Malaria and environmental, socioeconomics and public health conditions in the municipality of São Félix do Xingu, Pará, Eastern Amazon, Brazil: An ecological and cross-sectional study.

BACKGROUND: Malaria is a parasitosis conditioned by several factors. This study sought to analyze the spatial distribution of malaria considering environmental, socioeconomic, and political variables in São Félix do Xingu, Pará, Brazil, from 2014 to 2020. METHODS: Epidemiological, cartographic, and environmental data were obtained from the Ministry of Health, Brazilian Geographical and Statistical Institute, and National Space Research Institute. Statistical and spatial distribution analyses were performed using chi-squared tests of expected equal proportions and the kernel and bivariate global Moran's techniques with Bioestat 5.0 and ArcGIS 10.5.1. RESULTS: The highest percentage of cases occurred in adult males with brown skin color, mainly placer miners, with a primary education level, living in rural areas, who were infected with Plasmodium vivax and with parasitemia of two or three crosses as diagnosed by the thick drop/smear test. The disease had a non-homogeneous distribution, with distinct annual parasite indices associated with administrative districts and clusters of cases in locations with deforestation, mining, and pastures close to Conservation Units and Indigenous Lands. Thus, a direct relationship between areas with cases and environmental degradation associated with land use was demonstrated, along with the precarious availability of health services. Pressure on protected areas and epidemiological silence in Indigenous Lands were also noted. CONCLUSIONS: Environmental and socioeconomic circuits were identified for development of diseases associated with precarious health services in the municipality. These findings highlight the need to intensify malaria surveillance and contribute to the systematic knowledge of malaria's epidemiology by considering the complexity of its conditioning factors.

Malaria and environmental, socioeconomics and public health conditions in the municipality of São Félix do Xingu, Pará, Eastern Amazon, Brazil: An ecological and cross-sectional study

ABSTRACT Background: Malaria is a parasitosis conditioned by several factors. This study sought to analyze the spatial distribution of malaria considering environmental, socioeconomic, and political variables in São Félix do Xingu, Pará, Brazil, from 2014 to 2020. Methods: Epidemiological, cartographic, and environmental data were obtained from the Ministry of Health, Brazilian Geographical and Statistical Institute, and National Space Research Institute. Statistical and spatial distribution analyses were performed using chi-squared tests of expected equal proportions and the kernel and bivariate global Moran's techniques with Bioestat 5.0 and ArcGIS 10.5.1. Results: The highest percentage of cases occurred in adult males with brown skin color, mainly placer miners, with a primary education level, living in rural areas, who were infected with Plasmodium vivax and with parasitemia of two or three crosses as diagnosed by the thick drop/smear test. The disease had a non-homogeneous distribution, with distinct annual parasite indices associated with administrative districts and clusters of cases in locations with deforestation, mining, and pastures close to Conservation Units and Indigenous Lands. Thus, a direct relationship between areas with cases and environmental degradation associated with land use was demonstrated, along with the precarious availability of health services. Pressure on protected areas and epidemiological silence in Indigenous Lands were also noted. Conclusions: Environmental and socioeconomic circuits were identified for development of diseases associated with precarious health services in the municipality. These findings highlight the need to intensify malaria surveillance and contribute to the systematic knowledge of malaria's epidemiology by considering the complexity of its conditioning factors.

Hepatites B e C nas áreas de três Centros Regionais de Saúde do Estado do Pará, Brasil: uma análise espacial, epidemiológica e socioeconômica / Hepatitis B and C in the areas of three Regional Health Centers of Pará State, Brazil: a spatial, epidemiological and socioeconomic analysis

Resumo Introdução As hepatites virais são graves problemas de saúde pública e estão relacionadas às diferentes características socioeconômicas do território brasileiro. Objetivo Analisar a distribuição espacial das hepatites B e C e sua relação com o Índice de Desenvolvimento Humano Municipal (IDHM) nas áreas de três Centros Regionais de Saúde (CRS), no Estado do Pará, Brasil, de 2010 a 2014. Método Neste trabalho descritivo e transversal, foram utilizados dados do Sistema de Informação de Agravos de Notificação, do Ministério da Saúde, e do Censo 2010, do Instituto Brasileiro de Geografia e Estatística. Resultados As análises mostraram que o 11º CRS notificou o maior número de casos (60,9%). Os indivíduos mais acometidos por ambas as doenças foram do gênero feminino, pardos, adultos e com ensino fundamental. Os fatores de riscos mais significativos foram uso de medicamentos injetáveis e tratamentos dentário e cirúrgico. Foi observada dependência espacial entre o IDHM e os parâmetros da taxa de incidência das doenças, com autocorrelações diretas e indiretas. Assim, áreas com IDHM médio e baixo apresentaram altas taxas de incidência, sobretudo em municípios com intenso fluxo migratório, nas últimas décadas. Conclusão As análises foram eficazes para construir cenários epidemiológicos das doenças. Ressaltamos a necessidade de expandir o controle das hepatites nas áreas estudadas.

Abstract Background Viral hepatitis is a serious public health problem and is related to the different socioeconomic characteristics of the Brazilian territory. Objective To analyze the spatial distribution of the hepatitis B and C and their relationship with the Municipal Human Development Index (IDHM), in the areas of three Regional Health Centers (CRS), in the state of Pará, Brazil, from 2010 to 2014. Method In this descriptive and cross-sectional study, data from the Information System for Notifiable Diseases of the Ministry of Health and the 2010 Census of the Brazilian Institute of Geography and Statistics were used. Results The analyses showed that the 11th CRS reported the greater number of cases (60.9%). The most affected individuals by both diseases were female, brown skin color, adults and elementary school degree. The most significant risk factors were injecting drugs use, dental and surgical treatments. It was observed spatial dependence between the IDHM and the diseases incidence rate parameters, with direct and indirect autocorrelations. Thus, areas with medium and low IDHM showed high incidence rates, especially in municipalities with intense migratory flows, in the last decades. Conclusion The analyses were effective for construct epidemiological scenarios of the diseases. The need to expand the control of hepatitis in the studied areas is highlighted.

Cutaneous leishmaniasis: Spatial distribution and environmental risk factors in the state of Pará, Brazilian Eastern Amazon.

INTRODUCTION: Cutaneous leishmaniasis is an infectious disease transmitted by phlebotomine sandflies and is considered a great environmental and public health problem. Thus, this work presents initial results of the analyses about the relationship between the spatial distribution of this disease and its environmental risk factors in three municipalities, in the state of Pará, Brazil, from 2012 to 2016. METHODOLOGY: It was used data from the Ministry of Health, the National Institute for Space Research and the Brazilian Institute of Geography and Statistics. The statistical and spacial analysis of the variables were done using G-test goodness-of-fit, kernel interpolation technique and the Bivariate Global Moran Index (I). RESULTS: The analyses showed that the most affected individuals were males, adults, low schooling, residents in rural areas and small farmers. The disease spatial distribution was not homogeneous in the municipalities and it was associated to different relationships between the land use and occupation and the notificated cases density, with direct spatial autocorrelation. CONCLUSIONS: The deforestation was the most significant risk factor linked to the cases occurrence in all the studied area. We emphasize the need of intensification of epidemiological and environmental surveillance actions in the studied areas.