BackgroundTuberculosis remains an important disease which mainly affects the majority of vulnerable individuals in society, who are subjected to poor living conditions and difficulties to access the services of public health. Under these circumstances, the present study aims to understand patients’ perception in relation to the influence of individual and social vulnerabilities on the adherence to tuberculosis treatment.MethodsA qualitative descriptive cross sectional study was conducted in one large municipality at the state of Paraíba, Northeast of Brazil. The study subjects, who were residents of the study site, covered all tuberculosis cases diagnosed between March and June 2015. The sample was defined by the criteria of response saturation. All interviews were audio recorded, and data analysis was developed through the hermeneutic dialectic method and the theory of Generative Route Sense. The project was approved by the Research Ethics Committee of the University of São Paulo (USP).ResultsA total of 13 individuals were interviewed and the responses were identified into two analytical categories: the difficulties they had and the enabling factors they could mention during their tuberculosis treatment. Patients brought up social exclusion as an obstacle to treatment adherence, which, along with stigmatization, weakened their link with family members and health professionals. Moreover, economic precariousness was a major hindrance to the maintenance of a proper diet and transportation access to health centers. However, social support and directly observed treatment helped to break down barriers of prejudice and to promote individual and family empowerment. Finally, patients also reported that their will to live and faith gave them the strength to continue with the treatment.ConclusionsAccording to patients in this study, social support and the strengthening of links with family members and health professionals may reduce social exclusion and other difficulties they face, thus encouraging them to the adhere to tuberculosis treatment.

In order to study data about suicide attempts and do the mapping of occurrence areas, it was developed an ecologic and exploring study, making use of techniques of geoprocessing, based on confirmed cases of suicide attempts. Cases of self-poisoning were included in the urban area of Campina Grande county, in the period of 2010-2013. A total of 446 suicide attempts were geo-referred, pointing up an incidence of 120 cases out of each 100,000 inhabitants. The sample was mostly feminine (66.4%), and 62.3% being up to 30 years old. Kernel's map remarked hot spot areas. Compared to surrounding areas the suicide risk of populations within the hot spots was increased (38%; Relative Risk = 1.38; p= 0.0029), with an average estimative of 165 suicide attempts out of 100,000 inhabitants. Through identification of hot spots and index of living conditions of the neighborhoods, it is possible to set priorities in terms of public policies for the prevention of suicide attempts and control of the marketing of substances that are potentially toxic.

Introdução: A depressão é um transtorno que afeta mais de 300 milhões de pessoas no mundo, contudo, o número de mulheres que apresentam esse transtorno é alarmante. Objetivo: Analisar o perfil de mulheres que morreram de alguma causa associada à depressão na região Nordeste do Brasil, entre 2014 a 2019. Métodos: Usamos uma tabela de contingência para apresentar um resumo das variáveis, matriz de correlação para identificação das relações e para reduzir a dimensionalidade sem perder informações e explicar essas variáveis em termos de suas componentes aplicamos a Análise de Componentes Principais. A coleta de dados foi realizada a partir dos dados do Sistema de Informação sobre Mortalidade (SIM), selecionando também a categoria do CID-10 que correspondem a episódios depressivos e transtorno depressivo recorrente (F32 e F33). As variáveis selecionadas foram raça, estado civil e escolaridade levando em consideração apenas pessoas do sexo feminino. Os dados foram tabulados no Excel e analisados no programa estatístico R versão 3.5.2. Resultados: Ocorreram 613 óbitos no sexo feminino nesse período, sendo principalmente mulheres pardas e casadas. As variáveis estão fortemente correlacionadas e hipóteses são levantadas: preconceito, vulnerabilidade social, falta de suporte social, relacionamento abusivo, mulheres procuram mais ajuda do que os homens. Conclusão: O perfil de mortalidade varia em função de raça e estado civil, sendo Bahia e Ceará os dois estados que obtiveram os índices mais significativos. Logo, se fazem necessárias políticas públicas, investimento na prevenção e promoção de qualidade de vida, rede de apoio a mulheres que passam por alguma situação que seja considerada fator de risco para um quadro depressivo.

In this paper, we propose presenting a solution based on socio-epidemiological variables of tuberculosis, considering a clustering with spatial/geographical constraints; and, determine a value of alpha that increases spatial contiguity without significantly deteriorating the quality of the solution based on the variables of interest, i.e. those of the feature space. For the application of Ward’s hierarchical clustering method, two dissimilarity matrices were calculated, the first provides the dissimilarities in the feature space calculated from the socio-epidemiological variables D0 and the second provides the dissimilarities in the calculated constraints space from the geographical distances D1, together with an α mixing parameter and the non-uniform weight w assigned to the calculation of the dissimilarity matrix defined by the standardized incidence ratio (SIR) of TB and that contributed significantly to the increase in clarity, both from a spatial and socio-epidemiological point of view. The method is shown to be feasible in epidemiological studies in the joint understanding of factors of different dimensions, aggregated from a spatial perspective. It is analysis tool that allows making a better understanding of the socio-epidemiological reality of the municipality.

Objective: The relationship between the geographical space and the incidence of scorpion accidents in the context of vulnerability was questioned in the present study through the application of geoprocessing techniques. Methods: In order to recognize vulnerable groups, an ecological study was developed using spatial data analysis techniques of area. Results: A total of 631 cases of scorpion accidents occurred in Campina Grande/Paraíba/Brazil, with an incidence of 154.7 accidents/100,000 inhabitants and an average distance of 0.897 hm between the cases; thus, verifying the possible relationship between accidents and the vulnerability index. Conclusion: Social vulnerability was evidenced by the magnitude in scorpion accidents, considering a higher probability (of attacks) in the most vulnerable areas; therefore, it was possible to verify that the occurrence of scorpion accidents is strongly connected to social factors, and that neighborhoods that have a population with low purchasing power, low schooling and no infrastructure were the most affected.