Eco-epidemiology of cutaneous leishmaniasis in Buriticupu, Amazon region of Maranhão State, Brazil, 1996-1998

This study presents the distribution of leishmaniasis in the town of Buriticupu, Maranh?o, Brazil, by month, season, occupation, gender, and age from 1996 to 1998. These data were compared with those on sand flies obtained by other authors during the same period. The disease affected all age groups, in the following order: 0-5 years (4.1%), 6-10 (7.1%), 11-15 (13.6%), 16-21 (20.8%), 22-30 (21.1%), and > 30 (33.3%). The disease predominantly affected males (70.1%) and agricultural workers (52.5%), followed by students (17.7%), and domestic workers (16.0%). Like the sand fly vector, the disease was distributed throughout the year, but the greatest concentration of cases was recorded in the dry season (58.5%), while sand flies presented bimodal peaks in the first two years and occurred more frequently in the rainy season in 1998. The disease continues to present the same characteristics as in the past, but there was a proportional increase in cases among children and females, suggesting transmission in the anthropic environment.     

Demographic dynamics of the Suyá, a Jê people of the Xingu Indigenous Park, Central Brazil, 1970-2004

This paper analyses the demographic dynamics of the Suyá, a Jê people, inhabitants of the Xingu Indigenous Park, Mato Grosso State, Brazil, during the years 1970-2004. Data was gathered from medical records of the S?o Paulo Federal University Health Program at the Xingu Indigenous Park. The demographic characteristics addressed include composition by age and sex, crude birth rates, general mortality rates, mortality rates by age and sex, proportional mortality by sex, age, and basic causes of death. The results show a population recovery process, with growth rates of 3% per year between 1970 and 2004. In addition to moderate birth rates and declining mortality rates, migration has also played an important role in the demographic dynamics. Mortality indicators show a decline in general and infant mortality rates, higher death rates among women, higher proportions of deaths among individuals < 1 and 50+ years of age, and major causes of death to be infectious diseases and cancer.     

Epidemiological characteristics of dengue in the Municipality of São Luís, Maranhão, Brazil, 1997-2002

A total of 12,008 cases of dengue were reported from 1997 to 2002, with peaks in 1997 (35.8%) and 1998 (45.8%). The disease predominated in the 15-49-year age group (72.2%) and during the rainy season (83.3%), showing a positive correlation with the amount of rainfall (r = 0.84) and relative humidity (r = 0.76) and a negative correlation with temperature (r = -0.78). There was no significant difference (chi2 = 2.319; p > 0.05) in the number of cases in males (49%) and females (51%). Dengue was detected in all seven health districts: Tirirical (27%), Coroadinho (17%), Bequimao (16%), Cohab (14%), Itaqui-Bacanga (11%), Centro (8%), and Vila Esperanca (7%). The building infestation rate ranged from 1.01 to 7.15, and the Breteau index ranged from 1.10 to 8.18. The most frequent mosquito breeding sites were metal barrels or similar recipients (80.0%), followed by plant vases (4.7%), bottles, cans, and plastics (3.6%), tires (3.3%), water tanks (2.7%), and others (5.7%). In the case of Aedes aegypti, 134,631 positive water deposits were detected, with a predominance of type B (80.0%), followed by types C (4.7%), E (3.6%), and A (3.3%).     

Costs of mammogram campaigns in the Regional Health Division of Marília, São Paulo State, Brazil, 2005-2006

The aim of this study was to measure the direct costs of mammogram campaigns conducted by the Regional Health Division of Marília, S?o Paulo State, Brazil, in 2005 and 2006. A total of 11,952 mammograms were performed. Mammographic outcomes were classified according to BI-RADS. Cost analysis was based on the amount paid by the Brazilian Unified National Health System (SUS). Ten cases of breast cancer were diagnosed (0.84 per 1,000 mammograms), 70% of which between 50 and 69 years of age. The campaigns and follow-up cost a total of R$450,019 (U$280,000), with R$431,467 paid for 11,952 mammograms and R$18,552 for diagnosing 29 suspected cases and treating 3 cases of benign tumors and 6 cancer cases. Mean cost per diagnosed case was R$43,268. The high cost per diagnosed case highlights the need to implement effective screening programs and improve the quality of mammography services in this region of S?o Paulo State.     

Sunshine and suicide at the tropic of Capricorn, São Paulo, Brazil, 1996-2004

Several studies have confirmed seasonal variation in suicide rates according to hours of sunshine. The suicide pattern was assessed in S?o Paulo, southeastern Brazil, at the tropic of Capricorn from 1996 to 2004. Poisson regression was employed to estimate parameters of seasonality, as well as to verify associations for each day between daylight duration and suicide. During the nine-year study period, there were 3,984 suicides (76.9% in men; median age=38.7 years old). Seasonal averages of suicides were similar, as were monthly averages. Poisson regression did not reveal any association between suicide rates and hours of sunshine (p=0.45) for both sexes. In conclusion, no seasonal pattern was observed for suicides.     

Prevalence of malnutrition among children in Embu,São Paulo State,Brazil, 1996-1997

This paper focused on the nutritional profile of children in the municipality of Embu, S?o Paulo State, Brazil, in 1996-1997, to identify vulnerable population segments that require specific action by health services. The sample consisted of 320 children < or = 5 years of age distributed into four socioeconomic strata. The indices were expressed as z-scores: weight/age (W/A), height/age (H/A), and weight/height (W/H) to analyze the nutritional status, and the reference for normality was the NCHS curve. In all population strata and age groups, the height/age index was the most frequently affected, while the weight/height index had the fewest deficits. No statistically significant differences were observed in children's nutritional status between the four population strata or between the different age groups. Children with low birth weight showed the highest prevalence of deficits in all indices. In the municipality, the frequency of deficits were: H/A< 2z: 7.1%, W/H< 2z: 0.2%, and W/A< 2z: 2.9%. Height deficit can be used as an early warning, considering that loss observed over the course of years has future consequences.     

Quantitation of [5-14CH3]-(2R, 4'R, 8'R)-α-tocopherol in humans

Half-lives of α-tocopherol in plasma have been reported as 2-3 d, whereas the Elgin Study required >2 y to deplete α-tocopherol, so gaps exist in our quantitative understanding of human α-tocopherol metabolism. Therefore, 6 men and 6 women aged 27 ± 6 y (mean ± SD) ingested 1.81 nmol, 3.70 kBq of [5-(14)CH(3)]-(2R, 4'R, 8'R)-α-tocopherol. The levels of (14)C in blood plasma and washed RBC were monitored frequently from 0 to 460 d while the levels of (14)C in urine and feces were monitored from 0 to 21 d. Total fecal elimination (fecal + metabolic fecal) was 23.24 ± 5.81% of the (14)C dose, so feces over urine was the major route of elimination of the ingested [5-(14)CH(3)]-(2R, 4'R, 8'R)-α-tocopherol, consistent with prior estimates. The half-life of α-tocopherol varied in plasma and RBC according to the duration of study. The minute dose coupled with frequent monitoring over 460 d and 21 d for blood, urine, and feces ensured the [5-(14)CH(3)]-(2R, 4'R, 8'R)-α-tocopherol (the tracer) had the chance to fully mix with the endogenous [5-(14)CH(3)]-(2R, 4'R, 8'R)-α-tocopherol (the tracee). The (14)C levels in neither plasma nor RBC had returned to baseline by d 460, indicating that the t(1/2) of [5-CH(3)]-(2R, 4'R, 8'R)-α-tocopherol in human blood was longer than prior estimates.     

Gérard Abraham van Rijnberk, editor-in-chief of the Dutch Journal of Medicine 1913-1946

Gérard Abraham van Rijnberk (1875-1953), a professor of physiology, was the longest-reigning editor-in-chief in the history of The Nederlandsch Tijdschrift voor Geneeskunde (Dutch Journal of Medicine). During his 33 years in office the Journal and the Vereniging Nederland-sch Tijdschrift voor Geneeskunde (Dutch Journal of Medicine Society) prospered. Van Rijnberk started the historical library of the Society. World War II ended the long-standing connection with the Nederlandsche Maatschappij tot bevordering der Geneeskunst (NMG; The Dutch Medical Association). The NMG was closed down by the German occupier, but Van Rijnberk pursued publication of the Journal, which led to accusations of collaboration. After the war, the Journal continued independently of Medisch Contact, the journal of the NMG.     

Geostatistical analysis of leprosy cases in the State of São Paulo, 1991-2002

OBJECTIVE: To analyze the spatial pattern of leprosy case occurrences in order to identify areas with a probability of disease transmission risks. METHODS: This was an ecological study in which the analysis units were municipalities in the State of S?o Paulo that were georeferenced at their centroids. The data source was the electronic database of notified leprosy cases at the Epidemiological Surveillance Center of the State of S?o Paulo, from 1991 to 2001. Geostatistical techniques were used for detecting areas with a probability of leprosy risk, and for quantifying the spatial dependency of cases. RESULTS: The spatial dependence detected extended outwards to 0.55 degrees from the georeferenced coordinates, which corresponded to approximately 60 km. The main areas identified as presenting a probability of risk were the northeastern, northern and northwestern regions of the State. CONCLUSIONS: Verification of areas with the probability of leprosy risk using spatial dependence analysis may be a useful tool for assessing health conditions and planning budget allocations.     

Ecology of sandflies in Serra do Mar, Itaguaí, state of Rio de Janeiro, Brazil. I - Sandfly fauna and prevalence of the species in collections sites and method of capture

A two-year investigation was conducted in Itaguai, State of Rio de Janeiro, an area with cases of cutaneous leishmaniasis, in order to study the ecology of sandflies and their habits and role as parasitic vector for men and animals. Capturing took place at three sites: domiciliary (human bait, walls, and light traps); peridomiciliary (walls, from baits used simultaneously: humans, dogs, and chickens; and light traps); and sylvatic (human bait and light traps). A total of 10,172 sandflies were captured, belonging to 17 species of genuses Brumptomyia Fran?a & Parrot, 1921 and Lutzomyia Fran?a, 1924. L. intermedia was predominant, 100 m above sea level, as compared to L. migonei and L. fischeri. In a drier area 300 m above sea level L. migonei was prevalent, followed by L. longipalpis and L. fischeri. The species which presented the greatest endophily was L. fischeri, showing a certain degree of eclecticism regarding the biting site. L. intermedia and L. migonei proved to be more exophilic. L. intermedia was considered to be potentially the main transmitter of the disease because of its prevalence, anthropophily, and the fact it is known to be a vector of Leishmania (V.) braziliensis in other areas of the Southeastern region of Brazil. L. fischeri, because of its anthropophily, might also be involved.     

Epidemiological profile of reported beriberi cases in Maranhão State, Brazil, 2006-2008

This study aimed to describe the epidemiological profile of beriberi cases and related deaths reported from 2006 to 2008 in Maranh?o State, Brazil. Data were obtained from beriberi notification forms at the State Health Department. The global Moran index was used to evaluate spatial auto-correlation. 1207 cases and 40 deaths were reported. The western and central regions of the State showed strong spatial auto-correlation of incidence rates. Cases and deaths were concentrated from May to August, in young men (20-40 years). Regular alcohol consumption and smoking were recorded among fatal cases. Low income and heavy labor were widespread among cases. Common symptoms were asthenia, numbness, and swollen legs, difficulty walking, and calf pain. The profile of cases and their symptoms (except swollen legs) are characteristic of dry beriberi. We recommend further studies on the resurgence of beriberi in Brazil.