Perception of vulnerability to HIV infection in a cohort of homosexual/bisexual men in Rio de Janeiro, Brazil. Oswaldo Cruz Foundation STD/HIV Prevention Group.

The present study addresses sociodemographic characteristics, knowledge and attitudes regarding HIV/AIDS, as well as risk behaviour and perception of vulnerability to HIV infection, in the first 295 homosexual and bisexual volunteers (excluding male commercial sex workers and transvestites) taking part in a cohort study in Rio de Janeiro. The sample has a higher socio-economic level than the remainder of the cohort, and than comparable strata of the general population, and a sound knowledge about how to protect themselves against HIV infection. In addition, an association between perception of vulnerability to infection and the practice of unprotected anal sex was observed. An association was also observed between higher levels of formal education and perception of vulnerability; however no association was found with markers for past and recent exposure to sexually transmitted infections (hepatitis B, HbsAG and syphilis). The results of the present study suggest that knowledge and awareness of risk do not easily translate into behaviour change, since significant proportions of the cohort continue to practise unprotected sex with both principal and casual partners, despite their awareness of HIV infection risks as well as preventive measures.

[Mortality by firearms in the state of Rio de Janeiro, Brazil: a spatial analysis]. / Mortalidade por armas de fogo no estado do Rio de Janeiro, Brasil: uma análise espacial.

Mortality caused by firearms has been increasing at an alarming rate in the state of Rio de Janeiro, Brazil. This study analyzes the gradual evolution of firearm mortality rates in this Brazilian state from 1979 to 1992, according to sex, age, and area of residence (capital city, metropolitan area, or the state's interior), and uses spatial statistical techniques to describe the propagation of this firearm mortality epidemic in time and space. During the period analyzed, mortality due to firearms showed the greatest increase among 15- to 19-year-old male adolescents, with yearly rates ranging from 13 to 16%, according to area of residence. For children 10 to 14 years of age, mortality caused by firearms increased by 10% annually in the same period. The highest annual increase occurred in the state's interior. At the beginning of the period studied, dissemination of firearm mortality was observed to follow a definite direction parallel to the federal road that runs along the east coast of the state. Between 1990 and 1992, however, the increase in deaths by firearms spread out in practically every direction. Empirical confirmation of a general expansion of firearm wound mortality contradicts the usual claim that violence is concentrated in areas of extreme poverty within Brazil's largest cities. Programs for prevention and control of this epidemic should focus on its various aspects and take into consideration both collective issues (such as proliferation of firearms among persons involved with international firearm smuggling, increases in criminal activity, expansion of drug trafficking, and exclusion from social opportunities) and personal issues (relationships and interaction of young people with their families, schools, and social environment).

[Estimates of infant mortality in Brazil in the 80's: a proposal for a methodological procedure]. / Estimativas da mortalidade infantil no Brasil, década de oitenta: proposta de procedimento metodológico.

A procedure for the estimation of the infant mortality rate in Brazil, in the 1980's, based only on the age distribution of registered deaths, is here proposed. Using this technique, it is possible to estimate the probabilities of dying in the first year of life in a continuous way, year by year, for different regions of the country. The space-time distribution of the main causes of infant deaths is analysed and the relevance of using this coefficient to express the social and economic conditions of the Brazilian population from 1979 to 1989 is discussed.

[The epidemiological aspects of HIV/AIDS in Brazil]. / Aspectos epidemiológicos da AIDS/HIV no Brasil.

A trend analysis of the AIDS epidemics in Brazil is presented, emphasizing temporal changes among the population groups most affected. Regional comparisons as well as projections of the extension of HIV infection and AIDS cases are also reported. Amongst the most relevant conclusions the alarming increase of cases in heterosexual populations and intravenous drug users is emphasised, specially in the southeast region.

[Regional differentials in cancer mortality in the state of Rio de Janeiro, Brazil, 1979-1981]. / Diferenciais regionais de mortalidade por câncer no estado do Rio de Janeiro, Brasil, 1979-1981.

In 1980, malignant neoplasms ranked 3rd as a cause of death in the State of Rio de Janeiro, Brazil, with a crude mortality rate of 89.8 per 100,000. Cancer mortality data for 1979-1981 are presented for the State, with the objective of analyzing regional differentials. For the purpose of comparing mortality from the most important cancers, the State was divided into three regions: Capital, Metropolitan Belt and Interior, on the basis of the geographical structure of the State--which gave rise to the present urbanization patterns. Average annual age and sex-specific mortality rates per 100,000 were calculated for the period 1979-1981 for each cancer site and for 5-year age groups up to 79 years and for 80 years and above. Age standardized rates (ASR) were calculated by direct standardization to the world population and standardized mortality ratios (SMR) were also calculated with the objective of comparing different geographical areas. It was found that the most important malignant neoplasms among males were those of the lung (ASR 27.9), stomach (ASR 24.0), prostate, oesophagus and liver. The breast was the most important site for females (ASR 16.0), followed by the stomach (ASR 10.8), lung, cervix uteri and uterus (unspecified). The highest ASR were in the Capital (164.4 in males, 106.2 in females) and the lowest in the Interior (126.5 in males, and 91.3 in females). The highest SMR were found for breast (1.28), colon (1.71) and lung (1.70) cancers, the mortality rates for which were almost two-times higher in the Capital than in the Interior.(ABSTRACT TRUNCATED AT 250 WORDS)

Effectiveness of BCG vaccination against tuberculous meningitis: a case-control study in São Paulo, Brazil.

A case-control study was carried out in the Metropolitan Region of São Paulo, Brazil, to determine the protection against tuberculous meningitis conferred by BCG vaccination to children aged less than 5 years. The BCG vaccination coverage in the study area was about 88%. A total of 72 tuberculous meningitis patients were studied as well as 505 neighbourhood and 81 hospital controls. Analysis of the data using a conditional logistic regression for matched case-control studies indicated that the efficacy of BCG was similar for both groups of controls, that for neighbourhood controls (84.5%) being slightly greater than that for hospital controls (80.2%). No significant interactions were found between vaccination status and sex, age, or socioeconomic status.

Effectiveness of BCG vaccination against tuberulous meningitis: A case-control study in Sao Paulo, Brazil

A case-control study was carried out in the Metropolitan Region of Sào Paulo, Brazil, to determine the protection against tuberculous meningitis conferred by BCG vaccination to children aged less than 5 years. The BCG vaccination coverage in the study area was about 88 per cent. A total of 72 tuberculous meningitis patients were studied as well as 505 neighbourhood and 81 hospital controls. Analysis of the data using a conditional logistic regression for matched case-control studies indicated that the efficacy of BCG was similar for both groups of controls, that for neighbourhood controls (84.5 per cent) being slightly greater than that for hospital controls (80.2 per cent). No sifnificant interactions were found between vaccination status and sex, age, or socioeconomic status(AU)

[Proposal for a model for the desaggregation of demographic projections of large areas into their geographical components]. / Proposta de um modelo para desagregar projeções demográficas de grandes áreas em seus componentes geográficos.

The problem of the preparation of estimates of the total population of geographic subdivisions after the 1980 census is studied with a view to the tabulation on mortality data of Rio de Janeiro State (Brazil) by municipal districts and the estimation of regional mortality rates. In Brazil, the calculation of the official population estimates is undertaken by the Brazilian Institute of Geography and Statistics. The method employed to estimate the population of geographic subdivisions is known as the "AiBi method". This procedure is analysed and an alternative mathematical model is proposed that also satisfies the closure condition, that is, the projected values for the sum of the segments up to the total population projection. As an application of the proposed model, estimates of the population of the municipal districts of Rio de Janeiro State were prepared covering the period from 1981 to 1990.

Immunoenzymatic assy (ELISA) in mucocutaneous leishmaniasis, kala-azar, and Chagas' disease: an epimastigote Trypanosoma cruzi antigen able to distinguish between anti-Trypanosoma and anti-Leishmania antibodies.

Areas where mucocutaneous leishmaniasis, kala-azar and Chagas' disease are prevalent often overlap in Latin America. Due to a variable degree of cross-reactivity between the three etiological agents and antibodies synthesized during the course of the disease, a test able to distinguish between them is greatly needed. Saline-extracted antigen from live Trypanosoma cruzi epimastigotes behaved towards Chagas' disease sera in immunoenzymatic assays (ELISA) with the same specificity and sensitivity as the antigen used routinely for such tests. In tests using mucocutaneous leishmaniasis or kala-azar sera, the live T. cruzi antigen showed a much lower geometric mean titer (GMT) than the standard T. cruzi antigen. In ELISA tests with L. braziliensis antigen a higher GMT was seen with kala-azar sera than with those from cases of mucocutaneous leishmaniasis. Also, sera from Vale do Ribeira leishmaniasis showed higher GMT with an L. donovani antigen than with a homologous one. Such discrepancies were not seen in immunofluorescence tests employing the same sera and antigens.

Schistosome motility in saline media.

The authors observed the motility of 1067 worms used as a biological parameter indicating the vitality of the parasites, to define the survival time of S. mansoni males and females in 0,85% NaCl and PBS. Among the worms observed in 0,85% NaCl the mean time of survival in minutes was 204 for males and 240 for females and in PBS it was 267 min. for males and 344 min. for females. All the tested differences (media, sex; sex for saline group; sex for PBS group) were significant at a 0.0001 level.