BackgroundMany countries have reported an increase in the incidence of pertussis, which has become a global public health concern.MethodsIn this study, the epidemiology of pertussis in Brazil was assessed retrospectively using surveillance data gathered from case notification forms from 2007 to 2014.ResultsFrom 2007 to 2014, 80,068 suspected cases of pertussis were reported in Brazil. Of these, 24,612 (32 %) were confirmed by various criteria. The annual distribution of confirmed cases demonstrated a significant increase in incidence rate since 2012. A seasonal pattern in which cases occur most frequently between the end of spring and midsummer has been identified. Among the confirmed cases, 34.5 % occurred in infants aged 0–2 months, 22.4 % occurred in infants aged 3–6 months, 21 % occurred in children aged 7 months to 4 years, and 8 % were reported in adults >21 years. Of the confirmed cases, 47.2 % met only clinical criteria, 15.5 % met clinical and epidemiological criteria, and 36.6 % were confirmed in a laboratory. The overall case fatality rate was 2.1 %, reaching 4.7 % among infants aged 0–2 months. The complications most commonly reported in the notification forms were pneumonia, encephalitis, dehydration, otitis, and malnutrition. Of the confirmed cases, 23.1 % occurred in subjects who received at least 3 doses of the pertussis vaccine. Within this group, there were 1098 infants aged 7 to 15 months and 2079 children aged 16 months to 4 years. In 2012, 18 states did not achieve 95 % immunization coverage, a number that dropped to 10 and 6 in 2013 and 2014, respectively.ConclusionsBrazil’s main challenges in facing pertussis resurgence will be to offer the best quality medical attention to reduce mortality, to improve the infrastructure for laboratory diagnosis and to increase vaccination coverage. Additional studies to assess the effectiveness of the current vaccination schedule and basic research on the genetics and evolution of circulating B. pertussis strains are also needed.

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Teresina-Timon conurbation (TTC) area is an example of urban agglomeration, situated in the semiarid environment of the northeast region of Brazil, which has shown an accelerated process of urban development over the last four decades (1985–2019). In this study, we developed a semi-automatic urban land mapping framework at the Google Earth Engine (GEE) platform to (a) evaluate spatiotemporal sprawl of the TTC area (1985–2018); and (b) quantify current urban fabric structures of TTC area (2019). The main empirical results demonstrate that the use of the Landsat historical dataset is a suitable option for generating consistent urban land maps across the years in semiarid environments. Teresina and Timon expanded, respectively, from 70.34 km2 and 12.20 km2 in 1985 to 159.02 km2 and 30.68 km2 in 2018, increasing annually at 3.05% and 3.69% averaged rate, showing an underlying tendency of continuous growth, and magnitude similar to Asian cities. The results of the urban fabric (UF) structures mapping demonstrates a high complexity of the urbanized surfaces, characterized by irregular shapes and variability of urban coverage. In 2019, the TTC metropolitan area was covered by urban land use classes as ceramic roofs, other types of roofs, and impervious surface, in the proportions of 28.02%, 11.97%, and 5.67%, respectively.