Phlebotomine Fauna (Diptera: Psychodidae) and Infection by Leishmania spp. in Forest Fragments of a University Campus, Western Amazon.

Forest fragments consist of important ecosystems for the maintenance of sand fly populations and Leishmania hosts. This study sought to identify the phlebotomine fauna and its infection by Leishmania spp. in forest fragments on the campus of the Federal University of Acre (UFAC), Western Amazon. Monthly collections with CDC traps were carried out from March 2020 to June 2021, in four forest fragments of UFAC. Male and female insects were processed and identified at species level. A sample of females was subjected to polymerase chain reaction (PCR) analysis to verify the presence Leishmania DNA. In total, 465 specimens were collected, of which 238 were males and 227 were females. The most frequent species were Nyssomyia antunesi (Coutinho, 1939) (47.3%), Trichophoromyia sp. (Mangabeira, 1942) (18.70%), and Ny. whitmani (Antunes & Coutinho, 1939) (8.81%). Molecular analysis detected the presence of Leishmania (Ross, 1903) DNA in a specimen of Ny. antunesi, and another one of Evandromyia walker (Newstead, 1914). The forest fragments of the university campus harbor a diverse sand fly fauna with the presence of Leishmania DNA in these insects, in addition to the presence of other species considered incriminated vectors of Leishmania parasites.

Intestinal parasite infections associated with sociodemographic and seasonal factors in the Western Amazon.

Intestinal parasites are a constant public health problem in the Amazon region, with a high prevalence of cases related to poor sanitary conditions. We investigated the sociodemographic and seasonal factors associated with human intestinal parasite infections in an area of the Western Amazon, Brazil, from September 2017 to August 2019. Data were collected using a database available at the Diagnostic Support Centre (Centro de Apoio ao Diagnóstico, CAD) of the Municipality of Rio Branco, on positive diagnoses for intestinal parasites. Among the 53,200 samples analysed, 18.3% (n = 9712) were positive. Of these, 96.4% (n = 9363) and 3.6% (n = 349) were protozoan and helminthic infections, respectively. Males showed higher odds ratio (OR) for Enterobius vermicularis infection (OR: 2.3) and giardiasis (OR: 1.9) and lower OR for Endolimax nana (OR: 0.9) and Entamoeba coli (OR: 0.9) infections. Individuals aged ≥ 15 presented higher OR for Strongyloides stercoralis (OR: 3.4), hookworms (OR: 2.3), and almost all protozoan infections than younger individuals. In the dry season, the OR for hookworms (OR: 1.5), Iodamoeba butschlii (OR: 1.4), and Endolimax nana (OR: 1.3) infections was higher than that in the rainy season, including a high chance of polyparasitism (OR: 1.6). We concluded that there was a significant difference between the different types of intestinal parasites, particularly protozoa, with high OR in the dry season and for certain groups.

Preliminary observations of the urbanization and domiciliation of the American cutaneous leishmaniasis in Rio Branco, Acre, Western Amazon.

BACKGROUND: The American cutaneous leishmaniasis (ACL) is expanding in peri-urban environments. METHODS: An entomological survey was conducted in the area of the occurrence of an autochthonous urban case of ACL. Sandflies and a parasitological slide of the human case were submitted for molecular diagnosis. RESULTS: Nyssomyia whitmani and Ny. antunesi were the most frequently collected species. Ny. whitmani and Bichromomyia flaviscutellata were positive for Leishmania guyanensis and L. lainsoni, respectively. The human case tested positive for L. lainsoni. CONCLUSIONS: Sandflies and Leishmania parasites present in urban forest may occur frequently in nearby domiciliary environments; thus, these areas must be monitored.

Business Intelligence in supporting strategic health management: an experience report / Business Intelligence no apoio à gestão estratégica em saúde: um relato de experiência / Business Intelligence en apoyo a la gestión estratégica en salud: relato de experiencia

Background and objectives: In 2015, Microsoft launched a Business Intelligence service, called Power BI, which can be used in several areas of knowledge if operated by a qualified professional. Power BI has several utilities, including the integration of data from various sources and formats, case mapping, real-time data visualizations, and remote work. This study aimed to report the use experience of Power BI by utilizing data from a State Department of Health Western Amazon, Brazil. Methods: As an example, cases of tuberculosis in the state of Acre, from 2010 to 2020, were used. These data wee extracted from the Notifiable Diseases Information System, provided by the State Health Department of Acre ­ SESACRE. Results: Power BI offers a simple and intuitive interface. To share the experience, we provided a link (http://tiny.cc/tbacre) to explore the tool and understand the speed and practicality in data visualization. Conclusion: We recommend the use of Power BI mainly in agencies that need agile decision-making based on evidence.(AU)

Justificativa e objetivos: Em 2015, a Microsoft lançou um serviço de Business Intelligence (Inteligência de Negócios), chamado Power BI, que pode ser empregado em diversas áreas do conhecimento, desde que operado por um profissional capacitado. Possui diversas utilidades, entre elas: a integração de dados provenientes de diversas fontes e formatos, mapeamento de casos, visualizações de dados em tempo real e trabalho remoto. Este trabalho propôs relatar a experiência de uso do Microsoft Power BI utilizando dados de uma Secretaria Estadual de Saúde da Amazônia Ocidental, Brasil. Métodos: Como exemplo, utilizam-se casos de tuberculose no estado do Acre, de 2010 a 2020, extraídos do Sistema de Informação de Agravos de Notificação (Sinan), fornecidos pela Secretaria de Estado da Saúde do Acre (Sesacre). Resultados: O Power BI oferece uma interface simples e intuitiva. Para compartilhar a experiência, foi fornecido um link (http://tiny.cc/tbacre) por meio do qual foi possível explorar a ferramenta e perceber a rapidez e praticidade na visualização de dados. Conclusão: Recomenda-se sua utilização sobretudo em órgãos que necessitam de tomadas ágeis de decisões baseadas em evidências.(AU)

Justificación y objetivos: En 2015, Microsoft lanzó un servicio de Business Intelligence, denominado Power BI, que puede ser utilizado en diversas áreas del conocimiento siempre que sea realizado por un profesional capacitado. Tiene varias utilidades, incluyendo la integración de datos de diferentes fuentes y formatos, mapeo de casos, visualización de datos en tiempo real y trabajo remoto. Este trabajo propuso relatar la experiencia de uso de Microsoft Power BI utilizando datos de un departamento de salud estatal en la Amazonía Occidental, Brasil. Methods: Como ejemplo, se utilizaron casos de tuberculosis en el estado de Acre, de 2010 a 2020, extraídos del Sistema de Información de Enfermedades de Declaración Obligatoria ­ SINAN, proporcionado por la Secretaría de Salud del Estado de Acre ­ SESACRE. Results: Power BI ofrece una interfaz sencilla e intuitiva. Para compartir la experiencia, se facilitó el enlace (http://tiny.cc/tbacre). A través de esto, fue posible explorar la herramienta y darse cuenta de la rapidez y practicidad en la visualización de datos. Conclusión: Recomendamos su uso, sobre todo, en órganos que necesiten una toma de decisiones ágil y basada en evidencias.(AU)

Temporal trend and epidemiological profile of accidents involving venomous animals in Brazil, 2007-2019. / Tendência temporal e perfil epidemiológico dos acidentes por animais peçonhentos no Brasil, 2007-2019.

OBJECTIVE: to analyze the temporal trend of accidents involving venomous animals in Brazil from 2007 to 2019. METHODS: this was a cross-sectional study carried out with data from the Notifiable Health Conditions Information System (SINAN). Prais-Winsten linear regression was used for the temporal analysis. We calculated incidence rates according to sex and age group, relative risk and case fatality ratio. RESULTS: during the study period there were 2,102,657 cases of accidents involving venomous animals. With the exception of snakebite, the remaining accidents showed a rising temporal trend in most regions of the country. Scorpion stings, snake bites and spider bites were responsible for 86% of accidents, mainly affecting male people of working age. Accidents involving snakes (0.4%) and bees (0.3%) had the highest case fatality ratios. Children were the main victims of accidents involving bees, caterpillars and "others". CONCLUSION: accidents involving venomous animals showed a rising temporal trend for most conditions, as well as different epidemiological profiles.

Temporal trend and epidemiological profile of accidents by venomous animals in Brazil, 2007-2019 / Tendencia temporal y perfil epidemiológico de los accidentes por animales venenosos en Brasil, 2007-2019 / Tendência temporal e perfil epidemiológico dos acidentes por animais peçonhentos no Brasil, 2007-2019

Objective: To analyze the temporal trend of accidents by venomous animals in Brazil from 2007 to 2019. Methods: Cross-sectional study carried out with data from the Notifiable Diseases Information System ­ Sinan. For the temporal analysis, the Prais-Wistein Linear Regression was used. The incidences by sex and age group, relative risk and lethality were calculated. Results: During the study period there were 2,102,657 cases of accidents by venomous animals. With the exception of snakebite, the other accidents showed an increasing temporal trend in most regions of the country. Scorpionism, snakebite and spider bites were responsible for 86% of accidents, mainly affecting men of working age. Snake (0.4%) and beetle (0.3%) accidents were the most lethal. Children were the main victims of accidents by bees, caterpillars and 'others'. Conclusion: Accidents by venomous animals showed an increasing temporal trend for most diseases and different epidemiological profiles.

Objetivo: Analizar la tendencia temporal de los accidentes por animales ponzoñosos en Brasil de 2007 a 2019. Métodos: Estudio transversal realizado con datos del Sistema de Información de Enfermedades de Declaración Obligatoria ­ Sinan. Para el análisis temporal se utilizó la Regresión Lineal de Prais-Wistein. Se calcularon las incidencias por sexo y grupo de edad, riesgo relativo y letalidad. Resultados: Durante el período de estudio hubo 2.102.657 casos de accidentes por animales ponzoñosos. Con excepción de la mordedura de serpiente, los demás accidentes mostraron una tendencia temporal creciente en la mayoría de las regiones del país. El escorpionismo (51,2%), la mordedura de serpiente (17,4%) y la mordedura de araña (17,3%) fueron responsables del 86% de los accidentes, afectando principalmente a hombres en edad laboral. Conclusión: Los accidentes por animales venenosos mostraron una tendencia temporal creciente para la mayoría de las enfermedades y diferentes perfiles epidemiológicos.

Objetivo: Analisar a tendência temporal dos acidentes causados por animais peçonhentos no Brasil, de 2007 a 2019. Métodos: Estudo transversal, realizado com dados do Sistema de Informação de Agravos de Notificação ­ Sinan. Para a análise temporal, utilizou-se a regressão linear de Prais-Wistein. Foram calculadas as incidências por sexo e faixa etária, risco relativo e letalidade. Resultados: No período de estudo, houve 2.102.657 casos de acidentes por animais peçonhentos. Com exceção do ofidismo, os demais acidentes apresentaram tendência temporal crescente na maioria das macrorregiões nacionais. Escorpionismo, ofidismo e araneísmo foram responsáveis por 86% dos acidentes, principalmente entre homens em idade economicamente ativa. As taxas de letalidade mais elevadas foram por acidentes ofídicos (0,4%) e apílicos (0,3%). As crianças foram as principais vítimas de acidentes com abelhas, lagartas e 'outros'. Conclusão: Os acidentes com animais peçonhentos apresentaram tendência temporal crescente para a maioria dos agravos e diferentes perfis epidemiológicos.

Tendência temporal e perfil epidemiológico dos acidentes por animais peçonhentos no Brasil, 2007-2019 / Tendencia temporal y perfil epidemiológico de los accidentes por animales venenosos en Brasil, 2007-2019 / Temporal trend and epidemiological profile of accidents involving venomous animals in Brazil, 2007-2019

Objetivo: Analisar a tendência temporal dos acidentes causados por animais peçonhentos no Brasil, de 2007 a 2019. Métodos: Estudo transversal, realizado com dados do Sistema de Informação de Agravos de Notificação (Sinan). Para a análise temporal, utilizou-se a regressão linear de Prais-Winsten. Foram calculadas as incidências por sexo e faixa etária, risco relativo e letalidade. Resultados: No período de estudo, houve 2.102.657 casos de acidentes por animais peçonhentos. Com exceção do ofidismo, os demais acidentes apresentaram tendência temporal crescente na maioria das macrorregiões nacionais. Escorpionismo, ofidismo e araneísmo foram responsáveis por 86% dos acidentes, principalmente entre pessoas do sexo masculino em idade economicamente ativa. A de letalidade foi mais elevada para acidentes ofídicos (0,4%) e apílicos (0,3%). As crianças foram as principais vítimas de acidentes com abelhas, lagartas e "outros". Conclusão: Os acidentes com animais peçonhentos apresentaram tendência temporal crescente para a maioria dos agravos e diferentes perfis epidemiológicos.

Objetivo: Analizar la tendencia temporal de los accidentes con animales ponzoñosos en Brasil de 2007 a 2019. Métodos: Estudio transversal realizado con datos del Sistema de Información de Enfermedades de Declaración Obligatoria (Sinan). Para el análisis temporal se utilizó la Regresión Lineal de Prais-Wisten. Se calcularon las incidencias por sexo y grupo de edad, riesgo relativo y letalidad. Resultados: Durante el período del estudio hubo 2.102.657 casos de accidentes con animales ponzoñosos. Con excepción de la mordedura de serpiente, los demás accidentes mostraron una tendencia temporal creciente en la mayoría de las regiones del país. El escorpionismo, la mordedura de serpiente y la picadura de araña fueron responsables del 86% de los accidentes, afectando principalmente a personas del sexo masculino en edad laboral. Las tasas de letalidad más altas fueron por accidentes de mordedura de serpiente (0,4%) y picadura de araña (0,3%). Los niños fueron las principales vitimas de los acidentes con abejas, lagartas y "otros". Conclusión: Los accidentes com animales ponzoñosos mostraron una tendencia temporal creciente para la mayoría de las enfermedades y diferentes perfiles epidemiológicos.

Objective: to analyze the temporal trend of accidents involving venomous animals in Brazil from 2007 to 2019. Methods: this was a cross-sectional study carried out with data from the Notifiable Health Conditions Information System (SINAN). Prais-Winsten linear regression was used for the temporal analysis. We calculated incidence rates according to sex and age group, relative risk and case fatality ratio. Results: during the study period there were 2,102,657 cases of accidents involving venomous animals. With the exception of snakebite, the remaining accidents showed a rising temporal trend in most regions of the country. Scorpion stings, snake bites and spider bites were responsible for 86% of accidents, mainly affecting male people of working age. Accidents involving snakes (0.4%) and bees (0.3%) had the highest case fatality ratios. Children were the main victims of accidents involving bees, caterpillars and "others". Conclusion: accidents involving venomous animals showed a rising temporal trend for most conditions, as well as different epidemiological profiles.

Preliminary observations of the urbanization and domiciliation of the American cutaneous leishmaniasis in Rio Branco, Acre, Western Amazon

ABSTRACT Background: The American cutaneous leishmaniasis (ACL) is expanding in peri-urban environments. Methods: An entomological survey was conducted in the area of the occurrence of an autochthonous urban case of ACL. Sandflies and a parasitological slide of the human case were submitted for molecular diagnosis. Results: Nyssomyia whitmani and Ny. antunesi were the most frequently collected species. Ny. whitmani and Bichromomyia flaviscutellata were positive for Leishmania guyanensis and L. lainsoni, respectively. The human case tested positive for L. lainsoni. Conclusions: Sandflies and Leishmania parasites present in urban forest may occur frequently in nearby domiciliary environments; thus, these areas must be monitored.

Occurrence of geohelminths in the soil of public squares in Rio Branco, Acre State, Brazilian Western Amazon / Ocorrência de geohelmintos em solo de praças públicas em Rio Branco, estado do Acre, Amazônia Brasileira

Soil contamination by dog and cat feces can become a public health problem due to the transmission of various etiologic agents that cause zoonoses. This study aimed to verify the occurrence of geohelminths in the soil of some public square areas of the municipality of Rio Branco, Acre State, Western Brazilian Amazon. Five public squares were selected, and soil samples collection was performed from April 2014 to March 2015. The samples were processed by using the Baermann-Moraes and centrifugal-flotation methods. Geohelminths positivity was of 25% for Tox o c ara spp., 6.6% for the Ancylostomatoidea Superfamily and 1.6 for Trichuris spp.. Measures should be implemented to prevent the free access of animals to these places, as well as deworming of stray dogs and cats and the implementation of population control and policies for such animals.(AU)

A contaminação do solo por fezes de cães e gatos pode se tornar um problema de saúde pública devido à transmissão de vários agentes etiológicos que causam zoonoses. Este estudo objetivou verificar a ocorrência de geohelmintos no solo de praças públicas do município de Rio Branco, estado do Acre, Brasil. Cinco praças públicas foram selecionadas e amostras de solo foram colhidas entre abril de 2014 e março de 2015. As amostras foram processadas pelos métodos de Baermann-Moraes e centrífugo-flutuação. A positividade observada para geohelmintos foi de 25% para Tox o c ara spp., 6,6% para a Superfamília Ancylostomatoidea e 1,6% para Trichuris spp.. Medidas devem ser implementadas para prevenir a livre circulação de animais nestes locais, bem como a desverminação de cães e gatos de rua e a implementação de políticas de adoção e controle populacional de cães e gatos.(AU)

Climate variability and hospitalizations due to infectious diarrheal diseases in a municipality of the Western Brazilian Amazon Region. / Variabilidade climática e internações por doenças diarreicas infecciosas em um município da Amazônia Ocidental brasileira.

Morbimortality due to infectious diarrheal diseases still is a serious health issue in Brazil and is highly related to factors such as weather, environment, and people's life conditions. This study aimed to analyze the relationship between hospitalization rates due to infectious diarrheal diseases among the population of the municipality of Rio Branco (AC), Brazil and precipitation, river level, humidity and temperature between 2000 and 2013. Data were retrieved from the Hospital Information System of the SUS (Unified Health System), the National Institute of Meteorology and the National Water Agency. Multiple Poisson and negative binomial regression models were adjusted. Results showed that there is a positive association between hospitalization due to infectious diarrheal diseases and the level of the Acre river (RR: 1.07; CI 95%: 1.04 to 1.1); these hospitalization rates fell 14% between 2000 and 2013 (RR: 0.86; CI 95%: 0.85 to 0.87). The most vulnerable group was the age group of less than 1 year of age. This study showed the vulnerability of an Amazonian city to climate variability and its respective epidemiological influence on the incidence of hospitalizations due to infectious diarrheal diseases.

A morbimortalidade por doenças diarreicas infecciosas ainda representa um grave problema de saúde no Brasil e está altamente relacionada a fatores como condições climáticas, ambientais e de vida da população. O objetivo deste estudo foi analisar a associação das taxas de internações por doenças diarreicas infecciosas na população do município de Rio Branco/AC com a precipitação, o nível do rio, a umidade e a temperatura, entre os anos de 2000 e 2013. Os dados foram extraídos do Sistema de Informações Hospitalares do SUS, do Instituto Nacional de Meteorologia e da Agência Nacional das Águas. Foram ajustados modelos múltiplos de regressão de Poisson e binomial negativa. Os resultados mostram que existe uma associação positiva entre as internações por doenças diarreicas infecciosas e o nível do Rio Acre (RT:1,07; IC95%:1,04 a 1,1); houve um decréscimo de 14% nestas taxas de internações entre os anos de 2000 e 2013 (RT:0,86; IC95%:0,85 a 0,87); o grupo mais vulnerável pertence à faixa etária de menores de 1 ano de vida. Este estudo mostrou a vulnerabilidade de uma cidade na Amazônia quanto à variabilidade climática e a respectiva influência epidemiológica na incidência de internações por doenças diarreicas infecciosas.

Variabilidade climática e internações por doenças diarreicas infecciosas em um município da Amazônia Ocidental brasileira / Climate variability and hospitalizations due to infectious diarrheal diseases in a municipality of the Western Brazilian Amazon Region

Resumo A morbimortalidade por doenças diarreicas infecciosas ainda representa um grave problema de saúde no Brasil e está altamente relacionada a fatores como condições climáticas, ambientais e de vida da população. O objetivo deste estudo foi analisar a associação das taxas de internações por doenças diarreicas infecciosas na população do município de Rio Branco/AC com a precipitação, o nível do rio, a umidade e a temperatura, entre os anos de 2000 e 2013. Os dados foram extraídos do Sistema de Informações Hospitalares do SUS, do Instituto Nacional de Meteorologia e da Agência Nacional das Águas. Foram ajustados modelos múltiplos de regressão de Poisson e binomial negativa. Os resultados mostram que existe uma associação positiva entre as internações por doenças diarreicas infecciosas e o nível do Rio Acre (RT:1,07; IC95%:1,04 a 1,1); houve um decréscimo de 14% nestas taxas de internações entre os anos de 2000 e 2013 (RT:0,86; IC95%:0,85 a 0,87); o grupo mais vulnerável pertence à faixa etária de menores de 1 ano de vida. Este estudo mostrou a vulnerabilidade de uma cidade na Amazônia quanto à variabilidade climática e a respectiva influência epidemiológica na incidência de internações por doenças diarreicas infecciosas.

Abstract Morbimortality due to infectious diarrheal diseases still is a serious health issue in Brazil and is highly related to factors such as weather, environment, and people's life conditions. This study aimed to analyze the relationship between hospitalization rates due to infectious diarrheal diseases among the population of the municipality of Rio Branco (AC), Brazil and precipitation, river level, humidity and temperature between 2000 and 2013. Data were retrieved from the Hospital Information System of the SUS (Unified Health System), the National Institute of Meteorology and the National Water Agency. Multiple Poisson and negative binomial regression models were adjusted. Results showed that there is a positive association between hospitalization due to infectious diarrheal diseases and the level of the Acre river (RR: 1.07; CI 95%: 1.04 to 1.1); these hospitalization rates fell 14% between 2000 and 2013 (RR: 0.86; CI 95%: 0.85 to 0.87). The most vulnerable group was the age group of less than 1 year of age. This study showed the vulnerability of an Amazonian city to climate variability and its respective epidemiological influence on the incidence of hospitalizations due to infectious diarrheal diseases.

Leishmania (Viannia) braziliensis type 2 as probable etiological agent of canine cutaneous leishmaniasis in Brazilian Amazon.

Canine cutaneous leishmaniasis (CCL) is a zoonosis of public health interest, and in the Americas, Leishmania (Viannia) braziliensis has been identified as the main etiological agent. The present study sought to investigate Leishmania spp. infection in domestic dogs from a rural area of the Xapuri municipality, Acre state, Brazilian Amazonia. For this purpose, visits were carried out to domiciles where the human cases of American cutaneous leishmaniasis (ACL) occurred, followed by the clinical evaluation of the animals in search of clinical signs suggestive of CCL. Blood samples were collected from 40 dogs, 13 of which had lesions suggestive of CCL, and biopsies of these lesions were performed. The methods used were Neal, Novy, and Nicolle's (NNN) medium cultures and direct parasitological examination. Further, to detect and characterize Leishmania DNA some molecular techniques were performed such as conventional polymerase chain reaction (PCR) and sequencing targeting SSU rDNA and ITS1, restriction fragment length polymorphism (RFLP) and high resolution melting (HRM) analysis targeting hsp70. The investigation revealed that the results obtained from the parasitological methods were negative. In PCR by ITS1 and network topology sequences, six strains from dogs, isolated from the Peruvian Andes, appeared identical to Leishmania (Viannia) braziliensis type 2 (99-100%). By other molecular methods these samples turned out to be positive to Leishmania (Viannia) sp.. The diagnosis of Leishmania in domestic dogs from Acre state showed a high proportion of infected animals, and the occurrence of L. braziliensis type 2 in Brazil for the first time. This new report suggests that L. braziliensis type 2 is both trans- and cis-Andean. However, more studies are needed regarding the clinical and diagnostic aspects of this species of Leishmania.

Analysis of the risk factors for bovine brucellosis in dairy herds of the Rio Branco microregion, Acre, Brazil / Análise dos fatores de risco para brucelose bovina em rebanhos leiteiros da microrregião de Rio Branco, Acre, Brasil

Bovine brucellosis (BB) is a compulsory notifiable bacterial disease caused by Brucella abortus, which is responsible for severe reproductive disorders in cattle, considerable damages to trade and public health damage. The objectives of this study were to identify the frequency of BB and to analyze the risk factors in the dairy herds of the Rio Branco microregion, in the state of Acre, Brazil. Thus, 527-bovine-serological samples were submitted to the buffered acidified antigen test and to 2-mercaptoethanol. Risk factors were characterized by the administration of epidemiological questionnaires. The logistic regression test was used to evaluate the existence of a significant association between the variables. The frequency of BB in the Rio Branco microregion was 10.6% (56/527). The inappropriate destination of the aborted fetus and placental remnants (odds ratio ­ OR = 13.6), the slaughter of cattle within the property (OR = 3.4) and the age range above 4 years old (OR = 2.9) were the most significant risk factors identified by the logistic regression model. According to the results of this study, it is recommended to intensify BB control and prophylaxis measures in the microregion of Rio Branco, especially those related to sanitary and reproductive management in the livestock breeding.(AU)

A brucelose bovina (BB) é uma bacteriose de notificação obrigatória, causada pela Brucella abortus, responsável por distúrbios reprodutivos graves em bovinos, prejuízos consideráveis ao comércio e agravos em saúde pública. Objetivaram-se com este estudo identificar a frequência de BB e analisar os fatores de risco nos rebanhos leiteiros da microrregião de Rio Branco, Acre. Assim, 527 amostras sorológicas de bovinos foram submetidas ao teste do antígeno acidificado tamponado e ao 2-mercaptoetanol. Os fatores de risco foram caracterizados por aplicação de questionários epidemiológicos. Utilizou-se o teste de regressão logística para avaliar a existência de associação significativa entre as variáveis. A frequência da BB na microrregião de Rio Branco foi de 10,6% (56/527). O destino inadequado do feto abortado e restos placentários (odds ratio ­ OR = 13,6), o abate de bovinos na propriedade (OR = 3,4) e a faixa etária acima de 4 anos (OR = 2,9) foram os fatores de risco mais significativos apontados pelo modelo de regressão logística. Conforme os resultados deste estudo, recomenda-se a intensificação nas medidas de controle e profilaxia da BB na microrregião de Rio Branco, sobretudo relacionadas ao manejo sanitário e reprodutivo nas criações.(AU)

Spatial and temporal distribution of American cutaneous leishmaniasis in Acre state, Brazil.

BACKGROUND: Acre has reported the highest incidence of American cutaneous leishmaniasis (ACL) in Brazil in recent years. The present study seeks to identify high and low risk agglomerations of ACL in space and space-time during the period from 2007 to 2013 in Acre, and also to characterize the occurrence of the disease in time and according to sociodemographic variables. METHODS: This is an ecological study, the study population of which consisted of autochthonous ACL cases notified in the municipalities of Acre by an epidemiological surveillance system. Scan statistics of SaTScan™ software were used to identify spatial and space-time clusters. In addition, the cases were characterized by sex, age, home situation (in a rural or urban area), and temporal tendency. RESULTS: Acre reported an incidence rate of 12.4 cases per 10 000 inhabitant-years in the study period, with the rates varied greatly (standard deviation of 21.8) among their 22 municipalities. One agglomeration of high risk and three of low risk were detected in space and space-time. Four of the five micro-regions of Acre presented a stationary temporal tendency. The profile of transmission varied according to the micro-region. Generally speaking, the disease occurred more often among young people, those of male gender, and those living in rural areas. CONCLUSIONS: Acre has stood out within the Brazilian national context due to its high rates of ACL incidence in the central region of the Acre Valley. The high rates in the micro-region of Brasiléia are related to the disease's intra/peridomiciliary occurrence, and it would seem that the municipality of Sena Madureira is approaching a transmission pattern similar to that of Brasiléia. In other micro-regions, the profile of the disease's transmission is mainly related to the forest/sylvatic cycle of ACL.

Attractiveness of black and white modified Shannon traps to phlebotomine sandflies (Diptera, Psychodidae) in the Brazilian Amazon Basin, an area of intense transmission of American cutaneous leishmaniasis.

In the Amazon region the phlebotomine fauna is considered one of the most diverse in the world. The use of Shannon traps may provide information on the anthropophily of the species and improve the traps' performance in terms of diversity and quantity of insects collected when white and black colored traps are used together. This study sought to verify the attractiveness of the traps to the phlebotomine species of the Brazilian Amazon basin using Shannon traps under these conditions. The insects were collected using two Shannon traps installed side by side, one white and the other black, in a primary forest area of the municipality of Xapuri, Acre, Brazil. Samples were collected once a month during the period August 2013 to July 2015. A sample of females was dissected to test for natural infection by flagellates. A total of 6,309 (864 males and 5,445 females) specimens (36 species) were collected. Psychodopygus carrerai carrerai (42%), Nyssomyia shawi (36%), and Psychodopygus davisi (13%), together represented 90% of the insects collected. Nyssomyia shawi and Psychodopygus davisi were more attracted by the white color. Specimens of Nyssomyia shawi, Nyssomyia whitmani, and Psychodopygus hirsutus hirsutus were found naturally infected by flagellates in the mid and hindgut. This is the first study in Acre state using and comparing both black and white Shannon traps, demonstrating the richness, diversity, and anthropophilic behavior of the phlebotomine species and identifying proven and putative vectors of the etiological agents of leishmaniasis.

Climate variability and hospitalizations due to infectious diarrheal diseases in a municipality of the Western Brazilian Amazon Region / Variabilidade climática e internações por doenças diarreicas infecciosas em um município da Amazônia Ocidental brasileira

Abstract Morbimortality due to infectious diarrheal diseases still is a serious health issue in Brazil and is highly related to factors such as weather, environment, and people's life conditions. This study aimed to analyze the relationship between hospitalization rates due to infectious diarrheal diseases among the population of the municipality of Rio Branco (AC), Brazil and precipitation, river level, humidity and temperature between 2000 and 2013. Data were retrieved from the Hospital Information System of the SUS (Unified Health System), the National Institute of Meteorology and the National Water Agency. Multiple Poisson and negative binomial regression models were adjusted. Results showed that there is a positive association between hospitalization due to infectious diarrheal diseases and the level of the Acre river (RR: 1.07; CI 95%: 1.04 to 1.1); these hospitalization rates fell 14% between 2000 and 2013 (RR: 0.86; CI 95%: 0.85 to 0.87). The most vulnerable group was the age group of less than 1 year of age. This study showed the vulnerability of an Amazonian city to climate variability and its respective epidemiological influence on the incidence of hospitalizations due to infectious diarrheal diseases

A morbimortalidade por doenças diarreicas infecciosas ainda representa um grave problema de saúde no Brasil e está altamente relacionada a fatores como condições climáticas, ambientais e de vida da população. O objetivo deste estudo foi analisar a associação das taxas de internações por doenças diarreicas infecciosas na população do município de Rio Branco/AC com a precipitação, o nível do rio, a umidade e a temperatura, entre os anos de 2000 e 2013. Os dados foram extraídos do Sistema de Informações Hospitalares do SUS, do Instituto Nacional de Meteorologia e da Agência Nacional das Águas. Foram ajustados modelos múltiplos de regressão de Poisson e binomial negativa. Os resultados mostram que existe uma associação positiva entre as internações por doenças diarreicas infecciosas e o nível do Rio Acre (RT:1,07; IC95%:1,04 a 1,1); houve um decréscimo de 14% nestas taxas de internações entre os anos de 2000 e 2013 (RT:0,86; IC95%:0,85 a 0,87); o grupo mais vulnerável pertence à faixa etária de menores de 1 ano de vida. Este estudo mostrou a vulnerabilidade de uma cidade na Amazônia quanto à variabilidade climática e a respectiva influência epidemiológica na incidência de internações por doenças diarreicas infecciosas

Análise temporal, espacial e espaçotemporal da ocorrência da dengue, leishmaniose tegumentar americana e malária no estado do Acre / Temporal, spatial and spatio-temporal analysis of the occurrence of dengue, leishmaniasis and malaria in the state of Acre

Introdução: Dentre as inúmeras doenças infecciosas que ocorrem na Região Amazônica, destacam-se a malária, a leishmaniose tegumentar americana (LTA) e a dengue. Todas estas doenças têm em comum o fato de serem transmitidas por vetores, além de apresentarem elevadas incidências no Acre. Objetivos: Avaliar a ocorrência de malária, LTA e dengue no estado, a partir de uma abordagem no tempo, espaço e espaçotempo no período entre 2000 a 2015. Métodos: Os estudos sobre as três doenças tiveram delineamentos ecológicos. As áreas de estudo foram as mesorregiões (Vale do Acre e Vale do Juruá) e microrregiões do Acre (Rio Branco, Brasiléia, Sena Madureira, Cruzeiro do Sul e Tarauacá). As fontes dos dados secundários foram os sistemas de vigilância epidemiológica que estão sob a supervisão do Ministério da Saúde. De modo geral, foram estimados nestes estudos, os coeficientes de incidência, mortalidade e letalidade; realizadas análises de tendências temporais utilizando o programa Stata 13; e realizadas análises de aglomerados espaciais e espaçotemporais com o auxílio do programa SaTScan. Os resultados foram apresentados em mapas corocromáticos, gráficos e tabelas. O estudo foi submetido e aprovado pelo comitê de ética em pesquisa da Universidade Federal do Acre. Resultados: No estudo sobre malária foram identificados um aglomerado de alto risco no Vale do Juruá e três de baixo risco no vale do Acre, tanto no espaço como no espaçotempo e para os dois tipos de plasmódio. Os grupos de menores de 19 anos e mulheres mostraram alta incidência no Vale do Juruá, porém no Vale do Acre homens na idade produtiva foram os mais acometidos. O coeficiente de mortalidade por malária evidenciou tendência decrescente em todo estado, enquanto a taxa de letalidade aumentou apenas na microrregião de Rio Branco. No estudo sobre LTA detectaram-se um aglomerado de alto risco e três de baixo risco tanto no espaço como no espaçotempo. Apesar de quatro das cinco microrregiões do Acre terem apresentado tendência temporal estacionária, a tendência no estado foi decrescente. O perfil de transmissão da doença variou conforme as microrregiões. De modo geral, a doença no estado acometeu mais pessoas jovens, do sexo masculino e da zona rural. No estudo sobre dengue, todas as microrregiões, com exceção de Rio Branco, apresentaram tendência 8 crescente no número de casos de dengue. A doença apresentou sazonalidade, com maiores incidências entre os meses de janeiro e março. Ocorreram epidemias nos anos de 2009, 2010, 2011, 2014 e 2015, sendo que o município de Rio Branco foi o mais atingido nos três primeiros anos e Cruzeiro do Sul, nos dois últimos. Estes dois municípios foram identificados como aglomerados de alto risco no estado. Adultos, independente do sexo, foram os mais acometidos. Apesar da elevada incidência observou-se uma baixa mortalidade. Conclusões: A malária, a LTA e a dengue estão sujeitas a diferentes padrões no tempo, espaço e espaçotempo, assim, estratégias de controle devem ser sempre adotadas buscando o melhor modelo para cada localidade. Ressalta-se a importância na análise da variável espaço e tempo como alternativa metodológica para auxiliar no planejamento, monitoramento e avaliação das ações em saúde

Introduction: Among the many infectious diseases that occur in the Amazon region, there is malaria, American Cutaneous Leishmaniasis (ACL) and dengue. All these conditions have in common the fact that are transmitted by vectors, and have high incidences in Acre State. Objectives: To evaluate the occurrence of malaria, ACL and dengue in Acre State, from an approach in time, space and spacetime in the period from 2000 to 2015. Methods: Studies on the three diseases have ecological design. The study areas were the meso (Acre Valley and Juruá Valley) and micro-regions of Acre (Rio Branco, Brasiléia, Sena Madureira, the Southern Cross and Tarauacá). The sources of secondary data were the epidemiological surveillance systems that are under the supervision of the Ministry of Health In general, were estimated in these studies, incidence rates, mortality and lethality.; conducted analysis of time trends using STATA 13 program and carried out analysis of spatial and spatiotemporal clusters with the aid of SaTScan program. The results were presented in corocromatics charts, graphs and tables. The study was approved by the Ethics Committee in Researches of the Federal University of Acre. Results: In the study of malaria were identified one high-risk cluster in the Juruá Valley and three of low risk in Acre valley, both in space and spacetime and for both types of Plasmodium. Groups with less 19 years old and women showed high incidence in the Juruá Valley, but in the Acre Valley men of working age were the most affected. The mortality rate for malaria showed a decreasing trend throughout the state, while the fatality rate increased only in Rio Branco micro-region. In the study of ACL were detected one high risk cluster and three of low risk, both in space and in spacetime. Although four of the five micro-regions of Acre have presented stationary time trend, the trend in the state was decreasing. The transmission profile of the disease varied according to the micro-regions. In general, the disease in the state befell young people, male and countryside. In the study of dengue, all the regions, with the exception of Rio Branco, presented an increasing trend in the number of dengue cases. The disease was seasonal, with higher incidence between January and March. Epidemics occurred in 2009, 2010, 10 2011, 2014 and 2015, and the city of Rio Branco was the hardest hit in the first three years and Cruzeiro do Sul, in the last two. These two municipalities have been identified as high-risk clusters in the state. Adults, of both sex, were the most affected. Despite the high incidence, a low mortality was observed. Conclusions: Malaria, dengue and ACL are subject to different patterns in time, space and spacetime, thus control strategies should always be adopted seeking the best model for each location. It´s emphasized the importance of the space and time variable for the analysis of this diseases as a methodological alternative to assist in planning, monitoring and evaluation of health actions