RESUMO
The outbreak of COVID-19 has led to there being a worldwide socio-economic crisis, with major impacts on developing countries. Understanding the dynamics of the disease and its driving factors, on a small spatial scale, might support strategies to control infections. This paper explores the impact of the COVID-19 on neighborhoods of Recife, Brazil, for which we examine a set of drivers that combines socio-economic factors and the presence of non-stop services. A three-stage methodology was conducted by conducting a statistical and spatial analysis, including clusters and regression models. COVID-19 data were investigated concerning ten dates between April and July 2020. Hotspots of the most affected regions and their determinant effects were highlighted. We have identified that clusters of confirmed cases were carried from a well-developed neighborhood to socially deprived areas, along with the emergence of hotspots of the case-fatality rate. The influence of age-groups, income, level of education, and the access to essential services on the spread of COVID-19 was also verified. The recognition of variables that influence the spatial spread of the disease becomes vital for pinpointing the most vulnerable areas. Consequently, specific prevention actions can be developed for these places, especially in heterogeneous cities.
Assuntos
COVID-19 , Brasil/epidemiologia , COVID-19/epidemiologia , Humanos , Pandemias , Características de Residência , SARS-CoV-2RESUMO
The paper presents an innovative application to identify areas vulnerable to coronavirus disease 2019 (COVID-19) considering a combination of spatial analysis and a multi-criteria learning approach. We applied this methodology in the state of Pernambuco, Brazil identifying vulnerable areas by considering a set of determinants and risk factors for COVID-19, including demographic, economic and spatial characteristics and the number of human COVID-19 infections. Examining possible patterns over a set number of days taking the number of cases recorded, we arrived at a set of compatible decision rules to explain the relation between risk factors and COVID-19 cases. The results reveal why certain municipalities are critically vulnerable to COVID-19 highlighting locations for which knowledge can be gained about environmental factors.
Assuntos
COVID-19 , Brasil/epidemiologia , Cidades , Técnicas de Apoio para a Decisão , Humanos , SARS-CoV-2RESUMO
BACKGROUND: Multimorbidity is the co-occurrence of two or more chronic diseases. OBJECTIVE: This study, based on self-reported medical diagnosis, aims to investigate the dynamic distribution of multimorbidity across sociodemographic levels and its impacts on health-related issues over 15 years in Brazil using national data. METHODS: Data were analyzed using descriptive statistics, hypothesis tests, and logistic regression. The study sample comprised 679,572 adults (18-59 years of age) and 115,699 elderly people (≥60 years of age) from the two latest cross-sectional, multiple-cohort, national-based studies: the National Sample Household Survey (PNAD) of 1998, 2003, and 2008, and the Brazilian National Health Survey (PNS) of 2013. RESULTS: Overall, the risk of multimorbidity in adults was 1.7 times higher in women (odds ratio [OR] 1.73, 95% CI 1.67-1.79) and 1.3 times higher among people without education (OR 1.34, 95% CI 1.28-1.41). Multiple chronic diseases considerably increased with age in Brazil, and people between 50 and 59 years old were about 12 times more likely to have multimorbidity than adults between 18 and 29 years of age (OR 11.89, 95% CI 11.27-12.55). Seniors with multimorbidity had more than twice the likelihood of receiving health assistance in community services or clinics (OR 2.16, 95% CI 2.02-2.31) and of being hospitalized (OR 2.37, 95% CI 2.21-2.56). The subjective well-being of adults with multimorbidity was often worse than people without multiple chronic diseases (OR=12.85, 95% CI: 12.07-13.68). These patterns were similar across all 4 cohorts analyzed and were relatively stable over 15 years. CONCLUSIONS: Our study shows little variation in the prevalence of the multimorbidity of chronic diseases in Brazil over time, but there are differences in the prevalence of multimorbidity across different social groups. It is hoped that the analysis of multimorbidity from the two latest Brazil national surveys will support policy making on epidemic prevention and management.
Assuntos
Multimorbidade , Doenças não Transmissíveis , Adulto , Idoso , Brasil/epidemiologia , Doença Crônica , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Doenças não Transmissíveis/epidemiologia , PrevalênciaRESUMO
Plaster is a material which is widely used in Brazil on construction sites. However, its use in recent years has been limited by a legal resolution on the environment introduced in Brazil. One of the regions most affected by these restrictions is the Northeast where the strategic importance of plaster for the region is apparent from the extensive economic development, centered on the gypsum pole of Araripe in the state of Pernambuco. This problem has involved many interested parties, among whom are plaster producers, plastering companies, builders, unions (for plaster workers, and construction workers), Town Halls, and so forth. Therefore, there is a need to structure the problem with a view to obtaining a better understanding of the problem given the lack of information on the real decision problem. To reach this objective, value focus thinking (VFT), a methodology that addresses how values can be used to improve the decision making process, was applied and the problem was structured. Thus, it was possible for the parties involved to clarify their objectives, and specify more precisely the consequences and constraints for the decision problem. In addition, each party involved could get a better understanding of their own wishes. In conclusion, the VFT methodology application enables the parties involved to make more consistent decisions, and therefore to ensure that plaster will continue to be used in the construction industry.