Factors associated with Chagas disease among blood donors in Brazilian Northeast region.

BACKGROUND: Despite the intensification of Chagas disease control in Brazil, around 1980s and 1990s, the transmission still occurs. The aim of this study was to identify the factors associated with Chagas disease among blood donors in Piaui State, Brazilian Northeast Region from 2004 to 2013. METHODOLOGY: Records of 597 blood donors from Management System in Hemotherapy Services and Laboratory Environment Manager System of Piaui were studied. Sociodemographic variables and serological tests results for Chagas disease's confirmation were analyzed using adjusted multiple logistic regression and odds ratio (OR) evaluation. RESULTS: The frequency of serological test confirming Chagas disease was 15.6%. Multivariate analysis showed that the most important associated factors were among blood donors who were born until 1960 (OR 5.1; 95%; CI 1.95-13.14), with low educational level (OR 2.8; 95%; CI 0.75-10.29), who lives in cities with ≤50% of urbanization rate (OR 3.5; 95%; CI 1.42-8.72) and first-time blood donors (OR 3.0; 95%; CI 1.74-5.23). CONCLUSIONS: Unfortunately, the factors associated with Chagas disease are still the same pointed out in the scientific literature of decades ago. Our results are in line with the postulate of the 2nd Brazilian Consensus on Chagas disease, regarding the need to develop research that presents new scientific evidence, contributing not only to the Brazilian scenario but also to Latin America.

Prediction of high-risk areas for visceral leishmaniasis using socioeconomic indicators and remote sensing data.

Spatial heterogeneity in the incidence of visceral leishmaniasis (VL) is an important aspect to be considered in planning control actions for the disease. The objective of this study was to predict areas at high risk for visceral leishmaniasis (VL) based on socioeconomic indicators and remote sensing data. We applied classification and regression trees to develop and validate prediction models. Performance of the models was assessed by means of sensitivity, specificity and area under the ROC curve. The model developed was able to discriminate 15 subsets of census tracts (CT) with different probabilities of containing CT with high risk of VL occurrence. The model presented, respectively, in the validation and learning samples, sensitivity of 79% and 52%, specificity of 75% and 66%, and area under the ROC curve of 83% and 66%. Considering the complex network of factors involved in the occurrence of VL in urban areas, the results of this study showed that the development of a predictive model for VL might be feasible and useful for guiding interventions against the disease, but it is still a challenge as demonstrated by the unsatisfactory predictive performance of the model developed.

Identification of risk areas for visceral leishmaniasis in Teresina, Piaui State, Brazil.

This study used spatial analysis to identify areas at greatest risk of visceral leishmaniasis (VL) in the urban area of Teresina, Brazil during 2001-2006. The results from kernel ratios showed that peripheral census tracts were the most heavily affected. Local spatial analysis showed that in the beginning of the study period local clusters of high incidence of VL were mostly located in the southern and northeastern parts of the city, but in subsequent years those clusters also appeared in the northern region of the city, suggesting that the pattern of VL is not static, and the disease may occasionally spread to other areas of the municipality. We also observed a spatial correlation between VL rates and all socioeconomic and demographic indicators evaluated (P < 0.01). The concentration of interventions in high-risk areas could be an effective strategy to control the disease in the urban setting.

Modelo alternativo para o controle da esquistossomose: estado atual do projeto no estado do Espírito Santo, Brasil / An Alternative model for schistosomiasis control: the present status of the project in the state of Espírito Santo, Brazil

O trabalho que vem sendo desenvolvido em uma área rural do município de Afonso Cláudio (Espírito Santo) representa uma proposta alternativa aos atuais programas de controle. Este é um trabalho de pesquisa controlado, em integraçao interdisciplinar e multi-institucional, envolvendo várias entidades de pesquisa e de serviços. O modelo alternativo de controle da endemia conta com amplo envolvimento comunitário e com a organizaçao dos serviços locais de saúde a nível primário (SUS). A pesquisa participante tem sido o ponto de partida metedológico que baliza os procedimentos de coleta e análise de dados e os de intervençao na realidade local. Os métodos de controle estao limitados ao tratamento médico individualizado e à melhoria das condiçoes de saneamento. Estes métodos estao, evidentemente, integrados às açoes sociais acima descritas. O projeto está dividido em três fases: pré-controle, controle (intervençao) e avaliaçao final. No momento, o mesmo entra em sua fase de intervençao, com duraçao prevista de três anos