Evaluation of the Hematological Patterns from Up to 985 Days of Long COVID: A Cross-Sectional Study.

Long COVID affects many individuals following acute coronavirus disease 2019 (COVID-19), and hematological changes can persist after the acute COVID-19 phase. This study aimed to evaluate these hematological laboratory markers, linking them to clinical findings and long-term outcomes in patients with long COVID. This cross-sectional study selected participants from a 'long COVID' clinical care program in the Amazon region. Clinical data and baseline demographics were obtained, and blood samples were collected to quantify erythrogram-, leukogram-, and plateletgram-related markers. Long COVID was reported for up to 985 days. Patients hospitalized in the acute phase had higher mean red/white blood cell, platelet, and plateletcrit levels and red blood cell distribution width. Furthermore, hematimetric parameters were higher in shorter periods of long COVID than in longer periods. Patients with more than six concomitant long COVID symptoms had a higher white blood cell count, a shorter prothrombin time (PT), and increased PT activity. Our results indicate there may be a compensatory mechanism for erythrogram-related markers within 985 days of long COVID. Increased levels of leukogram-related markers and coagulation activity were observed in the worst long COVID groups, indicating an exacerbated response after the acute disturbance, which is uncertain and requires further investigation.

Cytokine Profiles Associated With Acute COVID-19 and Long COVID-19 Syndrome.

The duration and severity of COVID-19 are related to age, comorbidities, and cytokine synthesis. This study evaluated the impact of these factors on patients with clinical presentations of COVID-19 in a Brazilian cohort. A total of 317 patients diagnosed with COVID-19 were included; cases were distributed according to clinical status as severe (n=91), moderate (n=56) and mild (n=170). Of these patients, 92 had acute COVID-19 at sample collection, 90 had already recovered from COVID-19 without sequelae, and 135 had sequelae (long COVID syndrome). In the acute COVID-19 group, patients with the severe form had higher IL-6 levels (p=0.0260). In the post-COVID-19 group, there was no significant difference in cytokine levels between groups with different clinical conditions. In the acute COVID-19 group, younger patients had higher levels of TNF-α, and patients without comorbidities had higher levels of TNF-α, IL-4 and IL-2 (p<0.05). In contrast, patients over age 60 with comorbidities had higher levels of IL-6. In the post-COVID-19 group, subjects with long COVID-19 had higher levels of IL-17 and IL-2 (p<0.05), and subjects without sequelae had higher levels of IL-10, IL-6 and IL- 4 (p<0.05). Our results suggest that advanced age, comorbidities and elevated serum IL-6 levels are associated with severe COVID-19 and are good markers to differentiate severe from mild cases. Furthermore, high serum levels of IL-17 and IL-2 and low levels of IL-4 and IL-10 appear to constitute a cytokine profile of long COVID-19, and these markers are potential targets for COVID-19 treatment and prevention strategies.

Muscle dysfunction in the long coronavirus disease 2019 syndrome: Pathogenesis and clinical approach.

In long coronavirus disease 2019 (long COVID-19), involvement of the musculoskeletal system is characterised by the persistence or appearance of symptoms such as fatigue, muscle weakness, myalgia, and decline in physical and functional performance, even at 4 weeks after the onset of acute symptoms of COVID-19. Muscle injury biomarkers are altered during the acute phase of the disease. The cellular damage and hyperinflammatory state induced by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection may contribute to the persistence of symptoms, hypoxaemia, mitochondrial damage, and dysregulation of the renin-angiotensin system. In addition, the occurrence of cerebrovascular diseases, involvement of the peripheral nervous system, and harmful effects of hospitalisation, such as the use of drugs, immobility, and weakness acquired in the intensive care unit, all aggravate muscle damage. Here, we review the multifactorial mechanisms of muscle tissue injury, aggravating conditions, and associated sequelae in long COVID-19.

The socio-environmental production of malaria in three municipalities in the Carajás region, Pará, Brazil.

OBJECTIVE: To analyze the environmental production of malaria in the municipalities of Marabá, Parauapebas, and Canaã dos Carajás, in Pará, from 2014 to 2018. METHODS: This ecological, cross-sectional study used epidemiological data in the Sistema de Informações de Vigilância Epidemiológica da Malária (Malaria Epidemiological Surveillance Information System) from the Secretaria de Saúde do Estado do Pará (State of Pará Health Department), cartographic data from the Brazilian Institute of Geography and Statistics (IBGE), and environmental data in the Projeto TerraClass (TerraClass Project) from the National Institute of Space Research (INPE). Statistical analyses used the chi-square test, while the spatial ones, the kernel and Moran's (I) global bivariate techniques. RESULTS: We analyzed a total of 437 confirmed cases of malaria in the selected area and period. The highest percentage of cases occurred among male miners and farmers, living in rural areas; Plasmodium vivax was the most frequent species; and the most used diagnosis, the thick drop/smear. We also observed a heterogeneous distribution of the disease - with evidence of spatial dependence between incidence areas and different forms of land use, and spatial autocorrelations related to the high variability of anthropic activities in the municipalities. CONCLUSION: The environmental production of malaria relates mainly to cattle production and mining - anthropisms related to land use and occupation in the observed municipalities. Spatial data analysis technologies sufficed for the construction of the epidemiological scenario of the disease.

The socio-environmental production of malaria in three municipalities in the Carajás region, Pará, Brazil / A produção socioambiental da malária em três municípios da região de Carajás, Pará, Brasil

ABSTRACT OBJECTIVE To analyze the environmental production of malaria in the municipalities of Marabá, Parauapebas, and Canaã dos Carajás, in Pará, from 2014 to 2018. METHODS This ecological, cross-sectional study used epidemiological data in the Sistema de Informações de Vigilância Epidemiológica da Malária (Malaria Epidemiological Surveillance Information System) from the Secretaria de Saúde do Estado do Pará (State of Pará Health Department), cartographic data from the Brazilian Institute of Geography and Statistics (IBGE), and environmental data in the Projeto TerraClass (TerraClass Project) from the National Institute of Space Research (INPE). Statistical analyses used the chi-square test, while the spatial ones, the kernel and Moran's (I) global bivariate techniques. RESULTS We analyzed a total of 437 confirmed cases of malaria in the selected area and period. The highest percentage of cases occurred among male miners and farmers, living in rural areas; Plasmodium vivax was the most frequent species; and the most used diagnosis, the thick drop/smear. We also observed a heterogeneous distribution of the disease — with evidence of spatial dependence between incidence areas and different forms of land use, and spatial autocorrelations related to the high variability of anthropic activities in the municipalities. CONCLUSION The environmental production of malaria relates mainly to cattle production and mining — anthropisms related to land use and occupation in the observed municipalities. Spatial data analysis technologies sufficed for the construction of the epidemiological scenario of the disease.

RESUMO OBJETIVO Analisar a produção ambiental da malária nos municípios de Marabá, Parauapebas e Canaã dos Carajás, no Pará, entre 2014 e 2018. MÉTODOS Estudo ecológico e transversal a partir de dados epidemiológicos do Sistema de Informações de Vigilância Epidemiológica da Malária, da Secretaria de Saúde do Estado do Pará. Foram utilizados também dados cartográficos do Instituto Brasileiro de Geografia e Estatística (IBGE) e ambientais do projeto TerraClass, do Instituto Nacional de Pesquisas Espaciais (INPE). As análises estatísticas utilizaram o cálculo de percentuais e o teste qui-quadrado e as espaciais as técnicas de Kernel e de Moran global bivariado (I). RESULTADOS Foram analisados 437 casos confirmados de malária, na área e periodo de estudo. O maior percentual de casos ocorreu em indivíduos do sexo masculino, adultos, morador da zona rural, com atividades de garimpagem e agropecuária, sendo o Plasmodium vivax a espécie de maior frequência e o diagnóstico mais utilizado a gota espessa/esfregaço. A distribuição da malária não ocorreu de forma homogênea, com evidências de dependência espacial entre áreas com ocorrência de casos e diferentes tipos de uso da terra. Foram observadas também autocorrelações espaciais relacionadas à alta variabilidade dos tipos antropismos, ocorrida nos municípios. CONCLUSÃO A produção ambiental da malária está associada principalmente à pastagem e à mineração, antropismos relacionados às formas de uso e ocupação da terra nos municípios estudados. As tecnologias de análises de dados espaciais em saúde foram satisfatórias para a construção do cenário epidemiológico da doença.

Hepatites B e C nas áreas de três Centros Regionais de Saúde do Estado do Pará, Brasil: uma análise espacial, epidemiológica e socioeconômica / Hepatitis B and C in the areas of three Regional Health Centers of Pará State, Brazil: a spatial, epidemiological and socioeconomic analysis

Resumo Introdução As hepatites virais são graves problemas de saúde pública e estão relacionadas às diferentes características socioeconômicas do território brasileiro. Objetivo Analisar a distribuição espacial das hepatites B e C e sua relação com o Índice de Desenvolvimento Humano Municipal (IDHM) nas áreas de três Centros Regionais de Saúde (CRS), no Estado do Pará, Brasil, de 2010 a 2014. Método Neste trabalho descritivo e transversal, foram utilizados dados do Sistema de Informação de Agravos de Notificação, do Ministério da Saúde, e do Censo 2010, do Instituto Brasileiro de Geografia e Estatística. Resultados As análises mostraram que o 11º CRS notificou o maior número de casos (60,9%). Os indivíduos mais acometidos por ambas as doenças foram do gênero feminino, pardos, adultos e com ensino fundamental. Os fatores de riscos mais significativos foram uso de medicamentos injetáveis e tratamentos dentário e cirúrgico. Foi observada dependência espacial entre o IDHM e os parâmetros da taxa de incidência das doenças, com autocorrelações diretas e indiretas. Assim, áreas com IDHM médio e baixo apresentaram altas taxas de incidência, sobretudo em municípios com intenso fluxo migratório, nas últimas décadas. Conclusão As análises foram eficazes para construir cenários epidemiológicos das doenças. Ressaltamos a necessidade de expandir o controle das hepatites nas áreas estudadas.

Abstract Background Viral hepatitis is a serious public health problem and is related to the different socioeconomic characteristics of the Brazilian territory. Objective To analyze the spatial distribution of the hepatitis B and C and their relationship with the Municipal Human Development Index (IDHM), in the areas of three Regional Health Centers (CRS), in the state of Pará, Brazil, from 2010 to 2014. Method In this descriptive and cross-sectional study, data from the Information System for Notifiable Diseases of the Ministry of Health and the 2010 Census of the Brazilian Institute of Geography and Statistics were used. Results The analyses showed that the 11th CRS reported the greater number of cases (60.9%). The most affected individuals by both diseases were female, brown skin color, adults and elementary school degree. The most significant risk factors were injecting drugs use, dental and surgical treatments. It was observed spatial dependence between the IDHM and the diseases incidence rate parameters, with direct and indirect autocorrelations. Thus, areas with medium and low IDHM showed high incidence rates, especially in municipalities with intense migratory flows, in the last decades. Conclusion The analyses were effective for construct epidemiological scenarios of the diseases. The need to expand the control of hepatitis in the studied areas is highlighted.

Space-temporal analysis of Chagas disease and its environmental and demographic risk factors in the municipality of Barcarena, Pará, Brazil. / Análise espaço-temporal da doença de Chagas e seus fatores de risco ambientais e demográficos no município de Barcarena, Pará, Brasil.

INTRODUCTION: Chagas disease is a parasitosis considered a serious problem of public health. In the municipality of Barcarena, Pará, from 2007 to 2014, occurred the highest prevalence of this disease in Brazil. OBJECTIVE: To analyze the disease distribution related to epidemiological, environmental and demographic variables, in the area and period of the study. METHODS: Epidemiological and demographic data of Barcarena Health Department and satellite images from the National Institute For Space Research (INPE) were used. The deforestation data were obtained through satellite image classification, using artificial neural network. The statistical significance was done with the χ2 test, and the spatial dependence tests among the variables were done using Kernel and Moran techniques. RESULTS: The epidemiological curve indicated a disease seasonal pattern. The major percentage of the cases were in male, brown skin color, adult, illiterate, urban areas and with probable oral contamination. It was confirmed the spatial dependence of the disease cases with the different types of deforestation identified in the municipality, as well as agglomerations of cases in urban and rural areas. Discussion: The disease distribution did not occur homogeneously, possibly due to the municipality demographic dynamics, with intense migratory flows that generates the deforestation. CONCLUSION: Different relationships among the variables studied and the occurrence of the disease in the municipality were observed. The technologies used were satisfactory to construct the disease epidemiological scenarios.

INTRODUÇÃO: A doença de Chagas é uma parasitose considerada um grave problema de saúde pública. No município de Barcarena, Pará, de 2007 a 2014, ocorreu a maior prevalência dessa doença no Brasil. OBJETIVO: Analisar a distribuição dessa doença relacionada às variáveis epidemiológicas, ambientais e demográficas, na área e no período do estudo. MÉTODOS: Foram utilizados dados epidemiológicos e demográficos da Secretaria Municipal de Saúde de Barcarena e imagens de satélites do Instituto Nacional de Pesquisas Espaciais. Os dados de desmatamento foram obtidos por classificação de imagens de satélites, utilizando rede neural artificial. As análises de significância estatística foram realizadas com o teste do χ2, e as de dependência espacial entre as variáveis, com as técnicas de Kernel e Moran. RESULTADOS: A curva epidemiológica indicou um padrão sazonal da doença. O maior percentual dos casos foi em indivíduos do sexo masculino, pardos, adultos, analfabetos, da zona urbana e com provável contaminação oral. Foi confirmada dependência espacial dos casos da doença com os diferentes tipos de desmatamento identificados no município, bem como aglomerados de casos em áreas urbanas e rurais. Discussão: A distribuição da doença não ocorreu de forma homogênea, possivelmente pela dinâmica demográfica do município, com intensos fluxos migratórios que causam os desmatamentos. CONCLUSÃO: Foram observadas diferentes relações entre as variáveis estudadas e a ocorrência da doença no município. As tecnologias utilizadas foram satisfatórias para a construção dos cenários epidemiológicos da doença.

Análise espaço-temporal da doença de Chagas e seus fatores de risco ambientais e demográficos no município de Barcarena, Pará, Brasil / Space-temporal analysis of Chagas disease and its environmental and demographic risk factors in the municipality of Barcarena, Pará, Brazil

RESUMO: Introdução: A doença de Chagas é uma parasitose considerada um grave problema de saúde pública. No município de Barcarena, Pará, de 2007 a 2014, ocorreu a maior prevalência dessa doença no Brasil. Objetivo: Analisar a distribuição dessa doença relacionada às variáveis epidemiológicas, ambientais e demográficas, na área e no período do estudo. Métodos: Foram utilizados dados epidemiológicos e demográficos da Secretaria Municipal de Saúde de Barcarena e imagens de satélites do Instituto Nacional de Pesquisas Espaciais. Os dados de desmatamento foram obtidos por classificação de imagens de satélites, utilizando rede neural artificial. As análises de significância estatística foram realizadas com o teste do χ2, e as de dependência espacial entre as variáveis, com as técnicas de Kernel e Moran. Resultados: A curva epidemiológica indicou um padrão sazonal da doença. O maior percentual dos casos foi em indivíduos do sexo masculino, pardos, adultos, analfabetos, da zona urbana e com provável contaminação oral. Foi confirmada dependência espacial dos casos da doença com os diferentes tipos de desmatamento identificados no município, bem como aglomerados de casos em áreas urbanas e rurais. Discussão: A distribuição da doença não ocorreu de forma homogênea, possivelmente pela dinâmica demográfica do município, com intensos fluxos migratórios que causam os desmatamentos. Conclusão: Foram observadas diferentes relações entre as variáveis estudadas e a ocorrência da doença no município. As tecnologias utilizadas foram satisfatórias para a construção dos cenários epidemiológicos da doença.

ABSTRACT: Introduction: Chagas disease is a parasitosis considered a serious problem of public health. In the municipality of Barcarena, Pará, from 2007 to 2014, occurred the highest prevalence of this disease in Brazil. Objective: To analyze the disease distribution related to epidemiological, environmental and demographic variables, in the area and period of the study. Methods: Epidemiological and demographic data of Barcarena Health Department and satellite images from the National Institute For Space Research (INPE) were used. The deforestation data were obtained through satellite image classification, using artificial neural network. The statistical significance was done with the χ2 test, and the spatial dependence tests among the variables were done using Kernel and Moran techniques. Results: The epidemiological curve indicated a disease seasonal pattern. The major percentage of the cases were in male, brown skin color, adult, illiterate, urban areas and with probable oral contamination. It was confirmed the spatial dependence of the disease cases with the different types of deforestation identified in the municipality, as well as agglomerations of cases in urban and rural areas. Discussion: The disease distribution did not occur homogeneously, possibly due to the municipality demographic dynamics, with intense migratory flows that generates the deforestation. Conclusion: Different relationships among the variables studied and the occurrence of the disease in the municipality were observed. The technologies used were satisfactory to construct the disease epidemiological scenarios.

[Leptospirosis space-time distribution and risk factors in Belém, Pará, Brazil]. / Distribuição espaço-temporal da leptospirose e fatores de risco em Belém, Pará, Brasil.

The occurrence of leptospirosis has defied epidemiology even when using different analysis technologies at local geographical levels. This cross-sectional and descriptive study sought to identify spatial correlations between social and environmental risk factors and leptospirosis in Belém in the State of Pará from 2007 to 2013. Epidemiological data were obtained from the Information System for Notifiable Diseases of the Pará State Department of Public Health and the environmental, demographic and cartographical data from the Brazilian Institute of Geography and Statistics. Men aged 20 to 39 of unknown profession and mixed ethnicity were the most affected. Laboratory diagnosis (82%) and hospital care (67.22%) confirmed satisfactory access to the Unified Health System. Numerical Kriging indicated the highest concentrations of the disease in the Guamá and Jurunas neighborhoods in lower lying areas near canals. The Buffer technique showed higher concentrations of the disease in areas with no domestic solid garbage collection service (26%), sewage (22%), piped water (38%), with unpaved roads (20%) and street flooding (65%). The Moran technique revealed a direct spatial correlation between these variables (p = 0.01543). The general trend showed the decrease of the disease.

Distribuição espaço-temporal da leptospirose e fatores de risco em Belém, Pará, Brasil / Leptospirosis space-time distribution and risk factors in Belém, Pará, Brazil

Resumo A ocorrência da leptospirose tem desafiado a epidemiologia na utilização de diferentes tecnologias de análises em escalas geográficas locais. Este estudo transversal e descritivo objetivou identificar correlações espaciais de fatores de risco socioambientais com a leptospirose em Belém, Pará, entre 2007 e 2013. Os dados epidemiológicos foram obtidos no Sistema de Informação de Agravos de Notificação, da Secretaria do Estado de Saúde Pública e os ambientais, demográficos e territoriais no Instituto Brasileiro de Geografia e Estatística. Homens, 20 a 39 anos, ocupação indeterminada, etnia parda, foram os mais acometidos. O diagnóstico laboratorial (82%) e o atendimento hospitalar (67,22%) demonstraram acesso satisfatório ao Sistema de Saúde. A Krigagem numérica mostrou a maior concentração da doença nos bairros Guamá e Jurunas, em áreas de menores cotas altimétricas, próximas a canais. A técnica de Buffer apontou maior concentração da doença em áreas de ausência de coleta de resíduos sólidos domiciliares (26%), esgoto (22%), água encanada (38%), e com arruamento não pavimentado (20%) e alagamento de rua (65%). A técnica de Moran demonstrou uma correlação espacial direta entre estas variáveis (p = 0,01543). A tendência geral expressou o decréscimo da doença.

Abstract The occurrence of leptospirosis has defied epidemiology even when using different analysis technologies at local geographical levels. This cross-sectional and descriptive study sought to identify spatial correlations between social and environmental risk factors and leptospirosis in Belém in the State of Pará from 2007 to 2013. Epidemiological data were obtained from the Information System for Notifiable Diseases of the Pará State Department of Public Health and the environmental, demographic and cartographical data from the Brazilian Institute of Geography and Statistics. Men aged 20 to 39 of unknown profession and mixed ethnicity were the most affected. Laboratory diagnosis (82%) and hospital care (67.22%) confirmed satisfactory access to the Unified Health System. Numerical Kriging indicated the highest concentrations of the disease in the Guamá and Jurunas neighborhoods in lower lying areas near canals. The Buffer technique showed higher concentrations of the disease in areas with no domestic solid garbage collection service (26%), sewage (22%), piped water (38%), with unpaved roads (20%) and street flooding (65%). The Moran technique revealed a direct spatial correlation between these variables (p = 0.01543). The general trend showed the decrease of the disease.

Estudo socioepidemiológico e espacial da Leishmaniose tegumentar americana em município do Pará / Socioepidemiologic and spatial study of american cutaneous leishmaniasis in a city of Pará

Objetivo: analisar a distribuição espaço-temporal da Leishmaniose Tegumentar Americana ? LTA, no município deAugusto Corrêa, e a relação com variáveis ambientais e socioeconômicas. Método: Estudo transversal, retrospectivoe ecológico, em uma amostra de 74 pacientes. A fonte dos dados primários foia Secretaria Municipal de Saúde deAugusto Corrêa; os dados ambientais, socioeconômicos e epidemiológicos georrefrenciados foramos do laboratóriodegeoprocessamento de dados epidemiológicos do Instituto Evandro Chagas ? IEC, a partir do processo declassificação de imagens de satélite. Para geração dos modelos de integração de informação temáticas foram utilizadasfontes secundárias, como bases de dados cartográficos, imagens brutas de satélite e do Sistema de Informação deAgravos Notificáveis - SINAN. Para o desenvolvimento dos bancos de dados e execução das análises foi utilizada ageoindexação de informações temáticas, geradas em trabalhos de campo e laboratoriais, além de técnicas e métodosgeoestatísticos.Resultados:Aproporcionalidade foi maior na faixa etária de 11 a 34 anos(61,64%),no gêneromasculino (66%) e em indivíduos de cor parda (86%).No período estudado o ano de maior ocorrência de casosfoi 2008. A relação da doença com a ocupação esteve presente em maior frequência nospequenos agricultores,naproporção de (58%). A região de maior predominância foi a rural, onde se observou alto nível de desmatamento(90%).Conclusão:Para este estudo, foi possível observar que as características da frequência da LTA, na área e noperíodo estudado, apresentaram relação com a ocupação com condições socioeconômicas e alterações ambientais.

Objective:To analyze the spatial-temporal distribution of prevalence of american cutaneous leishmaniasis in AugustoCorrêa city, state of Pará, and its relationship with socioeconomic variables. Methods: Cross-sectional, retrospectiveecological study, a final sample of 74 patients was used at work. Primary data sources and records georeferencingof environmental, socioeconomic and epidemiological data were consulted. To develop the model of integratingthematic secondary information sources such as databases cartographic data, satellite imagery and gross SINAN,and information from the Municipal Health For preparation of analyzes were used to geographic index thematicinformation generated was used from and laboratory, and GIS technologies, statistical and epidemiologicaldatabase. Results: Proportion was highest in the age group 11-34 years (61.64%), the year with the highest numberof cases was in 2008, the proportion was higher in males (66%), was observed a relationship of the disease with theoccupation of the patient (58%) cases occurred predominantly in rural (90%), and individuals of mixed ethnicity(86%). Conclusion: According to this study, it was observed that the characteristics of proportion ofamericancutaneous leishmaniasisin the area and during the study period, compared with the present work, socioeconomic and environmental changes

Conhecimentos e hábitos da fotoproteção infantil / Profile and evaluation of knowledge and photoprotection child habits

Objetivo: descrever o perfil socioeconômico e avaliar a prática da fotoproteção em crianças, a partir dos conhecimentos de seus responsáveis, comparando dois centros de atendimento pediátrico de Belém-PA, um público e outro particular. Método: estudo transversal com responsáveis de crianças de seis meses a doze anos de idade, no qual foram aplicados questionários com perguntas sobre dados socioeconômicos, conhecimentos sobre fotoproteção e hábitos de fotopro-teção da criança. Foram utilizados os testes qui-quadrado e G com correção de Williams, sendo significante p<0,05. Resultados: das 191 crianças pesquisadas, foram 58,1% da instituição pública, onde prevaleceram, além das crianças faiodermas (40,3%), os responsáveis com escolaridade média (33,5%) e renda de 1 a 3 salários mínimos mensais (44,5%). Pais e/ou responsáveis que consideraram ser menos necessário o uso do protetor solar também prevaleceram no centro público (42,4%), bem como aqueles que foram informados pela primeira vez sobre o assunto por veículos de comunicação (22,5%). Ainda, foi observada maior frequência do uso do filtro solar no centro particular (19,9%), acrescida pela maior negligência de seu uso (34%) e aplicação de fator de proteção solar minimamente eficaz (21,5%) na instituição pública. Conclusão: não houve diferença estatística significativa entre os centros em conhecimentos so-bre fotoproteção, entretanto, observou-se desigualdade na aplicação desses conceitos, possivelmente influenciada pela menor escolaridade e renda dos pais da instituição pública.

Objective: to describe the socioeconomic profile and evaluate the photoprotection practice in children, based on the knowledge of their parents, comparing two pediatric care centers from Belem-PA, one public and other private. Method: cross-sectional study with guardians of children of six months to twelve years old, in which questionnaires were ap-plied with questions about socioeconomic data, knowledge about sunscreen and photoprotection habits of the child. It were used the chi-square and G with Williams' correction tests, being significant p<0.05. Results: of the 191 children surveyed, 58.1% were of the public institution, where prevailed, besides brown-skin children (40.3%), the parents in mean educational level and income 1-3 minimum wages (44.5%). Parents and/or guardians who considered it be less necessary to use sunscreen also prevailed at the public center (42.4%), as well as those who were informed of the subject for the first time by communication vehicles (22.5%). Still, it was observed higher frequency the use of sunscreen inparticular center (19.9%), increased by greatest neglect of its use (34%) and application sun protection factor minimally effective (21.5%) in the public institution. Conclusion: there was no significant statistical difference between the centers in knowledge of photoprotection, however, there was inequality in the application of these concepts, possibly influenced by lower educational and income of parents of public institution.

Leprosy and pregnancy: detection coefficient and proposal for a new index.

INTRODUCTION: Our study presents a method to generate a novel detection coefficient for the association between leprosy and pregnancy (DCLP). Methods The DCLP was calculated for women from the State of Pará (2007-2009), Brazil. Data were ordered, divided into five equal parts (corresponding to the P20, P40, P60, and P80 percentiles), and classified as low, medium, high, very high, or hyperendemic. RESULTS: Using the new index, we established the DCLP parameters for low (<0.36), medium (0.36-0.69), high (0.70-1.09), very high (1.10-1.50), and hyperendemic (>1.50). CONCLUSIONS: The new DCLP is more appropriate than the overall detection coefficient (DC), which does not take into account the particularities of the interaction between a disease and a specific physiological state.

Analysis of the detection coefficient for the association between leprosy and pregnancy in the integration region of Carajas, State of Para, Brazil

Introduction The association between leprosy and pregnancy is currently poorly understood and has been linked to serious clinical consequences. Methods A retrospective study between 2007 and 2009 was performed in the integration region of Carajás, Brazil on a population of pregnant lepers, with non-lepers of ages 12-49 years serving as the reference population. Results Twenty-nine pregnant lepers were studied during the study period. The detection rates (DRs) for the studied association were 4.7 in 2007, 9.4 in 2008, and 4.3 in 2009. Conclusions The Carajás region presented a medium pattern of endemicity during most of the study period, with a high DR found in 2008. .

Analysis of the detection coefficient for the association between leprosy and pregnancy in the integration region of Carajás, State of Pará, Brazil.

INTRODUCTION: The association between leprosy and pregnancy is currently poorly understood and has been linked to serious clinical consequences. METHODS: A retrospective study between 2007 and 2009 was performed in the integration region of Carajás, Brazil on a population of pregnant lepers, with non-lepers of ages 12-49 years serving as the reference population. RESULTS: Twenty-nine pregnant lepers were studied during the study period. The detection rates (DRs) for the studied association were 4.7 in 2007, 9.4 in 2008, and 4.3 in 2009. CONCLUSIONS: The Carajás region presented a medium pattern of endemicity during most of the study period, with a high DR found in 2008.

Leprosy and pregnancy in the State of Pará: an epidemiological perspective.

INTRODUCTION: A few older publications describe leprosy associated with pregnancy, a situation that has been linked to leprosy exacerbation. This study aimed to describe the detection rate of this association in the State of Pará by county and Integration Region (IR) from 2007 to 2009 via an analysis of socio demographic, epidemiological and operational indices. METHODS: This was a descriptive study using information generated by the SINAN. The Detection Coefficient of the Leprosy and Pregnancy Association (DCLP) epidemiological index was constructed to help interpret the endemicity parameters. The disease was considered hyperendemic when greater than two cases per 10,000 inhabitants were identified. RESULTS: During the study period,149 associations were detected, with 14 hyperendemic counties: seven in 2007, fi ve in 2008 and two in 2009. The Carajás Integrated Region displayed the highest DCLP index in the period. Eldorado dos Carajás had the single highest DCLP index(5.7/10,000 inhabitants, 2008), whereas the DCLP index in Conceição do Araguaia was very high in all three years. However,most counties displayed low or medium DCLP indices. The annual averages were 0.31 DCLP (2007), bass; 0.30 (2008), bass and 0.19 (2009), bass. The average DCLP index was 0.26, which is considered low. Three clusters of medium endemicity were identified by the average DCLP in the study period. CONCLUSIONS: The analyses indicated that the surveillance program is still unsatisfactory in Pará. The interpretation of the endemicity parameters enabled qualitative and quantitative analyses to determine the epidemiological panorama of this association. The identification of high endemicity requires further clarification.

Leprosy and pregnancy in the State of Para: an epidemiological perspective

Introduction A few older publications describe leprosy associated with pregnancy, a situation that has been linked to leprosy exacerbation. This study aimed to describe the detection rate of this association in the State of Pará by county and Integration Region (IR) from 2007 to 2009 via an analysis of sociodemographic, epidemiological and operational indices. Methods This was a descriptive study using information generated by the SINAN. The Detection Coefficient of the Leprosy and Pregnancy Association (DCLP) epidemiological index was constructed to help interpret the endemicity parameters. The disease was considered hyperendemic when greater than two cases per 10,000 inhabitants were identified. Results During the study period, 149 associations were detected, with 14 hyperendemic counties: seven in 2007, five in 2008 and two in 2009. The Carajás Integrated Region displayed the highest DCLP index in the period. Eldorado dos Carajás had the single highest DCLP index (5.7/10,000 inhabitants, 2008), whereas the DCLP index in Conceição do Araguaia was very high in all three years. However, most counties displayed low or medium DCLP indices. The annual averages were 0.31 DCLP (2007), bass; 0.30 (2008), bass and 0.19 (2009), bass. The average DCLP index was 0.26, which is considered low. Three clusters of medium endemicity were identified by the average DCLP in the study period. Conclusions The analyses indicated that the surveillance program is still unsatisfactory in Pará. The interpretation of the endemicity parameters enabled qualitative and quantitative analyses to determine the epidemiological panorama of this association. The identification of high endemicity requires further clarification. .

Perfil epidemiológico de grávidas HIV positivas atendidas em maternidade pública de referência / Profile of pregnant epidemiological answered in HIV positive maternity public reference

Objetivo: descrever o perfil epidemiológico de grávidas infectadas pelo HIV na maior maternidade pública do Norte do Brasil. Método: estudo descritivo, retrospectivo, envolvendo 770 grávidas atendidas na triagem obstétrica da Fundação Santa Casa de Misericórdia do Pará, o período de 2004 a 2010, após análise dos dados obtidos a partir de prontuários, sob os preceitos éticos recomendados. Resultados: a prevalência e a incidência no período foram de 1,87% e 0,40%, respectivamente; a faixa etária predominante entre 18 e 23 anos (42,1%), sendo que 50,4% tinham ensino fundamental incompleto, 68,2% exerciam atividades do lar, 89% eram solteiras e a maioria procedia de municípios com mais de 50 mil habitantes - Belém, 53,9%; Ananindeua, 13,0%; Castanhal 4,8%; Paragominas, 3,6%; Tailândia, 3,5%; Barcarena 3,1%; Marituba, 2,9%; Abaetetuba, 1,8% e São Miguel do Guamá, 0,6%. Conclusão: o conhecimento das variáveis epidemiológicas da maior casuística de grávidas infectadas pelo HIV da Amazônia brasileira, que chegaram à maternidade, permitiu concluir que o perfil de faixa etária, escolaridade, estado civil e ocupação está compatível com os dados nacionais; entretanto, a maior procedência de grávidas de municípios de médio e grande porte opõem-se ao fenômeno da interiorização da epidemia a municípios menores, como se observa no país. Os resultados obtidos vêm reforçar que o Estado do Pará mostrou alta taxa de prevalência da infecção pelo HIV na gravidez, contrapondo-se as demais regiões do país onde há um decréscimo

Objective: to describe the epidemiological profile of HIV-infected pregnant largest public hospital in northern Brazil. Method: a descriptive, retrospective study involving 770 pregnant women attending the obstetrics triage Foundation of Santa Casa de Misericordia of Pará, in the period between 2004 to 2010. After analyzing the data obtained from medical records, under the ethical recommended. Results: the prevalence and incidence in the period were 1.87% and 0.40% respectively, the predominant age group between 18 and 23 years (42.1%), while 50.4% had incomplete primary education, 68 , 2% had home activities, 89% were single and most came from municipalities with over 50,000 inhabitants (Belém, 53.9%; Ananindeua, 13.0%; Castanhal 4.8%; Paragominas, 3.6% ; Thailand, 3.5%, 3.1% Barcarena; Marituba, 2.9%; Abaetetuba, 1.8% and São Miguel do Guama, 0.6%.Conclusion: the knowledge of epidemiological variables of the largest sample of pregnant HIV-infected Brazilian Amazon, which arrived motherhood, concluded that the profile of age, education, marital status and occupation is consistent with national data, however, most merits of pregnant municipalities of medium and large oppose the phenomenon of internalization of the smaller municipalities like epidemic is being observed in país.Os results reinforces the state of Pará, showed high prevalence rate of HIV infection in pregnancy, as opposed to other regions of the country where there is a decrease.

Estudo da situação da hanseníase no estado do Pará / Study of leprosy situation at the Pará state

Objetivo: analisar a situação atual da hanseníase no Pará. Método: estudo transversal de prevalência baseado nasinformações do DATASUS, reunidas retrospectivamente, incluindo-se dados da hanseníase, entre 2004 e 2006, doEstado do Pará. Analisou-se sexo e classe operacional dos casos do período em pacientes entre 15 e 64 anos com registroativo; tabularam-se dados e analisaram-se os resultados paraenses, considerando números municipais, individualmente.Resultados: todos os municípios apresentaram casos de hanseníase, que pode, assim, considerar-se doença universalmentedistribuída no Pará, adensando-se no sul e sudeste paraenses e metrópole belenense, predominando homens entre 20a 49 anos, com apresentação multibacilar. Ressalta-se constatar casos anteriores a 1991 ainda ativos, possível causapara números como os da pequena Sapucaia, que apresentou prevalência de 62% em 2004. Considerações finais: ahanseníase ainda é temor em saúde pública, todavia, paulatinamente, chega-se ao objetivo de manter a incidência dahanseníase inferior a 1/10.000 habitantes.

Objective: to analyze the current leprosy situation at the Pará state. Method: this study is based on information fromDATASUS. Data were gathered in retrospect, being included Pará?s numbers of leprosy between 2004 and 2006. Itwas analyzed sex and operational class of the cases of the period in patients between 15 and 64 years old with activeregistration. Data were tabulated and the Pará?s results were analyzed considering municipal numbers individually.Results: practically all of the municipal districts presented cases of leprosy, which can so be considered universallydistributed disease in Pará with concentration in the states?s south and southeast besides Belém?s metropolis, prevailingmen from 20 to 49 years old with presentation multibacilar. It?s interesting to verify cases previous to 1991 still assets,possible cause to numbers like the small Sapucaia?s ones, which have presented prevalence of 62% in 2004. Finalconsiderations: leprosy is still fear in public health, though gradually the objective of maintaining its prevalenceinferior to 1/10.000 inhabitants is reached.