Search

OBJETIVO: Analisar o padrão espacial das taxas de mortalidade por homicídio em homens com idade de 15 a 49 anos no Estado de Pernambuco, Brasil, nos períodos de 1980 a 1984 e de 1995 a 1998, e identificar conglomerados de violência. MÉTODOS: Os dados sobre mortalidade foram obtidos junto ao Sistema de Informações sobre Mortalidade do Ministério da Saúde. A média das taxas de mortalidade por homicídio foi estimada por município para os dois períodos. O coeficiente de Moran, que varia de - 1 a + 1, foi calculado para explorar a dependência espacial. Um coeficiente positivo indica um conglomerado de valores semelhantes, enquanto que um coeficiente negativo indica a adjacência de valores dessemelhantes. Para localizar os conglomerados de municípios com taxas de homicídio altas e baixas, foi utilizado o indicador local de autocorrelação espacial (LISA). Por último, foi construído o mapa de Moran, que permite identificar os municípios com LISA estatisticamente significativo e, ao mesmo tempo, pode revelar se o agrupamento de municípios tem taxas de homicídio altas ou baixas. RESULTADOS: Os resultados do coeficiente de Moran para os períodos investigados apresentaram valores positivos (0,392 e 0,291, respectivamente) e altamente significativos (P < 0,001). Comparando-se os dois períodos analisados através do mapa de Moran, foi possível observar, no primeiro período, um conglomerado de altas taxas de homicídios predominante na Região da Mata Sul, próxima à Região Metropolitana. No segundo, foram identificados dois conglomerados, um predominantemente urbano, situado na Região Metropolitana, e outro no interior do Estado, no chamado Polígono da Maconha. CONCLUSÕES: O estudo sugere que não são exatamente as condições socioeconômicas as responsáveis pelos conglomerados de homicídios, mas sim a sua associação com o tráfico e o comércio ilícito de drogas.OBJECTIVES: To analyze the spatial distribution of homicide mortality rates among males 15 to 49 years old in the state of Pernambuco, Brazil, for the periods of 1980 to 1984 and 1995 to 1998, and to identify violence clusters. METHODS: Mortality data were obtained from the Brazilian Ministry of Health's Mortality Information System. The mean homicide mortality rate was estimated for each municipality in the state for the two periods. The Moran coefficient was calculated to determine spatial autocorrelation. (The Moran coefficient ranges from -1 to +1, with a positive coefficient indicating a cluster of similar values, and a negative coefficient indicating adjacent dissimilar values.) To identify clusters of municipalities with either high or low homicide mortality rates, the local indicator of spatial association (LISA) was used. Finally, a Moran map was constructed to identify municipalities with statistically significant LISA values and to identify clusters of municipalities with either high or low homicide mortality rates. RESULTS: The Moran coefficient for 1980-1984 was 0.392, and for 1995-1998 it was 0.291 (P < 0.001). In the 1980-1984 period, one cluster of high homicide mortality rates was found in the Mata Sul region of the state, close to the metropolitan region of the state capital, Recife. In the 1995-1998 period, two violence clusters were identified: a predominantly urban one in the Recife metropolitan region, and the other in the state interior, in an area known as the "Marijuana Polygon" (Polígono da Maconha). CONCLUSION: This study suggests that the violence clusters are not the result of the socioeconomic conditions per se, but rather the consequence of the interaction between poor economic conditions and drug trafficking.

OBJETIVO: Analisar o padrao espacial das taxas de mortalidade por homicidio em homens com idade de 15 a 49 anos no Estado de Pernambuco, Brasil, nos periodos de 1980 a 1984 e de 1995 a 1998, e identificar conglomerados de violencia. METODOS: Os dados sobre mortalidade foram obtidos junto ao Sistema de Informacoes sobre Mortalidade do Ministerio da Saude. A media das taxas de mortalidade por homicidio foi estimada por municipio para os dois periodos. O coeficiente de Moran, que varia de - 1 a + 1, foi calculado para explorar a dependencia espacial. Um coeficiente positivo indica um conglomerado de valores semelhantes, enquanto que um coeficiente negativo indica a adjacencia de valores dessemelhantes. Para localizar os conglomerados de municipios com taxas de homicidio altas e baixas, foi utilizado o indicador local de autocorrelacao espacial (LISA). Por ultimo, foi construido o mapa de Moran, que permite identificar os municipios com LISA estatisticamente significativo e, ao mesmo tempo, pode revelar se o agrupamento de municipios tem taxas de homicidio altas ou baixas. RESULTADOS: Os resultados do coeficiente de Moran para os periodos investigados apresentaram valores positivos (0,392 e 0,291, respectivamente) e altamente significativos (P < 0,001). Comparando-se os dois periodos analisados atraves do mapa de Moran, foi possivel observar, no primeiro periodo, um conglomerado de altas taxas de homicidios predominante na Regiao da Mata Sul, proxima a Regiao Metropolitana. No segundo, foram identificados dois conglomerados, um predominantemente urbano, situado na Regiao Metropolitana, e outro no interior do Estado, no chamado Poligono da Maconha. CONCLUSOES: O estudo sugere que nao sao exatamente as condicoes socioeconomicas as responsaveis pelos conglomerados de homicidios, mas sim a sua associacao com o trafico e o comercio ilicito de drogas.

Contribui-se com o sistema de Vigilância Epidemiológica em nível local por meio de análise espacial em razão do predomínio do caráter urbano da hanseníase em nosso meio e por sua distribuição não homogênea - em parte, pela forma de ocupação e transformação do espaço urbano. Trabalha-se o conceito de risco coletivo pela definição de micro-áreas homogêneas mediante o indicador de carência social, verificando-se sua coerência com padrões da distribuição da hanseníase obtidos da base de dados do SINAN para o Município de Olinda no período 1991-96. Para cada estrato, definido segundo níveis semelhantes dos indicadores, foi calculado o coeficiente de detecção médio para o período. Ao exame da associação entre carência social (risco) e coeficiente de detecção de hanseníase obteve-se coeficiente de explicação de 66,1% no modelo multiplicativo, acrescido para 84,3% com a variável renda. Para atender à lógica de intervenção, definiram-se estratos de alto, médio e baixo risco nos distritos sanitários e área programática. A construção desses mapas mostrou-se útil a instrumentalizar o planejamento em nível local. In the State of Pernambuco, Brazil, leprosy has been mainly an urban disease, with an uneven geographical distribution related at least partially to the way urban space has been occupied and transformed. Spatial analysis may thus become an important tool to establish an epidemiological surveillance system for leprosy. Homogeneous micro-areas were defined in the city of Olinda through the integration of two databases, the Population Census and SINAN, and through the use of digital maps and geoprocessing techniques. Census tracts were classified according to a social deprivation index (SDI), and micro-area homogeneity was based on similar values for this indicator. Cluster analysis (K-means) was used to define cut-offs between strata. The same procedure was repeated using the income variable only. When the association was tested between the mean SDI value and the mean leprosy detection rate for the period 1991-1996, the value obtained for r² was 66.1% in the multiplicative model, increasing to 84.3% when the income variable was used. To define different intervention strategies, census tracts were regrouped in three levels of risk: high, moderate, and low. The methodology enabled the identification (within each health district) of groups and/or areas with different risk of leprosy, hence allowing for the definition of control measures.

OBJECTIVE Lymphatic filariasis still represents a major public health problem in the city of Recife. In spite of the fact that previous surveys had already shown high frequency of microfilaraemia in pediatric population, the prevalence of filarial disease and the microfilaraemic pattern of this group were unknown. This paper describes the clinical-epidemiological pattern of filariasis in children and adolescents living in two highly endemic areas of Recife. METHODS The parasitological survey was done through a census carried out between December 1990 and July 1991. Thick drop technique (45 micro l) was performed on a total of 1,464 children and adolescents between the ages of 5 and 14, of whom 967 were submitted to clinical examination. Positive cases had their blood recollected (60 micro l) to measure the microfilaraemic density. RESULTS The microfilaraemia prevalence was 6.4 %. In the age groups of 5 to 9 and 10 to 14 a microfilaraemia prevalence of respectively 4.6% and 8.3% was observed. The microfilaraemic density varied from 3 to 864 microfilariae per 60 microl of blood, there having been no statistically significant difference between the sexes and age groups (p

OBJETIVOS: avaliar o impacto do uso da água de cisternas na ocorrência de episódios diarréicos comparando o número e a duração de episódios entre moradores de domicílios com e sem cisternas, numa mesma área geográfica. MÉTODOS: estudo longitudinal prospectivo aninhado a um estudo de corte transversal com dois grupos de comparação (domicílios com e sem cisternas) realizado, em 21 municípios do Agreste Central de Pernambuco, em 2007. O período de coleta foi de 60 dias, e incluiu 1765 indivíduos. Para análise descritiva utilizou-se modelos mistos hierárquicos, Mann-Whitney e Kaplan-Meyer com nível de significância de 5%. RESULTADOS: entre os 949 indivíduos com cisternas, obteve-se uma redução no risco de ocorrência de episódios diarréicos de 73% quando comparados aos 816 indivíduos sem cisternas (RR=0,27; p

A análise de tendência temporal da obesidade revela riscos crescentes desse agravo em todo o mundo. Este artigo objetiva verificar e comparar as prevalências do sobrepeso e da obesidade em adolescentes masculinos de todos os estados do Brasil, de 1980-2005. Utilizamos o Banco de Dados do Exército Brasileiro com 8.989.508 adolescentes de 17-19 anos de idade. Consideramos como sobrepeso o índice de massa corporal (IMC) entre 25kg/m² e 29,9kg/m², e obesidade como IMC > 30kg/m². Foi verificada tendência crescente da prevalência do sobrepeso e da obesidade, em todos os estados brasileiros, nos anos analisados. Nesse período, o número de adolescentes com sobrepeso aumentou em três vezes e com obesidade em seis vezes. Os valores absolutos de sobrepeso foram maiores que os da obesidade, porém a velocidade de ganho ao longo desse período foi maior para obesidade. Ao analisar a evolução das prevalências por qüinqüênio, observamos que de 1980-2005, à medida que a prevalência do sobrepeso diminuiu, a prevalência da obesidade aumentou em todos os estados brasileiros.

Analysis of the temporal trend in obesity shows the increasing risk posed by this condition worldwide. This article aims to verify and compare the prevalence rates for overweight and obesity in male adolescents in all States of Brazil, from 1980 to 2005. We used the Brazilian Army's database, with 8,989,508 males 17-19 years of age. We defined overweight as body mass index (BMI) from 25 kg/m2 to 29.9 kg/m2 and obesity as BMIor=30 kg/m2. The analysis showed an increasing trend in the prevalence of overweight and obesity in all States of Brazil for the period studied. There was a three-fold increase in adolescents with overweight and a six-fold increase in obesity. The absolute numbers for overweight were higher than for obesity, but the rate of increase over the period was greater for obesity. Analyzing the trend in prevalence rates by five-year period, we observed that from 1980 to 2005, as the prevalence of overweight decreased, that of obesity increased in all States of Brazil.

O objetivo deste estudo foi determinar a prevalência e a tendência temporal do sobrepeso/obesidade em adolescentes brasileiros do sexo masculino. Métodos: Utilizou-se como fonte de informações o Banco de Dados do Exército Brasileiro. Esses dados foram coletados entre 1980 e 2000 e consta de 4.031.297 adolescentes entre 17 e 19 anos de idade. Foram realizados cinco cortes transversais, e quantificou-se a prevalência do sobrepeso/obesidade. Considerou-se sobrepeso o índice de massa corporal (IMC) entre 25 e 29,9 Kg/m2, e obesidade, IMC > 30 Kg/m2(OMS26). Em todos os estados brasileiros, a prevalência de sobrepeso foi maior que a de obesidade, apesar de a velocidade de incremento ter sido mais alta para obesidade. Ao ser comparada a prevalência do início (1980) com a do final do estudo (2000), observou-se, no Brasil, uma razão de prevalência de 2,58 para sobrepeso e de 8,18 para obesidade. As prevalências de sobrepeso/obesidade mostraram curvas ascensionais com tendência temporal crescente. As informações obtidas neste estudo apontam a necessidade de ações concretas para a prevenção de doenças crônicas em adultos jovens brasileiros. The objective of this study was to determine the prevalence and the secular trend of overweight / obesity in adolescents Brazilians of the masculine sex. Methods A Brazilian Army's data bank. Those data were collected among 1980 to 2000, and it consists of 4.031.297 adolescents between 17 and 19 years of age. A cross-sectional study, with five cuts, was performed, and the prevalence of overweight and obesity was quantified. Overweight was considered when the Body Mass Index (BMI) 3 reached between 25 and 29.9 Kg/m² and obesity when the BMI was >30Kg/m²(WHO26). Results:In all the Brazilian states, the overweight prevalence was larger than the one of obesity, in spite of the increment speed to have been higher for obesity. To the prevalece of the beginning to be compared (1980) with the one of the end of the study (2000), it was observed, in Brazil, a reason of prevalência of 2,58 for overweight and of 8,18 for obesity. The prevalece of overweight and obesity shows ascendig curve, with a secular trend. Conclusion: The information obtained in this study points to the necessity of concrete actions to prevent chronic disease in Brazilians young adults. El objetivo de este estudio fué determinar el predominio y la tendencia temporal de sobrepeso / obesidad en brasileños de adolescentes del sexo masculino. Métodos: Se utilizó como fuente de información el banco de datos del Ejército brasileño. Esos datos eran reunido entre 1980 a 2000, y consiste en 4.031.297 adolescentes entre 17 y 19 años de edad. Se realizaron cinco cortes transversales y se cuantificó la prevalencia de sobrepeso/obesidad. Fué considerado sobrepeso el índice de masa corporal (IMC) entre 25 y 29,9 Kg/m2, y la obesidad con el mismo índice IMC > 30 Kg/m2(OMS26). En todos los estados brasileños, el predominio de sobrepeso fué mayor que el de la obesidad, a pesar de la velocidad de incremento haber sido mayor para obesidad. La prevalência del principio ser comparado (1980) con el uno del extremo del estudio (2000), fue observado, en Brasil, una razón de prevalência de 2,58 para sobrepeso y de 8,18 para obesidad. Los predominios de sobrepeso/obesidad muestran curvas ascendentes con tendencia temporal en crecimiento. Conclusión: La informaciones obtenidas en este estudio indican la necesidad de acciones concretas para la prevención de enfermedades crónicas en adultos jóvenes brasileños.

O desafio para redução da prevalência da Hanseníase, endemia de grande importância no cenário brasileiro, tem se fundamentado na descentralização para os serviços de atenção básica. Descreveu-se inicialmente a estruturação e a oferta dos serviços para o atendimento de casos de hanseníase. Em seguida analisou-se a evolução dos indicadores epidemiológicos e operacionais, tomando como referência os períodos pré e pós a municipalização. Por fim, a análise espacial permitiu identificar a distribuição territorial da ocorrência da endemia e analisar o padrão de áreas geográficas construídas segundo o atendimento pelas unidades de saúde e sua evolução. A partir da localização geográfica dos centróides dos setores censitários de residência, e usando técnica de alisamento espacial, com base na estimativa de Kernel, foram construídas áreas de domínio de atendimentos de cada unidade. Após a municipalização, observa-se aumento da detecção e tratamento pelo município, reduzindo a evasão a outros municípios, mudanças no comportamento da demanda, com aumento da clientela referida no uso dos serviços, e alterações importantes nos indicadores epidemiológicos e operacionais. Hansen disease or leprosy is a major endemic disease in Brazil. Well-designed strategies, including decentralization of basic care, are needed to reduce its prevalence. The article begins by describing the structure and supply of services for treating leprosy cases in the country, after which it analyzes the trends in epidemiological and operational indicators, comparing the periods before and after decentralization of services to the municipal (local) level. Finally, spatial analysis allowed identifying the territorial distribution of this endemic and analyzing the pattern of geographic areas according to care provided by health facilities and its evolution. Based on the location of the geographic centers in the census tracts by place of residence, and using spatial smoothing technique based on Kernel estimation, the study constructed domain areas of care for each health facility or unit. Following municipalization of care, there was an increase in the detection and treatment by the municipalities themselves, reducing patient evasion to neighboring counties and causing changes in demand trends, with an increase in use of services by the clientele and important alterations in the epidemiological and operational indicators.

To analyze the spatial distribution of homicide mortality rates among males 15 to 49 years old in the state of Pernambuco, Brazil, for the periods of 1980 to 1984 and 1995 to 1998, and to identify violence clusters.Mortality data were obtained from the Brazilian Ministry of Health's Mortality Information System. The mean homicide mortality rate was estimated for each municipality in the state for the two periods. The Moran coefficient was calculated to determine spatial autocorrelation. (The Moran coefficient ranges from -1 to +1, with a positive coefficient indicating a cluster of similar values, and a negative coefficient indicating adjacent dissimilar values.) To identify clusters of municipalities with either high or low homicide mortality rates, the local indicator of spatial association (LISA) was used. Finally, a Moran map was constructed to identify municipalities with statistically significant LISA values and to identify clusters of municipalities with either high or low homicide mortality rates.The Moran coefficient for 1980-1984 was 0.392, and for 1995-1998 it was 0.291 (P0.001). In the 1980-1984 period, one cluster of high homicide mortality rates was found in the Mata Sul region of the state, close to the metropolitan region of the state capital, Recife. In the 1995-1998 period, two violence clusters were identified: a predominantly urban one in the Recife metropolitan region, and the other in the state interior, in an area known as the "Marijuana Polygon" (Polígono da Maconha).This study suggests that the violence clusters are not the result of the socioeconomic conditions per se, but rather the consequence of the interaction between poor economic conditions and drug trafficking.

Hansen disease or leprosy is a major endemic disease in Brazil. Well-designed strategies, including decentralization of basic care, are needed to reduce its prevalence. The article begins by describing the structure and supply of services for treating leprosy cases in the country, after which it analyzes the trends in epidemiological and operational indicators, comparing the periods before and after decentralization of services to the municipal (local) level. Finally, spatial analysis allowed identifying the territorial distribution of this endemic and analyzing the pattern of geographic areas according to care provided by health facilities and its evolution. Based on the location of the geographic centers in the census tracts by place of residence, and using spatial smoothing technique based on Kernel estimation, the study constructed domain areas of care for each health facility or unit. Following municipalization of care, there was an increase in the detection and treatment by the municipalities themselves, reducing patient evasion to neighboring counties and causing changes in demand trends, with an increase in use of services by the clientele and important alterations in the epidemiological and operational indicators.

Purpose Accurate epidemiological surveillance of leprosy is a matter of international public health concern. It often suffers, however, from potential problems of under-registration of reported cases, particularly in poorer and more socially deprived areas. Such problems also apply in the surveillance of many other communicable or transmissible diseases. We develop a Bayesian model for small-area disease rates that allows for censoring of case detection in suspect districts and can therefore be used to estimate under-reporting of cases in a given study region. Methods Such methods are applied to leprosy incidence in a municipality of Pernambuco State in North Eastern Brazil, using a social deprivation indicator as the basis for considering data from certain districts to be censored. The time period we consider was immediately prior to an extension of the coverage and efficacy of the control program and model predictions concerning under reporting can therefore be compared with more reliable data subsequently collected from the same region. Results The proposed method produces informative estimates of under detection of leprosy cases in the defined study region and these estimates compare well, both in size and in geographical location, with the numbers of cases subsequently detected. Conclusions As illustrated by the application discussed in this article, the proposed model provides a general tool that may be used in spatial epidemiological surveillance situations where the available data is suspected to contain significant under-registrations of cases in certain geographical areas.

OBJETIVO: Analisar a distribuição espacial da hanseníase, identificar áreas de possível sub-registro de casos ou de provável alta transmissão (risco) e verificar a associação dessa distribuição à existência de casos de formas multibacilares. MÉTODOS: O estudo foi realizado em Recife, PE, de acordo com 94 bairros analisados. A fonte de coleta de dados foi o Sistema de Informações sobre Agravos de Notificação do Ministério da Saúde. Foi adotada uma abordagem ecológica com utilização do método bayesiano empírico para suavização local de taxas, a partir de informações de bairros vizinhos por adjacência. RESULTADOS: A ocorrência média anual foi de 17,3% de casos novos em menores de 15 anos (28,3% de formas multibacilares), indicando um processo de intensa transmissão da doença. A análise da distribuição espacial de hanseníase apontou três áreas onde se concentram bairros com taxas de detecção elevadas e que possuem baixa condição de vida. CONCLUSÕES: O emprego do modelo bayesiano, baseado em informações de unidades espaciais vizinhas, permitiu estimar novamente indicadores epidemiológicos. Foi possível identificar áreas prioritárias para o programa de controle de hanseníase no município, tanto pelo elevado número de ocorrências correlacionado à presença de formas multibacilares de doença em menores de 15 anos quanto pela existência de subnotificação.

In Brazil the challenge of meeting the needs of those living in deprived areas has generated discussions on replacing the existing approach to epidemiological surveillance with an integrated public health surveillance system. This new approach would supplant the traditional focus on high-risk individuals with a method for identifying high-risk populations and the areas where these persons live. Given the magnitude of the problem that tuberculosis (TB) poses for Brazil, we chose that disease as an example of how such a new, integrated public health surveillance system could be constructed. We integrated data from several sources with geographic information to create an indicator of tuberculosis risk for Olinda, a city in the Brazilian state of Pernambuco. In order to stratify the urban space in Olinda and to check for an association between the resulting TB risk gradient and the mean incidence of the disease between 1991 and 1996, we applied two different methods: 1) a "social deprivation index" and 2) principal component analysis followed by cluster analysis. Our results showed an association between social deprivation and the occurrence of TB. The results also highlighted priority groups and areas requiring intervention. We recommend follow-up that would include treating acid-fast bacilli smear-positive pulmonary TB cases, tracing of these persons' contacts, and monitoring of multidrug-resistant cases, all in coordination with local health services.

Neste artigo, discute-se o eixo metodológico utilizado na construção de modelo de vigilância de endemias em áreas urbanas, orientado por uma análise de situações de risco e por indicadores epidemiológicos espaciais. São apresentadas as premissas básicas do modelo, os critérios de seleção de variáveis sócio-econômicas e as etapas metodológicas necessárias na construção do indicador sintético de risco. Comenta-se, também, como algumas questões operacionais relativas à construção de mapas digitais de setores censitários e vinculação de bancos de dados foram equacionadas. Essa abordagem, incorporando o componente da organização do espaço na vigilância de doenças endêmicas, tendo como exemplo a hanseníase e a tuberculose, privilegia o uso integrado de sistemas de informação já existentes, na perspectiva de estratificar áreas urbanas diferenciadas que permite discriminar riscos desiguais para ocorrência de endemias. Essa é uma ferramenta para o planejamento e o gerenciamento das ações voltadas para o controle das endemias nas cidades. In this article we discuss the methodological issues associated with the creation of a surveillance system for endemic diseases in urban areas based on analysis of populations at risk and on spatially referenced epidemiological indicators. We comment on the system's basic requirements, selection criteria for socioeconomic variables, and methodological steps to combine these variables so as to construct a census-based deprivation index. We also present the ways we solved some operational problems related to generation of digitized census tracts maps and linkage of morbidity data from different sources. This approach, spatial organization into account in surveillance of endemic diseases, exemplified here by tuberculosis and leprosy, allows for the interaction of several official data sets from census and health services in order to geographically discriminate inner-city risk strata. Criteria for constructing these risk strata were considered a useful tool for health planning and management activities for the control of endemic diseases in cities.

A group of youngsters (4-18 years old) in northeast Brazil was studied to establish the prevalence of anaemia and intestinal parasitism, as well as to analyze the correlation between them. Two criteria were used to determine the state of anaemia, the level of haemoglobin and the mean of corpuscular volume. The first was considered a single criterion and the second an associated criteria, used in an attempt to correlate anaemia with iron deficiency. The prevalence of intestinal parasitism was 93%, while the prevalence of anaemia was 43.1% and 16.1% according to the criteria employed (single or associated respectively). Anaemia was significantly associated with both sex and age. No significant statistical difference was observed when the association was made between each parasite and anaemia even with those more related to anaemia.

Wuchereria bancrofti in Pernambuco was first documented in 1952 (Azevedo & Dobbin 1952), and since then it has been reported in surveys carried out in selected areas of Recife. Several surveys were carried out from 1981 to 1991 by SUCAM. In the 1985 SUCAM's report the disease is considered under control. The CPqAM Filariasis Research Program was established in 1985 and a filarial survey was carried out in the town of Olinda, Greater Recife. In order to verify the real epidemiological situation, a study was conducted in the city of Recife. 21/36 of the Special Zones of Social Interest (ZEIS), were randomly selected for the present study. From 10,664 persons screened, 683 were positive and the prevalence rate for microfilaraemia (mf) varied from 0.6% to 14.9%. A mean mf prevalence of 6.5%, showed that the infection occurs in a wide geographic distribution in Greater Recife and that the intensity of transmission is a real and potential threat to public health in affected communities. Mf rate among males and females differed significantly. Due to the rapid increase in population, unplanned urban settlements, poor sanitary facilities and the favorable geographical conditions to the development of the vector, filariasis may actually be increasing in Recife.

Background Lack of access to safe and secure water is an international issue recognized by the United Nations. To address this problem, the One Million Cisterns Project was initiated in 2001 in Brazil’s semi-arid region to provide a sustainable source of water to households. The objectives of this study were to determine the 30-day period prevalence of diarrhoea in individuals with and without cisterns and determine symptomology, duration of illness and type of health care sought among those with diarrhoea. A subgroup analysis was also conducted among children less than five years old. Methods A face-to-face survey was conducted between August 20th and September 20th, 2007 in the Agreste Central Region of Pernambuco State, Brazil. Households with and without a cistern that had at least one child under the age of five years were selected using systematic convenient sampling. Differences in health outcomes between groups were assessed using Pearson’s Chi-squared and two-way t-tests. Demographic variables were tested for univariable associations with diarrhoea using logistic regression with random effects. P-values of 0.05 or less were considered statistically significant. Results A total of 3679 people from 774 households were included in the analysis (1863 people from 377 households with cisterns and 1816 people from 397 households without cisterns). People from households with a cistern had a significantly lower 30-day period prevalence of diarrhoea (prevalence = 11.0%; 95% CI 9.5-12.4) than people from households without a cistern (prevalence = 18.2%; 95% CI 16.4-20.0). This significant difference was also found in a subgroup analysis of children under five years old; those children with a cistern had a 30-day period prevalence of 15.6% (95% CI 12.3-18.9) versus 26.7% (95% CI 22.8-30.6) in children without a cistern. There were no significant differences between those people with and without cisterns in terms of the types of symptoms, duration of illness and health care sought for diarrhoea. Conclusions Our results indicate that the use of cisterns for drinking water is associated with a decreased occurrence of diarrhoea in this study population. Further research accounting for additional risk factors and preventative factors should be conducted.