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Submitted by Maria Creuza Silva (mariakreuza@yahoo.com.br) on 2017-05-02T20:06:45Z No. of bitstreams: 1 artigo 23. 2016.pdf: 1694295 bytes, checksum: cd45fdbac6c4b3b8aab4eaf7e5730c31 (MD5) Made available in DSpace on 2017-05-02T20:06:45Z (GMT). No. of bitstreams: 1 artigo 23. 2016.pdf: 1694295 bytes, checksum: cd45fdbac6c4b3b8aab4eaf7e5730c31 (MD5) This original study describes the intra-urban distribution of cases of leprosy in residents under 15 years old in Salvador, Bahia, Brazil; the study also identifies the environment in which Mycobacterium leprae is being transmitted. The cases were distributed by operational classification, clinical forms, type of contact and the addresses were geo-referenced by neighborhood. Between 2007 and 2011, were reported 145 cases of leprosy in target population living in Salvador, corresponding to detection rates of 6.21, 6.14, 5.58, 5.41 and 6.88/100,000 inhabitants, respectively. The spatial distribution of the disease was focal. Of the 157 neighborhoods of Salvador, 44 (28.6%) notified cases of leprosy and in 22 (50%) of these were detected more than 10 cases per 100,000 inhabitants. The infectious forms were found in 40% of cases. Over 90% of cases had been living in Salvador for more than five years. Overall, 52.6% reported having had contact with another infected individual inside the household and 25% in their social circle. In Salvador, M. leprae transmission is established. The situation is a major concern, since transmission is intense at an early age, indicating that this endemic disease is expanding and contacts extend beyond individual households. Rio de Janeiro

Submitted by Maria Creuza Silva (mariakreuza@yahoo.com.br) on 2015-06-15T12:18:20Z No. of bitstreams: 1 Susan pereira. 2014.pdf: 999330 bytes, checksum: 03b268fd6a09f3f1280c21c0905f57ed (MD5) Made available in DSpace on 2015-06-15T12:18:20Z (GMT). No. of bitstreams: 1 Susan pereira. 2014.pdf: 999330 bytes, checksum: 03b268fd6a09f3f1280c21c0905f57ed (MD5) Previous issue date: 2014-07 OBJETIVO: Investigar las pautas de distribución espacial de la tuberculosis (TB) y la asociación de las condiciones de vida con la incidencia de esta enfermedad en Salvador, estado de Bahía (Brasil). MÉTODOS: Estudio ecológico que tomó el vecindario como unidad de análisis. Se recopilaron datos del Sistema de Información de Enfermedades de Notificación Obligatoria (Sistema de Informação de Agravos de Notificação, SINAN) y el Instituto Brasileño de Geografía y Estadística (Instituto Brasileiro de Geografia e Estatística, IBGE). Se transformaron y suavizaron las tasas de incidencia de la TB. Se aplicó análisis espacial para establecer la autocorrelación espacial y las áreas "conflictivas" de alto y bajo riesgo. Se confirmó la relación entre la TB y las condiciones de vida mediante regresión lineal espacial. RESULTADOS: La incidencia de la TB en Salvador mostró modelos heterogéneos, con tasas mayores en los vecindarios cuyas condiciones de vida eran desfavorables en 1995 y 1996. A lo largo del período de estudio, disminuyó la aparición de nuevos casos de la enfermedad, en particular en los estratos menos privilegiados. En el 2004 y el 2005, ya no se observó la asociación entre TB y condiciones de vida. CONCLUSIONES: La distribución espacial heterogénea de la tuberculosis en Salvador reflejaba anteriormente las desigualdades relacionadas con las condiciones de vida. Las mejoras de dichas condiciones y la atención de salud dirigida a los menos privilegiados pueden haber contribuido a los cambios observados. Washington

Submitted by Maria Creuza Silva (mariakreuza@yahoo.com.br) on 2016-04-28T19:28:05Z No. of bitstreams: 1 Artigo Per nac. Florisneide barreto. 2015.pdf: 753382 bytes, checksum: a8273e5042802f5ed1bd5dd37f765659 (MD5) Made available in DSpace on 2016-04-28T19:28:05Z (GMT). No. of bitstreams: 1 Artigo Per nac. Florisneide barreto. 2015.pdf: 753382 bytes, checksum: a8273e5042802f5ed1bd5dd37f765659 (MD5) Previous issue date: 2015-06 Understanding the transmission dynamics of infectious diseases is important to allow for improvements of control measures. To investigate the spatiotemporal pattern of an epidemic dengue occurred at a medium-sized city in the Northeast Region of Brazil in 2009, we conducted an ecological study of the notified dengue cases georeferenced according to epidemiological week (EW) and home address. Kernel density estimation and space-time interaction were analysed using the Knox method. The evolution of the epidemic was analysed using an animated projection technique. The dengue incidence was 6.918.7/100,000 inhabitants; the peak of the epidemic occurred from 8 February-1 March, EWs 6-9 (828.7/100,000 inhabitants). There were cases throughout the city and was identified space-time interaction. Three epicenters were responsible for spreading the disease in an expansion and relocation diffusion pattern. If the health services could detect in real time the epicenters and apply nimbly control measures, may possibly reduce the magnitude of dengue epidemics. Rio de Janeiro

Submitted by Maria Creuza Silva (mariakreuza@yahoo.com.br) on 2016-05-03T19:16:23Z No. of bitstreams: 1 Art Per Estrang Glória Teixeira. 2015.pdf: 122468 bytes, checksum: 3dcb989942f95a15586f914f11266f5c (MD5) Made available in DSpace on 2016-05-03T19:16:23Z (GMT). No. of bitstreams: 1 Art Per Estrang Glória Teixeira. 2015.pdf: 122468 bytes, checksum: 3dcb989942f95a15586f914f11266f5c (MD5) Previous issue date: 2015-05 BACKGROUND: Currently, knowledge does not allow early prediction of which cases of dengue fever (DF) will progress to dengue hemorrhagic fever (DHF), to allow early intervention to prevent progression or to limit severity. The objective of this study is to investigate the hypothesis that some specific comorbidities increase the likelihood of a DF case progressing to DHF. METHODS: A concurrent case-control study, conducted during dengue epidemics, from 2009 to 2012. Cases were patients with dengue fever that progressed to DHF, and controls were patients of dengue fever who did not progress to DHF. Logistic regression was used to estimate the association between DHF and comorbidities. RESULTS: There were 490 cases of DHF and 1,316 controls. Among adults, progression to DHF was associated with self-reported hypertension (OR = 1.6; 95% CI 1.1-2.1) and skin allergy (OR = 1.8; 95% CI 1.1-3.2) with DHF after adjusting for ethnicity and socio-economic variables. There was no statistically significant association between any chronic disease and progression to DHF in those younger than 15 years. CONCLUSIONS: Physicians attending patients with dengue fever should keep those with hypertension or skin allergies in health units to monitor progression for early intervention. This would reduce mortality by dengue. San Francisco

Submitted by Maria Creuza Silva (mariakreuza@yahoo.com.br) on 2016-05-03T19:16:23Z No. of bitstreams: 1 Art Per Estrang Glória Teixeira. 2015.pdf: 122468 bytes, checksum: 3dcb989942f95a15586f914f11266f5c (MD5) Made available in DSpace on 2016-05-03T19:16:23Z (GMT). No. of bitstreams: 1 Art Per Estrang Glória Teixeira. 2015.pdf: 122468 bytes, checksum: 3dcb989942f95a15586f914f11266f5c (MD5) Previous issue date: 2015-05 BACKGROUND: Currently, knowledge does not allow early prediction of which cases of dengue fever (DF) will progress to dengue hemorrhagic fever (DHF), to allow early intervention to prevent progression or to limit severity. The objective of this study is to investigate the hypothesis that some specific comorbidities increase the likelihood of a DF case progressing to DHF. METHODS: A concurrent case-control study, conducted during dengue epidemics, from 2009 to 2012. Cases were patients with dengue fever that progressed to DHF, and controls were patients of dengue fever who did not progress to DHF. Logistic regression was used to estimate the association between DHF and comorbidities. RESULTS: There were 490 cases of DHF and 1,316 controls. Among adults, progression to DHF was associated with self-reported hypertension (OR = 1.6; 95% CI 1.1-2.1) and skin allergy (OR = 1.8; 95% CI 1.1-3.2) with DHF after adjusting for ethnicity and socio-economic variables. There was no statistically significant association between any chronic disease and progression to DHF in those younger than 15 years. CONCLUSIONS: Physicians attending patients with dengue fever should keep those with hypertension or skin allergies in health units to monitor progression for early intervention. This would reduce mortality by dengue. San Francisco

Submitted by Maria Creuza Silva (mariakreuza@yahoo.com.br) on 2016-05-11T12:44:12Z No. of bitstreams: 1 Art Per Estrang Maria da Conceição Costa. 2015.pdf: 490165 bytes, checksum: 94e2a79e3e1531588a8d42015feb1dcd (MD5) Made available in DSpace on 2016-05-11T12:44:12Z (GMT). No. of bitstreams: 1 Art Per Estrang Maria da Conceição Costa. 2015.pdf: 490165 bytes, checksum: 94e2a79e3e1531588a8d42015feb1dcd (MD5) Previous issue date: 2015-04 Background: Metabolic syndrome (MetS) is a major factor for the occurrence of cardiovascular events. Causal factors for MetS are not well defined or yet unidentified. Preliminary investigations suggest that infections and inflammation may be involved in the etiology of this syndrome. This study aims to estimate the association between the severity of periodontitis (exposure) and MetS (outcome). Methods: A cross-sectional study was conducted with 419 participants recruited from the Diabetes and Hypertensive Treatment Center, Feira de Santana, Bahia, Brazil. After administration of a questionnaire, general and oral clinical examination and laboratory tests were performed. Diagnosis of periodontitis and MetS was performed according to various criteria. The analysis of the effect of periodontitis on MetS used logistic regression analysis with adjustment for confounders. Results: The prevalence of periodontitis was found to be between 34.61% and 55.37%, depending on the classification definitions used, and the prevalence of MetS ranged from 60.86% to 67.06%. In the group with periodontitis, 14.08% had severe and 41.29% had moderate levels of periodontitis. There was an association between severe periodontitis and MetS after adjustment for sex, age, household density, alcoholic beverage consumption, smoking habit, and cardiovascular disease (odds ratioORadjusted_6 = 2.11, 95% confidence interval = 1.01 to 4.40, P = 0.05). Conclusions: The results suggest that periodontitis is associated with MetS, and that MetS prevalence is related to severe periodontitis. Indianapolis

Submitted by Maria Creuza Silva (mariakreuza@yahoo.com.br) on 2012-11-03T06:17:00Z No. of bitstreams: 1 Evaluation Per Intrn 2012.pdf: 149336 bytes, checksum: 0cda3ad50478a32931a19413b7f4a3fe (MD5) Made available in DSpace on 2012-11-03T06:17:00Z (GMT). No. of bitstreams: 1 Evaluation Per Intrn 2012.pdf: 149336 bytes, checksum: 0cda3ad50478a32931a19413b7f4a3fe (MD5) Previous issue date: 2012 Objective. To evaluate Brazil’s public health surveillance system (HSS), identifying its core capacities, shortcomings, and limitations in dealing with public health emergencies, within the context of the International Health Regulations (IHR 2005). Methods. In 2008–2009 an evaluative cross-sectional study was conducted using semistructured questionnaires administered to key informants (municipal, state, and national government officials) to assess Brazilian HSS structure (legal framework and resources) and surveillance and response procedures vis-à-vis compliance with the IHR (2005) requirements for management of public health emergencies of national and international concern. Evaluation criteria included the capacity to detect, assess, notify, investigate, intervene, and communicate. Responses were analyzed separately by level of government (municipal health departments, state health departments, and national Ministry of Health). Results. Overall, at all three levels of government, Brazil’s HSS has a well-established legal framework (including the essential technical regulations) and the infrastructure, supplies, materials, and mechanisms required for liaison and coordination. However, there are still some weaknesses at the state level, especially in land border areas and small towns. Professionals in the field need to be more familiar with the IHR 2005 Annex 2 decision tool (designed to increase sensitivity and consistency in the notification process). At the state and municipal level, the capacity to detect, assess, and notify is better than the capacity to investigate, intervene, and communicate. Surveillance activities are conducted 24 hours a day, 7 days a week in 40.7% of states and 35.5% of municipalities. There are shortcomings in organizational activities and methods, and in the process of hiring and training personnel. Conclusions. In general, the core capacities of Brazil’s HSS are well established and fulfill most of the requisites listed in the IHR 2005 with respect to both structure and surveillance and response procedures, particularly at the national and state levels. Washington

Texto completo: acesso restrito. p. 1391–1395 Submitted by Edileide Reis (leyde-landy@hotmail.com) on 2014-05-13T17:32:29Z No. of bitstreams: 1 Maria G. Teixeira.pdf: 91731 bytes, checksum: b71ab02540fec208ffd773d29978d797 (MD5) Made available in DSpace on 2014-05-13T17:32:29Z (GMT). No. of bitstreams: 1 Maria G. Teixeira.pdf: 91731 bytes, checksum: b71ab02540fec208ffd773d29978d797 (MD5) Previous issue date: 2012 objective To estimate the seroincidence of dengue in children living in Salvador, Bahia, Brazil and to evaluate the factors associated. methods A prospective serological survey was carried out in a sample of children 0–3 years of age. A multilevel logistic model was used to identify the determinants of seroincidence. results The seroprevalence of dengue was 26.6% in the 625 children evaluated. A second survey detected an incidence of 33.2%. Multilevel logistic regression showed a statistically significant association between the seroincidence of dengue and age and the premises index. conclusion In Salvador, the dengue virus is in active circulation during early childhood; consequently, children have heterotypic antibodies and run a high risk of developing dengue haemorrhagic fever, because the sequence and intensity of the three dengue virus serotypes currently circulating in this city are very similar to those that were circulating in Rio de Janeiro, Brazil, in 2008. Therefore, the authors strongly recommend that the health authorities in cities with a similar epidemiological scenario be aware of this risk and implement improvements in health care, particularly targeting the paediatric age groups. In addition, information should be provided to the population and actions should be implemented to combat this vector.

p. 323-328 Submitted by Edileide Reis (leyde-landy@hotmail.com) on 2014-08-12T12:52:43Z No. of bitstreams: 1 Maria da Conceição Nascimento Costa.pdf: 945844 bytes, checksum: 4586d076c0140c61a191e4dc4d7ad3c4 (MD5) Made available in DSpace on 2014-08-12T12:52:43Z (GMT). No. of bitstreams: 1 Maria da Conceição Nascimento Costa.pdf: 945844 bytes, checksum: 4586d076c0140c61a191e4dc4d7ad3c4 (MD5) Previous issue date: 2012 INTRODUCTION: Bacterial meningitis has great social relevance due to its ability to produce sequelae and cause death. It is most frequently found in developing countries, especially among children. Meningococcal meningitis occurs at a high frequency in populations with poor living conditions. This study describes the temporal evolution of bacterial meningitis in Salvador, Brazil, 1995-2009, and verifies the association between its spatial variation and the living conditions of the population. METHODS: This was an ecological study in which the areas of information were classified by an index of living conditions. It examined fluctuations using a trend curve, and the relationship between this index and the spatial distribution of meningitis was verified using simple linear regression. RESULTS: From 1995-2009, there were 3,456 confirmed cases of bacterial meningitis in Salvador. We observed a downward trend during this period, with a yearly incidence of 9.1 cases/100,000 population and fatality of 16.7%. Children aged

p.S298-S308 Submitted by Rigaud Andréa (andrearigaud16@yahoo.com.br) on 2011-10-19T16:56:32Z No. of bitstreams: 1 16.pdf: 295363 bytes, checksum: f0c77acdd87fc98bb07fd1c5e6559364 (MD5) Made available in DSpace on 2011-10-19T16:56:32Z (GMT). No. of bitstreams: 1 16.pdf: 295363 bytes, checksum: f0c77acdd87fc98bb07fd1c5e6559364 (MD5) Previous issue date: 2011 An ecological study was carried out using information zones as units of analysis in order to assess the evolution of socio-spatial inequalities in mortality due to external causes and homicides in Salvador, Bahia State, Brazil, in 2000 and 2006. The Brazilian Institute of Geography and Statistics (Instituto Brasileiro de Geografia e Estatística - IBGE) and the City Health Department (Secretaria Municipal de Saúde) provided the data sources, and causes of death were reviewed and reclassified based on reports from the Institute of Legal Medicine (Instituto Médico Legal). The information zones were classified into four social strata according to income and schooling. The ratio between mortality rates (inequality ratio) was calculated and confirmed a rise of 98.5% in the homicide rate. In 2000, the risk of death due to external causes and murders in the stratum with the worst living conditions was respectively 1.40 and 1.94 times greater than in the reference stratum. In 2006 these figures were 2.02 and 2.24. The authors discuss the implications for inter-sectoral public policies, based on evidence from the study's findings. Rio de Janeiro

p.549-560 Submitted by Rigaud Andréa (andrearigaud16@yahoo.com.br) on 2011-08-31T18:35:53Z No. of bitstreams: 1 repos2010.33.pdf: 1872755 bytes, checksum: 1fe45e21d0eb7a865364818e81a84020 (MD5) Made available in DSpace on 2011-08-31T18:35:53Z (GMT). No. of bitstreams: 1 repos2010.33.pdf: 1872755 bytes, checksum: 1fe45e21d0eb7a865364818e81a84020 (MD5) Previous issue date: 2010 Introduction: In Brazil, deaths by external causes rank first in the mortality statistics. Nevertheless, studies which investigate the relationship between mortality by external causes and race/skin color are scarce. Objectives: To evaluate the relative contribution of race/skin color to the spatial distribution of mortality by homicide in Salvador, state of Bahia, Brazil, in the period 1998 - 2003. Material and Methods: This is a spatial aggregate study including secondary data on 5,250 subjects, using a unit of analysis called the “weighting area” (WA). Annual average death rates by homicide were estimated. The Global and Local Moran Index were used to evaluate the presence of spatial autocorrelation and the Conditional Auto Regressive (CAR) model was employed to evaluate the referred effect, using the R statistical package. Results: Global and Local Moran’s I tests were significant. CAR regression showed that the predicted mortality rate increases when there is a growth in the proportion of black males aged between 15 and 49 years. Geometrically weighted regression (GWR) showed a very small variation of the local coefficients for all predictors. Conclusion: We demonstrated that the interrelation between race, violence and space is a phenomenon which results from a long process of social inequality. Understanding these interactions requires interdisciplinary efforts that contribute to advancement of knowledge that leads to more specific Public Health interventions.

Texto completo: acesso restrito. p.337-384 Submitted by Suelen Reis (suziy.ellen@gmail.com) on 2013-08-28T14:30:56Z No. of bitstreams: 1 journal.pntd.0000699-1.pdf: 110855 bytes, checksum: 3a230212c42a46aeadb2bfab5284c167 (MD5) Approved for entry into archive by Rodrigo Meirelles (rodrigomei@ufba.br) on 2013-10-31T18:00:19Z (GMT) No. of bitstreams: 1 journal.pntd.0000699-1.pdf: 110855 bytes, checksum: 3a230212c42a46aeadb2bfab5284c167 (MD5) Made available in DSpace on 2013-10-31T18:00:19Z (GMT). No. of bitstreams: 1 journal.pntd.0000699-1.pdf: 110855 bytes, checksum: 3a230212c42a46aeadb2bfab5284c167 (MD5) Previous issue date: 2010 Background: The physiopathology of dengue hemorrhagic fever (DHF), a severe form of Dengue Fever, is poorly understood. We are unable to identify patients likely to progress to DHF for closer monitoring and early intervention during epidemics, so most cases are sent home. This study explored whether patients with selected co-morbidities are at higher risk of developing DHF. Methods: A matched case-control study was conducted in a dengue sero-positive population in two Brazilian cities. For each case of DHF, 7 sero-positive controls were selected. Cases and controls were interviewed and information collected on demographic and socio-economic status, reported co-morbidities (diabetes, hypertension, allergy) and use of medication. Conditional logistic regression was used to calculate the strength of the association between the co-morbidities and occurrence of DHF. Results: 170 cases of DHF and 1,175 controls were included. Significant associations were found between DHF and white ethnicity (OR = 4.70; 2.17–10.20), high income (OR = 6.84; 4.09–11.43), high education (OR = 4.67; 2.35–9.27), reported diabetes (OR = 2.75; 1.12–6.73) and reported allergy treated with steroids (OR = 2.94; 1.01–8.54). Black individuals who reported being treated for hypertension had 13 times higher risk of DHF then black individuals reporting no hypertension. Conclusions: This is the first study to find an association between DHF and diabetes, allergy and hypertension. Given the high case fatality rate of DHF (1–5%), we believe that the evidence produced in this study, when confirmed in other studies, suggests that screening criteria might be used to identify adult patients at a greater risk of developing DHF with a recommendation that they remain under observation and monitoring in hospital.

Trabalho completo: acesso restrito, p. 57–64 Submitted by Bruna Lessa (lessbruna@gmail.com) on 2012-06-01T18:46:44Z No. of bitstreams: 1 (47)j.1442-200X.2009.02888.x.pdf: 93247 bytes, checksum: eae034afeb1eea4755b2b8c361cb8ef9 (MD5) Made available in DSpace on 2012-06-01T18:46:44Z (GMT). No. of bitstreams: 1 (47)j.1442-200X.2009.02888.x.pdf: 93247 bytes, checksum: eae034afeb1eea4755b2b8c361cb8ef9 (MD5) Previous issue date: 2010 Background: Over the past decade, strong evidence for an association between maternal periodontitis and low birthweight has started to appear. However, few intervention studies have been proposed for investigating this hypothesis. The aim of this study was to evaluate whether periodontal therapy among pregnant women would reduce the incidence of low birthweight. Methods: A nonrandomized intervention study was performed, with two control groups. The sample comprised 339 pregnant women: 141 in the experimental group (treated for periodontitis), 145 in control group 1 (without periodontitis) and 53 in control group 2 (with untreated periodontitis). The experimental group received periodontal treatment throughout pregnancy, whereas control group 1 was only monitored over the same period. After delivery, birthweight information on the newborns was obtained. The analysis procedures consisted of stratified analysis followed by logistic regression. Results: The frequency of low birthweight among the women with treated periodontitis was 9.22%, while it was 13.10% in the group without periodontal disease. However, the difference was not statistically significant (RR 0.72; 95% CI 0.36–1.45). The occurrence of this outcome in the group with untreated periodontitis (24.53%) was greater than in the other two groups. Conclusion: This suggests that periodontal therapy is a protective factor for birthweight.

Trabalho completo: acesso restrito, p. 527–533 Submitted by Bruna Lessa (lessbruna@gmail.com) on 2012-06-13T20:02:02Z No. of bitstreams: 1 (67)j.1600-0528.2009.00492.x.pdf: 81275 bytes, checksum: 32120d8f09a8d17e3b3052a812ef099d (MD5) Made available in DSpace on 2012-06-13T20:02:02Z (GMT). No. of bitstreams: 1 (67)j.1600-0528.2009.00492.x.pdf: 81275 bytes, checksum: 32120d8f09a8d17e3b3052a812ef099d (MD5) Previous issue date: 2009-12 Starting in the 1990s, several authors sought to investigate the hypothesis that periodontitis during pregnancy may contribute towards the birth of low-weight children. However, this relationship is still not well established. The aim of this study was to evaluate whether this oral infection is associated with this gestational event. Methods: This was a case-control study among 548 puerperae, of whom 164 were the mothers of low-weight live births (case group) and 384 were the mothers of live births of normal gestational weight (control group). They were selected at two public hospital units in two municipalities in the State of Bahia. From interviews and data gathered using live birth cards or birth certificates, information was obtained regarding age, height, previous diseases, marital status, socioeconomic situation, smoking and alcohol use. Mothers who presented at least four teeth on which one or more sites had a probing depth of greater than or equal to 4 mm, clinical attachment loss of greater than or equal to 3 mm and bleeding on probing, at the same site, were deemed to present periodontal disease. The data were analysed by stratification from logistic regression. Results: Periodontal disease was diagnosed in 42.7% of the case group and 30% of the control group. A statistically significant association was found between periodontal disease and low birth weight (unadjusted OR = 1.74; 95% CI: 1.19–2.54), particularly among mothers with low schooling levels (adjusted OR = 2.30; 95% CI: 1.14–4.6). Conclusion: The findings suggest an association between periodontal disease and low birth weight among mothers with low education levels.

p. 7-18 Submitted by Ana Valéria de Jesus Moura (anavaleria_131@hotmail.com) on 2012-01-02T13:03:32Z No. of bitstreams: 1 02.pdf: 328558 bytes, checksum: eb7a1b64b15cc48146e2d52e936f5711 (MD5) Made available in DSpace on 2012-01-02T13:03:32Z (GMT). No. of bitstreams: 1 02.pdf: 328558 bytes, checksum: eb7a1b64b15cc48146e2d52e936f5711 (MD5) Previous issue date: 2009 This article revisits the epidemiology of dengue in Brazil, 25 years after its reemergence in the country, discussing the main determinants and implications for its control. The authors emphasize the clinical and epidemiological peculiarities of this viral disease in Brazil, which leads the world in both the number of cases reported and risk of occurrence of the disease. The article presents the changes occurring in the dengue epidemiological pattern in recent years, like the sudden age shift in the incidence of dengue hemorrhagic fever, and discusses possible associated factors. The article focuses specifically on the epidemic in Rio de Janeiro in 2008, this episode’s impact on the international community, and the fear that the disease could spread to Europe. The authors conclude that the current situation emphasizes the need for the international scientific community to renew its efforts to generate knowledge allowing improvement and progress in the development of new tools and strategies for dengue prevention.

p. 7 Submitted by Ana Valéria de Jesus Moura (anavaleria_131@hotmail.com) on 2011-08-05T14:13:09Z No. of bitstreams: 1 per nac 2009.28.pdf: 169970 bytes, checksum: a5510a8f3b8726d778f5fda3b59ce47a (MD5) Made available in DSpace on 2011-08-05T14:13:09Z (GMT). No. of bitstreams: 1 per nac 2009.28.pdf: 169970 bytes, checksum: a5510a8f3b8726d778f5fda3b59ce47a (MD5) Previous issue date: 2009 OBJECTIVE: Deaths by external causes represent one of the most important challenges for public health and are the second cause of death in Brazil. The aim of this study was to analyze differentials in mortality by external causes according to race/skin color. METHODS: A descriptive study was carried out in Salvador, Northeastern Brazil, using 9,626 cases of deaths by external causes between 1998 and 2003. Data were obtained from the Forensic Medicine Institute and from Instituto Brasileiro de Geografi a e Estatística (Brazilian Institute of Geography and Statistics). The indicator “potential years of life lost” was utilized to identify the existence of differences among age groups, sex groups and race/skin color groups. RESULTS: Deaths by external causes provoked the loss of 339,220 potential years of life, of which 210,000 were due to homicides. Nonwhite individuals died at earlier ages and lost 12.2 times as much potential years of life due to deaths by homicidies than white individuals. Although the nonwhite (black and mixed) population was three times larger than the white population, its number of potential years of life lost was 30 times higher. The population of blacks was 11.4 % smaller than the white population, but its loss of potential years of life was almost three times higher. Even after the adjustment for age, the differences observed in the indicator potential years of life lost/100,000 inhabitants and in the ratios between strata according to race/skin color were maintained. CONCLUSIONS: The results showed differentials in mortality by external causes according to race/skin color in Salvador. The nonwhite population had greater loss of potential years of life, higher average number of years not lived and, on average, they died at an earlier age due to homicides, traffi c accidents an all other external causes.

p. 46-52 Submitted by RI Repositorio (repositorio@ufba.br) on 2011-07-02T14:46:07Z No. of bitstreams: 1 4375-10911-1-PB.pdf: 127493 bytes, checksum: 27b06d0665d7512c4366351144c1c97e (MD5) Made available in DSpace on 2011-07-02T14:46:07Z (GMT). No. of bitstreams: 1 4375-10911-1-PB.pdf: 127493 bytes, checksum: 27b06d0665d7512c4366351144c1c97e (MD5) Previous issue date: 2009 This study evaluated the existence of an association between gingivitis and low birth weight in the municipality of Feira de Santana. A case-control design was used, with a total of 185 women: 53 mothers of live births of low weight (case group) and 132 mothers of live births with normal gestational weight (control group). The existence of an association between gingivitis and low birth weight was evaluated by means of a multivariate logistic regression model that took into consideration other risk factors. The two groups of mothers were comparable with regard to age, height, pregestational weight, smoking, alcohol use, previous diseases, marital status, socioeconomic situation, frequency of tooth brushing, use of dental floss, number of meals per day and visits to the dentist. Logistic regression analysis showed that, among the puerperal women with gingivitis, the chance of having a child with low birth weight was 37% greater than for those without this disease, after adjusting for schooling level, thus indicating the existence of a positive association, albeit without statistical significance. It was concluded that gingivitis is a possible factor associated with low birth weight. Salvador

Texto completo: acesso restrito. p. 380-387 Submitted by Suelen Reis (suziy.ellen@gmail.com) on 2013-10-11T14:04:33Z No. of bitstreams: 1 j.1600-051X.2009.01387.x.pdf: 158976 bytes, checksum: 9c064d93deb2d41d096860deea46907a (MD5) Made available in DSpace on 2013-10-11T14:04:33Z (GMT). No. of bitstreams: 1 j.1600-051X.2009.01387.x.pdf: 158976 bytes, checksum: 9c064d93deb2d41d096860deea46907a (MD5) Previous issue date: 2009 Aim: To evaluate the possible association between periodontitis and nosocomial lower respiratory tract infection (LRTI). Material and Methods: A case–control study was conducted at a General Hospital in Feira de Santana, Bahia, Brazil. The sample consisted of 103 individuals: 22 cases (presence of nosocomial LRTI) and 81 controls (absence of nosocomial LRTI). The diagnosis of periodontitis was based on probing depth, gingival recession, clinical attachment loss and bleeding on probing. The diagnosis of nosocomial LRTI was made in accordance with established medical criteria. Results: Invasive ventilation was much more frequent in cases (95.5%) than in controls (7.4%). An orotracheal tube was used in 81.8% of cases and in 7.4% of controls; bronchoaspiration was suspected in 81.8% of cases and in 6.2% of controls. There was no statistically significant difference in any of the clinical periodontal parameters between cases and controls. The crude odds ratio (OR) value for individuals with periodontitis having LRTI was not statistically significant [ORcrude=1.70; 95% confidence interval:(0.60–4.87)]. After including age, smoking and duration of hospitalization in the logistic regression, the adjusted OR for individuals with periodontitis having LRTI was statistically significant [ORadjusted=3.67 (1.01–13.53); p=0.049]. Conclusions: A marginal association between periodontitis and LRTI was found when smoking, age and length of hospitalization were included as covariates. Patients with LRTI had a high frequency of suspected bronchoaspiration and this could explain the possible association of periodontal disease and LRTI found in this and other studies. Additional studies are needed to further clarify the possible relationship between periodontal disease and LRTI.

p.S4-S4 Submitted by Rigaud Andréa (andrearigaud16@yahoo.com.br) on 2011-10-27T17:54:05Z No. of bitstreams: 1 01.pdf: 47097 bytes, checksum: 1363df893164c3fc9368f23aca82d492 (MD5) Made available in DSpace on 2011-10-27T17:54:05Z (GMT). No. of bitstreams: 1 01.pdf: 47097 bytes, checksum: 1363df893164c3fc9368f23aca82d492 (MD5) Previous issue date: 2009 Rio de Janeiro

Texto completo: acesso restrito. p. 380-387 Submitted by Suelen Reis (suziy.ellen@gmail.com) on 2013-10-11T14:04:33Z No. of bitstreams: 1 j.1600-051X.2009.01387.x.pdf: 158976 bytes, checksum: 9c064d93deb2d41d096860deea46907a (MD5) Made available in DSpace on 2013-10-11T14:04:33Z (GMT). No. of bitstreams: 1 j.1600-051X.2009.01387.x.pdf: 158976 bytes, checksum: 9c064d93deb2d41d096860deea46907a (MD5) Previous issue date: 2009 Aim: To evaluate the possible association between periodontitis and nosocomial lower respiratory tract infection (LRTI). Material and Methods: A case–control study was conducted at a General Hospital in Feira de Santana, Bahia, Brazil. The sample consisted of 103 individuals: 22 cases (presence of nosocomial LRTI) and 81 controls (absence of nosocomial LRTI). The diagnosis of periodontitis was based on probing depth, gingival recession, clinical attachment loss and bleeding on probing. The diagnosis of nosocomial LRTI was made in accordance with established medical criteria. Results: Invasive ventilation was much more frequent in cases (95.5%) than in controls (7.4%). An orotracheal tube was used in 81.8% of cases and in 7.4% of controls; bronchoaspiration was suspected in 81.8% of cases and in 6.2% of controls. There was no statistically significant difference in any of the clinical periodontal parameters between cases and controls. The crude odds ratio (OR) value for individuals with periodontitis having LRTI was not statistically significant [ORcrude=1.70; 95% confidence interval:(0.60–4.87)]. After including age, smoking and duration of hospitalization in the logistic regression, the adjusted OR for individuals with periodontitis having LRTI was statistically significant [ORadjusted=3.67 (1.01–13.53); p=0.049]. Conclusions: A marginal association between periodontitis and LRTI was found when smoking, age and length of hospitalization were included as covariates. Patients with LRTI had a high frequency of suspected bronchoaspiration and this could explain the possible association of periodontal disease and LRTI found in this and other studies. Additional studies are needed to further clarify the possible relationship between periodontal disease and LRTI.

Submitted by Rigaud Andréa (andrearigaud16@yahoo.com.br) on 2011-08-05T01:35:52Z No. of bitstreams: 1 per%20int2008.5[1].pdf: 98754 bytes, checksum: 8c490a100607309924f59974754d3c78 (MD5) Made available in DSpace on 2011-08-05T01:35:52Z (GMT). No. of bitstreams: 1 per%20int2008.5[1].pdf: 98754 bytes, checksum: 8c490a100607309924f59974754d3c78 (MD5) Previous issue date: 2008-10

p. 1-20 Submitted by Rodrigo Meirelles (rodrigomei@ufba.br) on 2011-08-02T20:10:18Z No. of bitstreams: 1 per int2008.2.pdf: 1219009 bytes, checksum: 73ee42ced527f00a859db3e26468aa7d (MD5) Made available in DSpace on 2011-08-02T20:10:19Z (GMT). No. of bitstreams: 1 per int2008.2.pdf: 1219009 bytes, checksum: 73ee42ced527f00a859db3e26468aa7d (MD5) Previous issue date: 2008 Background: The explosive epidemics of dengue that have been occurring in various countries have stimulated investigation into new approaches to improve understanding of the problem and to develop new strategies for controlling the disease. The objective of this study was to evaluate the characteristics of diffusion of the first dengue epidemic that occurred in the city of Salvador in 1995. Methods: The epidemiological charts and records of notified cases of dengue in Salvador in 1995 constituted the source of data. The cases of the disease were georeferenced according to census areas (spatial units) and epidemiological weeks (temporal unit). Kernel density estimation was used to identify the pattern of spatial diffusion using the R-Project computer software program. Results: Of the 2,006 census areas in the city, 1,400 (70%) registered cases of dengue in 1995 and the spatial distribution of these records revealed that by the end of 1995 practically the entire city had been affected by the virus, with the largest concentration of cases occurring in the western region, composed of census areas with a high population density and predominantly horizontal residences compared to the eastern region of the city, where there is a predominance of vertical residential buildings. Conclusion: The pattern found in this study shows the characteristics of the classic process of spreading by contagion that is common to most infectious diseases. It was possible to identify the epicenter of the epidemic from which centrifugal waves of the disease emanated. Our results suggest that, if a more agile control instrument existed that would be capable of rapidly reducing the vector population within a few days or of raising the group immunity of the population by means of a vaccine, it would theoretically be possible to adopt control actions around the epicenter of the epidemic and consequently reduce the incidence of the disease in the city. This finding emphasizes the need for further research to improve the technology available for the prevention of this disease.

p. 1-6 Submitted by Rodrigo Meirelles (rodrigomei@ufba.br) on 2011-07-09T15:51:54Z No. of bitstreams: 1 artigo internac.5.livre 2007.pdf: 674450 bytes, checksum: 4d927177695b0373a94460bbd614eb08 (MD5) Made available in DSpace on 2011-07-09T15:51:54Z (GMT). No. of bitstreams: 1 artigo internac.5.livre 2007.pdf: 674450 bytes, checksum: 4d927177695b0373a94460bbd614eb08 (MD5) Previous issue date: 2007 Background: There is evidence of higher prevalence of asthma in populations of lower socioeconomic status in affluent societies, and the prevalence of asthma is also very high in some Latin American countries, where societies are characterized by a marked inequality in wealth. This study aimed to examine the relationship between estimates of asthma prevalence based on surveys conducted in children in Brazilian cities and health and socioeconomic indicators measured at the population level in the same cities. Methods: We searched the literature in the medical databases and in the annals of scientific meeting, retrieving population-based surveys of asthma that were conducted in Brazil using the methodology defined by the International Study of Asthma and Allergies in Childhood. We performed separate analyses for the age groups 6–7 years and 13–14 years. We examined the association between asthma prevalence rates and eleven health and socio-economic indicators by visual inspection and using linear regression models weighed by the inverse of the variance of each survey. Results: Six health and socioeconomic variables showed a clear pattern of association with asthma. The prevalence of asthma increased with poorer sanitation and with higher infant mortality at birth and at survey year, GINI index and external mortality. In contrast, asthma prevalence decreased with higher illiteracy rates. Conclusion: The prevalence of asthma in urban areas of Brazil, a middle income country, appears to be higher in cities with more marked poverty or inequality.

p. 499-504 Submitted by Suelen Reis (suziy.ellen@gmail.com) on 2014-01-14T11:30:15Z No. of bitstreams: 1 0037-86822007000500002.pdf: 275363 bytes, checksum: 44c7f878f029b923c209a9bc13d53a1c (MD5) Made available in DSpace on 2014-01-14T11:30:15Z (GMT). No. of bitstreams: 1 0037-86822007000500002.pdf: 275363 bytes, checksum: 44c7f878f029b923c209a9bc13d53a1c (MD5) Previous issue date: 2007 Leptospirosis is a zoonotic disease that has emerged to cause epidemics in urban communities in developing countries. However, little is known about the infection in the general population. A seroprevalence survey was performed on a random sample of 1,390 subjects in Salvador, Brazil. Data on environmental and socioeconomic factors were collected. The microagglutination test of serum samples was used to show any prior Leptospira infection. The overall seroprevalence was 12.4%. Among the seropositive individuals, 111 (61%) had high titers for serovars of the Icterohaemorrhagiae serogroup. Seroprevalence increased with age and was similar for males and females. A positive correlation between Leptospira infection and low educational level was found. These findings indicate that a significant proportion of this urban population is exposed to pathogenic Leptospira. Public health actions for leptospirosis control will need to target not only the traditional groups at risk of infection with severe forms of this disease, but also the general population that is at risk.

p.257-262 Submitted by Texeira Ana (atanateixeira@gmail.com) on 2012-10-09T17:59:55Z No. of bitstreams: 1 Macêdo, Taíze Cassia Nascimento de.pdf: 118676 bytes, checksum: 49e5e799d75fe8d3fee1795fb984204a (MD5) Made available in DSpace on 2012-10-09T17:59:55Z (GMT). No. of bitstreams: 1 Macêdo, Taíze Cassia Nascimento de.pdf: 118676 bytes, checksum: 49e5e799d75fe8d3fee1795fb984204a (MD5) Previous issue date: 2006-07 To estimate the prevalence and related aspects of periodontitis in a rural area of the State of Bahia, Brazil, this cross-sectional study was carried out in the village of Matinha dos Pretos, Feira de Santana County, Bahia, among 172 subjects ranging from 20 to 60 years of age. During household visits, a full-mouth periodontal exam was performed on each subject, who also answered a questionnaire about socio-demographic, economic and health-related issues. The factors assessed were plaque index, bleeding on probing index, probing depth, gingival recession or hyperplasia measurements. Clinical attachment loss was also calculated. The multivariate logistic regression method was used to evaluate the relative contribution of these factors to the periodontitis condition. The prevalence of periodontitis was 24.4%. The following factors were all positively associated with the presence of periodontitis: being male (OR = 1.58; 1.00 – 2.53), being 30 years of age or older (OR = 2.80; 1.00 – 7.39), living in a house where there was more than one person per room (OR = 1.53; 0.96 – 2.45), being a cigarette or pipe smoker or ex-smoker (OR = 1.49; 0.92 – 2.39), having a plaque index of over 65% (OR = 2.97; 2.72 – 7.39) and more than four missing teeth (OR = 1.51; 0.82 – 2.78). The authors concluded that socioeconomic and biological factors, especially poor oral hygiene and older age, are positively associated with periodontitis in the rural population of a small village in the county of Feira de Santana, State of Bahia, Brazil. São Paulo

p. 1307-1315 Submitted by Ana Valéria de Jesus Moura (anavaleria_131@hotmail.com) on 2011-12-16T12:46:48Z No. of bitstreams: 1 dengueanddenguehemorrhagic.pdf: 88367 bytes, checksum: 93a1f0404f2787f8b734cdadcd56e11d (MD5) Made available in DSpace on 2011-12-16T12:46:48Z (GMT). No. of bitstreams: 1 dengueanddenguehemorrhagic.pdf: 88367 bytes, checksum: 93a1f0404f2787f8b734cdadcd56e11d (MD5) Previous issue date: 2005 Dengue epidemics account annually for several million cases and deaths worldwide. The high endemic level of dengue fever and its hemorrhagic form correlates to extensive domiciliary infestation by Aedes aegypti and multiple viral serotype human infection. This study analyzed serial case reports registered in Brazil since 1981, describing incidence evolutionary patterns and spatial distribution. Epidemic waves followed the introduction of every serotype (DEN 1 to 3), and reduction in susceptible individuals possibly accounted for decreasing case frequency. An incremental expansion of affected areas and increasing occurrence of dengue fever and its hemorrhagic form with high case fatality were noted in recent years. In contrast, efforts based solely on chemical vector control have been insufficient. Moreover, some evidence demonstrates that educational measures do not permanently modify population habits. Thus, as long as a vaccine is not available, further dengue control depends on potential results from basic interdisciplinary research and intervention evaluation studies, integrating environmental changes, community participation and education, epidemiological and virological surveillance, and strategic technological innovations aimed to stop transmission.

Texto completo: acesso restrito. p. 757-762 Submitted by Suelen Reis (suelen_suzane@hotmail.com) on 2012-12-12T16:42:54Z No. of bitstreams: 1 j.1365-3156.2002.00930.x.pdf: 78052 bytes, checksum: e846d4af256df12f6bd5639fcb3b6a5e (MD5) Made available in DSpace on 2012-12-12T16:42:54Z (GMT). No. of bitstreams: 1 j.1365-3156.2002.00930.x.pdf: 78052 bytes, checksum: e846d4af256df12f6bd5639fcb3b6a5e (MD5) Previous issue date: 2002-09 Serotypes of dengue DEN-1 and DEN-2 have been reported in much of Brazil over the last 15 years, and DEN-3 serotype was only recently detected. This prospective study was conducted in Salvador, a large city in north-east Brazil, where two epidemics were previously recorded (DEN-1 and DEN-2). We obtained the seroprevalence and 1-year incidence of dengue infections in the population of 30 sampling areas of Salvador and analysed the relationship between intensity of viral circulation, standard of living and vector density. High seroprevalence (68.7%) and annual incidence (70.6%) of infection for one or both circulating serotypes (DEN-1 and DEN-2) were found. High rates of transmission were observed in all studied areas, from the highest to the lowest socio-economic status. The mean PI (Premise Index) for Aedes aegypti was 7.4% (range 0.27–25.6%). Even in the areas with the lowest PI (£ 3%) the observed seroincidence was 54.6%. These findings highlighted the existence of a silent epidemic during a period perceived by the Health Services as of low endemicity, indicating the strength and speed of dengue transmission in the city of Salvador.

p.1189-1195 Submitted by Rigaud Andréa (andrearigaud16@yahoo.com.br) on 2011-10-31T19:01:08Z No. of bitstreams: 1 10991.pdf: 60815 bytes, checksum: 7ae865f0c40536fd6df21a1c5d731a44 (MD5) Made available in DSpace on 2011-10-31T19:01:08Z (GMT). No. of bitstreams: 1 10991.pdf: 60815 bytes, checksum: 7ae865f0c40536fd6df21a1c5d731a44 (MD5) Previous issue date: 2002-09 Available techniques for monitoring the health situation have proven insufficient, thus leading to a discussion of the need for their improvement based on new data collection strategies allowing for data use by local health systems. This article presents the methodological basis for a strategy to monitor health problems utilizing demarcated intra-urban spaces called "sentinel areas" to collect fundamental social, economic, behavioral, and biological data for public health that allow for a closer approach to the reality of complex social spaces. The authors present an experience that is being developed in Salvador, Bahia, Brazil, to evaluate the epidemiological impact of an environmental sanitation program. They discuss selection criteria for the areas and the potential uses of this strategy allowing for the rapid utilization of epidemiological resources by health services and the timely application of the results to reorient and enhance health intervention practices. Rio de Janeiro

Submitted by Maria Creuza Silva (mariakreuza@yahoo.com.br) on 2012-06-15T15:10:34Z No. of bitstreams: 1 Paim JS. artigo 1987.pdf: 1025581 bytes, checksum: 43c5e4b92e86e46798d6e4c7e74448bf (MD5) Made available in DSpace on 2012-06-15T15:10:34Z (GMT). No. of bitstreams: 1 Paim JS. artigo 1987.pdf: 1025581 bytes, checksum: 43c5e4b92e86e46798d6e4c7e74448bf (MD5) Previous issue date: 1987 The study reported here,which was conducted in Salvador, Brazil,examines patterns of infant mortality in different portions of that city. Because the available 1980 data on the number of live births were not broken down by reporting zones, the study employs proportional infant mortality (the number of infant deaths as a percentage of all deaths) as an indicator. It also groups the city’s reporting zones into quartiles according to their levels of proportional infant mortality and makes statistical comparisons between these quartiles with respect to various socioeconomic and medical indicators. Washington