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BACKGROUND: Scorpion stings in Brazil represent a major public health problem due to their incidence and their potential ability to lead to severe and often fatal clinical outcomes. A better understanding of scorpionism determinants is essential for a precise comprehension of accident dynamics and to guide public policy. Our study is the first to model the spatio-temporal variability of scorpionism across municipalities in São Paulo (SP) and to investigate its relationship with demographic, socioeconomic, environmental, and climatic variables. METHODOLOGY: This ecological study analyzed secondary data on scorpion envenomation in SP from 2008 to 2021, using the Integrated Nested Laplace Approximation (INLA) to perform Bayesian inference for detection of areas and periods with the most suitable conditions for scorpionism. PRINCIPAL FINDINGS: From the spring of 2008 to 2021, the relative risk (RR) increased eight times in SP, from 0.47 (95%CI 0.43-0.51) to 3.57 (95%CI 3.36-3.78), although there has been an apparent stabilization since 2019. The western, northern, and northwestern parts of SP showed higher risks; overall, there was a 13% decrease in scorpionism during winters. Among the covariates considered, an increase of one standard deviation in the Gini index, which captures income inequality, was associated with a 11% increase in scorpion envenomation. Maximum temperatures were also associated with scorpionism, with risks doubling for temperatures above 36°C. Relative humidity displayed a nonlinear association, with a 50% increase in risk for 30-32% humidity and reached a minimum of 0.63 RR for 75-76% humidity. CONCLUSIONS: Higher temperatures, lower humidity, and social inequalities were associated with a higher risk of scorpionism in SP municipalities. By capturing local and temporal relationships across space and time, authorities can design more effective strategies that adhere to local and temporal considerations.

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Background Scorpion stings in Brazil represent a major public health problem due to their incidence and their potential ability to lead to severe and often fatal clinical outcomes. A better understanding of scorpionism determinants is essential for a precise comprehension of accident dynamics and to guide public policy. Our study is the first to model the spatio-temporal variability of scorpionism across municipalities in São Paulo (SP) and to investigate its relationship with demographic, socioeconomic, environmental, and climatic variables. Methodology This ecological study analyzed secondary data on scorpion envenomation in SP from 2008 to 2021, using the Integrated Nested Laplace Approximation (INLA) to perform Bayesian inference for detection of areas and periods with the most suitable conditions for scorpionism. Principal findings From the spring of 2008 to 2021, the relative risk (RR) increased eight times in SP, from 0.47 (95%CI 0.43–0.51) to 3.57 (95%CI 3.36–3.78), although there has been an apparent stabilization since 2019. The western, northern, and northwestern parts of SP showed higher risks; overall, there was a 13% decrease in scorpionism during winters. Among the covariates considered, an increase of one standard deviation in the Gini index, which captures income inequality, was associated with a 11% increase in scorpion envenomation. Maximum temperatures were also associated with scorpionism, with risks doubling for temperatures above 36°C. Relative humidity displayed a nonlinear association, with a 50% increase in risk for 30–32% humidity and reached a minimum of 0.63 RR for 75–76% humidity. Conclusions Higher temperatures, lower humidity, and social inequalities were associated with a higher risk of scorpionism in SP municipalities. By capturing local and temporal relationships across space and time, authorities can design more effective strategies that adhere to local and temporal considerations.

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BACKGROUND: West Nile virus (WNV) is a vector-borne pathogen of global relevance and is currently the most widely distributed flavivirus causing encephalitis worldwide. Climate conditions have direct and indirect impacts on vector abundance and virus dynamics within the mosquito. The significance of environmental variables as drivers in WNV epidemiology is increasing under the current climate change scenario. In this study we used a machine learning algorithm to model WNV distributions in South America. METHODS: Our model evaluated eight environmental variables for their contribution to the occurrence of WNV since its introduction in South America in 2004. RESULTS: Our results showed that environmental variables can directly alter the occurrence of WNV, with lower precipitation and higher temperatures associated with increased virus incidence. High-risk areas may be modified in the coming years, becoming more evident with high greenhouse gas emission levels. Countries such as Bolivia, Paraguay and several Brazilian areas, mainly in the northeast and midwest regions and the Pantanal biome, will be greatly affected, drastically changing the current WNV distribution. CONCLUSIONS: Understanding the linkages between climatological and ecological change as determinants of disease emergence and redistribution will help optimize preventive strategies. Increased virus surveillance, integrated modelling and the use of geographically based data systems will provide more anticipatory measures by the scientific community.

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Scorpion envenomation is a significant public health concern in São Paulo, Brazil, and its incidence and mortality have increased in recent decades. The present study analyzed documented scorpion envenomation notifications from 2008 to 2018 throughout the 645 municipalities of São Paulo. Annual incidence and mortality rates were calculated and stratified according to sex and age. The local empirical Bayesian method and Getis-Ord Gi* statistic were used to represent standardized incidence rates in the municipalities and to identify high- and low-risk agglomerates. The incidence rate of scorpion envenomation quintupled between 2008 and 2018. Overall, the risk was higher for man, and increased with age. Deaths due to envenomation, however, were concentrated almost entirely in children 0-9 years of age. Incidence maps showed that the risk of envenomation increased in almost all regions and municipalities of São Paulo throughout the study period. The highest incidence rates were found in the western, northwestern and northern regions of the state, in contrast to the São Paulo metropolitan area and southern and coastal regions. Hot spots were identified in the Presidente Prudente, Barretos, São José do Rio Preto, and Araçatuba regional health districts, which over time formed a single high-risk cluster. In spatial terms, however, deaths were randomly distributed. In this study, we identified areas and populations at risk of scorpion envenomation and associated-fatalities, which can be used to support decision-making by health services to reduce human contact with these arachnids and avoid fatalities, especially in children.

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Background: Aedes aegypti is the dominant vector of several arboviruses that threaten urban populations in tropical and subtropical countries. Because of the climate changes and the spread of the disease worldwide, the population at risk of acquiring the disease is increasing. Methods: This study investigated the impact of the larval habitats control (CC), nebulization (NEB), and both methods (CC + NEB) using the distribution of Ae. aegypti eggs collected in urban area of Santa Bárbara d'Oeste, São Paulo State, Brazil. A total of 142,469 eggs were collected from 2014 to 2017. To verify the effects of control interventions, a spatial trend, and a predictive machine learning modeling analytical approaches were adopted. Results: The spatial analysis revealed sites with the highest probability of Ae. aegypti occurrence and the machine learning generated an asymmetric histogram for predicting the presence of the mosquito. Results of analyses showed that CC, NEB, and CC + NEB control methods had a negative impact on the number of eggs collected in ovitraps, with effects on the distribution of eggs in the three weeks following the treatments, according to the predictive machine learning modeling. Conclusions: The vector control interventions are essential to decrease both occurrence of the mosquito vectors and urban arboviruses. The inference processes proposed in this study revealed the relative causal impact of distinct mosquito control interventions. The spatio-temporal and the machine learning analysis are relevant and Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporation robust analytical approach to be employed in surveillance and monitoring the results of public health programs focused on combating urban arboviruses.

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The Middle Paranapanema region in the state of São Paulo, Brazil, is an area with high diversity for Biomphalaria species, with municipalities historically marked by cases of schistosomiasis transmission. The objectives of the study were to evaluate the current distribuition and predict the future distribution of habitats of Biomphalaria species at a high spatial resolution along 114 freshwater sites in the Middle Paranapanema watershed. The modelling encompassed 55 municipalities of the Middle Paranapanema region, which were analyzed through the maximum entropy algorithm. All geographic coordinates of the Biomphalaria species collected from 2015-2018 and environmental data were obtained through WorldClim, HydroSHEDS, TOPODATA and Secretaria do Meio Ambiente for the 1970-2017 period. For the 2041-2060 period we used the HadGEM2-ES climate model. Due to climate change, MaxEnt showed that there was a high probability for the maintenance of B. glabrata habitats near Ourinhos and Assis, an expansion of scattered spots, and a 50% probability that the species will spread throughout new suitable areas. The results showed that the geographical range of B. straminea will most likely expand in the future along the Middle Paranapanema hydrographic basin, especially in the municipalities near Ourinhos. For B. glabrata and B. straminea, the geographic expansion was related to the predicted increase in the annual temperature range. The habitats suitable for B. tenagophila and B. peregrina seemed to slightly expand around the west border of the Middle Paranapanema region. Biomphalaria occidentalis may have a small reduction in its distribution due to climate change. The variables that contributed the most to the future modelling for these three species were precipitation and temperature. Identifying the sites with intermediate hosts for schistosomiasis may guide public health measures to avoid or reduce future transmissions in this region.

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Kerteszia cruzii is a sylvatic mosquito and the primary vector of Plasmodium spp., which can cause malaria in humans in areas outside the Amazon River basin in Brazil. Anthropic changes in the natural environments are the major drivers of massive deforestation and local climate change, with serious impacts on the dynamics of mosquito communities and on the risk of acquiring malaria. Considering the lack of information on the dynamics of malaria transmission in areas across the Atlantic Forest biome, where Ke. cruzii is the dominant vector, and the impact of climate drivers of malaria, the present study aimed to: (i) investigate the occurrence and survival rate of Ke. cruzii based on the distinct vegetation profiles found in areas across the coastal region of the Brazilian Atlantic Forest biome; (ii) estimate the extrinsic incubation period (EIP) and survival rates of P. vivax and P. falciparum parasites in Ke. cruzii under current and future scenarios. The potential distribution of Plasmodium spp. was estimated using simulation analyses under distinct scenarios of average temperature increases from 1 °C to 3.7 °C. Our results showed that two conditions are necessary to explain the occurrence and survival of Ke. cruzii: warm temperature and presence of the Atlantic Forest biome. Moreover, both Plasmodium species showed a tendency to decrease their EIP and increase their estimated survival rates in a scenario of higher temperature. Our findings support that the high-risk malaria areas may include the southern region of the distribution range of the Atlantic Forest biome in the coming years. Despite its limitations and assumptions, the present study provides robust evidence of areas with potential to be impacted by malaria incidence in a future scenario. These areas should be monitored in the next decades regarding the occurrence of the mosquito vector and the potential for malaria persistence and increased occurrence.

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BACKGROUND: Dengue is an arbovirus disease that threatens approximately 200 million people annually worldwide. Aedes (Stegomyia) aegypti (Linnaeus, 1762) is anthropophilic mosquito, extremely well adapted to the urban environment and utilizes varied habitats for egg-laying and development. This study analysed the distribution of mosquito larvae and eggs in urban area of Santa Bárbara d'Oeste, São Paulo, Brazil. The spatial correlation between locations in which people store recyclable materials and the distribution of larvae and eggs were verified. METHODS: Larvae and ovitrap egg collections were conducted from 2014 to 2016. All persons who stored recyclable materials for living were registered and georeferenced. The Mann-Kendall test was used to verify spatial and temporal trends in the number of eggs and larvae/pupae. Euclidian distance map was constructed to correlate recyclable collectors and Ae. aegypti, and Moran's index was employed to verify their spatial autocorrelation and identification of groupings. RESULTS: A total of 137,825 eggs and 16,393 larvae were collected in different habitats from 2014 to 2016. The analyses showed that there was a spatial correlation between larvae and eggs collected, and these two kinds of surveys also presented a spatial correlation with the handling of recyclable materials. The results of the analyses showed significant spatial correlations between eggs and recyclable material collectors and between larvae and collectors. CONCLUSION: The entomological surveillance conducted using ovitraps as a proxy for the presence of Ae. aegypti is an efficient and sensitive method for monitoring the presence of mosquitoes and the impact of interventions employed for decreasing vector populations. Mosquito surveys employing ovitraps should be used more often in routine activities aiming to control dengue through vector control interventions. The locations used to store recyclable materials have a significant relationship with the maintenance of the dengue virus infection in the area. Further studies will be needed to analyse the contribution of recyclable locations, for which there is no ideal infrastructure to minimize the potential use of these materials as mosquito habitats. The entomological surveillance focused on locations of recyclable materials involving interventions that are different from those commonly used in Ae. aegypti control.

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Because of the high adaptive capacity of mosquitoes, studies that focus on transitional environments become very important, such as those in rural areas, which are considered as bridges between wild diseases and human populations of urban areas. In this study, a survey of the existing species of mosquitoes was performed in an Atlantic Forest area of the city of Santa Bárbara d'Oeste, São Paulo state, Brazil, using traps for immatures and analyzing the frequency and distribution of these insects over the sampling months. Five mosquito species were found: Aedes albopictus (the most frequent species), Aedes aegypti, Aedes fluviatilis, Culex quinquefasciatus, and Toxorhynchites theobaldi. The 4,524 eggs collected in ovitraps showed the presence of the tribe Aedini. Aedes aegypti and Ae. albopictus were identified after larval hatching in the laboratory, with different spatial distributions: the first of which coincides with the area of greatest diversity calculated using the Simpson index, while the second does not. The association of ecological analysis of spatial diversity with simple methods of data collection enables the identification of possible epidemiological risk situations and is a strategy that may be implemented to monitor ecological processes resulting from the interaction among different species of mosquitoes.

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