ABSTRACT
This study aimed to analyse the geographical distribution of coronavirus disease 2019 (COVID-19) and to identify high-risk areas in space and time for the occurrence of cases and deaths in the indigenous population of Brazil. This is an ecological study carried out between 24 March and 26 October 2020 whose units of analysis were the Special Indigenous Sanitary Districts. The Getis-Ord General G and Getis-Ord Gi* techniques were used to verify the spatial association of the phenomena and a retrospective space-time scan was performed. There were 32 041 confirmed cases of COVID-19 and 471 deaths. The non-randomness of cases (z score = 5.40; P < 0.001) and deaths (z score = 3.83; P < 0.001) were confirmed. Hotspots were identified for cases and deaths in the north and midwest regions of Brazil. Sixteen high-risk space-time clusters were identified for the occurrence of cases with a higher RR = 21.23 (P < 0.001) and four risk clusters for deaths with a higher RR = 80.33 (P < 0.001). These clusters were identified from 22 May and were active until 10 October 2020. The results indicate critical areas in the indigenous territories of Brazil and contribute to better directing the actions of control of COVID-19 in this population.
Subject(s)
COVID-19/epidemiology , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Brazil/epidemiology , COVID-19/mortality , COVID-19/virology , Child , Child, Preschool , Female , Humans , Indians, South American , Infant , Infant, Newborn , Male , Middle Aged , Retrospective Studies , Risk Factors , SARS-CoV-2 , Sex Factors , Young AdultABSTRACT
BACKGROUND: Reducing TB mortality is a great challenge in Brazil due to its territorial extension, cultural variations and economic and political crises, which impact the health system. This study aimed to estimate in space and time the risk of TB mortality and test its relationship with social inequities. METHODS: This was an ecological study that included deaths from TB between 2006 and 2016 in Cuiabá, Brazilian Legal Amazon. Bayesian models based on the integrated nested Laplace approximation approach were used to estimate spatio-temporal RRs. RRs for TB mortality were obtained according to the covariables representative of social inequities. RESULTS: The risk of TB mortality was stable between 2006 and 2016 and high-risk areas were identified throughout the municipality studied. Regarding social inequities, income was an important factor associated with TB mortality risk, as an increase of 1 SD in income resulted in a 35.4% (RR 0.646; CI 95% 0.476 to 0.837) decrease in risk. CONCLUSIONS: The results provided evidence of areas with higher TB mortality risks that have persisted over time and are related to social inequities. Advancing social policies and protections in these areas will contribute to achieving the WHO's End TB strategy.
Subject(s)
Tuberculosis , Bayes Theorem , Brazil/epidemiology , Cities , Humans , Income , Spatio-Temporal AnalysisABSTRACT
AIM: We hypothesized that IL-1ß concentrations are augmented in overweight adolescents, who do not display metabolic syndrome. Additionally, we aimed to correlate the IL-1ß concentrations with several established risk factors for CVD. METHODS: Overweight or control subjects, aging from 14-18 years, were classified according to their adjusted body mass index and evaluated for biochemical and anthropometric parameters. The proinflammatory cytokine IL-1ß was assessed in the serum. RESULTS: Increased body fat percentage, waist circumference, triglycerides, total cholesterol, Very Low-Density Lipoprotein (VLDL) cholesterol, Low-Density Lipoprotein (LDL) cholesterol, Castelli I index, IL-1ß, and IL-8 levels, were observed in overweight adolescents. No differences were observed in systolic blood pressure, diastolic blood pressure, glucose or High-Density Lipoprotein (HDL) cholesterol. Positive correlations between IL-1ß with anthropometric and or biochemical parameters were found. CONCLUSION: In conclusion, increased IL-1ß levels correlate to dyslipidemic factors and may further support low-grade inflammation. IL-1ß may further predict the early onset of cardiovascular disease in this population, taking into consideration its important regulatory role.
Subject(s)
Heart Disease Risk Factors , Inflammation/blood , Interleukin-1beta/blood , Overweight/blood , Adolescent , Brazil/epidemiology , Cardiovascular Diseases/blood , Cardiovascular Diseases/diagnosis , Cardiovascular Diseases/epidemiology , Cardiovascular Diseases/etiology , Case-Control Studies , Chronic Disease , Female , Humans , Inflammation/epidemiology , Inflammation/pathology , Male , Overweight/complications , Overweight/epidemiology , Pediatric Obesity/blood , Pediatric Obesity/complications , Pediatric Obesity/epidemiology , Prognosis , Risk FactorsABSTRACT
Knowledge about the determinants of female sexual function in breastfeeding women is limited. A total of 355 breastfeeding women completed the Female Sexual Function Index (FSFI) and the Qol-8 quality of life questionnaire. FSFI scores decreased in the first six months of breast feeding. There was a positive relationship between FSFI scores and the importance of sex, level of communication, income, quality of life, and receiving brief sexual counseling.
