Página 29 dos resultados de 1440 itens digitais encontrados em 0.013 segundos

‣ Awareness of eye diseases in an urban population in southern India

Dandona,Rakhi; Dandona,Lalit; John,Rajesh K.; McCarty,Catherine A.; Rao,Gullapalli N.
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2001 Português
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OBJECTIVE: To assess the level of awareness of eye diseases in the urban population of Hyderabad in southern India. METHODS: A total of 2522 subjects of all ages, who were representative of the Hyderabad population, participated in the population-based Andhra Pradesh Eye Disease Study. Of these subjects, 1859 aged >15 years responded to a structured questionnaire on cataract, glaucoma, night blindness and diabetic retinopathy to trained field investigators. Having heard of the eye disease in question was defined as ‘‘awareness’’ and having some understanding of the eye disease was defined as ‘‘knowledge’’. FINDINGS: Awareness of cataract (69.8%) and night blindness (60.0%) was moderate but that of diabetic retinopathy (27.0%) was low, while that of glaucoma (2.3%) was very poor. Knowledge of all the eye diseases assessed was poor. Subjects aged > 30 years were significantly more aware of all eye diseases assessed except night blindness. Multivariate analysis revealed that women were significantly less aware of night blindness (odds ratio (OR) = 0.78; 95% confidence interval (CI) = 0.63-0.97). Education played a significant role in awareness of these eye diseases. Study subjects of upper socioeconomic status were significantly more aware of night blindness (OR = 2.20; 95% CI = 1.29-3.74) and those belonging to upper and middle socioeconomic strata were significantly more aware of diabetic retinopathy (OR = 2.79; 95% CI = 2.19-3.56). Muslims were significantly more aware of cataract (OR = 2.36; 95% CI = 1.84-3.02) and less aware of night blindness (OR = 0.52; 95% CI = 0.42-0.64). The major source of awareness of the eye diseases was a family member/friend/relative suffering from that eye disease. CONCLUSION: These data suggest that there is a need for health education in this Indian population to increase their level of awareness and knowledge of common eye diseases. Such awareness and knowledge could lead to better understanding and acceptance of the importance of routine eye examinations for the early detection and treatment of eye diseases...

‣ The use of models in the estimation of disease epidemiology

Kruijshaar,Michelle E.; Barendregt,Jan J.; Hoeymans,Nancy
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/08/2002 Português
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OBJECTIVE: To explore the usefulness of incidence-prevalence-mortality (IPM) models in improving estimates of disease epidemiology. METHODS: Two artificial and four empirical data sets (for breast, prostate, colorectal, and stomach cancer) were employed in IPM models. FINDINGS: The internally consistent artificial data sets could be reproduced virtually identically by the models. Our estimates often differed considerably from the empirical data sets, especially for breast and prostate cancer and for older ages. Only for stomach cancer did the estimates approximate to the data, except at older ages. CONCLUSION: There is evidence that the discrepancies between model estimates and observations are caused both by data inaccuracies and past trends in incidence or mortality. Because IPM models cannot distinguish these effects, their use in improving disease estimates becomes complicated. Expert opinion is indispensable in assessing whether the use of these models improves data quality or, inappropriately, removes the effect of trends.

‣ Brief introductory guide to agent-based modeling and an illustration from urban health research

Auchincloss,Amy H.; Garcia,Leandro Martin Totaro
Fonte: Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz Publicador: Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/11/2015 Português
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Abstract There is growing interest among urban health researchers in addressing complex problems using conceptual and computation models from the field of complex systems. Agent-based modeling (ABM) is one computational modeling tool that has received a lot of interest. However, many researchers remain unfamiliar with developing and carrying out an ABM, hindering the understanding and application of it. This paper first presents a brief introductory guide to carrying out a simple agent-based model. Then, the method is illustrated by discussing a previously developed agent-based model, which explored inequalities in diet in the context of urban residential segregation.

‣ Estimating human rabies mortality in the United Republic of Tanzania from dog bite injuries

Cleaveland,Sarah; Fèvre,Eric M.; Kaare,Magai; Coleman,Paul G.
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2002 Português
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OBJECTIVE: To make quantitative predictions about the magnitude of underreporting of human rabies deaths in the United Republic of Tanzania. METHODS: Human rabies deaths were estimated by using a series of probability steps to calculate the likelihood of rabies developing after the bite of a suspected rabid dog, incorporating field data on the incidence of animal bite injuries, the accuracy of rabies recognition, the distribution of bite wounds, and post-exposure treatment. FINDINGS: Predicted human rabies mortality was estimated to be (a) 1499 deaths per year (95% confidence interval 891-2238), equivalent to an annual incidence of 4.9 (2.9-7.2) deaths/100 000, when active surveillance data on bite incidence were used, and (b) 193 deaths per year (32-409), corresponding to an annual incidence of 0.62 (0.1-1.32) deaths/100 000, when national bite statistics were used. The annual mean number of rabies deaths officially recorded for the same period was 10.8 (7.7-14.0). CONCLUSION: In the United Republic of Tanzania, cases of rabies in humans have been greatly underreported. Dog bite injuries are an accessible source of epidemiological data that may be used to estimate the public health burden of rabies and to monitor epidemiological trends in developing countries.

‣ Prevalence and patterns of HIV transmitted drug resistance in Guatemala

Avila-Ríos,Santiago; Mejía-Villatoro,Carlos R.; García-Morales,Claudia; Soto-Nava,Maribel; Escobar,Ingrid; Mendizabal,Ricardo; Girón,Amalia; García,Leticia; Reyes-Terán,Gustavo
Fonte: Organización Panamericana de la Salud Publicador: Organización Panamericana de la Salud
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/12/2011 Português
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OBJECTIVE: To assess human immunodeficiency virus (HIV) diversity and the prevalence of transmitted drug resistance (TDR) in Guatemala. METHODS: One hundred forty-five antiretroviral treatment-naïve patients referred to the Roosevelt Hospital in Guatemala City were enrolled from October 2010 to March 2011. Plasma HIV pol sequences were obtained and TDR was assessed with the Stanford algorithm and the World Health Organization (WHO) TDR surveillance mutation list. RESULTS: HIV subtype B was highly prevalent in Guatemala (96.6%, 140/145), and a 2.8% (4/145) prevalence of BF1 recombinants and 0.7% (1/145) prevalence of subtype C viruses were found. TDR prevalence for the study period was 8.3% (12/145) with the Stanford database algorithm (score > 15) and the WHO TDR surveillance mutation list. Most TDR cases were associated with non-nucleoside reverse transcriptase inhibitors (NNRTIs) (83.3%, 10/12); a low prevalence of nucleoside reverse transcriptase inhibitors and protease inhibitors was observed in the cohort (< 1% for both families). Low selection of antiretroviral drug resistance mutations was found, except for NNRTI-associated mutations. Major NNRTI mutations such as K101E, K103N, and E138K showed higher frequencies than expected in ART-naïve populations. Higher literacy was associated with a greater risk of TDR (odds ratio 4.14...

‣ Performance of rubella suspect case definition: implications for surveillance

Oliveira,Solange Artimos de; Camacho,Luiz Antonio Bastos; Pereira,Antonio Carlos de Medeiros; Bulhões,Marília Mattos; Aguas,Angélica Fortes; Siqueira,Marilda Mendonça
Fonte: Faculdade de Saúde Pública da Universidade de São Paulo Publicador: Faculdade de Saúde Pública da Universidade de São Paulo
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2006 Português
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OBJECTIVE: To assess the performance of the rubella suspect case definition among patients with rash diseases seen at primary care units. METHODS: From January 1994 to December 2002, patients with acute rash, with or without fever, were seen at two large primary health care units and at a public general hospital in the municipality of Niterói, metropolitan area of Rio de Janeiro, Brazil. Data from clinical and serologic assessment were used to estimate the positive predictive values of the definition of rubella suspect case from the Brazilian Ministry of Health and other combination of signs/symptoms taking serologic status as the reference. Serum samples were tested for anti-rubella virus IgM using commercially available enzyme immunoassays. Positive predictive values and respective 95% confidence intervals were calculated. RESULTS: A total of 1,186 patients with an illness characterized by variable combinations of rash with fever, arthropathy and lymphadenopathy were studied. Patients with rash, regardless of other signs and symptoms, had 8.8% likelihood of being IgM-positive for rubella. The Brazilian suspect case definition (fever and lymphadenopathy in addition to rash) had low predictive value (13.5%). This case definition would correctly identify 42.3% of the IgM-positive cases...

‣ Spatial analysis of leprosy incidence and associated socioeconomic factors

Cury,Maria Rita de Cassia Oliveira; Paschoal,Vania Del´Arco; Nardi,Susilene Maria Tonelli; Chierotti,Ana Patrícia; Rodrigues Júnior,Antonio Luiz; Chiaravalloti-Neto,Francisco
Fonte: Faculdade de Saúde Pública da Universidade de São Paulo Publicador: Faculdade de Saúde Pública da Universidade de São Paulo
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/02/2012 Português
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OBJECTIVE: To identify clusters of the major occurrences of leprosy and their associated socioeconomic and demographic factors. METHODS: Cases of leprosy that occurred between 1998 and 2007 in São José do Rio Preto (southeastern Brazil) were geocodified and the incidence rates were calculated by census tract. A socioeconomic classification score was obtained using principal component analysis of socioeconomic variables. Thematic maps to visualize the spatial distribution of the incidence of leprosy with respect to socioeconomic levels and demographic density were constructed using geostatistics. RESULTS: While the incidence rate for the entire city was 10.4 cases per 100,000 inhabitants annually between 1998 and 2007, the incidence rates of individual census tracts were heterogeneous, with values that ranged from 0 to 26.9 cases per 100,000 inhabitants per year. Areas with a high leprosy incidence were associated with lower socioeconomic levels. There were identified clusters of leprosy cases, however there was no association between disease incidence and demographic density. There was a disparity between the places where the majority of ill people lived and the location of healthcare services. CONCLUSIONS: The spatial analysis techniques utilized identified the poorer neighborhoods of the city as the areas with the highest risk for the disease. These data show that health departments must prioritize politico-administrative policies to minimize the effects of social inequality and improve the standards of living...

‣ Changes in the AIDS epidemiologic situation in Puerto Rico following health care reform and the introduction of HAART

Báez-Feliciano,Doris V.; Thomas,James C.; Gómez,María A.; Miranda,Sandra; Fernández,Diana M.; Velázquez,Miriam; Ríos-Olivares,Eddy; Hunter-Mellado,Robert F.
Fonte: Organización Panamericana de la Salud Publicador: Organización Panamericana de la Salud
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/02/2005 Português
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OBJECTIVES: To compare the occurrence of AIDS as well as the sociodemographic and clinical profiles of AIDS patients in Puerto Rico before and after the introduction of highly active antiretroviral therapy (HAART) and the privatization of the island’s public health care system. METHODS: We compared the incident AIDS cases for two three-year periods, 1992-1994 and 1998-2000, in four populations: (1) entire United States, (2) Puerto Rico, (3) Bayamón Health Region (located in north-central Puerto Rico, it includes 11 of the island’s 78 municipalities), and (4) an HIV cohort enrolled at the Universidad Central del Caribe (UCC) School of Medicine. The UCC is located in Bayamón, Puerto Rico, within an academic medical complex that houses the teaching hospital (Ramón Ruíz Arnaú University Hospital), the ambulatory health care facilities (Immunology Clinics) for patients with HIV, and administrative buildings. This represents the major government-sponsored health care infrastructure within the Bayamón Health Region. RESULTS: Incident AIDS declined substantially between the two periods in each of the four populations studied. The 48.1% decline in Puerto Rico exceeded the 40.9% decline in the United States. The decline in Puerto Rico likely resulted from increased availability and implementation of HAART and the delivery of health care to HIV/AIDS patients in an integrated fashion within each regional ambulatory clinic. In spite of this improvement...

‣ Socioeconomic differences in the burden of disease in Sweden

Ljung,Rickard; Peterson,Stefan; Hallqvist,Johan; Heimerson,Inger; Diderichsen,Finn
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/02/2005 Português
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OBJECTIVE: We sought to analyse how much of the total burden of disease in Sweden, measured in disability-adjusted life years (DALYs), is a result of inequalities in health between socioeconomic groups. We also sought to determine how this unequal burden is distributed across different disease groups and socioeconomic groups. METHODS: Our analysis used data from the Swedish Burden of Disease Study. We studied all Swedish men and women in three age groups (15-44, 45-64, 65-84) and five major socioeconomic groups. The 18 disease and injury groups that contributed to 65% of the total burden of disease were analysed using attributable fractions and the slope index of inequality and the relative index of inequality. FINDINGS: About 30% of the burden of disease among women and 37% of the burden among men is a differential burden resulting from socioeconomic inequalities in health. A large part of this unequally distributed burden falls on unskilled manual workers. The largest contributors to inequalities in health for women are ischaemic heart disease, depression and neurosis, and stroke. For men, the largest contributors are ischaemic heart disease, alcohol addiction and self-inflicted injuries. CONCLUSION: This is the first study to use socioeconomic differences...

‣ Prevalence and factors associated with nutritional deviations in women in the pre-pregnancy phase in two municipalities of the State of Rio de Janeiro, Brazil

Marano,Daniele; Gama,Silvana Granado Nogueira da; Domingues,Rosa Maria Soares Madeira; Souza Junior,Paulo Roberto Borges de
Fonte: Associação Brasileira de Pós -Graduação em Saúde Coletiva Publicador: Associação Brasileira de Pós -Graduação em Saúde Coletiva
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/03/2014 Português
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OBJECTIVE: To assess the prevalence and potential factors associated with pre-pregnancy nutritional status of women. METHODS: This is a cross-sectional study carried out between December 2007 and November 2008 with 1,535 women in the first trimester of pregnancy and randomly selected in health units of the Brazilian public health system (SUS) in the municipalities of Queimados and Petrópolis in the State of Rio de Janeiro. The diagnosis of nutritional deviations was based on the Body Mass Index, according to the classification of the Institute of Medicine, and the following categories were obtained: underweight, normal weight, overweight and obesity. In the statistical analysis, the multinomial logistic regression model was used and an odds ratio and confidence interval of 95% were estimated. RESULTS: The sample included women between 13 and 45 years. The prevalence of underweight, overweight and obesity were 10, 18 and 11%, respectively. Women living in Queimados, adolescents, women who did not live with a partner and smokers had a higher proportion of low pre-pregnancy weight. There was an association between hypertension, overweight and obesity. Adolescents presented lower chance to overweight and obesity. Living in Queimados reduced the odds of overweight. CONCLUSION: The proportion of pre-pregnancy nutritional deviations was high...

‣ Determinants of homicides in the state of Bahia, Brazil, in 2009

Sousa,Carlos Augusto Moreira de; Silva,Cosme Marcelo Furtado Passos da; Souza,Edinilsa Ramos de
Fonte: Associação Brasileira de Pós -Graduação em Saúde Coletiva Publicador: Associação Brasileira de Pós -Graduação em Saúde Coletiva
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/03/2014 Português
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PURPOSE: To carry out a study of association between socioeconomic and demographic factors and homicides in general population, in the state of Bahia, in 2009. METHODS: This is an ecological study. The data were collected from the database of the Information System about Mortality of the Ministry of Health, from the Brazilian Institute of Geography and Statistics and the Institute of Applied Economic Research. The Global Moran index was calculated for the detection of spatial autocorrelation, and the Local Moran index was calculated for the detection of spatial Clusters. The transformation in the variable answer (homicides rates) was performed and it was shaped using the Conditional Autoregressive Model. RESULTS: The data showed spatial autocorrelation. Two clusters of municipalities with high rates of homicides were identified, one located predominantly in the Greater Metropolitan Region of Salvador and the other in the South Region of Bahia, especially Eunápolis and Lauro de Freitas, which had the highest rates. The Average Residents Variables, local GDP and the Percentage of Illiteracy presented an inverse association with homicide rates, and the variables Firjan's municipal development index of work and income. Enrolment in high school and the Average of Bolsa Família were directly associated. CONCLUSIONS: The urbanization process...

‣ Epidemiology of meningitis due to Haemophilus influenzae type b in children in Bulgaria: a prospective, population-based surveillance study

Kojouharova,Mira; Gatcheva,Nina; Setchanova,Lena; Robertson,Susan E.; Wenger,Jay D.
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/09/2002 Português
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OBJECTIVE: To assess the incidence of meningitis caused by Haemophilus influenzae type b (Hib) among children in Bulgaria and to provide evidence for an informed decision on the use of Hib vaccines in Bulgaria. METHODS: From 1 July 1997 to 31 December 1999, active surveillance for meningitis was conducted in six regions. For children with suspected meningitis, a cerebrospinal fluid (CSF) specimen was sent for cytology, chemistry, latex agglutination testing, culture and sensitivity. FINDINGS: During the 2.5-year study period, surveillance was conducted among 138 249 children aged <5 years - a sample representing 40% of all Bulgarian children in this age group. Overall, 285 children with suspected meningitis were identified. In eight children, clinical symptoms of meningitis resolved rapidly before a CSF specimen could be obtained. Of the remaining 277 children, 121 (44%) were classified as having probable bacterial meningitis on the basis of a CSF examination. An organism was identified for 88 (73%) of the 121 cases with probable bacterial meningitis. There were 21 cases of Hib, giving a mean annual incidence of 6.1 Hib meningitis cases per 100 000 children <5 years; the case-fatality rate was 10%. Nearly 60% of Hib isolates were resistant to one or more antibiotics...

‣ Use of remote sensing and a geographical information system in a national helminth control programme in Chad

Brooker,Simon; Beasley,Michael; Ndinaromtan,Montanan; Madjiouroum,Ester Mobele; Baboguel,Marie; Djenguinabe,Elie; Hay,Simon I.; Bundy,Don A.P.
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/10/2002 Português
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OBJECTIVE: To design and implement a rapid and valid epidemiological assessment of helminths among schoolchildren in Chad using ecological zones defined by remote sensing satellite sensor data and to investigate the environmental limits of helminth distribution. METHODS: Remote sensing proxy environmental data were used to define seven ecological zones in Chad. These were combined with population data in a geographical information system (GIS) in order to define a sampling protocol. On this basis, 20 schools were surveyed. Multilevel analysis, by means of generalized estimating equations to account for clustering at the school level, was used to investigate the relationship between infection patterns and key environmental variables. FINDINGS: In a sample of 1023 schoolchildren, 22.5% were infected with Schistosoma haematobium and 32.7% with hookworm. None were infected with Ascaris lumbricoides or Trichuris trichiura. The prevalence of S. haematobium and hookworm showed marked geographical heterogeneity and the observed patterns showed a close association with the defined ecological zones and significant relationships with environmental variables. These results contribute towards defining the thermal limits of geohelminth species. Predictions of infection prevalence were made for each school surveyed with the aid of models previously developed for Cameroon. These models correctly predicted that A. lumbricoides and T. trichiura would not occur in Chad but the predictions for S. haematobium were less reliable at the school level. CONCLUSION: GIS and remote sensing can play an important part in the rapid planning of helminth control programmes where little information on disease burden is available. Remote sensing prediction models can indicate patterns of geohelminth infection but can only identify potential areas of high risk for S. haematobium.

‣ Methodological aspects of the 1993 Pelotas (Brazil) birth cohort study

Victora,Cesar Gomes; Araújo,Cora Luiza Pavin; Menezes,Ana Maria Batista; Hallal,Pedro Curi; Vieira,Maria de Fátima; Neutzling,Marilda Borges; Gonçalves,Helen; Valle,Neiva Cristina; Lima,Rosangela Costa; Anselmi,Luciana; Behague,Dominique; Gigante,Denis
Fonte: Faculdade de Saúde Pública da Universidade de São Paulo Publicador: Faculdade de Saúde Pública da Universidade de São Paulo
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/02/2006 Português
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This paper describes the main methodological aspects of a cohort study, with emphasis on its recent phases, which may be relevant to investigators planning to carry out similar studies. In 1993, a population based study was launched in Pelotas, Southern Brazil. All 5,249 newborns delivered in the city's hospitals were enrolled, and sub-samples were visited at the ages of one, three and six months and of one and four years. In 2004-5 it was possible to trace 87.5% of the cohort at the age of 10-12 years. Sub-studies are addressing issues related to oral health, psychological development and mental health, body composition, and ethnography. Birth cohort studies are essential for investigating the early determinants of adult disease and nutritional status, yet few such studies are available from low and middle-income countries where these determinants may differ from those documented in more developed settings.

‣ The epidemiologic paradox of low birth weight in Brazil

Silva,Antônio Augusto Moura da; Silva,Leopoldo Muniz da; Barbieri,Marco Antonio; Bettiol,Heloísa; Carvalho,Luciana Mendes de; Ribeiro,Valdinar Sousa; Goldani,Marcelo Zubaran
Fonte: Faculdade de Saúde Pública da Universidade de São Paulo Publicador: Faculdade de Saúde Pública da Universidade de São Paulo
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/10/2010 Português
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OBJECTIVE: To examine whether the low birth weight (LBW) paradox exists in Brazil. METHODS: LBW and cesarean section rates between 1995 and 2007 were estimated based on data from SINASC (Brazilian Live Births Database). Infant mortality rates (IMRs) were obtained using an indirect method that correct for underreporting. Schooling information was obtained from census data. Trends in LBW rate were assessed using joinpoint regression models. The correlations between LBW rate and other indicators were graphically assessed by lowess regression and tested using Spearman's rank correlation. RESULTS: In Brazil, LBW rate trends were non-linear and non-significant: the rate dropped from 7.9% in 1995 to 7.7% in 2000, then increased to 8.2% in 2003 and remained nearly steady thereafter at 8.2% in 2007. However, trends varied among Brazilian regions: there were significant increases in the North from 1999 to 2003 (2.7% per year), and in the South (1.0% per year) and Central-West regions (0.6% per year) from 1995 to 2007. For the entire period studied, higher LBW and lower IMRs were seen in more developed compared to less developed regions. In Brazilian States, in 2005, the higher the IMR rate, the lower the LBW rate (p=0.009); the lower the low schooling rate...

‣ Surveillance for leptospirosis in the Americas, 1996-2005: a review of data from ministries of health

Costa,Federico; Martinez-Silveira,Martha Silvia; Hagan,José E.; Hartskeerl,Rudy A.; Reis,Mitermayer Galvão dos; Ko,Albert Icksang
Fonte: Organización Panamericana de la Salud Publicador: Organización Panamericana de la Salud
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/09/2012 Português
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OBJECTIVE: To characterize current leptospirosis reporting practices in the Americas. METHODS: Information was collected from the official websites of national ministries of health from the Americas region and two international organizations; personal communications; and three international morbidity databases. For all sources other than the morbidity databases, the review was limited to official reports citing clinically suspected and laboratory confirmed leptospirosis cases or deaths during the period 1996-2005. RESULTS: A total of 73 out of 1 644 reports met the selection criteria and were included in the analysis. Published leptospirosis data were available from half of the countries/sovereign territories (24 out of 48), and 18 of them had mandatory notification policies for leptospirosis. The sum of the median number of leptospirosis cases notified annually by the 24 countries/territories was 4 713.5, but just three countries (Brazil, Costa Rica, and Cuba) accounted for 83.1% (3 9cas20 es) of the notifications. Eight (16.7%) countries reported deaths due to leptospirosis. The sum of the median number of deaths reported annually for the eight countries was 380, but 349 (91.8%) were reported by Brazil. CONCLUSIONS: Notification practices in the Americas for leptospirosis are limited. Therefore...

‣ Malaria transmission model for different levels of acquired immunity and temperature-dependent parameters (vector)

Yang,Hyun M
Fonte: Faculdade de Saúde Pública da Universidade de São Paulo Publicador: Faculdade de Saúde Pública da Universidade de São Paulo
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2000 Português
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OBJECTIVE: Describe the overall transmission of malaria through a compartmental model, considering the human host and mosquito vector. METHODS: A mathematical model was developed based on the following parameters: human host immunity, assuming the existence of acquired immunity and immunological memory, which boosts the protective response upon reinfection; mosquito vector, taking into account that the average period of development from egg to adult mosquito and the extrinsic incubation period of parasites (transformation of infected but non-infectious mosquitoes into infectious mosquitoes) are dependent on the ambient temperature. RESULTS: The steady state equilibrium values obtained with the model allowed the calculation of the basic reproduction ratio in terms of the model's parameters. CONCLUSIONS: The model allowed the calculation of the basic reproduction ratio, one of the most important epidemiological variables.

‣ Criteria for priority-setting in health care in Uganda: exploration of stakeholders' values

Kapiriri,Lydia; Norheim,Ole Frithjof
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/03/2004 Português
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OBJECTIVE: To explore stakeholders' acceptance of criteria for setting priorities for the health care system in Uganda. METHODS: A self-administered questionnaire was used. It was distributed to health workers, planners and administrators working in all levels of the Ugandan health care system. It was also distributed to members of the public. Participants were asked how strongly they agreed or disagreed with 18 criteria that could be used to set priorities for allocating health care. A total of 408 people took part . Data were entered and analysed using SPSS statistical software. Predetermined cut-off points were used to rank the criteria into three different categories: high weight (>66% of respondents agreed), average weight (33-66% of respondents agreed) and low weight (<33% of respondents agreed). We also tested for associations between respondents' characteristics and their degree of agreement with the criteria. FINDINGS: High-weight criteria included severity of disease, benefit of the intervention, cost of the intervention, cost-effectiveness of the intervention, quality of the data on effectiveness, the patients age, place of residence, lifestyle, importance of providing equity of access to health care and the community's views. The average-weight criteria included the patient's social status...

‣ Hospitalization rates for pneumococcal disease in Brazil, 2004 - 2006

Novaes,Hillegonda Maria Dutilh; Sartori,Ana Marli Christovam; Soárez,Patricia Coelho de
Fonte: Faculdade de Saúde Pública da Universidade de São Paulo Publicador: Faculdade de Saúde Pública da Universidade de São Paulo
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2011 Português
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OBJECTIVE: To estimate hospitalization rates for pneumococcal disease based on the Brazilian Hospital Information System (SIH). METHODS: Descriptive study based on the Hospital Information System of Brazilian National Health System data from January 2004 to December 2006: number of hospitalizations and deaths for pneumococcal meningitis, pneumococcal sepsis, pneumococcal pneumonia and Streptococcus pneumoniae as the cause of diseases reported in Brazil. Data from the 2003 Brazilian National Household Survey were used to estimate events in the private sector. Pneumococcal meningitis cases and deaths reported to the Notifiable Diseases Information System during the study period were also analyzed. RESULTS: Pneumococcal disease accounted for 34,217 hospitalizations in the Brazilian National Health System (0.1% of all hospitalizations in the public sector). Pneumococcal pneumonia accounted for 64.8% of these hospitalizations. The age distribution of the estimated hospitalization rates for pneumococcal disease showed a "U"-shape curve with the highest rates seen in children under one (110 to 136.9 per 100,000 children annually). The highest hospital case-fatality rates were seen among the elderly, and for sepsis and meningitis. CONCLUSIONS: PD is a major public health problem in Brazil. The analysis based on the SIH can provide an important input to pneumococcal disease surveillance and the impact assessment of immunization programs.

‣ Annual risk of tuberculous infection in the northern zone of India

Chadha,V.K.; Vaidyanathan,P.S.; Jagannatha,P.S.; Unnikrishnan,K.P.; Mini,P.A.
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2003 Português
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OBJECTIVE: To estimate the annual risk of infection with tubercle bacilli in the northern zone of India. METHODS: A community-based cross-sectional tuberculin survey was conducted among children aged 1-9 years who lived in a sample of villages and urban blocks of six selected districts in a defined north zone of India. A two-stage cluster sampling method was used to select rural and urban clusters. A total of 48 624 children in 598 clusters were subjected to tuberculin testing with one tuberculin unit (1 TU) of PPD RT23 stabilized with Tween 80. The maximum transverse diameter of induration was measured about 72 hours after the test. FINDINGS: Among the 48 624 test-read children, 22 064 (45.4%) had a bacille Calmette-Guérin (BCG) scar. On the basis of the frequency distribution of tuberculin reaction size among 25 816 children without a BCG scar, the prevalence of infection with tubercle bacilli was estimated as 10.3%. The annual risk of infection was computed as 1.9%. The proportion of infected children was significantly higher in urban than rural areas. CONCLUSION: The high rate of tuberculous infection in the north zone of India suggests the need for further intensification of tuberculosis control efforts on a sustained and long-term basis.