Desastres naturais e saúde: uma análise da situação do Brasil Natural disasters and health: an analysis of the situation in Brazil (meteorological; hydrological; climatological; geophysical/ geological)

The Hansen's disease new case detection rate, which reflects the magnitude of disease, is associated with social conditions and land settlement practices in the Brazilian Amazon.

OBJECTIVE:To compare new registrations of recurrences of leprosy cases in primary healthcare units (PHUs) and in specialized units in the State of Mato Grosso. METHODS:This was a cross-sectional study based on all new registrations (N = 323) of recurrences of leprosy cases within the Notifi able Disease Information System (SINAN) between 2004 and 2006 that were made in the State of Mato Grosso, Central-West Brazil. The cases diagnosed were compared regarding sex, age, clinical-laboratory characteristics and geographical distribution among the municipalities. To compare and calculate the proportions of the variables, the chi-square test at the signifi cance level of 5% was used. RESULTS:Among the new registrations of recurrences, 20% were confi rmed at specialized units and 80% at PHUs. However, most of the diagnoses at PHUs presented negative bacilloscopy fi ndings (c2 = 12.34; p = 0.002). Seventyone per cent of the cases were among males; the mean age was 43 years. No differences in the percentages of registrations were observed between the healthcare units with regard to clinical form, operational classifi cation or degree of physical incapacity. Out of the total number of municipalities in the state, 64.7% presented recurrences and these accounted for 6 to 20% of all registrations. CONCLUSIONS:The new registrations of cases of recurrence in Mato Grosso were infl uenced by the diagnoses made at PHUs, thus suggesting that there is a defi ciency within the healthcare services in recognizing cases of recurrence.

Snakebite accidents are considered category A neglected tropical diseases. Brazil stands out for snakebite accidents, mainly in the Amazon region. The best possible care after snakebite accidents is to obtain antiophidic sera on time. And the maximum ideal time to reach it is about 2 hours after an accident. Based on public health information and using a tool to analyze geographical accessibility, we evaluate the possibility of reaching Brazilian serum-providing health facilities from the relationship between population distribution and commuting time. In this exploratory descriptive study, the geographic accessibility of Brazilian population to health facilities that supply antiophidic serum is evaluated through a methodology that articulates several issues that influence the commuting time to health units (ACCESSMOD): population and facilities’ distribution, transportation network and means, relief and land use, which were obtained in Brazilian and international sources. The relative importance of the population without the possibility of reaching a facility in two hours is highlighted for Macro-Regions, States and municipalities. About nine million people live in locations more than two hours away from serum-providing facilities, with relevant variations between regions, states, and municipalities. States like Mato Grosso, Pará and Maranhão had the most important participation of population with reaching time problems to those units. The most significant gaps are found in areas with a dispersed population and sometimes characterized by a high incidence of snakebites, such as in the North of the country, especially in the Northeastern Pará state. Even using a 2010 population distribution information, because of the 2020 Census postponement, the tendencies and characteristics analyzed reveal challenging situations over the country. The growing availability of serum-providing health facilities, the enhanced possibilities of transporting accident victims, and even the availability of sera in other types of establishments are actions that would allow expanding the possibilities of access to serum supply.

Introduction: Visceral leishmaniasis has a broad worldwide distribution and constitutes a public health problem in the Northeast of Brazil. Located in this region is the state of Alagoas, where the disease is endemic in humans and where there has been a significant increase in the number of positive dogs. The objective of this study was to describe the temporal and spatial distribution of the cases of human VL in the state of Alagoas with the aim of identifying transmission risk areas in the period from 2007 to 2018. Methods: The data available in the National Disease Notification System (SINAN-NET) were used. The Bayesian incidence rate and the Moran's global index were calculated using the Terra View 4.2.2 program, and the maps were created using QGIS2.18.0. Results: From the 102 municipalities, 68.6% (n= 70) had at least one notified case of VL in the years of study. A total of 489 cases were registered, with an average of 40.7 cases per year and an incidence rate of 1.25/100,000 inhabitants. The highest number of confirmed cases (105) occurred in 2018. Male individuals and children between 1-4 years old were the most affected, and 64% of the cases were in rural areas. Spatial dependence was detected in all the intervals except for the first triennium, and clusters were formed in the west of the state. Conclusions: Alagoas presented an accentuated geographical expansion of VL, and it is necessary to prioritize areas and increase surveillance actions and epidemiological control.