Human visceral leishmaniasis is a major public health problem in the Amazon. Thus, we analyzed the spatial distribution of this disease and its relationship with epidemiological, socioeconomic, and environmental variables in the Carajás Integration Region, Pará state, from 2011 to 2020. Epidemiological data for this ecological study were obtained from the State Public Health Secretariat, environmental data were obtained from the National Space Research Institute, and socioeconomic data were obtained from the Brazilian Geography and Statistics Institute. ArcGIS 10.5.1 software was used for classifying land use and cover and for the Kernel and Moran spatial analyses. It was observed in 685 confirmed cases that the epidemiological profile followed the national pattern of the disease occurrence, with a high prevalence in children who were not school-aged. The disease had a non-homogeneous distribution with clusters related to different human activities, such as urbanization, ranching, and mining. A spatial dependence between the disease prevalence and socioeconomic indicators was observed. The municipalities presented gradients of case densities associated with a direct relationship between areas with cases and deforestation. The disease is developing due to risk factors such as establishment and maintenance related to the non-sustainable development model implemented in the region, pointing to the need for its revision.

O estudo objetivou analisar a distribuição espacial da LTA em Tucuruí e a sua relação com variáveis socioambientais e epidemiológicas, no período de 2012 a 2016. Os dados epidemiológicos foram obtidos no SINAN da SESPA e os cartográficos, populacionais, unidades de conservação e terras indígenas, foram obtidos no IBGE. Os ambientais foram obtidos no PRODES. As análises dos casos e da relação espacial destes com o desflorestamento utilizaram o Bioestat 5.0 e o ArcGis 10.5.1, respectivamente. O município teve 286 casos confirmados, distribuídos de forma não homogênea em seus setores censitários.  Os indivíduos mais acometidos foram do sexo masculino, adultos, pardos, baixo nível de escolaridade e moradores da zona urbana. Foi verificado na série histórica um aumento de casos de LTA e do incremento do desmatamento. A análise espacial mostrou a presença de dois aglomerados de casos localizados na área urbana. Foi observado também a existência de um mosaico de ocupações e terras indígenas. A LTA é um grande e complexo problema de saúde pública em Tucuruí, relacionado à fatores de riscos socioambientais, gerados e condicionados pela insuficiência de políticas públicas no município, que pode ter contribuído para a exposição da população local a vários fatores de risco da doença.

No abstract

The Amazon region has the largest hydrographic basin in the world and a favorable geographical location as a strategic export point but does not satisfactorily exploit its potential for transport and cargo flow, mainly as a differential factor of logistic competitiveness. For the waterway mode, cargo transportation is predominantly carried out by pushed convoys. The objective of this research is to evaluate and select, the best river train for the outflow of iron ore on the Marabá – Vila do Conde stretch, through a multiple criteria decision-making approach. To meet the objectives, a methodological framework is proposed using a hybrid AHP-DEMATEL method, based on a statistical analysis and to guarantee the reliability of the results for the proposed alternatives and not only considering the preference function, the ELECTRE method was used and also a parametric comparison of the AHP results. The main goals of this work were achieved and it was possible to infer that the combination of these methods has, in addition to the evident efficacy, a high reliability in the water transport area, being able to be used with accuracy of diverse forms in the academic area, as well as in industrial applications. Therefore, it can be affirmed that the best-pushed convoy configuration for the iron ore runoff in the Marabá – Vila do Conde stretch is composed by six barges in the arrangement of two columns and three rows with the measurements, by barge, with length of 60.96[Formula: see text]m; beam of 13.75[Formula: see text]m; and a 5[Formula: see text]m molded depth.