Incidence of congenital syphilis according to inequalities and living conditions in the city of Recife, Pernambuco, Brazil / Incidência de sífilis congênita segundo as desigualdades na condição de vida no município de Recife, Pernambuco, Brasil

Abstract Objectives: to analyze the variation in the incidence rates of congenital syphilis according to the spatial distribution of Life Condition Index (LCI) among neighborhoods in the city of Recife-PE. Methods: an ecological study, developed from 3,234 cases of congenital syphilis notified in the Sistema de Informação de Agravos de Notificação (Severe Disease Notification Information System), between 2007 and 2016. LCI was built from seven variables related to the dimensions of the environment, education and income, aggregated at the neighborhood levels and spatially distributed in four strata: very high, high, low and very low. The correlation between the rates of congenital syphilis in the strata and LCI was investigated by applying the Spearman correlation coefficient and demonstrated by means of scatter graphics. Results: the mean rate on disease incidence was 6.8 cases per thousand live births. There was a higher incidence in the strata of very low and low living conditions, as well as in Districts that presented poor sanitary conditions and low schooling for the head of the family (District VII), higher proportion of illiteracy among 10 and 14 year olds (District II) and low income of the head of the household (Districts I, II and VII). Conclusions: this study showed the persistence of health inequalities in areas with worse living conditions.

Resumo Objetivos: analisar a variação das taxas de incidência de sífilis congênita segundo a distribuição espacial do Índice de Condição de Vida (ICV) entre os bairros do município do Recife-PE. Métodos: estudo ecológico, desenvolvido a partir de 3234 casos de sífilis congênita notificados no Sistema de Informação de Agravos de Notificação, entre 2007 e 2016. O ICV foi construído a partir de sete variáveis relacionadas as dimensões ambiente, educação e renda, agregadas ao nível dos bairros, e distribuído espacialmente em quatro estratos: muito alto, alto, baixo e muito baixo. A correlação entre as taxas de sífilis congênita nos estratos e o ICV foi investigada aplicando-se o coeficiente de correlação de Spearman e demonstrada por meio de gráficos de dispersão. Resultados: a taxa média de incidência da doença foi de 6,8 casos por mil nascidos vivos. Houve maior incidência nos estratos de condição de vida muito baixa e baixa bem como nos Distritos que apresentaram condições sanitárias ruins e baixa escolaridade do chefe da família (Distrito VII), maior proporção de analfabetismo entre 10 e 14 anos (Distrito II) e baixa renda do chefe do domicílio (Distritos I, II e VII). Conclusões: o estudo evidenciou a persistência das desigualdades de saúde nas áreas com piores condições de vida.

Áreas prioritárias para controle do abandono do tratamento da tuberculose em Recife, Brasil / Mundo da Saúde 2021,45:210-220, e1092020* Universidade Federal de Pernambuco (UFPE). Recife (PE), Brasil. ** Fiocruz-PE. Recife (PE), Brasil. *** Universidade de São Paulo - USP. Ribeirão Preto (SP). Brasil.E-mail: gleds_r1@hotmail.comPriority areas for the control of tuberculosis treatment abandonment in Recife, Brazil

A tuberculose encontra-se entre as doenças infecciosas do mundo com alta morbimortalidade. Possui a descontinuidade do tratamento como desafio a ser enfrentado para reduzir os casos de resistência aos fármacos e mortalidade. O objetivo foi identificar áreas prioritárias para o controle dos casos de abandono do tratamento da tuberculose (TB) no município de Recife. Tratou-se de estudo ecológico, realizado com casos novos de TB diagnosticados em Recife e registrados no Sistema de Informação e Agravos de Notificação entre 2012 a 2014. A variável desfecho foi a média da proporção de abandono do tratamento da TB por setor censitário. Para composição desta variável foram geocodificados todos os endereços dos casos novos de tuberculose e os de abandono do tratamento no triênio investigado. Para avaliação da autocorrelação espacial foi utilizado o Índice Global de Moran. Foram registrados e geocodificados 641 casos de abandono. O valor do Índice Global de Moran foi 0,0313816 (p=0,03) e, por meio do Moran Map, foram identificados 153 setores com significância estatística espacial, destes 43 com alta prioridade para intervenção em saúde distribuídos em 21 bairros. Identificou-se áreas prioritárias para o monitoramento da adesão ao tratamento da tuberculose. O uso dos setores censitários permite a realização de intervenções em saúde para melhor qualidade da assistência aos doentes e redução dos desfechos desfavoráveis com racionalidade dos recursos públicos por ser o menor nível de desagregado territorial disponível, dinâmica populacional e socioeconômica semelhante entre os residentes.(AU)

Tuberculosis is among the world's high morbidity and mortality infectious diseases. The discontinuity of treatment is a challenge to be faced in order to reduce cases of drug resistance and mortality. The objective of this study was to identify priority areas for the control of cases of tuberculosis (TB) treatment abandonment in the city of Recife. This was an ecological study, carried out with new cases of TB diagnosed in Recife and registered in the Information System for Notifiable Diseases between 2012 and 2014. The outcome variable was the average proportion of the abandonment of TB treatment by census sector. To compose this variable, all addresses of new cases of tuberculosis and those of treatment abandonment in the investigated three-year period were geocoded. Moran's Global Index was used to assess spatial autocorrelation. 641 abandonment cases were recorded and geocoded. The value of the Global Moran Index was 0.0313816 (p=0.03) and, through the Moran Map, 153 sectors with spatial statistical significance were identified, of these 43 were high priority for health interventions distributed in 21 neighborhoods. Priority areas were identified for monitoring adherence to tuberculosis treatment. Due to the lower level of available territorial sectors, similar populations, and socioeconomic dynamics among residents, the use of the census sectors allows health interventions to be carried out to improve the quality of care for patients and to reduce the unfavorable outcomes while considering public resources.(AU)

Household Survey of Trachoma among Children Living in Pernambuco, Brazil.

This study analyzed the association between individual and household factors and the incidence of trachoma among a population aged between 1 and 9 years in the state of Pernambuco. This was a population-based household study conducted using a population-based sample of residents from 96 census sectors of the 1778 sectors considered to be at social risk in the state. The estimated odds ratio of the univariate analysis presented a confidence interval of 95%. Weights and clusters were adjusted through the Generalized Linear and Latent Mixed Model (GLLAM) method. Trachoma cases were the dependent variable in the multivariate analysis. The independent variables were selected through the stepwise forward method, with an input criterion of 20% (p < 0.20) and an output criterion of 10% (p < 0.10). The prevalence was 6.65%. Trachoma was associated with a female sex, age of 5-9 years, either the absence of use or infrequent use of soap to wash the hands and face, the presence of nasal secretion, a lack of piped water from a public supply system, a greater number of rooms used for sleeping, a greater number of people living in the same household, and a family income of up to one minimum monthly wage. The prevalence of follicular trachoma in Pernambuco was higher than what is recommended by the World Health Organization (WHO).

Evaluation of the quality of oral health care in Primary Health Care in Pernambuco, Brazil, 2014. / Avaliação da qualidade da assistência em saúde bucal na Atenção Primária à Saúde em Pernambuco, 2014.

OBJECTIVE: to evaluate the quality of oral health care in Primary Health Care services in Pernambuco state, Brazil, 2014. METHODS: this was an ecological health evaluation study based on the Donabedian model, involving secondary data from the 2nd cycle of the National Program for Improving Access and Quality of Primary Health Care (PMAQ-AB); comparison between the structure, process and outcome variables was done using the Kruskal-Wallis test (p<0.050); variables showing statistical significance (p<0.05) were portrayed through thematic and spatial dependence maps. Results: the standard of quality in the municipalities for the 'Structure' dimension gained better scores than the 'Work process' dimension; correlations were identified between the indicators for dental urgency, supervised tooth brushing coverage and treatments completed, in quality strata related to the work process of the Oral Health teams. CONCLUSION: organization of the work process was seen to be a determining factor in the impact on some indicators of service use.

Spatial analysis of intentional homicides in João Pessoa, Paraíba, Brazil, 2011-2016. / Análise espacial dos homicídios intencionais em João Pessoa, Paraíba, 2011-2016.

OBJECTIVE: to describe spatial patterns of intentional homicides in João Pessoa, Paraíba, Brazil, 2011-2016. METHODS: this was an ecological study using census tracts as units of analysis; the study used data on intentional homicides of victims living in João Pessoa obtained by cross-checking Mortality Information System SIM information with Public Security information; mortality coefficients were calculated for the whole period and its triennia and were later smoothed using the local empirical Bayesian method; spatial autocorrelation techniques were applied to the smoothed coefficients which were using Moran's spatial statistics. RESULTS: significant spatial autocorrelation was detected for the period as a whole I=0.679, p=0.01, the 1st triennium I=0.508, p=0.01, and the 2nd triennium I=0.572, p=0.01; areas of greater risk were identified distributed among the western, northwestern, southeastern, and far south zones of the city, mainly in regions with low socioeconomic conditions; census tracts with low coefficients were located in areas of medium/high socioeconomic status. CONCLUSION: homicides in João Pessoa were high in poor districts and these are priority areas for intervention.

Análise espacial dos homicídios intencionais em João Pessoa, Paraíba, 2011-2016 / Análisis espacial de los homicidios intencionales en João Pessoa, Paraíba, Brasil, 2011-2016 / Spatial analysis of intentional homicides in João Pessoa, Paraíba, Brazil, 2011-2016

Objetivo: descrever padrões espaciais dos homicídios intencionais em João Pessoa, Paraíba, Brasil, 2011-2016. Métodos: estudo ecológico, tendo o setor censitário como unidade de referência; utilizaram-se dados dos homicídios dolosos das vítimas residentes no município, mediante o cruzamento das informações do Sistema de Informação sobre Mortalidade SIM e da Segurança Pública; calcularam-se coeficientes de mortalidade para todo o período e seus triênios, posteriormente suavizados pelo método bayesiano empírico local; utilizaram-se técnicas de autocorrelação espacial dos coeficientes, suavizados por meio da estatística espacial de Moran. Resultados: detectou-se autocorrelação espacial significativa no período total I=0,679; p=0,01, 1º triênio I=0,508; p=0,01 e 2º triênio I=0,572; p=0,01; identificaram-se áreas de maior risco distribuídas pelas zonas oeste, noroeste, sudeste e extremo sul, prioritariamente em regiões de baixas condições socioeconômicas; setores de baixos coeficientes situaram-se em áreas de padrão socioeconômico médio/alto. Conclusão: homicídios em João Pessoa foram elevados em locais de pobreza, constituindo áreas prioritárias de intervenção.

Objetivo: describir patrones espaciales de los homicidios en João Pessoa, Paraíba, Brasil, 2011-2016. Métodos: estudio ecológico del sector censitario como unidad geográfica. Se consideran los homicidios de víctimas residentes en João Pessoa, teniendo como fuente el cruce de informaciones del Sistema de Informaciones sobre Mortalidad SIM y de la Seguridad Pública; se calcularon los coeficientes de mortalidad en todo período y sus trienios, posteriormente suavizados por el método bayesiano empírico local; se utilizaron técnicas de autocorrelación espacial de los coeficientes a través de la estadística de Moran. Resultados: se detectó autocorrelación espacial significativa en todo el período I=0,679; p=0,01, 1º trienio I=0,508; p=0,01 y 2º trienio I=0,572; p=0,01; se identificaron áreas de mayor riesgo distribuidas entre las zonas oeste, noroeste, sudeste y extremo sur, prioritariamente en regiones de bajas condiciones socioeconómicas; sectores de bajos coeficientes se situaron en áreas de patrón socioeconómico medio/alto. Conclusión: los homicidios fueron elevados en lugares de pobreza, definidos como áreas prioritarias de intervención.

Abstract Objective: to describe spatial patterns of intentional homicides in João Pessoa, Paraíba, Brazil, 2011-2016. Methods: this was an ecological study using census tracts as units of analysis; the study used data on intentional homicides of victims living in João Pessoa obtained by cross-checking Mortality Information System SIM information with Public Security information; mortality coefficients were calculated for the whole period and its triennia and were later smoothed using the local empirical Bayesian method; spatial autocorrelation techniques were applied to the smoothed coefficients which were using Moran's spatial statistics. Results: significant spatial autocorrelation was detected for the period as a whole I=0.679, p=0.01, the 1st triennium I=0.508, p=0.01, and the 2nd triennium I=0.572, p=0.01; areas of greater risk were identified distributed among the western, northwestern, southeastern, and far south zones of the city, mainly in regions with low socioeconomic conditions; census tracts with low coefficients were located in areas of medium/high socioeconomic status. Conclusion: homicides in João Pessoa were high in poor districts and these are priority areas for intervention.