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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

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.

INTRODUÇÃO: A força da reemergência do vírus do dengue e a gravidade destas infecções colocaram esta doença na agenda de prioridades das instituições responsáveis pela proteção à saúde das populações. Aspecto importante para a compreensão da epidemiologia do dengue nos dias atuais refere-se ao conhecimento dos padrões da difusão espaço-temporal, entretanto são escassas as investigações que abordam esta questão. Este estudo descreve o processo de difusão do dengue no estado da Bahia, de 1994 a 2000. MÉTODOS: Trata-se de estudo ecológico espaço-temporal, tendo como unidades de análise município, semana epidemiológica, mês, trimestre e ano. Procedeu-se construção da curva de tendência e realizou-se mapeamento seqüencial da ocorrência de dengue por município para o período. RESULTADOS: Foram notificados 164.050 casos de dengue e a introdução desse vírus na Bahia, diferentemente de outros estados, se deu por um município de pequeno porte, constatando-se intermitência temporal e espacial nos registros de casos no início desta epidemia. Contudo, a partir de 1995 o processo de difusão da doença se deu de forma rápida e intensa. O vírus circulou em todas as zonas climáticas do estado o que revela o seu elevado poder de transmissão. A maior intensidade de detecção de casos e expansão territorial foi nas regiões úmidas e semi-úmidas do litoral, ideais para a sobrevivência e proliferação do vetor, e também, por serem mais densamente povoadas. CONCLUSÕES: Hipoteticamente, o padrão espaço-temporal intermitente de detecção de casos observado inicialmente, poderia permitir o controle da progressão da epidemia, caso houvesse ações de combate vetorial estruturadas. INTRODUCTION: The strength of the re-emergence of dengue virus and the severity of these infections put this disease in the priority agenda of the institutions responsible for protecting the health of populations. Important for understanding the epidemiology of dengue nowadays refers to the knowledge of the patterns of spatial-temporal diffusion, though there is few research addressing this issue. This study describes the process of dissemination of dengue in the state of Bahia, from 1994 to 2000. METHODS: This ecological study space-time, with the units of analysis, county, epidemiological week, month, trimester and year. There has been construction of the trend line and has been mapping the sequential occurrence of dengue in the municipality for the period. RESULTS: There were 164,050 reported cases of dengue and the introduction of this virus in Bahia, unlike other states, occurred on a small city, though there is intermittency in spatial and temporal records of cases at the beginning of this epidemic. The virus circulated in all climatic zones fact what highlight its high transmission power. The highest intensity of detection of cases and territorial expansion was in the littoral (zone humid and half-humid) ideal area for the survive of the vector. CONCLUSIONS: Hypothetically, the intermittent space-time pattern initially observed, could have allowed the control of the progression of the epidemic, if structured action to vectorial combat was carried out.

p.139-144 Submitted by Rigaud Andréa (andrearigaud16@yahoo.com.br) on 2011-08-31T19:31:22Z No. of bitstreams: 1 repos2010.36.pdf: 2724068 bytes, checksum: 9db828ca1b59dcb711c55ce32ba8d5c2 (MD5) Made available in DSpace on 2011-08-31T19:31:22Z (GMT). No. of bitstreams: 1 repos2010.36.pdf: 2724068 bytes, checksum: 9db828ca1b59dcb711c55ce32ba8d5c2 (MD5) Previous issue date: 2010-03 INTRODUÇÃO: A força da reemergência do vírus do dengue e a gravidade destas infecções colocaram esta doença na agenda de prioridades das instituições responsáveis pela proteção à saúde das populações. Aspecto importante para a compreensão da epidemiologia do dengue nos dias atuais refere-se ao conhecimento dos padrões da difusão espaço-temporal, entretanto são escassas as investigações que abordam esta questão. Este estudo descreve o processo de difusão do dengue no estado da Bahia, de 1994 a 2000. MÉTODOS: Trata-se de estudo ecológico espaço-temporal, tendo como unidades de análise município, semana epidemiológica, mês, trimestre e ano. Procedeu-se construção da curva de tendência e realizou-se mapeamento seqüencial da ocorrência de dengue por município para o período. RESULTADOS: Foram notificados 164.050 casos de dengue e a introdução desse vírus na Bahia, diferentemente de outros estados, se deu por um município de pequeno porte, constatando-se intermitência temporal e espacial nos registros de casos no início desta epidemia. Contudo, a partir de 1995 o processo de difusão da doença se deu de forma rápida e intensa. O vírus circulou em todas as zonas climáticas do estado o que revela o seu elevado poder de transmissão. A maior intensidade de detecção de casos e expansão territorial foi nas regiões úmidas e semi-úmidas do litoral, ideais para a sobrevivência e proliferação do vetor, e também, por serem mais densamente povoadas. CONCLUSÕES: Hipoteticamente, o padrão espaço-temporal intermitente de detecção de casos observado inicialmente, poderia permitir o controle da progressão da epidemia, caso houvesse ações de combate vetorial estruturadas.

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. 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.

p.87 - 97 Submitted by Neves Antonio (aneves03@hotmail.com) on 2010-11-30T14:14:48Z No. of bitstreams: 1 2003.artigo.3.pdf: 137469 bytes, checksum: b5b532e3d14fcd43c858642df6f1449a (MD5) Approved for entry into archive by Maria Creuza Silva(mariakreuza@yahoo.com.br) on 2010-12-03T22:05:44Z (GMT) No. of bitstreams: 1 2003.artigo.3.pdf: 137469 bytes, checksum: b5b532e3d14fcd43c858642df6f1449a (MD5) Made available in DSpace on 2010-12-03T22:05:44Z (GMT). No. of bitstreams: 1 2003.artigo.3.pdf: 137469 bytes, checksum: b5b532e3d14fcd43c858642df6f1449a (MD5) Previous issue date: 2003 A dinâmica de circulação da vírus da dengue em espaços intra-urbanos de grandes metrópoles e os fatores de risco para esta infecção ainda não são bem conhecidos. Embora esteja estabelecido que a pobreza é um dos determinantes da maioria das doenças infecciosas e parasitárias, no caso da dengue esta ainda é uma questão controversa. Este estudo teve como objetivos descrever a distribuição da soroprevalência e soroincidência de dengue em distintos espaços intra-urbanos de uma grande e complexa cidade do Brasil; e verificar a existência de relação entre a intensidade de circulação viral e as condições de vida da população, bem como com os índices de infestação vetorial. Utilizou-se um desenho de estudo prospectivo de análise ecológica, procedendo-se a inquéritos sorológicos de uma amostra de residentes em 30 distintos espaços da cidade de Salvador – “áreas sentinelas” – selecionados de acordo com diferenças extremas de condições de vida. Os resultados revelaram elevadas soroprevalência (67,7%) e soroincidência (70,6%) para os sorotipos circulantes (DEN-1 e DEN-2), com grande variabilidade nos valores entre as 30 áreas estudadas; reduzida efetividade das medidas de combate vetorial; circulação viral em todo o território da cidade, constatando-se que mesmo adequadas condições de vida não foram capazes de impedir a ocorrência de elevados riscos de transmissão. Brasília-DF

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.

Submitted by Neves Antonio (aneves03@hotmail.com) on 2010-11-30T09:13:23Z No. of bitstreams: 1 2002.artigo 1.pdf: 87074 bytes, checksum: cb8007a166d730b74f45f973e382f573 (MD5) Approved for entry into archive by Maria Creuza Silva(mariakreuza@yahoo.com.br) on 2010-12-02T15:25:29Z (GMT) No. of bitstreams: 1 2002.artigo 1.pdf: 87074 bytes, checksum: cb8007a166d730b74f45f973e382f573 (MD5) Made available in DSpace on 2010-12-02T15:25:29Z (GMT). No. of bitstreams: 1 2002.artigo 1.pdf: 87074 bytes, checksum: cb8007a166d730b74f45f973e382f573 (MD5) Previous issue date: 2002 No atual estágio do conhecimento científico, a única medida de controle disponível para as infecções causadas pelo vírus da dengue é a eliminação do seu principal vetor urbano, o Aedes aegypti. O Brasil há muitas décadas desenvolve programas de combate a este mosquito; entretanto, observa-se desde o início dos anos oitenta uma expansão geográfica da infestação do seu território e circulação progressiva e intensa deste vírus, com registro de grandes epidemias e de transmissão endêmica em diferentes centros urbanos. Esta situação epidemiológica evidencia a existência de dificuldades para o controle destas infecções, razão pela qual o Ministério da Saúde solicitou uma avaliação da efetividade das ações que vinham sendo implementadas na cidade de Salvador pelo atual programa de combate vetorial, sendo o objetivo deste artigo apresentar os resultados deste estudo. Foi utilizado um desenho prospectivo, procedendo-se a inquéritos sorológicos de uma população amostral de indivíduos residentes em 30 distintos espaços da cidade - “áreas sentinelas”. Os resultados revelaram elevadas soroprevalência (67,7%) e soroincidência (70,6%) para os sorotipos circulantes (DEN-1 e DEN-2), com grande variabilidade nos valores entre as 30 áreas estudadas. Verificou-se que a efetividade das medidas de combate vetorial é muito reduzida e, embora tenha sido encontrada uma Fração Prevenível de 29,7 %, mesmo em áreas sentinelas com Índices de Infestação Predial

Desde 1981, o Brasil tem registrado epidemias de dengue de grande magnitude e atualmente circulam simultaneamente dois sorotipos DEN-1 e DEN--2, em mais de 2.700 municípios. Em Salvador - Bahia, situada na Região Nordeste do país, ocorreram duas epidemias nos anos de 1995 e 1996, e posterior endemização da doença. Este estudo analisa a incidência desta virose nesse município, no período de 1995 a 1999, considerando entre outras variáveis, sua distribuição nos Distritos Sanitários e a situação de densidade do Aedes aegypti. Utiliza como fonte de dados registros oficiais de notificação e do programa de combate vetorial da cidade. A taxa de incidência de dengue foi de 691,4 e 393,5 por 100.000 habitantes, respectivamente, em 1995 e 1996, reduziu-se para 65 por 100.000 em 1998. Nos Distritos Sanitários mais carentes, este indicador alcançou valores superiores a 800 por 100.000 habitantes. O Índice de Infestação Predial pelo Aedes chegou a atingir 54,1% em um dos seus bairros. Considerando a importância da reemergência do dengue no mundo os autores discutem os possíveis fatores que condicionaram a introdução do vírus, as suas apresentações epidemiológicas no curso de 4 anos, e a efetividade do programa de combate vetorial. Since 1981, Brazil has registered dengue epidemic and simultaneous circulation of the DEN-1 and DEN-2 serotypes in over 2,700 municipalities. In Salvador- Bahia, located in the Northeastern region of the Country, two epidemic outbreaks occurred in the years of 1995 and 1996, with further endemic spread of the disease. This study analyses the incidence of the virosis within this municipal area, from 1995 to 1999, considering, among other variables, its distribution in the Sanitary Districts and density of Aedes aegypti. Registers of notified cases and the city's Vectorial Control Program were used as data source. The incidence rate of notified cases of dengue in 1995 and 1996, which were 691.4 and 393.5 per 100,000 inhabitants, respectively, decreased to 65 per 100,000 inhabitants in 1998. In the poorer Sanitary Districts, this index reached figures of over 800 per 100,000 inhabitants. The Premise Index for Aedes aegypti reached 54.1% in one of the Districts. Bearing in mind the relevance of the re-emergence of dengue in the world, the authors discuss the possible factors which condition the virus introduction, its epidemiological presentation over the course of four years, and the effectiveness of the vectorial combat (eradication) program.

Submitted by Maria Creuza Silva (mariakreuza@yahoo.com.br) on 2015-04-20T14:02:11Z No. of bitstreams: 1 Dissertação Enny S. Paixão. 2013.pdf: 819378 bytes, checksum: a90381c9f008f3ce0d742397034a7710 (MD5) Approved for entry into archive by Maria Creuza Silva (mariakreuza@yahoo.com.br) on 2015-04-20T14:26:08Z (GMT) No. of bitstreams: 1 Dissertação Enny S. Paixão. 2013.pdf: 819378 bytes, checksum: a90381c9f008f3ce0d742397034a7710 (MD5) Made available in DSpace on 2015-04-20T14:26:08Z (GMT). No. of bitstreams: 1 Dissertação Enny S. Paixão. 2013.pdf: 819378 bytes, checksum: a90381c9f008f3ce0d742397034a7710 (MD5) Com o objetivo de analisar a tendência temporal da mortalidade e letalidade por dengue e identificar fatores associados a esse desfecho no Brasil, realizou-se estudo de série temporal e agregados espaciais dos óbitos por dengue, registrados de 2000 a 2011, utilizando-se como fontes de dados Sistemas Oficiais de Informação. Ano-calendário e município foram unidades de análise. Curvas de tendência temporal das taxas de mortalidade e letalidade foram construídas para o Brasil, Regiões e faixa-etária. Avaliou-se associação entre essas taxas (média em 2008-2011) e indicadores sócio- econômicos e de atenção à saúde, mediante Regressão Binomial Negativa. De 2000 a 2011, a tendência da letalidade por FHD/SCD foi crescente no Brasil (β=0,67; p=0,036), na Região Sudeste (β=1,17; p=0,003) e nos grupos de 0-14 e 15 anos e mais (β=0,48; p=0,03 e β=1,1; p