Wildfire and smoke association with COVID-19 cases in the Pantanal wetland, Brazil.

OBJECTIVES: In 2020, Brazil experienced two concurrent public health challenges related to respiratory disease: wildfires and increased mortality due to the coronavirus (COVID-19) pandemic. Smoke from these wildfires contributed to a variety of air pollutants, including fine particulate matter (PM2.5). The present study aims to investigate the effects of environmental and socio-economic factors on COVID-19 hospitalisation in the Pantanal. STUDY DESIGN: Ecological retrospective study. METHODS: We applied a multilevel negative binomial model to relate monthly hospitalisation data with environmental variables. RESULTS: We showed that monthly PM2.5 concentration levels had the greatest influence on the increase in hospitalisations by COVID-19 in the elderly (23 % increase). The Gini index, a coefficient that reflects income inequalities, also had a positive association with COVID-19 hospitalisations (18 % increase). Higher temperatures and humidity were protective factors, showing a 15 % and 14 % decrease in hospitalisations, respectively. The results of the present study suggest that high PM2.5 exposure contributed to the increase in COVID-19 hospitalisations, as did the social inequalities of each municipality. CONCLUSIONS: The present study highlights the importance of gathering evidence supported by multiple information sources to guide decision-making and identify populations needing better public health systems.

Clusters of high-risk, low-risk, and temporal trends of breast and cervical cancer-related mortality in São Paulo, Brazil, during 2000-2016.

PURPOSE: Studying breast and cervical cancers in space and time and verifying divergences of different territorially established socioeconomic profiles. METHODS: Ecological study using spatial scanning (with socioeconomic characterization), space-time, and spatial variation of temporal trends, in order to identify significant clusters of high- and low-risk or temporal trends, of deaths from breast cancer and cervical cancer, in the city of São Paulo, Brazil, during 2000-2016. RESULTS: High-risk spatial clusters were identified in the central areas, and low-risk clusters were identified in the peripheral areas, which were associated with better and worse socioeconomic conditions, respectively. As for cervical cancer, the pattern was the opposite. High-risk space-time clusters occurred in the early years of the study, whereas low-risk clusters occurred in the most recent years. For breast cancer, the central areas showed a temporal trend of decreasing mortality and the peripheral areas showed an increasing trend. While for cervical cancer, in general, the temporal trend was for the identified clusters to fall. CONCLUSIONS: It is expected that this study will provide insights for the formulation of public policies to implement prevention and control measures, in order to reduce mortality and inequalities related to breast and cervical cancers.

Assessment of the relationship between entomologic indicators ofAedes aegypti and the epidemic occurrence of dengue virus 3 in asusceptible population, São José do Rio Preto, São Paulo, Brazil

The aims of this study were to describe the occurrence of dengue in space and time and to assess the relationships between dengue incidence and entomologic indicators. We selected the dengue autochthonous cases that occurred between September 2005 and August 2007 in São José do Rio Preto to calculate incidence rates by month, year and census tracts. The monthly incidence rates of the city were compared to the monthly Breteau indices (BI) of the São José do Rio Region. Between December 2006 and February 2007, an entomological survey was conducted to collect immature forms of Aedes aegypti in Jaguaré, a São José do Rio Preto neighborhood, and to obtain entomological indices. These indices were represented using statistical interpolation. To represent the occurrence of dengue in the Jaguaré neighborhood in 2006 and 2007, we used the Kernel ratio and to evaluate the relationship between dengue and the entomological indices, we used a generalized additive model in a spatial case–control design. Between September 2005 and August 2007, the occurrence of dengue in São José do Rio Preto was almost entirely caused by DENV3, and the monthly incidence rates presented high correlation coefficients with the monthly BI. In Jaguaré neighborhood, the entomological indices calculated by hectare were better predictors of the spatial distribution of dengue than the indices calculated by properties, but the pupae quantification did not show better prediction qualities than the indices based on the container positivity, in relation to the risk of dengue occurrence. The fact that the municipality’s population had a high susceptibility to the serotype DENV3 before the development of this research, along with the almost total predominance ofthe occurrence of this serotype between 2005 and 2007, facilitated the analysis of the epidemiological situation of the disease and allowed us to connect it to the entomological indicators...

Spatio-Temporal Tracking and Phylodynamics of an Urban Dengue 3 Outbreak in São Paulo, Brazil

The dengue virus has a single-stranded positive-sense RNA genome of ,10.700 nucleotides with a single open readingframe that encodes three structural (C, prM, and E) and seven nonstructural (NS1, NS2A, NS2B, NS3, NS4A, NS4B, and NS5)proteins. It possesses four antigenically distinct serotypes (DENV 1–4). Many phylogenetic studies address particularities ofthe different serotypes using convenience samples that are not conducive to a spatio-temporal analysis in a single urbansetting. We describe the pattern of spread of distinct lineages of DENV-3 circulating in Sa˜o Jose´ do Rio Preto, Brazil, during2006. Blood samples from patients presenting dengue-like symptoms were collected for DENV testing. We performed M-NPCRusing primers based on NS5 for virus detection and identification. The fragments were purified from PCR mixtures andsequenced. The positive dengue cases were geo-coded. To type the sequenced samples, 52 reference sequences werealigned. The dataset generated was used for iterative phylogenetic reconstruction with the maximum likelihood criterion.The best demographic model, the rate of growth, rate of evolutionary change, and Time to Most Recent Common Ancestor(TMRCA) were estimated...

Tuberculosis risks and socio-economic level: a case study of a city in the Brazilian south-east, 1998-2004.

OBJECTIVES: To explore tuberculosis (TB) risks in relation to potential determinants in the city of São José do Rio Preto, São Paulo State, Brazil; to analyse morbidity and mortality indicators in São José do Rio Preto, and to determine the relationship between the risk of TB and socio-economic level (SEL) using a geo-referenced information system (GIS) and the national census for 2000. METHOD: Standardised incidence rates and TB incidence and mortality rates were calculated. Socio-economic variables were determined using the statistical technique of principal component analysis. Data sources were the São Paulo State Data Analysis System (SEADE), the TB Notification Database (EPI-TB), the Information Department of the Brazilian Health Ministry (DATASUS), and the Brazilian Institute of Geography and Statistics (IBGE). New cases reported in 1998-1999 and 2003-2004 in the urban area of the city were geo-referenced and analysed. RESULTS: TB risk in the city is twice as high in areas of lower SEL than in areas with higher SEL. CONCLUSION: The identification of areas with different levels of risk enables the Municipal Health Department to propose innovative interventions to minimise the risk of disease at both individual and population level.

[Aedes aegypti (l.) population in an endemic area of dengue in Southeast Brazil]. / População de Aedes aegypti (l.) em área endêmica de dengue, Sudeste do Brasil.

OBJECTIVE: A Aedes aegypti population from an area of dengue transmission was studied to determine mosquito's frequency, spatial distribution, parity, its ovarian development and midgut contents. METHODS: The study carried out in São José do Rio Preto country, São Paulo, SP, Brazil. Low and intermediate socioeconomic level regions were chosen to the study, which was carried out 1996 and 1997. Using a manual electric aspirator, captures were performed inside and outside the houses. Dissections were conducted to allow classify female mosquitoes according to their physiologic state. RESULTS: One hundred and eighty-eight males and 189 females were captured in both regions. A general index of 0.46 Ae. aegypti females per house was determined. Of the total sample, 82.4% of males and 87.3% of females were collected indoors. Greater proportions of females were found in the region of low socioeconomic level, and higher population density. One hundred and forty-eight female mosquitoes were analyzed: 27.0% were nulliparous and 10.1% parous. The rest were classified as Christophers and Mer's (C & M) phases III to V, 28.0% of which had red blood in their midgut. Of the total female population, 87.9% had bloodmeals. CONCLUSIONS: The mosquito species revealed a high degree of endophily. There was a higher proportion of nulliparous mosquitoes, although the majority of the females were classified as C & M's phases III to V. These results highlight both the great number of females who had had bloodmeals, and the lack of gonotrophic concordance.

[An evaluation of municipal actions in the control of dengue vectors in the region of São José do Rio Prêto, São Paulo, 1989 to 1995]. / Avaliação de ações municipais de combate a vetores da dengue na região de São José do Rio Prêto, São Paulo, 1989 a 1995.

The aim of this study was to determine the coverage of municipal activities in terms of the control of Aedes aegypti and/or Aedes albopictus by routine house-to-house visits and by emergency activity, carried out between 1989 and 1995 in the area of São José do Rio Prêto, São Paulo State, and to evaluate the cross-correlation between them and the Breteau index (BI). For towns with up to 50,000 real estate properties, the joint coverage by routine and emergency activities was mostly appropriate and the routine activities showed a negative cross-correlation with the BI. For the county seat (more than 50,000 real estate properties), the coverage provided by the above activities was not correlated with the BI. In general, the coverage was inversely proportional to town size. Emergency activities did not show a correlation with the BI in any town size range, proving to be ineffective.

[Results of activities encouraging community participation in dengue control in an outlying neighborhood of São José do Rio Preto, São Paulo, and the relationship between the population's knowledge and habits]. / Avaliação dos resultados de atividades de incentivo à participação da comunidade no controle da dengue em um bairro periférico do Município de São José do Rio Preto, São Paulo, e da relação entre conhecimentos e práticas desta população.

This study evaluates the results of an educational campaign developed in an outlying neighborhood of São José do Rio Preto, São Paulo, and the relationship between the population's knowledge and habits. Prior to and after the educational activities, samples were taken to measure level of knowledge concerning dengue and its vectors, breeding sites, and control measures. Potential breeding sites were also counted. Knowledge of the disease and its vectors and breeding sites increased, but the same was not true for control measures focusing on water recipients serving as potential breeding sites. There was no change in the number of breeding sites between the first and second stages of the research. Thus, despite increased knowledge, the local population's habits did not changes. These findings are worrisome, since the main goal of the educational campaign, i.e., the change of habits concerning breeding sites for dengue vectors, has not been achieved.

Descrição da colonização de Aedes aegypti na região de São José do Rio Preto, São Paulo / A description of Aedes aegypti colonization in the region of São José do Rio Preto, São Paulo

O objetivo do trabalho é descrever a colonização da região pelo Aedes aegypti. Levantamento entomológico realizado em 1985 detectou a espécie em São José do Rio Preto. A dispersão do mosquito atingiu, até 1988, os 30 municípios da região. Nos distritos e aglomerados rurais, o primeiro foco do vetor foi encontrado em 1987 em um dos 29 existentes, dispersando-se para os demais até 1991. Os focos foram identificados, principalmente, através de pesquisas larvárias em locais com grande concentração de recipientes, e a maior freqüência de encontro de larvas de Ae. aegypti ocorreu em pneus, principais responsáveis por sua dispersão. Os focos foram identificados, basicamente, entre novembro e abril, períodos de maior incidência de chuvas. As delimitações dos focos mostraram que os principais recipientes infestados pelo mosquito nos domicílios foram os pneus e vasos de plantas. A conseqüência mais importante da presença do Ae. aegypti tem sido as ocorrências de epidemias de dengue.

The aim of this study is to describe the colonization by the Aedes aegypti in the region. A survey carried out in 1985 detected the species in São José do Rio Preto. The mosquito has spread and reached the 30 countries of the region till 1988. In the district and rural areas, the first vector focus was found out in 1987 in one of the 29 districts and rural areas, having spread to the others till 1991. The foci have been mainly identified through larval researches in locations with a great concentration of containers, and the greatest occurrence of larvae of Aedes aegypti has been in tires, the most frequent means of spread. The foci have been mainly identified between November and April, periods of greater incidence of rains. The delimits of foci showed that the containers which were mostly infested by the mosquito in homes have been tires and vases of plants. The most important consequence of the presence of Aedes aegypti has been the occurrence of dengue epidemics.

[A description of Aedes aegypti colonization in the region of São José do Rio Preto, São Paulo]. / Descrição da colonização de Aedes aegypti na região de São José do Rio Preto, São Paulo.

The aim of this study is to describe the colonization by the Aedes aegypti in the region. A survey carried out in 1985 detected the species in São José do Rio Preto. The mosquito has spread and reached the 30 countries of the region till 1988. In the district and rural areas, the first vector focus was found out in 1987 in one of the 29 districts and rural areas, having spread to the others till 1991. The foci have been mainly identified through larval researches in locations with a great concentration of containers, and the greatest occurrence of larvae of Aedes aegypti has been in tires, the most frequent means of spread. The foci have been mainly identified between November and April, periods of greater incidence of rains. The delimits of foci showed that the containers which were mostly infested by the mosquito in homes have been tires and vases of plants. The most important consequence of the presence of Aedes aegypti has been the occurrence of dengue epidemics.

[The population's knowledge concerning dengue fever, vectors, and control measures in São José do Rio Preto, São Paulo state] / Conhecimentos da população sobre dengue, seus vetores e medidas de controle em São José do Rio Preto, São Paulo.

Educational campaigns to inform the population about dengue fever, vectors, and related control measures have been carried out since 1985 by health services. In order to assess knowledge levels in São José do Rio Preto, São Paulo, a household survey was performed with a sample of 537 households in the urban area of São José do Rio Preto, São Paulo, in April and May 1995, where the same number of women were interviewed with questions about dengue fever, vectors, and control measures. Knowledge as displayed was satisfactory, except for that concerning hemorrhagic dengue. However, acquisition of knowledge was not followed by adoption of necessary control measures was insufficient to decrease infestation rates for dengue vectors in the city.

[Description of the colonization of Aedes albopictus (Diptera: culicidae) in the region of Saõ José do Rio Preto, SP, 1991-1994]. / Descrição da colonização de Aedes albopictus (Diptera: culicidae) na região de São José do Rio Preto, SP, 1991-1994.

This study aims to describe and analyze the colonization of Aedes albopictus whose presence was detected in 1991 in the area of Sào José do Rio. Preto already colonized by the Aedes aegypti. Year and month of occurrence, counties, composition and location of larval samples, kinds of containers, average number of larvae an Breteau Index bare been analyzed from the information obtained in measurements of larval density by Superintendência de Controle de Endemias (SUCEN). The presence of Aedes albopictus was ascertained in 34 towns up to December 1994. The colonization of the area by the mosquito is still reduced showing some differences in relation to Aedes aegypti such as greater ratio outdoors, occupying container in different proportions. The average number of Aedes albopictus larvae has had influence of larvae of another species. It has showed a seasonal behavior similar to Aedes aegypti and it has moved from east to west direction.