Determination of the spatial susceptibility to Yellow Fever using a multicriteria analysis.

BACKGROUND: The outbreak of sylvatic Yellow Fever (SYF) in humans during 2016-2017 in Brazil is one of the greatest in the history of the disease. The occurrence of the disease in areas with low vaccination coverage favoured the dissemination of the disease; therefore, it is necessary to identify the areas vulnerability to the YF virus (YFV) to assist in the adoption of preventive measures. OBJECTIVE: To correlate the physical-environmental elements associated with the occurrence of SYF in humans via a multicriteria analysis. METHODS: For the multicriteria analysis, preponderant elements related to SYF occurrences, including soil usage and coverage, temperature, precipitation, altitude, mosquito transmitters, and non-human primate occurrence areas, were considered. The results were validated by assessing the correlation between the incidence of SYF and the vulnerable areas identified in the multicriteria analysis. RESULTS: Two regions with different vulnerability to the occurrence of the disease were identified in the multicriteria analysis, with emphasis on the southern areas of the state of São Paulo northeast areas of Minas Gerais, and the entire states of Rio de Janeiro and Espírito Santo. The map of SYF vulnerability obtained in the multicriteria analysis coincides with the areas in which cases of the disease have been recorded. The regions that presented the greatest suitability were in fact the municipalities with the highest incidence. MAIN CONCLUSIONS: The multicriteria analysis revealed that the elements that were used are suited for and consistent in the prediction of the areas that are vulnerable to SYF. The results obtained indicate the proximity of the areas that are most vulnerable to the disease to densely populated areas where an Aedes aegypti infestation was observed, which confers a high risk of re-urbanisation of YF.

Determination of the spatial susceptibility to Yellow Fever using a multicriteria analysis

BACKGROUND The outbreak of sylvatic Yellow Fever (SYF) in humans during 2016-2017 in Brazil is one of the greatest in the history of the disease. The occurrence of the disease in areas with low vaccination coverage favoured the dissemination of the disease; therefore, it is necessary to identify the areas vulnerability to the YF virus (YFV) to assist in the adoption of preventive measures. OBJECTIVE To correlate the physical-environmental elements associated with the occurrence of SYF in humans via a multicriteria analysis. METHODS For the multicriteria analysis, preponderant elements related to SYF occurrences, including soil usage and coverage, temperature, precipitation, altitude, mosquito transmitters, and non-human primate occurrence areas, were considered. The results were validated by assessing the correlation between the incidence of SYF and the vulnerable areas identified in the multicriteria analysis. RESULTS Two regions with different vulnerability to the occurrence of the disease were identified in the multicriteria analysis, with emphasis on the southern areas of the state of São Paulo northeast areas of Minas Gerais, and the entire states of Rio de Janeiro and Espírito Santo. The map of SYF vulnerability obtained in the multicriteria analysis coincides with the areas in which cases of the disease have been recorded. The regions that presented the greatest suitability were in fact the municipalities with the highest incidence. MAIN CONCLUSIONS The multicriteria analysis revealed that the elements that were used are suited for and consistent in the prediction of the areas that are vulnerable to SYF. The results obtained indicate the proximity of the areas that are most vulnerable to the disease to densely populated areas where an Aedes aegypti infestation was observed, which confers a high risk of re-urbanisation of YF.

Estudo do impacto das deficiencias de saneamento basico sobre a saude publica no Brasil no periodo de 2001 a 2009 / Study of the impact of deficiencies of sanitation on public health in Brazil from 2001 to 2009

O artigo teve como objetivo desenvolver um estudo do impacto sobre a saúde pública das deficiências do saneamento básico no Brasil no período de 2001 a 2009. Os óbitos resultantes de doenças relacionadas ao saneamento básico inadequado corresponderam, em média, a 13.449 mortes por ano, ou seja, cerca de 1,31% do total. A média anual de casos de notificação compulsória devido a doenças relacionadas ao saneamento básico inadequado foi de 466.351 casos, com uma despesa de R$ 30.428.324,92 em consultas médicas nesse período. Foi identificada também uma média anual de 758.750 internações hospitalares devido a deficiências do saneamento básico, com uma despesa total de R$ 2.111.567.634,61 no período. A despesa total com consultas médicas e internações hospitalares devido a doenças associadas ao saneamento básico consumiu 2,84% dos gastos do Sistema Único de Saúde nesse intervalo de tempo.

The objective of this article was to develop a study of the impact on public health of the sanitation deficiencies in Brazil from 2001 to 2009. Deaths due to diseases related to inadequate sanitation accounted, on average, 13,449 deaths per year, or about 1.31% of total deaths. The annual average of compulsory notification of cases due to diseases related to inadequate sanitation conditions was 466,351 cases, with an expense of R$ 30,428,324.92 with medical appointments in this period. It was identified an average of 758,750 hospitalizations due to lack of sanitation, with a total expenditure of R$ 2,111,567,634.61 in the period. The total expenditure on medical appointments and hospitalizations due to diseases associated with sanitation consumed 2.84% of the Unified Health System expenditures with these items in the period.