Eric Renato Lima Figueiredo

Introdução: A COVID-19 afetou significativamente a região Norte do Brasil, impondo desafios decorrentes da extensão geográfica, da densidade populacional variada e da infraestrutura de saúde heterogênea. A interação entre fatores socioeconômicos, ambientais e de políticas públicas tem sido determinante para compreender a dinâmica da doença no estado do Pará. Objetivo: Analisar a correlação entre a incidência e a letalidade da COVID-19 e variáveis socioeconômicas, climáticas e de políticas públicas em dois Centros Regionais de Saúde do estado do Pará. Métodos: Estudo ecológico longitudinal com abordagem analítica, baseado nos casos confirmados de COVID-19 nos Centros Regionais de Saúde de Belém e Altamira, no período de 2020 a 2024. Foram analisadas as taxas de incidência e letalidade, o Índice de Desenvolvimento Humano Municipal, a cobertura vacinal e parâmetros meteorológicos. As associações foram avaliadas por meio de matrizes de correlação de Pearson, com nível de significância de 5%. Resultados: Observou-se redução dos casos após os picos de 2021 e 2022, com estabilização a partir de 2023. Janeiro apresentou a maior proporção de casos (29,31%), enquanto setembro registrou a menor (2,43%). Em Belém, no ano de 2024, a incidência apresentou correlação positiva forte com a temperatura média diária (r = 0,78). Em Altamira, em 2023, identificou-se correlação negativa muito forte entre incidência e o Índice de Desenvolvimento Humano Municipal (r = -0,96). Em Belém, em 2021, a letalidade apresentou correlação positiva fraca com a cobertura vacinal (r = 0,17) e moderada com o Índice de Desenvolvimento Humano Municipal (r = 0,41). Conclusão: A incidência e a letalidade apresentaram relações distintas conforme o território e o período analisado, evidenciando a complexidade da dinâmica da COVID-19 na região amazônica paraense. A integração de indicadores pode contribuir para o aprimoramento da vigilância epidemiológica e o planejamento de ações em saúde.

Background: Cryptococcosis, a systemic mycosis, remains a neglected disease in Brazil due to the absence of systematic national surveillance. This study developed an interactive dashboard to analyze cryptococcosis-related deaths (2000–2022) and forecast trends through regional ARIMA modeling. Methodology: The Cross-Industry Standard Process for Data Mining framework was employed to extract mortality data from the Brazilian Mortality Information System, utilizing the microdatasus package in R Studio software, with R version 3.4.0. The records were then filtered using the International Classification of Diseases, Tenth Revision codes (B45 series) to identify primary and associated causes of death. After data extraction, a series of data preprocessing steps was implemented, including deduplication, variable recoding, and the management of missing values. The Shiny framework was employed to construct an interactive dashboard, incorporating Plotly and DT packages, with time-series visualizations, demographic variables, and multilingual support (Portuguese/English). Results: Among 12,308 deaths (2227 primary; 10,081 associated causes), most occurred in males aged 21–60 years. Data completeness was high for age/residence (100%) but lower for education (82%). The dashboard enables dynamic exploration of trends, demographic patterns, and open-data downloads. Regional ARIMA models revealed heterogeneous forecasts, with the Southeast projecting a decline (193 deaths in 2025; 95% CI: 146–240) and the South showing stability (141 deaths; 95% CI: 109–173). Conclusions: This tool bridges a critical gap in cryptococcosis surveillance, enabling dynamic mortality trend analysis, identification of high-risk demographics, and regional forecasting to guide public health resource allocation. While the absence of HIV serostatus data limits etiological analysis, the dashboard’s open-source framework supports adaptation for other neglected diseases.

Introduction: Human malaria is a zoonosis considered a serious global public health problem caused by five species of protozoa of the genus Plasmodium spp., which are transmitted by mosquito vectors belonging to the genus Anopheles spp. Objective: To verify whether there is a relationship between the age-standardized malaria mortality rate in Brazil and age–period–cohort effect variables, sociodemographic differences, and indicators of sustainable development. Methods: Data on malaria mortality in Brazil from 2000 to 2022 were analyzed using sociodemographic factors such as ethnicity, region of residence, and sustainable development indicators. Results: Statistical data demonstrated that from 2000 to 2022, there was a reduction in malaria mortality; the 0–4 years age group was more susceptible to death, and the infection affected more men, Indigenous people, and residents of the North Region. Environmental factors such as CO₂ emissions and sanitation predict mortality in specific regions. The North and Northeast Regions had higher mortality rates. In the North, low CO₂ emissions, deforestation, weak urban sanitation, a lower GDP, and a higher Gini index were related to high mortality; the latter was also a factor in high rates of deforestation and solid waste collection in the Central West and Northeast Regions. The number of consultations and professionals was a predictive factor for high rates in the three regions mentioned. The Southeast Region had the lowest mortality rate and lowest health expenditure, while the Northeast and Midwest Regions had the highest expenditure in this sector. Conclusions: This study can contribute to the direction of public policy due to the specificities of each region in Brazil.

O objetivo desta pesquisa é investigar a mortalidade por gravidez que termina em aborto, no estado do Pará, no período de 2011 a 2021. Estudo transversal, descritivo e espacial temático através dos Sistemas de informação de Mortalidade e de Nascidos Vivos. Calculou-se a razão de mortalidade segundo informações sociodemográficas, causa específica, método de investigação do óbito e o fluxo de migrações segundo local de residência para local de ocorrência. De 2011 a 2021, 83 mulheres morreram, sendo o perfil sociodemográfico das vítimas mulheres jovens, negras e com certo grau de instrução. As causas mais comuns de morte por aborto foram gravidez ectópica e aborto não especificado. Mesorregiões com maior taxa de mortalidade por aborto foram Marajó, Sudoeste Paraense e Baixo Amazonas. O fluxo de mulheres que morreram por aborto concentrou-se nas mesorregiões do Nordeste Paraense, Marajó, Sudoeste Paraense e Baixo Amazonas em direção à Região Metropolitana de Belém. A pesquisa fornece uma visão exploratória e abrangente da mortalidade de mulheres gravidez que termina em óbito no estado do Pará de 2011 a 2021. A análise destaca a necessidade de políticas de saúde direcionadas, com ênfase particular nos grupos e regiões mais vulnerabilizadas identificadas pela análise.

A Hanseníase é uma doença infectocontagiosa causada pela bactéria Mycobacterium Leprae ou Bacilo de Hansen. O enfermeiro da Equipe Estratégia Saúde da Família (ESF) desempenha o papel de promoção, prevenção e controle da hanseníase, prestando uma assistência adequada e individualizada ao paciente. O objetivo deste estudo é descrever o conhecimento dos enfermeiros da ESF acerca da assistência aos pacientes com Hanseníase. Trata-se de um estudo de campo, transversal, de natureza descritiva, com abordagem quantitativa. Realizado com 14 enfermeiros em sete Unidades Básicas de Saúde no município de Marabá, onde o instrumento utilizado foi um questionário fechado. Com base na coleta de dados, foi possível observar que há necessidade de realização de capacitações e treinamentos anuais no município de Marabá para os profissionais de enfermagem da ESF, para garantir um serviço com maior habilidade e aptidão. Conclui-se que os enfermeiros possuem conhecimentos básicos em relação a hanseníase, visto que a assistência prestada acerca da doença é insuficiente, alcançando um nível moderado.

Human Visceral Leishmaniasis is an endemic public health problem in the Amazon. This article analyzed the spatial distribution of this disease and its relationship with socioeconomic, environmental and public health policy variables in four mesoregions of the state of Pará, from 2011 to 2022. This ecological study used secondary data obtained from official Brazilian agencies. Spatial analysis was performed using the Flow, Kernel and Global Moran bivariate techniques expressed in thematic maps. In the mesoregions studied, 2685 cases of the disease were confirmed, with the highest number of cases in Southeast Pará state. The epidemiological profile followed the national pattern of occurrence of the disease, with a higher number of cases in children below school age. Spatial dependence was observed between the prevalence of the disease and socio-economic indicators. The most intense movement of patients was towards the Belém Metropolitan mesoregion. The disease showed an inhomogeneous pattern of distribution of cases, with a direct relationship between areas with cases and deforestation associated with different anthropic activities. There is a socio-environmental production of the disease that goes beyond the border limits of the mesoregions, and its establishment is related to the unsustainable development model implemented in the region.

Background. Breast cancer mortality is increasing in Brazil. This study examines the impact of sociodemographic factors, screening procedures, and primary healthcare (PHC) on breast cancer mortality. Methods. An ecological study analyzed secondary data of women diagnosed with breast cancer who died between 2000 and 2019. Sociodemographic factors, screening procedures, and PHC were examined in relation to breast cancer mortality. Statistical analyses included normality tests, Kruskal-Wallis and one-way ANOVA tests with post hoc comparisons, Pearson and Spearman correlation tests, age-period-cohort analysis, Kaplan-Meier analysis, and Cox regression analysis. Significance was set at . Results. Mortality rates were higher in the southeast (15.77) and south (15.97) regions compared to the north (5.07) ( ). Survival rates were longer in the southeast ( ) and south ( ) than in the north ( ) ( ). Mortality increased with age after 32 years ( ). Brown and indigenous women had lower mortality and survival rates. Increased coverage of PHC, ultrasound, and biopsy did not reduce mortality. However, improved cytopathologic analysis led to a decrease in mortality. Conclusions. Sociodemographic factors, screening procedures, and PHC are specific predictors of breast cancer mortality in Brazil.

Testicular cancer is common in young men, and early detection and multimodality treatment can lead to successful outcomes. This study aims to identify sociodemographic and risk factors associated with higher testicular cancer mortality and poorer survival rates, while examining the impact of diagnostic and treatment procedures on reducing mortality. The retrospective ecological study analyzed mortality data from testicular cancer in Brazil from 2001 to 2020. Sociodemographic variables such as marital status, age, birth period, year of death (cohort), race, and geographic region were assessed. Risk factors included cryptorchidism and pesticide exposure. Data were subjected to statistical analysis, which revealed an increasing trend in mortality after 2011 among persons born after 1976 in the 15–40 age group. Individuals in the South Region, whites, and singles had higher age-standardized mortality rates (ASMRs), while singles had lower survival rates. The Northeast region had a higher survival rate. Fungicides and insecticides increase ASMR in Brazil. Herbicides increase ASMR in the Northeast and Midwest regions and insecticides increase ASMR in the Northeast, Southeast, and Midwest regions. High rates of implementation of diagnostic procedures in the Midwest were not sufficient to reduce ASMR. No treatment procedure was associated with mortality at the national or regional level.

Microcephaly is a neurological condition characterized by anomalies in the growth of the cranial circumference. This study aims to examine the association between sociodemographic and clinical variables and the occurrence of secondary microcephaly in newborns in Brazil. It also aims to investigate the association between this congenital anomaly and teratogenic infections. This research adopts an observational approach with an ecological, descriptive, and analytical design. The sample includes infants aged ≤28 days and registered in the country’s Live Births Information System from January 2015 to December 2021. Newborns were categorized into G1, consisting of newborns with one of the three infections (Zika, toxoplasmosis, or syphilis), and G2, consisting of newborns with two of the three infections. A total of 1513 samples were analyzed and divided into two groups: one infection (syphilis n = 423; toxoplasmosis n = 295; or Zika n = 739) and two infections (n = 56). The northeastern region of Brazil has the highest prevalence of microcephaly. Regarding the population profile, the Zika virus infection is more common among white mothers, while the syphilis infection is more common among black mothers. Among newborns with microcephaly, boys have a lower prevalence of toxoplasmosis infection, while girls have a lower prevalence of Zika virus infection. This study provides pertinent information on each infection and contributes to the epidemiologic understanding of the association between teratogenic infections and microcephaly.

Several factors may increase the risk of development of ovarian cancer. In this study, we investigated the relationship between social, genetic, and histopathologic factors in women with ovarian serous cystadenocarcinoma and titin (TTN) mutations, whether the TTN gene mutation may be a predictor, and its impact on mortality and survival in these patients. A total of 585 samples from patients with ovarian serous cystadenocarcinoma were collected from The Cancer Genome Atlas and PanCancer Atlas through the cBioPortal for analysis of social, genetic, and histopathological factors. Logistic regression was used to investigate whether TTN mutation could be a predictor, and the Kaplan–Meier method was applied to analyze survival time. TTN mutation frequency did not differ between age at diagnosis, tumor stage, and race, and was related to increased Buffa hypoxia score (p = 0.004), mutation count (p < 0.0001), Winter hypoxia Score (p = 0.030), nonsynonymous tumor mutation burden (TMB) (p < 0.0001), and reduced microsatellite instability sensor score (p = 0.010). The number of mutations (p < 0.0001) and winter hypoxia score (p = 0.008) were positively associated with TTN mutations, and nonsynonymous TMB (p < 0.0001) proved to be a predictor. Mutated TTN affects the score of genetic variables involved in cancer cell metabolism in ovarian cystadenocarcinoma.