ResumoObjetivo: descrever a situação epidemiológica da raiva, bem como, as atividades do Programa Nacional de Profilaxia da Raiva (PNPR) realizadas no Brasil, no período de 2000 a 2009. Metodologia: foi realizada uma análise descritiva dos casos de raiva humana e atendimento antirrábico humano com dados do Sistema de Informação de Agravos de Notificação (Sinan), da ficha de vigilância epidemiológica nº 7 e de planilhas padronizadas utilizadas pelo PNPR. Resultados: observouse redução dos casos humanos e caninos e uma mudança no perfil de ocorrência e transmissão, nos últimos cinco anos, com 78,0% dos casos humanos transmitidos por morcegos, além do aumento na detecção de casos em espécies silvestres. Conclusão: a situação atual da raiva no país impõe a necessidade de aprimoramento e manutenção das ações de vigilância voltadas para o ciclo urbano, implementação no ciclo silvestre e reforça a importância da profilaxia humana, visando prevenir ocorrência de casos humanos.Palavras-chave: raiva; epidemiologia; vigilância em saúde pública. Summary Objective: to describe the epidemiological situation of rabies and the activities of the National Program for Prevention of Human Rabies in

An effective surveillance system is critical for the elimination of canine rabies in Latin America. Brazil has made substantial progress towards canine rabies elimination, but outbreaks still occurred in the last decade in two states. Brazil uses a health information system (SINAN) to record patients seeking post-exposure prophylaxis (PEP) following contact with an animal suspected of having rabies. This study evaluated: (i) whether SINAN can be reliably used for rabies surveillance; (ii) if patients in Brazil are receiving appropriate PEP and (iii) the benefits of implementing the latest World Health Organization (WHO) recommendations on PEP. Analysing SINAN records from 2008 to 2017 reveals an average of 506,148 bite-injury patients/year [range: 437k-545k] in the country, equivalent to an incidence of 255 bite-injuries/100,000 people/year [range: 231–280]. The number of reports of bites from suspect rabid dogs generally increased over time. In most states, records from SINAN indicating a suspect rabid dog do not correlate with confirmed dog rabies cases reported to the Regional Information System for Epidemiological Surveillance of Rabies (SIRVERA) maintained by the Pan American Health Organization (PAHO). Analyses showed that in 2017, only 45% of patients received appropriate PEP as indicated by the Brazilian Ministry of Health guidance. Implementation of the latest WHO guidance using an abridged intradermal post-exposure vaccination regimen including one precautionary dose for dog bites prior to observation would reduce the volume of vaccine required by up to 64%, with potential for annual savings of over USD 6 million from reduced vaccine use. Our results highlight the need to improve the implementation of SINAN, including training of health workers responsible for delivering PEP using an Integrated Bite Case Management approach so that SINAN can serve as a reliable surveillance tool for canine rabies elimination.

RESUMEN Objetivos. Describir el perfil epidemiológico de las personas discapacitadas por accidentes de tránsito (AT) en Perú. Materiales y métodos. Análisis secundario de la Encuesta Nacional Especializada Sobre Discapacidad (ENEDIS) del año 2012. Además, se realizó un análisis ecológico con los registros de AT del Ministerio de Transportes y Comunicaciones. Resultados. 49 036 personas reportaron algún tipo de discapacidad por accidentes de tránsito (DAT); 81,3% de los discapacitados reside en zonas urbanas. La discapacidad reportada más frecuente fue limitación en la locomoción y destreza (77,4%), seguida de la discapacidad visual (22,9%). Se reporta dependencia en 44,7% de las personas con discapacidad. Las regiones con mayor prevalencia de AT presentan mayor prevalencia de discapacidad por accidente de tránsito (Coeficiente de Spearman: 0,426, p=0,034). Conclusiones. La mayor parte de los discapacitados por AT proceden de la zona urbana, son varones y se encuentran en la edad económicamente productiva. La forma más común de limitación es la de locomoción. Gran parte de los afectados no reciben ningún tipo de rehabilitación, lo que acentúa la inequidad en salud relacionada a los accidentes de tránsito. Palabras clave: Accidentes de tránsito; Personas con discapacidad; Prevalencia (fuente: BIREME). ABSTRACT Objectives. To describe the epidemiological profile of people living with disabilities due to traffic accidents (TA) in Peru. Materials and methods. Secondary analysis of the National Survey Specialized on Disability (ENEDIS) of 2012 and an ecological analysis of TA records of the Ministry of Transportation and Communications was done. Results. Disability by traffic accidents (DAT) was reported by 49,036 persons; 81.3% of whom live in urban areas. The most frequent disability was limited locomotion and skill (77.4%), followed by visual impairment (22.9%). Dependence for activities was reported in 44.7% of persons with disabilities. The regions with the highest prevalence of TA have a higher prevalence of disability by traffic accidents (Spearman coefficient: 0.426, p=0.034). Conclusions. Most of disability due to TA is found in urban areas, correspond to males and consist of persons in economically productive age. The most common form of disability is in locomotion. Most of individuals do not receive any form of rehabilitation, which accentuates health inequity related to traffic accidents.