Efeito da pandemia da COVID-19 sobre os casos novos de tuberculose no Brasil: uma análise temporal e espacial / Effect of COVID-19 Pandemic on New Cases of Tuberculosis in Brazil: A Temporal and Spatial Analysis

Objetivou-se analisar, por meio do padrão espacial e temporal, o efeito da pandemia de COVID-19 na detecção de casos novos de tuberculose no Brasil. Trata-se de um estudo ecológico, que adotou a taxa média de detecção de casos novos de tuberculose no período pré-pandemia (2016 a 2019) e pandêmico (2020). Na análise espacial foi calculada a variação percentual da detecção para regiões brasileiras e estados e a razão de risco entre as taxas de detecção suavizadas, por meio do método empírico bayesiano local, para os municípios. A análise de tendência temporal foi realizada por meio da Regressão de Joinpoint, sendo o mês de detecção a unidade de análise. Observou-se a redução da taxa de detecção de tuberculose em todas as regiões brasileiras e em 81,5% dos estados. Aproximadamente 60,0% dos municípios apresentaram estabilização ou decréscimo das taxas de detecção. A análise temporal revelou que todas as regiões apresentavam, desde 2016, tendência de aumento de detecção de casos e que, sobretudo no primeiro semestre de 2020, foi identificada forte tendência a redução das taxas. A mudança da organização dos serviços de saúde impostos pela pandemia pode ter influenciado a subnotificação de casos e consequente redução das taxas de detecção da tuberculose.

This study aimed to analyze, through the spatial and temporal patterns, the effect of the COVID-19 pandemic in the detection of new cases of tuberculosis in Brazil. This is an ecological study, which adopted the average rate of detection of new cases of tuberculosis in the pre-pandemic (2016 to 2019) and pandemic (2020) periods. The spatial analysis was calculated using the percent variation of detection in Brazilian regions and states and the risk ratio between smoother detection rates through the local Bayesian empirical method for municipalities. The temporal trend analysis was performed through Joinpoint regression, with the month of detection as the unit of analysis. A reduction of the tuberculosis detection rate was observed in all Brazilian regions and in 81.5% of states. Approximately 60.0% of municipalities showed stabilization or a decrease in detection rates. Time analysis revealed that all regions had, since 2016, a trend of increased case detection and that, especially in the first half of 2020, a strong decreasing rate was identified. Changing the organization of healthcare services imposed by pandemic may have influenced the under-reporting of cases and consequent reduction of tuberculosis detection rates.

Técnicas educativas como instrumentos preventivos de la salud bucal en adolescentes / Educational techniques as preventive tools for oral health in adolescents

Se realizó un estudio de intervención en estudiantes de 7mo grado de la ESBU Camilo Cienfuegos de Bayamo, donde se aplicaron diversas técnicas participativas grupales con el propósito de determinar la efectividad de estas en la transmisión de conocimientos sobre la salud bucodental y cambiar actitudes negativas en cuanto a la higiene bucal en adolescentes del reparto El Cristo de Bayamo. El universo estuvo conformado por los 216 estudiantes de 7mo grado pertenecientes al área de salud de la Policlínica Bayamo Oeste de los cuales se seleccionó una muestra de 60 alumnos que no necesitaban tratamientos estomatológicos curativos, fueron elegidos a través de simple aleatorio, con lo que se conformaron 3 grupos de 20 alumnos cada uno, a cuyos integrantes se les aplicó un cuestionario sobre temas de salud bucodental antes y después de la aplicación de las técnicas de participación. Se logró que el 91.7 por ciento adquirieran conocimientos categorizados de bien y 96.7 por ciento alcanzaran niveles de higiene bucal adecuados. Se aplicaron las pruebas estadísticas de Stuart Maxwell y Mc Nemar que arrojaron diferencias altamente significativas (p<0.05) en las categorías evaluadas antes y después de la intervención, revelando que las técnicas fueron eficaces al obtener con participación conscienteresultados satisfactorios(AU)

An intervention study was performed in 7th grade students from Camilo Cienfuegos Secondary School of Bayamo, where there were applied several participatory group techniques in order to determine the ir effectiveness in the transmission of knowledge on oral health and change negative attitudes regarding the oral hygiene in adolescents of Christ in Bayamo. The universe consisted of 216 seventh graders belonging to the health area of the Polyclinic West Bayamo and it was selected a sample of 60 students who did not need Stomatological healing treatments, there were chosen through simple random, conforming 3 groups of 20 students each, whose members applied a questionnaire on issues of oral health before and after the application of the participatory techniques. 91.7 percent obtained categorized good knowledge and 96.7 percent reached adequate levels of oral hygiene. Statistical tests of Stuart Maxwell and Mc Nemar were applied, showing highly significant differences (p <0.05) in the categories assessed before and after the intervention, revealing that the techniques were effective because satisfactory results were obtained with conscious participation(EU)

Breast cancer risk and genetic ancestry: a case-control study in Uruguay.

BACKGROUND: Uruguay exhibits one of the highest rates of breast cancer in Latin America, similar to those of developed nations, the reasons for which are not completely understood. In this study we investigated the effect that ancestral background has on breast cancer susceptibility among Uruguayan women. METHODS: We carried out a case-control study of 328 (164 cases, 164 controls) women enrolled in public hospitals and private clinics across the country. We estimated ancestral proportions using a panel of nuclear and mitochondrial ancestry informative markers (AIMs) and tested their association with breast cancer risk. RESULTS: Nuclear individual ancestry in cases was (mean ± SD) 9.8 ± 7.6% African, 13.2 ± 10.2% Native American and 77.1 ± 13.1% European, and in controls 9.1 ± 7.5% African, 14.7 ± 11.2% Native American and 76.2 ± 14.2% European. There was no evidence of a difference in nuclear or mitochondrial ancestry between cases and controls. However, European mitochondrial haplogroup H was associated with breast cancer (OR = 2.0; 95% CI 1.1, 3.5). CONCLUSIONS: We have not found evidence that overall genetic ancestry differs between breast cancer patients and controls in Uruguay but we detected an association of the disease with a European mitochondrial lineage, which warrants further investigation.

The mitochondrial DNA history of a former native American village in northern Uruguay.

OBJECTIVES: In 1828, between 8,000 and 15,000 Indians from the Jesuit Missions were brought to Uruguay. There, they were settled in a village, presently named Bella Unión, in the northwest corner of the country. According to historic sources, the Indians abandoned the settlement shortly thereafter, with the village subsequently repopulated by "criollos" and immigrants from abroad. As a first approach to reconstruct the genetic history of the population, data about the living population genetic structure will be used. Based on the analysis of the maternal lineages of the inhabitants of Bella Unión, and of those from two nearby villages, we expect to partially answer what happened with the first and subsequent inhabitants. METHODS: We analyzed the maternal lineages of the present inhabitants of Bella Unión and neighboring localities through the sequencing of the mitochondrial DNA control region. RESULTS: A total of 64.3%, 5.7%, and 30% of the mtDNAs were of Native, African, and West Eurasian origin, respectively. These figures are quite similar to that of the population of Tacuarembó, which is located in northeastern Uruguay. The four main Native American founding haplogroups were detected, with B2 being the most frequent, while some rare subhaplogroups (B2h, C1b2, D1f1) were also found. When compared with other Native American sequences, near- matches most consistently pointed to an Amazonian Indian origin which, when considered with historical evidence, suggested a probable Guaraní-Missionary-related origin. CONCLUSIONS: The data support the existence of a relationship between the historic and present inhabitants of the extreme northwest Uruguay, with a strong contribution of Native Americans to the mitochondrial DNA diversity observed there.