ABSTRACT
SETTING: Brazil ranks eighteenth worldwide in annual numbers of new tuberculosis (TB) cases. The municipality of Manaus, Amazonas State, has the highest incidence of TB in Brazil. OBJECTIVE: To evaluate the quality of TB epidemiological surveillance, and to describe the spatial distribution pattern of TB incidence in Manaus and its social determinants. DESIGN: An ecological study was performed based on secondary data from TB epidemiological surveillance reports. RESULTS: An index was developed to classify neighborhoods in terms of the quality of surveillance and suspected underreporting. Based on data from neighborhoods with better surveillance performance, we observed that the average number of residents per room, the unemployment rate and the proportion of households connected to a sewage system were significant predictors of TB incidence. Seven neighborhoods in the south and west of the city had clusters of high TB transmission. CONCLUSION: Our results suggest that the association between TB and social vulnerability is obscured by the poor quality of TB surveillance data. We identified priority areas that require immediate TB control interventions and those where local surveillance efforts should be improved, and generated information useful for formulating more effective actions.
Subject(s)
Tuberculosis, Pulmonary/epidemiology , Brazil/epidemiology , Humans , Incidence , Population Surveillance , Risk Factors , Socioeconomic Factors , Spatio-Temporal Analysis , Tuberculosis, Pulmonary/prevention & controlABSTRACT
The State of Amazonas in the Brazilian Amazon region is an area of high prevalence of hepatitis B and D virus (HBV and HDV) infection. The aim of this study was to identify epidemiological patterns and risk factors of HBV and HDV infections in Barcelos, in the basin of the Negro river. A random sample (798 in all) of the total population in the urban area and in 2 rural villages was surveyed. A standardized questionnaire was used and blood samples were tested by enzyme-linked immunosorbent assay: 1.63% had hepatitis B surface antigen, 12.9% had anti-hepatitis B surface antibody and 21.4% had anti-hepatitis B core antigen. The overall prevalence of HBV infection was 24.6%. Anti-hepatitis D was present in 5 subjects, all of them non-natives, and hepatitis B e antigen in 2. A positive association between history of dental treatment with an unqualified dental surgeon was found (P < 0.05). These results suggest a low prevalence of HVB and HDV infection, in contrast with other parts of the Amazon area.
Subject(s)
Hepatitis B/epidemiology , Hepatitis D/epidemiology , Adolescent , Adult , Aged , Aged, 80 and over , Brazil/epidemiology , Child , Child, Preschool , Female , Hepatitis B/immunology , Hepatitis B Antibodies/analysis , Hepatitis B Core Antigens/analysis , Hepatitis B Surface Antigens/analysis , Hepatitis B e Antigens/analysis , Hepatitis D/immunology , Humans , Infant , Male , Middle Aged , Prevalence , Risk Factors , Sampling StudiesSubject(s)
Splenomegaly/diagnosis , Adolescent , Adult , Brazil , Female , Humans , Immunoglobulin G/analysis , Immunoglobulin M/analysis , Liver/pathology , Liver Cirrhosis/complications , Liver Cirrhosis/pathology , Malaria/complications , Malaria/diagnosis , Male , Plasmodium/immunology , Splenomegaly/etiology , SyndromeSubject(s)
Humans , Bunyaviridae Infections , Disease Outbreaks , Brazil , Bunyaviridae , Hemagglutination Inhibition TestsABSTRACT
Sao apresentados os resultados do emprego de clindamicina na dosagem de 20 mg/Kg/peso/dia, durante cinco dias. A droga foi administrada por via oral ou venosa, a 26 pacientes infectados com P. falciparum, observando-se negativacao da parasitemia a partir do 3o. dia, com o maximo entre o 4o. e 6o. dia, quando 21 (80,8%) pacientes deixaram de apresentar parasitos assexuados no sangue periferico. A cura clinica e parasitologica foi obtida em todos os pacientes
Subject(s)
Child, Preschool , Child , Adolescent , Adult , Middle Aged , Humans , Male , Female , Clindamycin , Malaria , Drug Administration ScheduleABSTRACT
A associacao de sulfadoxina mais pirimetamina (FANSIDAR) foi administrada a 19 pacientes que adquiriram a infeccao malarica pelo P. falciparum, na Amazonia Brasileira A avaliacao da resistencia mostrou que 12 (63,1%) dos pacientes eram portadores de cepa (s) resistente (s) sendo 8 (66,6%) a nivel de RI, 2 (16,7%) a nivel de RII e 2 (16,7%) a nivel de RIII
Subject(s)
Humans , Male , Female , Malaria , Plasmodium falciparum , Pyrimethamine , Drug Resistance, Microbial , Sulfadoxine , BrazilABSTRACT
Sao descritos com infeccao pelo P. falciparum que receberam como terapeutica, a associacao de sulfametoxazol + trimetoprim De 45 tratados, 30 apresentaram resistencia a nivel de RI e RII.Todos os pacientes eram procedentes da Amazonia Brasileira
Subject(s)
Humans , Malaria , Plasmodium falciparum , Sulfamethoxazole , Trimethoprim , Drug Resistance, MicrobialABSTRACT
Sao descritos 10 pacientes portadores de grande e persistente esplenomegalia, procedentes de area onde a malaria e hiperendemica. Deles, quatro apresentavam sindrome da esplenomegalia tropical, cinco cirrose hepatica pos-necrotica, e em um, a associacao de ambas. Dos casos de esplenomegalia tropical tres eram irmaos e, havia infiltrado linfocitario sinusoidal hepatico com reacao de imunofluorescencia positiva para IgM em todos. Nos de cirrose o figado era duro e nodular em tres, o coagulograma anormal em todos e o AgHbs encontrado em tres
Subject(s)
Adolescent , Adult , Humans , Male , Female , Plasmodium , Splenomegaly , Immunoglobulin G , Immunoglobulin MABSTRACT
Entre janeiro de 1977 a abril de 1982 foram internados no Instituto de Medicina Tropical de Manaus (I.M.T.M.) 1.429 pacientes com malaria por Plasmadium falciparum. Destes, 37 (2,58%) desenvolveram insuficiencia renal aguda (IRA) com creatinina serica superior a 3 mg%, sendo que 30 (81,08%) eram primo-infectados.No grupo que desenvolveu IRA o periodo entre o inicio dos sintomas e a internacao hospitalar foi de 9,00 +/- 4,87 dias (2-30) e que foi maior quando comparado com um grupo controle (p < 0,01). A ureia serica de internacao foi de 155,24 +/- 67,36 mg% (29-266) e a creatinina de 5,89 +/- 3,88 mg% (0,9-22,5). A mortalidade foi de 11 (29,72%) pacientes, sendo mais frequente no grupo em que a creatinina serica foi superior a 7 mg% (P < 0,1). Dialise peritoneal (DP) foi realizada em 11 pacientes e destes 6 (54,54%) morreram. Dos 26 restantes, que nao fizeram DP, 5 (19, 23%) foram a obito (p < 0,05). Nao observamos tendencias a hiperpotassemia. Edema cerebral pulmonar agudo foi a principal causa de obito
Subject(s)
Humans , Acute Kidney Injury , MalariaABSTRACT
Os autores descrevem o emprego de clindamicina em dois esquemas, no tratamento da infeccao malarica pelo P. falciparum. Foram tratados 19 pacientes com dosagem de 20 mg/kg/peso durante tres dias e 17 pacientes por sete dias. O esquema de tratamento em sete dias mostrou ser mais eficaz em tratar e curar os pacientes
