Hermano Gomes Albuquerque

Since 2015, there has been a renewed global commitment to malaria elimination. Understanding the dynamics of the disease in regions with declining cases is essential to prevent reintroduction. This study aims to analyze the epidemiological indicators of malaria in Maranhao, a Brazilian state with a significant decline in cases. This is a descriptive, retrospective, and ecological study, with data from the malaria surveillance system, from 2003 to 2022. Demographic, spatial, temporal, and parasitological variables were analyzed. During this period, 83,517 malaria cases were reported, of which 67.8% were autochthonous, and among these, 83.1% occurred in rural areas. The Annual Parasitic Incidence (API) has recently been considered low risk in most municipalities. The analysis of seasonality was important at the beginning of the series, but with the reduction of cases, it lost relevance. The epidemiological profile has shifted, with an increase in imported cases initially from abroad and more recently from other Brazilian states. There was also a significant reduction in the proportion of P. falciparum, from 17.7% in 2003 to 6.01% in 2022. Most infected individuals were male, predominantly aged 15 to 45 years, of which increased from 59.1% to 70.5%. Although the overall trend is downward, recent changes in the disease profile are concerning, as they could reverse progress and cause a new rise in cases in a state close to elimination. Surveillance must be strengthened and adapted to prevent the reintroduction and resurgence of endemic transmission.

BACKGROUND The malaria control strategy of the Brazilian Ministry of Health involves the classification of transmission contexts into special areas based on the distinct determinants of malaria in each location.

Brazilian garimpeiros are a highly hard-to-reach and mobile population, with little access to basic hygiene and health services, and have been crossing the border to work irregularly in gold mines in French Guiana since the 1990s. This study aimed to characterize this population and identify their main health problems. A cross-sectional study was carried out in the municipality of Oiapoque-AP, with two surveys: before (2018) and after (2019) the implementation of Malakit. Individuals were recruited from resting places and given a questionnaire regarding demographic variables, history and knowledge of malaria, and health issues in the mines. Simultaneously, a clinical evaluation was performed. The garimpeiros were mainly men from Maranhão, Pará, and Amapá, with a low educational level and who had worked on average for 10 years in the mining sites. The study population mentioned numerous health problems: malaria, followed by leishmaniasis, flu, body aches, headaches, and digestive problems. Other diseases mentioned were skin diseases, bat bites, hepatitis, and HIV infection. This vulnerable population is constantly subjected to heavy routines and exposed to different diseases and infections that can spread across borders. Knowledge of this is essential for developing public health policies that can be integrated into specific epidemiological situations.

Brazilian garimpeiros are a highly hard-to-reach and mobile population, with little access to basic hygiene and health services, and have been crossing the border to work irregularly in gold mines in French Guiana since the 90s. This study aimed to characterize this population and identify their main health problems. A cross-sectional study was carried out in the municipality of Oiapoque-AP, with two surveys: before (2018) and after (2019) the implementation of Malakit. Individuals were recruited from resting places and submitted to a questionnaire with demographic variables, history and knowledge of malaria, and health issues in the mines. Simultaneously, a clinical evaluation was performed. The garimpeiros were mainly men from Maranhão, Pará, and Amapá, with a low educational level and worked on average for 10 years in the mining sites. The study population mentioned numerous health problems: malaria, followed by leishmaniasis, flu, body aches, headaches, and digestive problems. Other diseases mentioned were skin diseases, bat bites, hepatitis, and HIV infection. This vulnerable population is constantly subjected to heavy routines and exposed to different diseases and infections that can spread across borders. Knowledge of this is essential for developing public health policies that can be integrated into specific epidemiological situations.

OBJETIVO: Apresentar a metodologia de estratificação das arboviroses urbanas (dengue, zika e chikungunya) pelo índice de receptividade territorial, instrumento de vigilância e controle dessas doenças que considera a heterogeneidade territorial intramunicipal. MÉTODOS: Estudo ecológico que utiliza como unidade de análise as áreas de abrangência dos centros de saúde de Belo Horizonte (MG). Para a construção do índice de receptividade territorial foram selecionados indicadores de determinação socioambiental das arboviroses urbanas a fim de integrar à análise de componentes principais. As componentes resultantes foram ponderadas por análise de processos hierárquicos (AHP) e agregadas por meio de álgebra de mapas. RESULTADOS: O índice de receptividade territorial evidenciou grande heterogeneidade das condições de infraestrutura urbana. As áreas classificadas como alta e muito alta receptividade correspondem a aproximadamente 33% da área ocupada e se concentram sobretudo nas regiões de planejamento administrativo Leste, Nordeste, Norte, Oeste e Barreiro, principalmente em áreas limítrofes do município. Quando sobrepostas à densidade de casos de dengue e de ovos de Aedes em 2016, a estratificação pelo índice de receptividade territorial às arboviroses urbanas demonstra que áreas de muito alta receptividade apresentam uma densidade de casos, bem como de ovos de Aedes superior àquela observada nas demais áreas da cidade, o que corresponde a um percentual bastante reduzido do território municipal (13,5%). CONCLUSÕES: As análises indicam a necessidade do desenvolvimento de ações de vigilância e controle adequadas para cada contexto, superando, assim, a lógica de alocação homogênea em todo o território.

O objetivo deste trabalho foi apresentar a proposta metodológica denominada de “Pronta Resposta” modelada nas cidades de Belo Horizonte (Minas Gerais) e Natal (Rio Grande do Norte), Brasil. A metodologia visa identificar e delimitar áreas prioritárias para o direcionamento das ações de vigilância em tempo oportuno, buscando a redução da intensidade e velocidade da dispersão de epidemias em áreas urbanas endêmicas. Para tanto, a metodologia utiliza três variáveis, que representam as causas necessárias para a produção e reprodução da dengue: casos notificados (vírus), ovos de Aedes (vetor) e população (hospedeiro). Trata-se de um estudo ecológico que utilizou os dados dos três planos de informações agregados em escalas temporais e espaciais mais finas, de três a quatro semanas e grades de 400 a 600 metros respectivamente. As áreas de pronta resposta foram definidas por meio de análise estatística de varredura Scan, com definição de clusters espaciais simultâneos para os três planos por meio do programa SaTScan. Os resultados observados foram: na cidade de Natal, as áreas definidas como pronta resposta ocuparam em média 15,2% do território do município e concentraram 67,77% dos casos de dengue do período posterior ao utilizado na delimitação das áreas de pronta resposta, e em Belo Horizonte, os números observados foram de 64,16% dos casos em 23,23% do território. Esses resultados foram obtidos em duas cidades com realidades socioambientais e geográficas diferentes e com perfis epidemiológicos também distintos, apontando que a metodologia pode ser aplicada em diferentes realidades urbanas, criando a possibilidade de os programas de controle atuarem em porções reduzidas do território e impactar num alto percentual de casos em tempo oportuno.

Haiti is one of the Caribbean countries where malaria persists. More than 99% of malaria cases are caused by Plasmodium falciparum, the main vector being the mosquito Anopheles albimanus. In this paper, we describe the epidemiological profile of malaria in Haiti between 2009 and 2018. We analyzed information on cases reported by the Ministry of Health of Haiti and the World Health Organization (WHO). Between 2009 and 2018, 232,479 malaria cases were reported by the Ministry of Public Health and Population (MSPP); an increase in the incidence of malaria in the country in 2010, followed by a decrease in 2011, was primarily observed. Due to recent efforts to reduce malaria by 2020, its incidence declined from 60,130 cases in 2010 to 8,978 cases in 2018. Controversially, in terms of the number of reported cases, the MSPP and WHO report conflicting data. However, the results from both datasets present the same trend in Haiti from 2009 to 2018. The results also illustrate the endemicity of the disease throughout Haiti, both in rural and urban areas, especially along the coast. This study emphasizes the need to promote official data collection and analyses, as well as the application of epidemiological surveillance of malaria at the municipal level, for a better understanding of the real impact of malaria on the Haitian population and to create more appropriate interventions.

Bimonthly diurnal and nocturnal captures were conducted in four different sampling sites of the Mato Grosso Pantanal region over 24 consecutive months between March 2009 and January 2011. The goal of performing these collections was to elucidate aspects of the biology and ecology of mosquitoes in this region since little to nothing is known about these aspects for many species. A total of 17,532 specimens were captured, comprising two subfamilies, nine genera, and 44 species. The main species of culicids found in the Mato Grosso Pantanal had strong ecological compatibility with well-preserved environments and with some of the specific habitats found in at least one of the four selected collection sampling sites. Anopheles darlingi, An. albitarsis, and An. triannulatus are well-suited to environments with large water bodies and greater anthropic activity. Culex nigripalpus and Cx. quinquefasciatus prefer environments with bush fragments and pronounced human action and movement. Culex declarator and Psorophora albigenu, the most eclectic, prefer wild areas and with some anthropic activity. Mansonia titillans is associated with environments offering a wide variety of natural breeding areas that enable its development, in particular natural swamp areas covered with macrophytes, which is one of the natural components of the Pantanal biome. The effect of the flooding season on the population density of anophelines is especially advantageous, with an explosion in the number of individuals in periods of widespread flooding. The region’s environmental dynamics are regulated by flooding cycles with alternating periods of flooding and drought, which are the main factors governing the ecology of the local fauna and flora. Flooding periods contribute to raising culicid species’ richness and diversity, while the droughts result in a more even distribution of specimens within species. The flooding season of the Pantanal occurs between November and May and coincides with the greatest abundance of culicid species. During this period, the human population of the region has greater contact with mosquito vectors carrying pathogens, including arboviruses, which previous studies have confirmed via seropositivity in the region’s equines and birds.

Objetivo: caracterizar o processo de difusão espacial da Covid-19 pelos municípios do Estado do Rio de Janeiro. Método: Para análise da difusão espacial dos primeiros casos confirmados de Covid-19 segundo municípios do estado foi utilizada a metodologia de interpolação pelo IDW. Resultados: Foram identificados três eixos principais de difusão no Estado do Rio de Janeiro, todos partindo da Região metropolitana. O primeiro eixo segue em direção a São Paulo pela via Dutra promovendo a difusão pelo Vale do Paraíba. O segundo eixo segue em direção ao Espírito Santo pela BR-101. O terceiro eixo segue em direção a região da cidade de Juiz de Fora em Minas Gerais pela BR-040.Conclusão: A caracterização da difusão da Covid-19 no estado do Rio de Janeiro demostrou seu processo de espalhamento tanto por saltos (seguindo a hierarquia urbana) quanto por contágio uma vez instalada nos novos centros de difusão. A interiorização da difusão impõe a urgente tomada de ações articuladas e solidárias considerando que as políticas de saúde para contenção da Covid-19 se baseiam majoritariamente em medidas não farmacológicas e que a capacidade médico-hospitalar dos municípios de médio e pequeno porte que se encontram nessa rota de difusão é limitada.

Em 1º de abril, foram registrados globalmente mais de 4,8 mil mortos por COVID-19. No dia seguinte, esse número já havia ultrapassado a marca de 5 mil por dia ^1,2. A rápida variação no número de óbitos coloca a COVID-19 como a doença infeciosa que mais mata pessoas no mundo por dia, superando a tuberculose que registrou aproximadamente 4 mil óbitos por dia no ano de 2018, segundo a Organização Mundial da Saúde (OMS) ³.