RESUMO
SETTING: Brazil ranks eighteenth worldwide in annual numbers of new tuberculosis (TB) cases. The municipality of Manaus, Amazonas State, has the highest incidence of TB in Brazil. OBJECTIVE: To evaluate the quality of TB epidemiological surveillance, and to describe the spatial distribution pattern of TB incidence in Manaus and its social determinants. DESIGN: An ecological study was performed based on secondary data from TB epidemiological surveillance reports. RESULTS: An index was developed to classify neighborhoods in terms of the quality of surveillance and suspected underreporting. Based on data from neighborhoods with better surveillance performance, we observed that the average number of residents per room, the unemployment rate and the proportion of households connected to a sewage system were significant predictors of TB incidence. Seven neighborhoods in the south and west of the city had clusters of high TB transmission. CONCLUSION: Our results suggest that the association between TB and social vulnerability is obscured by the poor quality of TB surveillance data. We identified priority areas that require immediate TB control interventions and those where local surveillance efforts should be improved, and generated information useful for formulating more effective actions.
Assuntos
Tuberculose Pulmonar/epidemiologia , Brasil/epidemiologia , Humanos , Incidência , Vigilância da População , Fatores de Risco , Fatores Socioeconômicos , Análise Espaço-Temporal , Tuberculose Pulmonar/prevenção & controleRESUMO
The State of Amazonas in the Brazilian Amazon region is an area of high prevalence of hepatitis B and D virus (HBV and HDV) infection. The aim of this study was to identify epidemiological patterns and risk factors of HBV and HDV infections in Barcelos, in the basin of the Negro river. A random sample (798 in all) of the total population in the urban area and in 2 rural villages was surveyed. A standardized questionnaire was used and blood samples were tested by enzyme-linked immunosorbent assay: 1.63% had hepatitis B surface antigen, 12.9% had anti-hepatitis B surface antibody and 21.4% had anti-hepatitis B core antigen. The overall prevalence of HBV infection was 24.6%. Anti-hepatitis D was present in 5 subjects, all of them non-natives, and hepatitis B e antigen in 2. A positive association between history of dental treatment with an unqualified dental surgeon was found (P < 0.05). These results suggest a low prevalence of HVB and HDV infection, in contrast with other parts of the Amazon area.
Assuntos
Hepatite B/epidemiologia , Hepatite D/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Criança , Pré-Escolar , Feminino , Hepatite B/imunologia , Anticorpos Anti-Hepatite B/análise , Antígenos do Núcleo do Vírus da Hepatite B/análise , Antígenos de Superfície da Hepatite B/análise , Antígenos E da Hepatite B/análise , Hepatite D/imunologia , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Estudos de AmostragemAssuntos
Esplenomegalia/diagnóstico , Adolescente , Adulto , Brasil , Feminino , Humanos , Imunoglobulina G/análise , Imunoglobulina M/análise , Fígado/patologia , Cirrose Hepática/complicações , Cirrose Hepática/patologia , Malária/complicações , Malária/diagnóstico , Masculino , Plasmodium/imunologia , Esplenomegalia/etiologia , SíndromeAssuntos
Clindamicina/administração & dosagem , Malária/tratamento farmacológico , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Clindamicina/farmacologia , Esquema de Medicação , Feminino , Humanos , Malária/parasitologia , Masculino , Pessoa de Meia-Idade , Plasmodium falciparum/efeitos dos fármacosRESUMO
Sao apresentados os resultados do emprego de clindamicina na dosagem de 20 mg/Kg/peso/dia, durante cinco dias. A droga foi administrada por via oral ou venosa, a 26 pacientes infectados com P. falciparum, observando-se negativacao da parasitemia a partir do 3o. dia, com o maximo entre o 4o. e 6o. dia, quando 21 (80,8%) pacientes deixaram de apresentar parasitos assexuados no sangue periferico. A cura clinica e parasitologica foi obtida em todos os pacientes