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      ANÁLISE ESPACIAL DO RISCO DE ADOECIMENTO DA HANSENÍASE EM UM ESTADO DO NORDESTE BRASILEIRO Translated title: SPATIAL ANALYSIS OF THE RISK OF LEPROSY DISEASE IN A NORTHEASTERN BRAZILIAN STATE Translated title: ANÁLISIS ESPACIAL DEL RIESGO DE ENFERMEDAD DE LA LEPRA EN UN ESTADO DEL NORESTE BRASILEÑO

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          Abstract

          Objetivo analisar a distribuição espacial do risco para o adoecimento de hanseníase nos municípios do estado da Paraíba, Brasil. Método trata-se de estudo ecológico de análise espacial. Foram incluídos casos novos de hanseníase residentes na Paraíba, registrados no Sistema de Informação de Agravos de Notificação de 2001 a 2016. Foi realizada análise espacial descritiva nos períodos de 2001-2008 e 2009-2016 do índice composto de indicadores epidemiológico e análise de dependência espacial por meio dos índices de Moran global e local. Resultados foram registrados 12.134 casos novos no período estudado. Identificou-se no primeiro período clusters com classificação alto/alto nas regiões leste, oeste e noroeste. No segundo período, os clusters concentram-se nas regiões leste e sudeste e decresceu no oeste e noroeste. Conclusão o risco para o adoecimento de hanseníase está presente nos municípios da Paraíba. A distribuição espacial é dessemelhante no estado. Ações de vigilância devem ser prioritárias para o controle da endemia.

          Translated abstract

          Objective to analyze the spatial distribution of the risk for leprosy disease in the municipalities of the state of Paraíba, Brazil. Method this is an ecological study of spatial analysis. New cases of leprosy living in Paraíba, registered in the Notifiable Diseases Information System from 2001 to 2016, were included. Descriptive spatial analysis was performed in the periods of 2001-2008 and 2009-2016 of the composite index of epidemiological indicators and spatial dependence analysis through the global and local Moran indices. Results 12,134 new cases were recorded in the period studied. Clusters with high/high classification in the east, west and northwest regions were identified in the first period. In the second period, clusters are concentrated in the east and southeast regions and decreased in the west and northwest. Conclusion the risk for leprosy disease is present in the municipalities of Paraíba. Spatial distribution is dissimilar in the state. Surveillance actions should be a priority for the control of the endemic disease.

          Translated abstract

          Objetivo analizar la distribución espacial del riesgo de enfermedad de la lepra en los municipios del estado de Paraíba, Brasil. Método este es un estudio ecológico del análisis espacial. Se incluyeron nuevos casos de lepra que viven en Paraíba, inscritos en el Sistema de Información sobre Enfermedades Notificabbles de 2001 a 2016. El análisis espacial descriptivo se realizó en los períodos 2001-2008 y 2009-2016 del índice compuesto de indicadores epidemiológicos y análisis de dependencia espacial a través de los índices globales y locales de Moran. Resultados se registraron 12.134 nuevos casos en el período estudiado. En el primer período se identificaron los clusters con clasificación alta/alta en las regiones este, oeste y noroeste. En el segundo período, los clusters se concentran en las regiones este y sureste y disminuyen en el oeste y noroeste. Conclusión el riesgo de enfermedad de la lepra está presente en los municipios de Paraíba. La distribución espacial es diferente en el estado. Las acciones de vigilancia deben ser una prioridad para el control de la enfermedad endémica.

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          Most cited references 25

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          The epidemiological behaviour of leprosy in Brazil.

          The elimination strategy reduced known leprosy prevalence but the detection rate remains high in many countries, including Brazil. The high Brazilian detection rate imposes a limit to the reduction of known prevalence in the short term. The knowledge of time behaviour and spatial distribution of leprosy statistics will contribute to decision making for leprosy control. The numbers of newly diagnosed leprosy cases by region and year from 1980 to 2004, and prevalent cases from 1990 to 2007 were fitted as a parabolic function of time in negative binomial regression models. To detect areas with increased leprosy detection rates we used spatial scan statistics for cases detected from 2005 to 2007 in the three regions where leprosy is still a public health problem. All detection rate series except the one for the south region showed statistically significant regression coefficients for time and time squared, showing an initial increasing trend. Scan statistics detected 29 statistically significant spatial clusters. These clusters cover 789 municipalities with a total of 51,904 cases detected. Time behaviour of the detection rate is probably a result of better access to primary health care. According to spatial scan statistics, Brazil can be divided into highly endemic areas, containing 11.2% of the total Brazilian population, with a mean detection rate in 2007 of 76.4 per 100,000 inhabitants, and areas of much lower endemicity, containing 888% of the population with a mean detection rate of 132. Leprosy is concentrated in a small proportion of the Brazilian population.
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            Phylogenomics and antimicrobial resistance of the leprosy bacillus Mycobacterium leprae

            Leprosy is a chronic human disease caused by the yet-uncultured pathogen Mycobacterium leprae. Although readily curable with multidrug therapy (MDT), over 200,000 new cases are still reported annually. Here, we obtain M. leprae genome sequences from DNA extracted directly from patients’ skin biopsies using a customized protocol. Comparative and phylogenetic analysis of 154 genomes from 25 countries provides insight into evolution and antimicrobial resistance, uncovering lineages and phylogeographic trends, with the most ancestral strains linked to the Far East. In addition to known MDT-resistance mutations, we detect other mutations associated with antibiotic resistance, and retrace a potential stepwise emergence of extensive drug resistance in the pre-MDT era. Some of the previously undescribed mutations occur in genes that are apparently subject to positive selection, and two of these (ribD, fadD9) are restricted to drug-resistant strains. Finally, nonsense mutations in the nth excision repair gene are associated with greater sequence diversity and drug resistance.
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              Stimulation of lactic acid production in chick embryo fibroblasts by serum and high pH in the absence of external glucose

               D Fodge,  H. Rubin (1975)
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                Author and article information

                Journal
                rbaen
                Revista Baiana de Enfermagem
                Rev. baiana enferm.
                Universidade Federal da Bahia (Salvador, BA, Brazil )
                0102-5430
                2178-8650
                2020
                : 34
                Affiliations
                Belo Horizonte Minas Gerais orgnameUniversidade Federal de Minas Gerais Brazil
                ampina Grande Paraíba orgnameUniversidade Federal de Campina Grande Brazil kleanemaria@ 123456yahoo.com.br.
                Picuí Paraíba orgnameInstituto Federal de Educação, Ciência e Tecnologia da Paraíba Brazil
                Article
                S2178-86502020000100352 S2178-8650(20)03400000352
                10.18471/rbe.v34.37902

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

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