BackgroundSpotted fever is a tick-borne rickettsial disease. In Brazil, its notification to the Ministry of Health is compulsory. Since 2007, cases of spotted fever have been integrated to the Notifiable Diseases Information System, and epidemiological analyzes are part of the routines on surveillance programs.MethodsThis descriptive study updates epidemiological information on cases of spotted fever registered in Brazil between 2007 and 2015.ResultsIn Brazil, 17,117 suspected cases of the disease were reported and 1,245 were confirmed in 12 states, mainly in São Paulo (550, 44.2 %) and Santa Catarina (276, 22.2 %). No geographic information was registered for 132 cases (10.6 %). Most of the infected people were men (70.9 %), mainly in rural areas (539, 43.3 %), who had contact with ticks (72.7 %). A higher number of suspected cases were registered between 2011 and 2015, but the number of confirmed cases and the incidence were relatively low. Moreover, 411 deaths were registered between 2007 and 2015, mainly in the southeastern region of the country, where the case-fatality rate was 55 %. Lack of proper filling of important fields of notification forms was also observed.ConclusionsThe results showed expansion of suspected cases of spotted fever and high case-fatality rates, which could be related to diagnostic difficulties and lack of prompt treatment. These factors may comprise limitations to the epidemiological surveillance system in Brazil, hence improvement of notification and investigation are crucial to reduce morbidity and mortality due to spotted fever in Brazil.
Despite the dramatic reduction in Trypanosoma cruzi vectorial transmission in Brazil, acute cases of Chagas disease (CD) continue to be recorded. The identification of areas with greater vulnerability to the occurrence of vector-borne CD is essential to prevention, control, and surveillance activities. In the current study, data on the occurrence of domiciliated triatomines in Brazil (non-Amazonian regions) between 2007 and 2011 were analyzed. Municipalities' vulnerability was assessed based on socioeconomic, demographic, entomological, and environmental indicators using multi-criteria decision analysis (MCDA). Overall, 2275 municipalities were positive for at least one of the six triatomine species analyzed (Panstrongylus megistus, Triatoma infestans, Triatoma brasiliensis, Triatoma pseudomaculata, Triatoma rubrovaria, and Triatoma sordida). The municipalities that were most vulnerable to vector-borne CD were mainly in the northeast region and exhibited a higher occurrence of domiciliated triatomines, lower socioeconomic levels, and more extensive anthropized areas. Most of the 39 new vector-borne CD cases confirmed between 2001 and 2012 in non-Amazonian regions occurred within the more vulnerable municipalities. Thus, MCDA can help to identify the states and municipalities that are most vulnerable to the transmission of T. cruzi by domiciliated triatomines, which is critical for directing adequate surveillance, prevention, and control activities. The methodological approach and results presented here can be used to enhance CD surveillance in Brazil.
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.
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