Spatial distribution of the human development index, HIV infection and AIDS-Tuberculosis comorbidity: Brazil, 1982 - 2007

INTRODUCTION: AIDS epidemic has given visibility to the incidence of tuberculosis, for being the most frequent opportunistic infection. It is known that individuals who are socially vulnerable are more susceptible to HIV transmission and tuberculosis as well. OBJECTIVE: This study aims to conduct a geoepidemiological study on HIV/AIDS, AIDS-Tuberculosis co-infection and social vulnerability. METHOD: This is an ecological study using incidence rates and the human development index to produce thematic maps and a descriptive analysis of epidemiology. The records of reported cases of HIV/AIDS from 1982 to 2007 were used, considering as cases of AIDS-Tuberculosis those records that were positively diagnosed with tuberculosis and those records with unknown diagnosis of tuberculosis, but showing compatible signs and symptoms with tuberculosis (fever, cough, cachexia and asthenia). RESULTS: The maps allowed the identification of areas with social differences and different patterns of incidence of HIV/AIDS and AIDS-Tuberculosis; regional differences were similar to those found by Josué de Castro, in 1940; regions with higher human development index values also showed higher incidence HIV/AIDS and AIDS-Tuberculosis. CONCLUSION: The prevention of HIV infection must be geographically specific, given socioeconomic and cultural differences. Although official records show decline in AIDS-TB co-infection, treatment of cases of HIV/AIDS should observe the occurrence of opportunistic diseases, which should be notified and/or updated.

INTRODUÇÃO: A epidemia de AIDS deu visibilidade à incidência de tuberculose, por ter sido a infecção oportunista mais frequente nesses casos. Sabe-se que os indivíduos socialmente vulneráveis são mais suscetíveis à transmissão do HIV e também à tuberculose. OBJETIVO: Realizar um estudo geoepidemiológico sobre HIV/AIDS, coinfecção AIDS-tuberculose e vulnerabilidade social. MÉTODO: Trata-se de estudo ecológico com uso de coeficientes de incidência e do índice de desenvolvimento humano para produzir mapas temáticos e uma análise de epidemiologia descritiva. Foram utilizados os registros de notificação de casos de HIV/AIDS de 1982 a 2007. Foram considerados casos de AIDS-tuberculose os registros que tinham o diagnóstico positivo para tuberculose e aqueles que tinham diagnóstico ignorado para tuberculose, mas apresentavam sinais e sintomas compatíveis com a doença (febre, tosse, caquexia e astenia). RESULTADOS: Os mapas permitiram identificar regiões com diferenças sociais e diferentes padrões de incidência de HIV/AIDS e de AIDS-tuberculose. As diferenças regionais assemelham-se às encontradas por Josué de Castro, em 1940. As regiões com índice de desenvolvimento humano alto apresentaram alta incidência de HIV/AIDS e de AIDS-tuberculose. CONCLUSÃO: A prevenção da infecção pelo HIV deve ser geograficamente específica, dadas as diferenças socioeconômicas e culturais. Apesar de os registros oficiais mostrarem declínio da coinfecção AIDS-tuberculose, o tratamento dos casos de HIV/AIDS deve constatar a ocorrência de doenças oportunistas, que deveriam ser notificadas e/ou atualizadas.

Geomarketing en salud para ubicar oferta de servicios médicos de valor Caso: Proyecto de investigación para ubicar una nueva oferta hospitalaria / Geomarketing health services offer for locating medical value: case: a research project to locate a new hospital bid

El geomarketing de la salud es útil para definir políticas sanitarias y buscar un mayor bienestar bio-psico y social de las personas que cohabitan un mismo espacio geográfico. Los límites de división geográfica y política entre comunidades son importantes para el control y manejo de epidemias, endemias y pandemias. La ubicación geográfica (espacio que ocupa una persona y sus pares) en un tiempo definido, nos muestra perfiles culturales similares, manifiestos en hábitos, costumbres y patrones de comportamiento similares. Con esta información de manera oportuna y lo más exacta posible se podrán realizar las actividades de promoción de la salud y prevención de las enfermedades que conduzcan a un bienestar sostenible de la población. Es recomendable, para toda oferta de servicios de salud, ubicar la competencia directa e indirecta de la localidad, con su respectiva demanda en servicios de salud, para así diseñar una oferta de valor que vaya dirigida a un mercado meta que sea sustentable y sostenible. Este artículo muestra una metodología de geomarketing para ubicar la oferta, las necesidades, deseos y demanda de los servicios de salud pública y privada que contribuya en el diseño de los planes estratégicos de marketing en salud...

The geomarketing of health is useful in defining health policies in search of greater psychosocial well-being and social integration of people with the same geographic space, hence the limits of geographical and political division between communities is important for control and management of epidemics, endemic diseases and pandemics. The geographical location (space occupied by a person and his peers) in a defined time, shows similar profiles manifests in cultural habits, customs and behavioral patterns similar. With this information in a timely manner and as accurate as possible will be able to carry out the activities of health promotion and disease prevention that will lead to a sustainable welfare of the population. It is recommendable to any offer of health services, track direct and indirect competition from the place with their demand on health services, as well as for designing or offering the services of value to be directed at a target market that is sustainable and sustainable. This paper shows a methodology to locate geomarketing supply, needs, desires and demands of public health services and private help in designing strategic plans for marketing in health...

The Geopolitics of Tropical Diseases: A Geo-epidemiological Perspective / 의사학

The objective of my article is to investigate how the West had strong interest in tropical diseases and developed tropical medicine and hygiene from the 1870s through the 1910s. Its focus is to identify the geopolitical conditions in which the West constructed 'tropical diseases'to extend its imperial interests into non-Western tropical regions. The article has several specific research tasks: first, I attempt to explore the way in which European people transformed their attitudes toward tropical diseases from the sixteenth century to the 1860s. A variety of writings by European physicians are discussed; the second part shows European change in its domestic sanitary situation in relation to its imperial interests in tropical regions. Sanitary hygiene in metropole and colonies are not separate, but interconnected; third, the paper illuminates how the West responded to the spread of 'Asiatic cholera' in the nineteenth century. Cholera provides a typical example for the West to perceive Asian origin of tropical diseases; finally, the article demonstrates that hygienic governance of tropical diseases is the key to imperial dominion over colonies by taking the Panama Canal as an example. Although several European countries such as Spain, Britain, Germany, and France had strong imperial interests in the Panama Canal that might facilitate trade between the Atlantic and the Pacific, they failed to occupy the canal because of their inability to control high prevalence of malaria and yellow fever. Taking advantage of 'tropical medicine, ' the United States succeeded in taking up the canal by eradicating tropical diseases in the canal. It was owing to the scientific development of tropical hygiene and medicine that the West transformed its pessimistic into optimistic position about the colonization of tropical regions. Tropical diseases became the geopolitical reference for Western conceptualization of Asia, Africa, Latin America, and the Pacific.