ABSTRACT
OBJECTIVE: To analyze spatial distribution of tuberculosis in individuals under 15 years old and socioeconomic factors in Paraíba, Brazil, 2007-2016. METHODS: This was an ecological study based on data from the Notifiable Health Conditions Information System (SINAN), taking each municipality to be a unit of analysis. Spatial distribution of incidence was performed, the local empirical Bayesian method and Moran's I were applied. Socioeconomic data were crossed-checked to identify areas of social prosperity. RESULTS: 426 cases were notified, with average incidence of 4.5/100,000 inhabitants. Moran's I was 0.59 (p=0.010). The Moran Map revealed concentration of cases in children under 15 in 38 high priority municipalities, in clusters with high-high and low-low patterns, in the east and northwest of the state, coinciding with areas of low social prosperity. CONCLUSION: There were clusters with greater tuberculosis transmission, indicating priority areas for addressing tuberculosis.
Subject(s)
Tuberculosis , Adolescent , Bayes Theorem , Brazil/epidemiology , Child , Humans , Socioeconomic Factors , Spatial Analysis , Tuberculosis/epidemiologyABSTRACT
Objective: To analyze the spatial distribution of tuberculosis in individuals under 15 years old and the socioeconomic factors in Paraíba, Brazil, 2007-2016. Methods: Ecological study, with Sinan's data, considering the municipality as the unit of analysis. The spatial distribution of the incidence was performed, the local empirical Bayesian method and Moran's statistics were applied. Socioeconomic data were crossed to identify areas of social prosperity. Results: 426 cases were reported, with an average incidence of 4.5/100 thousand inhabitants. Moran's index = 0.59 (p=0.010). The Moran Map revealed a concentration of cases in children under 15 in 38 municipalities with a high priority of care, in conglomerates in the high-high and low-low patterns, in the east and northwest of the state, coincided with areas of low social prosperity. Conclusion: There are clusters with greater transmission of tuberculosis, indicating priority areas for approaching tuberculosis.
Objetivo: Analisar a distribuição espacial da tuberculose em indivíduos menores de 15 anos de idade e fatores socioeconômicos na Paraíba, Brasil, 2007-2016. Métodos: Estudo ecológico, com dados do Sinan, tendo-se o município como unidade de análise. Realizou-se distribuição espacial da incidência, aplicou-se o método bayesiano empírico local e a estatística de Moran. Dados socioeconômicos foram cruzados, para identificação das áreas de prosperidade social. Resultados: Foram notificados 426 casos, com incidência média de 4,5/100 mil habitantes. O índice de Moran foi de 0,59 (p-valor=0,010). O Moran Map revelou concentração de casos em menores de 15 anos em 38 municípios com alta prioridade da atenção, em conglomerados nos padrões alto-alto e baixo-baixo, nas regiões leste e noroeste do estado, coincidindo com áreas de baixa prosperidade social. Conclusão: Há clusters com maior transmissão da tuberculose, apontando áreas prioritárias para abordagem da tuberculose.
ABSTRACT
Objetivo: Analisar a distribuição espacial da tuberculose em indivíduos menores de 15 anos de idade e fatores socioeconômicos na Paraíba, Brasil, 2007-2016. Métodos: Estudo ecológico, com dados do Sistema de Informação de Agravos de Notificação, sendo o município a unidade de análise. Realizou-se distribuição espacial da incidência, aplicou-se o método bayesiano empírico local e a estatística de Moran. Dados socioeconômicos foram cruzados, para identificação das áreas de prosperidade social. Resultados: Foram notificados 426 casos, com incidência média de 4,5/100 mil habitantes. O índice de Moran foi de 0,59 (p-valor=0,010). O Moran Map revelou concentração de casos em menores de 15 anos em 38 municípios com alta prioridade da atenção, em conglomerados nos padrões alto-alto e baixo-baixo, nas regiões leste e noroeste do estado, coincidindo com áreas de baixa prosperidade social. Conclusão: Houve clusters com maior transmissão da tuberculose, apontando áreas prioritárias para abordagem da tuberculose.
Objetivo: Analizar la distribución espacial de la tuberculosis en menores de 15 años y los factores socioeconómicos en Paraíba, Brasil, 2007-2016. Métodos: Estudio ecológico, con datos de Sistema de Información de Agravamientos de Notificación, considerando el municipio como unidad de análisis. Se realizó la distribución espacial de la incidencia, se aplicó el método empírico local Bayesiano y la estadística de Moran. Se cruzaron datos socioeconómicos para identificar áreas de vulnerabilidad social. Resultados: Se notificaron 426 casos, con una incidencia promedio de 4,5/100 mil habitantes. El índice de Moran = 0,59 (p=0,010). El Mapa de Moran reveló una concentración de casos en menores de 15 años en 38 municipios con alta prioridad de atención, en conglomerados en los patrones alto-alto y bajo-bajo, en las regiones este y noroeste del estado, coincidiendo con áreas de baja prosperidad social. Conclusión: Existían clusters con mayor transmisión de tuberculosis, lo que indica áreas prioritarias para abordar la tuberculosis.
Objective: To analyze spatial distribution of tuberculosis in individuals under 15 years old and socioeconomic factors in Paraíba, Brazil, 2007-2016. Methods: This was an ecological study based on data from the Notifiable Health Conditions Information System (SINAN), taking each municipality to be a unit of analysis. Spatial distribution of incidence was performed, the local empirical Bayesian method and Moran's I were applied. Socioeconomic data were crossed-checked to identify areas of social prosperity. Results: 426 cases were notified, with average incidence of 4.5/100,000 inhabitants. Moran's I was 0.59 (p=0.010). The Moran Map revealed concentration of cases in children under 15 in 38 high priority municipalities, in clusters with high-high and low-low patterns, in the east and northwest of the state, coinciding with areas of low social prosperity. Conclusion: There were clusters with greater tuberculosis transmission, indicating priority areas for addressing tuberculosis.
Subject(s)
Humans , Child , Adolescent , Tuberculosis/epidemiology , Bayes Theorem , Neglected Diseases , Health Information Systems , Socioeconomic Factors , Brazil/epidemiology , Spatial AnalysisABSTRACT
BACKGROUND: Brazil has the fourth highest prevalence of malaria of all countries in the Americas, with an estimated 42 million people at risk of contracting this disease. Although most cases occur in the Amazon region, cases of an autochthonous nature have also been registered in the extra-Amazonian region where Anopheles aquasalis and An. albitarsis are the mosquito species of greatest epidemiological interest. In 2019, the municipality of Conde (state of Paraíba) experienced an epidemic of autochthonous cases of malaria. Here we present preliminary results of an entomological and case epidemiology investigation, in an attempt to correlate the diversity and spatial distribution of species of Anopheles with the autochthonous cases of this outbreak of malaria. METHODS: Case data were collected using case report forms made available by the Conde Municipal Health Department. The entomological survey was carried out from July to November 2019. The various methods of capture included the use of battery-powered aspirators, mouth aspirators, Shannon traps, BG-Sentinel traps (with and without dry ice) and CDC light traps. Captured mosquitoes were separated, packaged and sent to the laboratory for sexing and molecular identification of the various species of anophelines. The data were tabulated and analyzed using Microsoft Excel. Spatial analysis of the data was performed using ArcGis 10 software. RESULTS: In 2019, 20 autochthonous cases and one imported case of malaria caused by Plasmodium vivax were diagnosed, with three cases of relapses. A total of 3713 mosquitoes were collected, of which 3390 were culicines and 323 were anophelines. Nine species of genus Anopheles were identified, with the most abundant being An. aquasalis (38.9%), followed by An. minor (18.2%) and An. albitarsis (9.0%). Spatial analysis of the data showed that the area could be considered to be at risk of malaria cases and that there was a high prevalence of Anopheles. CONCLUSIONS: The results presented indicate that this extra-Amazonian region has an environment conducive to maintenance of the malaria transmission cycle owing to the wide diversity of Anopheles species. This environment in combination with the high influx of people from endemic areas to the study area provides a perfect setting for the occurrence and maintenance of malaria.
Subject(s)
Anopheles/classification , Disease Outbreaks , Malaria, Vivax , Plasmodium vivax/isolation & purification , Adult , Animals , Brazil/epidemiology , Cities/epidemiology , Female , Humans , Malaria, Vivax/epidemiology , Malaria, Vivax/transmission , Male , Middle Aged , Young AdultABSTRACT
INTRODUCTION: Laboratory and clinical features of childhood tuberculosis (TB) are non-specific and establishing an accurate diagnosis remains a challenge. This study evaluated a Single tube nested-PCR (STNPCR) to detect genomic DNA of Mycobacterium tuberculosis complex in blood and urine. METHODS: Biological samples were obtained from children (<15 years old) with clinical suspicion of pulmonary and extrapulmonary TB at public hospitals in Recife-Pernambuco, Brazil. Cultures yielded negative results in a majority of childhood TB cases, which are generally paucibacillary. A set of clinical, epidemiological, radiological, and laboratory criteria with evident clinical improvement after anti-TB treatment were frequently used to define childhood TB cases. RESULTS: Ninety children with clinical suspicion were enrolled in this study (44 with TB and 46 without TB). The pulmonary TB group had 20 confirmed cases and 46 negative controls, while the extrapulmonary TB group had 24 confirmed cases. The STNPCR showed sensitivities to pulmonary and extrapulmonary TB of 47.4% and 52.2% (blood) and 38.8% and 20% (urine), respectively. Considering the low performance of STNPCR on separate samples, we decided to perform a combined analysis (parallel sensitivity analysis) of the results from blood and urine samples. The parallel sensitivity increased to 65% in blood and 62.5% in urine. The specificity in both samples ranged from 93.5-97.8%. CONCLUSIONS: Although STNPCR showed moderate sensitivity, the specificity is high; therefore, the test can be used as an auxiliary tool to diagnose TB in children. It is a rapid test that demonstrated better performance than other diagnostic tests in paucibacillary samples as it does in childhood tuberculosis.
Subject(s)
Mycobacterium tuberculosis/isolation & purification , Tuberculosis, Pulmonary/diagnosis , Adolescent , Brazil , Case-Control Studies , Child , Child, Preschool , Diagnostic Tests, Routine , Female , Humans , Infant , Infant, Newborn , Male , Mycobacterium tuberculosis/genetics , Polymerase Chain Reaction , Prospective Studies , Tuberculosis, Pulmonary/blood , Tuberculosis, Pulmonary/urineABSTRACT
Abstract INTRODUCTION: Laboratory and clinical features of childhood tuberculosis (TB) are non-specific and establishing an accurate diagnosis remains a challenge. This study evaluated a Single tube nested-PCR (STNPCR) to detect genomic DNA of Mycobacterium tuberculosis complex in blood and urine. METHODS: Biological samples were obtained from children (<15 years old) with clinical suspicion of pulmonary and extrapulmonary TB at public hospitals in Recife-Pernambuco, Brazil. Cultures yielded negative results in a majority of childhood TB cases, which are generally paucibacillary. A set of clinical, epidemiological, radiological, and laboratory criteria with evident clinical improvement after anti-TB treatment were frequently used to define childhood TB cases. RESULTS: Ninety children with clinical suspicion were enrolled in this study (44 with TB and 46 without TB). The pulmonary TB group had 20 confirmed cases and 46 negative controls, while the extrapulmonary TB group had 24 confirmed cases. The STNPCR showed sensitivities to pulmonary and extrapulmonary TB of 47.4% and 52.2% (blood) and 38.8% and 20% (urine), respectively. Considering the low performance of STNPCR on separate samples, we decided to perform a combined analysis (parallel sensitivity analysis) of the results from blood and urine samples. The parallel sensitivity increased to 65% in blood and 62.5% in urine. The specificity in both samples ranged from 93.5-97.8%. CONCLUSIONS: Although STNPCR showed moderate sensitivity, the specificity is high; therefore, the test can be used as an auxiliary tool to diagnose TB in children. It is a rapid test that demonstrated better performance than other diagnostic tests in paucibacillary samples as it does in childhood tuberculosis.