study is based on the theoretical postulate that the social dynamics nested in the relations between risk managers and inhabitants contributing to explain inhabitants' relationship to flood risk. These social dynamics are analysed through the type of trust granted by inhabitants to risk managers and the level of knowledge inhabitants state to have. 20 semi-structured interviews were conducted with inhabitants of a coastal city subject to flood hazards, recruited through snowballing method until saturation point. Results suggest that inhabitants who feel that they have little knowledge are prone to display social trust toward risk managers and a positive vision of communications provided on this risk, while those who are aware about floods, endorse a calculating trust based on the technical aspects of management, and eventually a form of distrust about communications delivered by public actors. These types of trust reflect a relation to flood risk embedded in the social space where individuals and groups take positions in social dynamics. In this sense and to be successful, preventive communication should consider not only the actual content of the message but also the social mechanisms that support its interpretation, in particular the trust between the messenger and the receiver.

Relação entre casos de hepatite A e áreas de inundação, município de Encantado, Rio Grande do Sul, Brasil / Relationship between cases of hepatitis A and flood areas, municipality of Encantado, Rio Grande do Sul, Brazil

Resumo A relação entre os desastres de origem hidrometeorológicos e a saúde das populações atingidas ainda é pouco abordada no Rio Grande do Sul (RS), Brasil. A Hepatite A é uma doença que envolve questões sanitárias e do meio urbano, sendo uma doença do tipo evitável. Esse estudo tem como objetivo analisar a relação entre áreas de inundação e a ocorrência de doenças de veiculação hídrica, neste caso, a Hepatite A. Foi estruturado um banco de dados dos casos confirmados de Hepatite A e de eventos de inundações no município de Encantado-RS entre os anos de 2012 e 2014. Esses dados foram analisados espacialmente a partir do estimador Kernel dos pontos de ocorrência de casos de Hepatite A e correlacionados para o perímetro urbano. Verificou-se que nos três meses posteriores à ocorrência de inundação, foram registrados 44 casos, um aumento de quase 300%, no registro de casos de Hepatite A. Os resultados identificaram que todos os casos confirmados estão na área urbana localizada na planície de inundação. O que reafirma a importância de incentivo a formulação e implementação de políticas de prevenção a surtos de doenças pós-desastres hidrometeorológicos.

Abstract The relationship between hydrometeorological disasters and the health of affected populations is still hardly discussed in Rio Grande do Sul (RS), Brazil. Hepatitis A is a disease that involves health and urban environment issue and is an avoidable disease. This study aims to analyze the relationship between flood areas and waterborne diseases, in this case, Hepatitis A. A database of confirmed cases of Hepatitis A and flood events in the municipality of Encantado-RS, Brazil between 2012 and 2014 was structured. These data were analyzed spatially from the kernel estimator of the occurrence points of Hepatitis A cases and correlated to the urban perimeter. It was verified that 44 cases were registered in the three months following the occurrence of flood, an increase of almost 300% in the records of Hepatitis A. The results identified that all the confirmed cases are in the urban area located in the floodplain. This reaffirms the importance of encouraging the formulation and implementation of policies to prevent outbreaks of waterborne diseases post hydrometeorological disaster.

Associations between floods and bacillary dysentery cases in main urban areas of Chongqing, China, 2005-2016: a retrospective study

BACKGROUND@#Understanding the association between floods and bacillary dysentery (BD) incidence is necessary for us to assess the health risk of extreme weather events. This study aims at exploring the association between floods and daily bacillary dysentery cases in main urban areas of Chongqing between 2005 and 2016 as well as evaluating the attributable risk from floods.@*METHODS@#The association between floods and daily bacillary dysentery cases was evaluated by using distributed lag non-linear model, controlling for meteorological factors, long-term trend, seasonality, and day of week. The fraction and number of bacillary dysentery cases attributable to floods was calculated. Subgroup analyses were conducted to explore the association across age, gender, and occupation.@*RESULTS@#After controlling the impact of temperature, precipitation, relative humidity, long-term trend, and seasonality, a significant lag effect of floods on bacillary dysentery cases was found at 0-day, 3-day, and 4-day lag, and the cumulative relative risk (CRR) over a 7-lag day period was 1.393 (95%CI 1.216-1.596). Male had higher risk than female. People under 5 years old and people aged 15-64 years old had significantly higher risk. Students, workers, and children had significantly higher risk. During the study period, based on 7-lag days, the attributable fraction of bacillary dysentery cases due to floods was 1.10% and the attributable number was 497 persons.@*CONCLUSIONS@#This study confirms that floods can increase the risk of bacillary dysentery incidence in main urban areas of Chongqing within an accurate time scale, the risk of bacillary dysentery caused by floods is still serious. The key population includes male, people under 5 years old, students, workers, and children. Considering the lag effect of floods on bacillary dysentery, the government and public health emergency departments should advance to the emergency health response in order to minimize the potential risk of floods on public.

Inundações e leptospirose nos municípios brasileiros no período de 2003 a 2013: utilização de técnicas de mineração de dados / Floods and leptospirosis in Brazilian municipalities from 2003 to 2013: use of data mining techniques / Inundaciones y leptospirosis en municipios brasileños durante el período de 2003 a 2013: utilización de técnicas de mineración de datos

A leptospirose se relaciona a problemas de saneamento ambiental, com incremento de casos em períodos de inundações. Levando-se em consideração as questões relacionadas a mudanças climáticas, as inundações tendem a um aumento. As inundações não atingem as populações de maneira homogênea, em geral os menos favorecidos em termos socioeconômicos são os mais acometidos. Para saber se o número de inundações aumentaria a incidência de leptospirose e sua relação com as variáveis contextuais, utilizou-se dados socioeconômicos, ambientais e de ocorrência da doença no nível municipal. Os municípios que tinham problemas no esgotamento sanitário apresentaram maior risco para a ocorrência da leptospirose. O total de inundações adquirida a partir da decretação pela autoridade municipal constituiu um importante marcador de risco para a ocorrência de leptospirose. A modelagem de árvore de regressão mostrou-se útil para estimar a ocorrência de leptospirose no Brasil.

Leptospirosis is related to problems with environmental sanitation, and the incidence tends to increase during flood periods. Considering issues related to climate change, floods can be expected to increase. Floods do not affect populations homogeneously, and communities with worse socioeconomic conditions tend to be impacted more heavily. In order to determine whether the number of floods increases the incidence of leptospirosis and its relationship to contextual variables, the study used socioeconomic, environmental, and disease occurrence data at the municipal (county) level. Municipalities suffering problems with sewage disposal showed a higher risk of leptospirosis incidence. Total flooding since the municipality's declaration of flood emergency was an important risk marker for leptospirosis incidence. Regression tree modeling proved useful for estimating leptospirosis incidence in Brazil.

La leptospirosis se relaciona con problemas de saneamiento ambiental, así como con el incremento de casos en períodos de inundaciones. Teniendo en consideración las cuestiones relacionadas con el cambio climático, las inundaciones tienden a aumentar. Las inundaciones no afectan a las poblaciones de manera homogénea, en general, los menos favorecidos en términos socioeconómicos son los más afectados. Para saber si el número de inundaciones aumentaría la incidencia de leptospirosis, y su relación con variables contextuales, se utilizaron datos socioeconómicos, ambientales y de ocurrencia de la enfermedad en el nivel municipal. Los municipios que poseían problemas en el alcantarillado sanitario presentaron un mayor riesgo para la ocurrencia de leptospirosis. El total de inundaciones sufridas a partir de su reconocimiento oficial por parte de la autoridad municipal constituyó un importante marcador de riesgo para la ocurrencia de leptospirosis. El modelo de árbol de regresión se mostró útil para estimar la ocurrencia de leptospirosis en Brasil.

Percepção e hierarquia de riscos de inundação recorrente em área urbana regularizada: uma análise discursiva / Risk perception and hierarchy of risks related to recurrent floods in a regularized urban area: a discursive analysis

RESUMO Este estudo analisou estratégias discursivas adotadas por moradores que vivem em uma área de risco de inundações recorrentes para justificar sua permanência no bairro. Foi baseado em suas percepções, critérios de hierarquização de riscos, ações preventivas e ações de mitigação de riscos. Para tanto, foram analisados trechos de diários de campo e entrevistas semiestruturadas com dois moradores que discordavam sobre o risco de inundações e a necessidade de permanecer no bairro. Os resultados mostram que as dificuldades econômicas de realocação e os princípios morais que impedem alguém de vender sua casa são argumentos usados pelo morador que quer se mudar do bairro. O morador que deseja permanecer no bairro tende a normalizar os riscos e a valorizar os benefícios da região. Os residentes decidem se devem ou não deixar a água entrar em suas casas durante uma enchente e se devem ou não sair de casa durante a estação chuvosa para realizar suas atividades diárias com base em sua organização prévia e apego ao lugar e bens materiais. Conclui-se que as inundações afetam a vida cotidiana dos moradores e envolvem processos de tomada de decisão que precisam ser considerados pelas autoridades públicas na gestão de riscos.

ABSTRACT This study analyzed discursive strategies adopted by residents who live in an area of risk of recurrent flooding to justify their stay in the neighborhood. It was based on their perceptions, risk hierarchisation criteria, preventive actions and risk mitigation actions. For this purpose, excerpts from field diaries and semi-structured interviews with two residents who disagreed about the risk of flooding and the need to stay in the neighborhood were analyzed. Results show that economic difficulties of relocation and the moral principles that prevent someone from selling their house are arguments used by the resident who wants to move from the neighborhood. The resident who wants to stay in the neighborhood tends to normalize the risks and to value the benefits of the region. Residents decide whether or not to let water enter their homes during a flood and whether or not to leave the house during the rainy season to carry out their daily activities based on their prior organization and attachment to the place and material goods. It is concluded that floods affect the daily lives of residents and involve decision-making processes, which need to be considered by the public authorities in risk management.

Emergência em saúde pública por inundações: a atuação do Ministério da Saúde em ocorrências no Brasil de 2004 a 2017 / Emergency in public health caused by floods: the Ministry of Health actions in occurrences in Brazil, from 2004 to 2017

RESUMO Este artigo teve por objetivos contextualizar os impactos das inundações na saúde e analisar relatórios do Centro de Operações de Emergência em Saúde, mobilizados pelo Ministério da Saúde (MS), para monitoramento federal desses eventos no Brasil, de 2004 a 2017. Para isso, foi realizado levantamento bibliográfico e documental, incluindo relatórios do MS sobre inundações, e feita análise de dados do Sistema Integrado de Informações sobre Desastres, da Defesa Civil, no referido período. Verificou-se que as inundações atingiram todas as regiões brasileiras, com eventos críticos em 2004, 2009, 2010 e 2011. O MS atuou em nove ocorrências, e essa experiência subsidiou o estabelecimento da estratégia de preparação e resposta, incluindo Comitês de Saúde em Desastres, documentos e normativas para orientar a atividade do Sistema Único de Saúde (SUS) na atuação em desastres hidrológicos. Inundações de grande magnitude exigem resposta rápida, e isso prescinde de preparação prévia. O MS avançou nas articulações intersetoriais e interinstitucionais, no entanto, dotar o SUS municipal da capacidade necessária para atuação oportuna apresenta-se ainda como um desafio a ser superado.

ABSTRACT The objective of this article is to contextualize the impacts of floods on health and to analyze reports from the Emergency Health Operations Center, mobilized by the Ministry of Health (MS), for the federal monitoring of these events in Brazil, between 2004 and 2017. For such, a bibliographical and documentary survey was carried out, including MS reports on floods and data analysis of the Integrated Disaster Information System, from the Civil Defense, from 2004 to 2017. It was verified that floods reached all Brazilian regions, with critical events in 2004, 2009, 2010, and 2011. The MS worked in nine occurrences and this experience subsidized the establishment of the preparedness and response strategy, including Health in Disaster Committees, documents, and regulations to guide the SUS's (Unified Health System) action in hydrological disasters. Floods of great magnitude require rapid response and this does not require prior preparation. The MS has advanced in inter-sectorial and interinstitutional articulations, however, providing the municipal SUS with the necessary capacity for timely action is still a challenge to be overcome.

Variabilidade climática e internações por doenças diarreicas infecciosas em um município da Amazônia Ocidental brasileira / Climate variability and hospitalizations due to infectious diarrheal diseases in a municipality of the Western Brazilian Amazon Region

Resumo A morbimortalidade por doenças diarreicas infecciosas ainda representa um grave problema de saúde no Brasil e está altamente relacionada a fatores como condições climáticas, ambientais e de vida da população. O objetivo deste estudo foi analisar a associação das taxas de internações por doenças diarreicas infecciosas na população do município de Rio Branco/AC com a precipitação, o nível do rio, a umidade e a temperatura, entre os anos de 2000 e 2013. Os dados foram extraídos do Sistema de Informações Hospitalares do SUS, do Instituto Nacional de Meteorologia e da Agência Nacional das Águas. Foram ajustados modelos múltiplos de regressão de Poisson e binomial negativa. Os resultados mostram que existe uma associação positiva entre as internações por doenças diarreicas infecciosas e o nível do Rio Acre (RT:1,07; IC95%:1,04 a 1,1); houve um decréscimo de 14% nestas taxas de internações entre os anos de 2000 e 2013 (RT:0,86; IC95%:0,85 a 0,87); o grupo mais vulnerável pertence à faixa etária de menores de 1 ano de vida. Este estudo mostrou a vulnerabilidade de uma cidade na Amazônia quanto à variabilidade climática e a respectiva influência epidemiológica na incidência de internações por doenças diarreicas infecciosas.

Abstract Morbimortality due to infectious diarrheal diseases still is a serious health issue in Brazil and is highly related to factors such as weather, environment, and people's life conditions. This study aimed to analyze the relationship between hospitalization rates due to infectious diarrheal diseases among the population of the municipality of Rio Branco (AC), Brazil and precipitation, river level, humidity and temperature between 2000 and 2013. Data were retrieved from the Hospital Information System of the SUS (Unified Health System), the National Institute of Meteorology and the National Water Agency. Multiple Poisson and negative binomial regression models were adjusted. Results showed that there is a positive association between hospitalization due to infectious diarrheal diseases and the level of the Acre river (RR: 1.07; CI 95%: 1.04 to 1.1); these hospitalization rates fell 14% between 2000 and 2013 (RR: 0.86; CI 95%: 0.85 to 0.87). The most vulnerable group was the age group of less than 1 year of age. This study showed the vulnerability of an Amazonian city to climate variability and its respective epidemiological influence on the incidence of hospitalizations due to infectious diarrheal diseases.

Critical Requirements for Nursing Practice in Rural Disasters Caused by Floods / Exigencias críticas para la práctica de enfermeros en desastres rurales causados por inundaciones / Exigências críticas para a prática de enfermeiros em desastres rurais causados por inundações

ABSTRACT Objective: To identify critical requirements for nursing practice when responding to hydrological disasters in the rural area. Method: A descriptive, exploratory and qualitative study was developed. The Critical Incidents Technique was adopted. Twenty public health nurses who worked during the flood season in the years of 2014 and 2015 in a rural area in Southern Brazil were interviewed. Content analysis of the data was developed. Results: Critical requirements for nurses' practice were derived from the situations (n=78), critical behaviors (n=98) and consequences to the population (n=43) and to the nurses (n=38) identified. Conclusion / Final considerations: Although the requirements could be related to the established international referential for nurses' practice in disasters, some were described only in this study. They can contribute to the education and practice of nurses in primary health care, strengthening its capacity to face disaster situations by flood in the rural area.

RESUMEN Objetivo: Identificar las exigencias críticas para la práctica de enfermeros en la respuesta a desastres hidrológicos en áreas rurales. Método: Estudio descriptivo, exploratorio y cualitativo. Se adoptó la Técnica de Incidentes Críticos. Se entrevistó a 20 enfermeros de salud pública que trabajaron en la época de las inundaciones en los años 2014 y 2015 en áreas rurales del sur de Brasil. Se realizó el análisis de contenido de los datos. Resultados: Los requisitos críticos para la práctica de los enfermeros fueron originados de las situaciones (n = 78), comportamientos críticos (n = 98) y consecuencias para la población (n = 43) y para los enfermeros (n = 38). Conclusión: Aunque las exigencias pueden estar relacionadas al referencial internacional establecido para la práctica de enfermeros en desastres, algunos sólo se describieron en este estudio. Pueden contribuir a la educación y práctica del enfermero en la atención primaria a la salud, fortaleciendo su capacidad en inundaciones.

RESUMO Objetivo: Identificar as exigências críticas para a prática de enfermeiros na resposta a desastres hidrológicos na área rural. Método: Estudo descritivo, exploratório e qualitativo. Adotou-se a Técnica de Incidentes Críticos. Foram entrevistados 20 enfermeiros de saúde pública que trabalharam na época das inundações nos anos de 2014 e 2015 em áreas rurais do sul do Brasil. Realizou-se a análise de conteúdo dos dados. Resultados: Os requisitos críticos para a prática dos enfermeiros se originaram das situações (n = 78), comportamentos críticos (n = 98) e consequências para a população (n = 43) e para os enfermeiros (n = 38) identificados. Conclusão: Embora os requisitos possam estar relacionados ao referencial internacional estabelecido para a prática de enfermeiros em desastres, alguns foram descritos apenas neste estudo. Eles podem contribuir para a educação e prática do enfermeiro na Atenção Primária à Saúde, fortalecendo sua capacidade de enfrentar situações de desastre por inundação rural.

Percepción de riesgo ante las inundaciones en personas que habitan en zonas vulnerables de Lima, Perú / Risk perception of people living in vulnerable zones of Lima (Peru) during floods

Introducción: En el último año, el Perú experimentó un fenómeno climático denominado el Niño costero. Este generó lluvias, huaicos e inundaciones, afectando a miles de personas y ocasionando la declaración en emergencia sanitaria del país. A pesar de la ocurrencia de fenómenos similares en las zonas afectadas, estas suelen ser ocupadas como lugares de residencia. Objetivo: Identificar las características de la percepción de riesgo ante las inundaciones en personas que habitan en zonas vulnerables. Método: Investigación empírica cualitativa desarrollada en el año 2017. Se aplicó la técnica de la entrevista semiestructurada a nueve personas residentes en cuatro distritos de Lima (Perú) propensos a inundaciones. La información recolectada se analizó con el apoyo del software para el análisis cualitativo de datos Atlas.ti v.7.0, utilizando elementos de la Teoría Fundamentada para desarrollar los procesos de codificación y categorización. Resultados: Se encontró que los participantes no poseen percepción de riesgo ante la amenaza de las inundaciones. Conciben a las inundaciones como una amenaza cuando experimentan sus consecuencias. Conclusiones: Se requieren desarrollar investigaciones de carácter interdisciplinario que permitan generar evidencia para el desarrollo de intervenciones orientadas a la construcción de una percepción de riesgo coherente con las consecuencias e impacto de las inundaciones(AU)

Introduction: In the last year, Peru experienced a climatic phenomenon called Niño Costero. This generated rains, alluviums and floods affecting thousands of people and causing the declaration of health emergency in the country. In spite of the occurrence of similar phenomena in the affected areas, these are usually occupied as places to live. Objective: To identify the characteristics of risk's perception during floods in people who live in vulnerable zones. Method: A qualitative empirical research was developed in the year 2017. The semi-structured interview technique was conducted in nine people living in four districts of Lima (Peru) whom were susceptible to flooding. The information collected was analyzed with the support of Atlas.ti v. 7.0., software for the qualitative data analysis, using elements of the Grounded Theory to develop the coding and categorization processes. Results: It was found that the participants do not elaborate a perception of risk before the threat of floods. They envisage the floods as a threat when experience their consequences. Conclusions: It is necessary to implement interdisciplinary researches that allow to generate evidence for the development of interventions aimed to the creation of a risk's perception that will be coherent with the consequences and the impact of floods(AU)

Prevalence and severity of depression among people residing in flood affected areas of Kerala

Background: The world is witnessing significant change in its climate leading to an increase in natural disasters. Kerala state of India recently witnessed its worst Monsoon rainfall in the century. Floods have significant effects on mental health. Screening of psychological problems is necessary in the background of recent floods in Kerala. So this study was done with the objectives to assess the prevalence of depression in the flood affected people of Kerala and to assess the severity of depression among people residing in flood affected areas of Kerala.Methods: Cross sectional study was done four weeks after flood. Individuals aged ≥15 years residing in flood affected areas were included and people not willing to participate were excluded. Purposive sampling was done and 306 participants were studied. Participants were assessed by interview technique using PHQ9 questionnaire. Data was analysed using SPSS-22. Descriptive statistics like percentage were applied. Inferential statistical tests like chi-square test were applied for association.Results: Among the participants 48% showed symptoms of depression. 28.10 % were mildly depressed, 12.74% were moderately depressed, 5.56% had moderately severe and 1.63% had severe depression. Maximum prevalence of depression was observed in geriatric age group.Conclusions: A significant amount of people residing in flood affected areas showed signs and symptoms of depression. An urgent intervention is therefore required to improve mental health status of the flood affected individuals.

Incidência da leptospirose em uma capital da Amazônia Ocidental brasileira e sua relação com a variabilidade climática e ambiental, entre os anos de 2008 e 2013 / Incidencia de la leptospirosis en una capital de la Amazonía Occidental brasileña y su relación con la variabilidad climática y ambiental, entre los años 2008 y 2013 / Leptospirosis incidence in a state capital in the Western Brazilian Amazon and its relationship with climate and environmental variability, 2008-2013

Objetivo: analisar a associação de variáveis ambientais com a incidência da leptospirose no município de Rio Branco, Acre, Brasil, de 2008 a 2013. Métodos: estudo ecológico com associação das médias mensais de variáveis ambientais com as incidências mensais da leptospirose, pelos modelos generalizados autorregressivos e médias móveis. Resultados: os aumentos nas médias mensais do nível do rio Acre e dos dias de precipitação no mês estiveram associados a um aumento de 7% (razão de taxas de incidência [RT] 1,07 - IC95% 1,02;1,14) e 4% (RT 1,04 - IC95% 1,00;1,07) nas incidência mensais da leptospirose, respectivamente; em 2013, a incidência de leptospirose no município foi 8 vezes maior que em 2008 (RT 8,00 - IC95% 4,07;15,71). Conclusão: este estudo mostrou forte aumento nas incidências de leptospirose, ao longo dos anos estudados, e associações positivas com as variáveis ambientais.

Objetivo: analizar la asociación de variables ambientales con la incidencia de la leptospirosis en el municipio de Rio Branco, Acre, Brasil, de 2008 a 2013. Métodos: en este estudio ecológico se asociaron los promedios mensuales de variables ambientales con las incidencias mensuales de la leptospirosis, por los modelos generalizados autorregresivos y promedios móviles. Resultados: los aumentos en los promedios mensuales del nivel del río Acre y de los días de precipitación en el mes, estuvieron asociados a un aumento del 7% (razón de las tasas de incidencia [RT] 1,07 - IC95% 1,02;1,14) y del 4% (RT 1,04 - IC95% 1,00;1,07) en las incidencias mensuales de la leptospirosis, respectivamente; en 2013, la incidencia de leptospirosis en el municipio fue 8 veces mayor que en 2008 (RT 8,00 - IC95% 4,07;15,71). Conclusión: este estudio mostró un fuerte aumento en las incidencias de leptospirosis, durante los años estudiados, y asociaciones positivas con las variables ambientales.

Objective: to analyze association between environmental variables and leptospirosis incidence in the municipality of Rio Branco, Acre, Brazil, 2008-2013. Methods: this was an ecological study of association between monthly average environmental variables and monthly leptospirosis incidence, according to generalized autoregressive score models and moving averages. Results: increases in the monthly average levels of the River Acre and days of precipitation per month were associated with a 7% increase (incidence rate ratio [RR] 1.07 - 95%CI 1.02;1.14) and a 4% increase (RR 1.04 - 95%CI 1,00;1,07) in the monthly incidence of leptospirosis, respectively; in 2013 leptospirosis incidence in the municipality was 8 times higher than in 2008 (RR 8.00 - 95%CI 4.07;15.71). Conclusion: this study showed a strong increase in leptospirosis incidence, over the years studied, and positive associations with environmental variables.

Modelação hidráulica e de qualidade da água dos sistemas de drenagem em meios urbanos / Hydraulic and water quality modelling of urban drainage systems

RESUMO: As inundações urbanas estão se tornando cada vez mais frequentes, de tal forma que a União Europeia publicou a Diretiva 2007/60/CE no sentido de mitigar as consequências relacionadas com este fenômeno e de impor limites à concentração de poluentes nas águas pluviais. O objetivo deste artigo foi apresentar uma modelação dos sistemas de drenagem em situação de inundações, baseada no software da United States Environmental Protection Agency (EPA), Storm Water Management Model (SWMM), em que o estudo de caso é analisar um sistema de drenagem urbana unitário, inserido na Zona Central de Coimbra, em Portugal. Recorrendo à metodologia Automatic Overland Flow Delineation (AOFD) para a geração de uma rede de drenagem superficial e implementando-a no SWMM, obteve-se um modelo de drenagem dual, que permite a análise do escoamento em situação de inundações, incluindo o controle de escoamento entre a superfície e a rede de coletores e a modelação da qualidade da água à superfície. Este modelo permite quantificar a carga poluente à superfície, relativamente ao parâmetro de sólidos suspensos totais, para um evento de precipitação extrema.

ABSTRACT: Urban floods are becoming more frequent. Thus, the European Union published the Directive 2007/60/CE to mitigate costs related with this phenomenon and to impose limits on the concentration of pollutants in pluvial water. The purpose of this study was to present the modelling of drainage systems in flood situations, based on the software of the United States Environmental Protection Agency (EPA), the Storm Water Management Model (SWMM), in which the study case is to analyze a unitary urban drainage system of Zona Central catchment in Coimbra, Portugal. By using the Automatic Overland Flow Delineation (AOFD) methodology for the generation of a superficial drainage network and implementing it in the SWMM, it was obtained a dual drainage model that allows the flow analysis in flood conditions, including flow control between the surface and collectors network and also modeling of water quality at the surface. This model allows quantifying the pollution load at the surface, relatively to the parameter of total suspended solids, for any extreme rainfall event.

Mapeamento de áreas de risco a escorregamentos e inundações em áreas marginais a rodovias na Região Metropolitana de São Paulo / Landslide and flood risk mapping in marginal road areas in São Paulo Metropolitan Region

RESUMO: O objetivo principal deste trabalho foi realizar o mapeamento de áreas de risco a escorregamentos e a inundações em áreas marginais a uma importante rodovia do Estado de São Paulo. Sendo assim, um segundo objetivo do trabalho foi apresentar medidas geotécnicas de contenção aos processos mapeados. Para isso, as áreas de risco foram mapeadas a partir de visitas de campo e classificadas em quatro graus de risco (R1: baixo; R2: médio; R3: alto ou; R4: muito alto) utilizando fichas de cadastro que contemplam condicionantes naturais, antrópicos e evidências de instabilidade. Foram identificados oito setores de risco a escorregamentos (cinco com risco R2; dois com risco R3 e um com risco R4) e um setor de risco a inundação (R3). Este trabalho poderá contribuir no melhor monitoramento de impactos ambientais resultantes da construção de rodovias, sobretudo, resultantes do aparecimento de ocupações irregulares em áreas impróprias para a ocupação.

ABSTRACT: The objective of this paper was develop a landslide and flood risk map to areas located close to an important road in São Paulo state. Thus, the second objective was present geotechnical measures to mitigate the mapped processes. The risk areas were mapped from fieldwork and classified into four risk levels (R1: low; R2: medium; R3: high or; R4: very high) using registration forms that include natural constraints, anthropogenic processes and instability evidences. There were identified eight landslide risk areas (five were classified as a R2 risk, two were classified as a R3 risk and one were classified as a R4 risk) and one flood risk classified as a R3 risk. This paper can help monitoring the environmental impacts that may occur after the road construction, especially in the emergence of irregular settlements in unsuitable areas.

Análise de desempenho de medidas estruturais e não estruturais de controle de inundações em uma bacia urbana / Performance analysis of structural and non-structural flood control measures in an urban watershed

RESUMO Este trabalho teve como objetivo analisar, por meio de simulações hidrológicas e hidráulicas, o desempenho de algumas medidas de controle de inundação, estruturais e não estruturais. Para tanto, os mapas e demais informações espaciais da bacia hidrográfica do Córrego do Gregório, em São Carlos (SP), foram digitalizadas com auxílio do software de geoprocessamento ArcGIS(r) e imagens de satélite de alta resolução. Com base nessas informações, foram propostos cenários alternativos que incorporaram as medidas de controle. Através da utilização dos softwares HEC-HMS e HEC-RAS realizaram-se as modelações hidráulicas e hidrológicas, utilizando tempos de retorno de 25, 50 e 100 anos para a chuva de projeto. Com os resultados obtidos (hidrogramas de cheia e manchas de inundação referentes a cada tempo de retorno), foi possível analisar as medidas, comparando-se os diferentes cenários. Concluiu-se, para este caso, que os melhores resultados correspondem à associação das medidas estruturais e não estruturais. Contudo, também foi verificado que, mesmo com a concretização do cenário mais favorável, o problema das inundações não seria satisfatoriamente equacionado, o que revela a necessidade de se considerar outras medidas para minimizar os prejuízos decorrentes das inundações, tais como medidas de controle na fonte, seguros contra inundações e sistemas de alerta antecipados.

ABSTRACT The present study shows an analysis of the performance of some structural and nonstructural flood control measures by means of hydrologic and hydraulic simulations. The basin of the Gregório River, in São Carlos (SP), Brazil, was scanned and scenarios that incorporate the management measures were created, both with the aid of the GIS software ArcGIS and high-resolution satellite images. Hydraulic and hydrologic modeling were performed by HEC-HMS and HEC-RAS software using return periods of 25, 50 and 100 years for the design storm. The results (flood hydrographs and flooding areas for each return period) allowed analyzing the measures by comparing the different scenarios and the best results corresponded to the association of structural and nonstructural measures. However, even by implementing the best scenario, the problem of flooding would not be satisfactorily solved, revealing the need to consider other measures to minimize flood damage, such as runoff source control measures, flood insurance and early warning systems.

Study on influence of floods on bacillary dysentery incidence in Liaoning province, 2004-2010 / 中华流行病学杂志

Objective To understand the influence of floods on bacillary dysentery in Liaoning province.Methods The monthly surveillance data of bacillary dysentery,floods,meteorological and demographic data in Liaoning from 2004 to 2010 were collected.Panel Poisson regression analysis was conducted to evaluate the influence of floods on the incidence of bacillary dysentery in Liaoning.Results The mean monthly morbidity of bacillary dysentery was 2.17 per 100 000 during the study period,the bacillary dysentery cases mainly occurred in during July-September.Spearman correlation analysis showed that no lagged effect was detected in the influence of floods on the incidence of bacillary dysentery.After adjusting the influence of meteorological factors,panel data analysis showed that the influence of floods on the incidence of bacillary dysentery existed and the incidence rate ratio was 1.439 4 (95％CI:1.408 1-1.471 4).Conclusion Floods could significantly increase the risk of bacillary dysentery for population in Liaoning.

Study on influence of floods on bacillary dysentery incidence in Liaoning province, 2004-2010 / 中华流行病学杂志

Objective To understand the influence of floods on bacillary dysentery in Liaoning province.Methods The monthly surveillance data of bacillary dysentery,floods,meteorological and demographic data in Liaoning from 2004 to 2010 were collected.Panel Poisson regression analysis was conducted to evaluate the influence of floods on the incidence of bacillary dysentery in Liaoning.Results The mean monthly morbidity of bacillary dysentery was 2.17 per 100 000 during the study period,the bacillary dysentery cases mainly occurred in during July-September.Spearman correlation analysis showed that no lagged effect was detected in the influence of floods on the incidence of bacillary dysentery.After adjusting the influence of meteorological factors,panel data analysis showed that the influence of floods on the incidence of bacillary dysentery existed and the incidence rate ratio was 1.439 4 (95％CI:1.408 1-1.471 4).Conclusion Floods could significantly increase the risk of bacillary dysentery for population in Liaoning.

Estudo do comportamento hidráulico da Bacia do Paracuri em Belém (PA) utilizando o programa Storm Water Management Model / Study of hydraulic behavior of Paracuri Basin in Belém (PA) with the use of Storm Water Management Model software

RESUMOEstuda-se o comportamento hidráulico do sistema de drenagem da Bacia do Paracuri, no município de Belém (PA), com o uso do código computacional livre Storm Water Management Model (SWMM), sendo simulados dois cenários, ambos referentes à ocorrência de uma chuva de 82 mm de precipitação e duração de 6 horas. O primeiro cenário consiste no canal projetado, em perfeitas condições, e nesse caso não ocorrem alagamentos. O segundo cenário simula o mesmo canal com assoreamento de 50 cm, e ocorre inundação. Assim, verifica-se a utilidade do SWMM para simular o comportamento hidráulico dos sistemas de drenagem com dados de precipitações reais, diferentes das chuvas de projeto.

ABSTRACTThe Paracuri Basin in Belém (PA), Brazil, hydraulic behavior is studied with the use of free computer code Storm Water Management Model (SWMM). Two scenarios are simulated; both related to the occurrence a rain of 82 mm precipitation and in a time of 6 hours. The first scenario consists of the channel designed in perfect condition, and hence no flooding occurs. The second scenario simulates the same channel with 50 cm of sedimentation, and flooding occurs. So it turns out the usefulness of SWMM to simulate the hydraulic behavior of drainage systems with actual rainfall data, different of project rain.

The Record-Setting Flood of 2014 in Kelantan: Challenges and Recommendations from an Emergency Medicine Perspective and Why the Medical Campus Stood Dry

Floods are considered an annual natural disaster in Kelantan. However, the record-setting flood of 2014 was a ‘tsunami-like disaster’. Hospital Universiti Sains Malaysia was the only fully functioning hospital in the state and had to receive and manage cases from the hospitals and clinics throughout Kelantan. The experiences, challenges, and recommendations resulting from this disaster are highlighted from an emergency medicine perspective so that future disaster preparedness is truly a preparation. The history of how the health campus was constructed with the collaboration of Perunding Alam Bina and Perkins and Willis of Chicago is elaborated.

Análise temporal da relação entre leptospirose e ocorrência de inundações por chuvas no município do Rio de Janeiro, Brasil, 2007-2012 / Temporal analysis of the relationship between leptospirosis and the occurrence of flooding due to rainfall in the city of Rio de Janeiro, Brazil, 2007-2012

O objetivo do presente estudo é examinar o efeito da média mensal de precipitações sobre o risco de leptospirose na cidade do Rio de Janeiro entre 2007 e 2012. Trata-se de um estudo ecológico analítico cuja variável de desfecho foi o número de casos de leptospirose por mês, e a variável independente foi a precipitação média mensal para as 32 estações de monitoramento por ano. Optou-se por modelar a relação entre os casos de leptospirose e o efeito da chuva através da construção de um modelo linear generalizado, utilizando a distribuição binomial negativa. A precipitação-lag mês mostrou ser um fator explicativo forte para o número de casos de leptospirose. Este estudo indica que a média mensal de precipitações pode se constituir em um indicador que permita a realização de ações visando a preparação do setor saúde para o provável aumento de casos desta doença. Cabe, portanto, a articulação entre o trabalho da vigilância epidemiológica, especialmente aquele feito pelas salas de situação em períodos de crise, e as instâncias de gestão de riscos da vigilância ambiental, para aumentar a capacidade de resposta a desastres naturais no município do Rio de Janeiro.

The scope of this study is to examine the effect of the average monthly rainfall on the risk of contracting leptospirosis in the city of Rio de Janeiro between 2007 and 2012. It involves an analytical ecological study conducted in the city of Rio de Janeiro in the 2007-2012 period. The variable for the outcome was the number of leptospirosis cases per month, and the independent variable was the average monthly rainfall recorded by the 32 monitoring stations per year. It was decided to model the relationship between cases of leptospirosis and the effects of rain by building a generalized linear model using negative binomial distribution. The rainfall-lag per month was found to be a strong explanatory factor for the number of cases of leptospirosis. This study indicates that the average monthly rainfall may constitute an indicator that enables the execution of actions in order to prepare the health sector for the probable increase in cases of this disease. Therefore, it is necessary to implement the interaction between the work of epidemiological surveillance, especially by situation rooms in periods of crisis, and the risk management teams of environmental surveillance, to increase the response capacity to natural disasters in the municipality of Rio de Janeiro.