The map for shows higher rates in the northern and southern regions, especially in the more peripheral census tracts, and in some tracts in the central and eastern regions. Areas with greater risk of VL were detected through the kernel ratio, a smoothed estimate of the risk surface, which is calculated by the ratio between the kernel intensity of cases in relation to the kernel of the population distribution, obtained thusly:. A categoria "outras etiologias" incluiu diversos agentes: One can thereby infer that occurrence of the disease in the urban census tracts of Teresina is a focal process, which corresponds to the limited flight autonomy of the sand fly. Thus, although VL is a serious disease subject to mandatory reporting and the treatment of which is only provided by government health services , the available data are based on passive case detection, and one cannot rule out the possibility of case underreporting. Therefore, with the circulation of serotype 4 in nearby or even border countries such as Venezuela, there is a risk of re-introduction of this serotype, which allied to a susceptible population and high vector density would be the ideal ingredients for a new explosive epidemic process. epidemiologia roberto medronho

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Kernel density is an appropriate interpolation technique for individual point positions that is based on a mathematical function that creates a symmetrical surface on each point, evaluating the distance from the point to a reference position, and later adding up the values of all the surfaces for this reference position.

A more detailed analysis by using a local indication of spatial autocorrelation showed that in the beginning of the study period local clusters of high incidence of VL were mostly epkdemiologia in the southern and northeastern parts of the city, but in epidfmiologia years those clusters also appeared in the northern region of the city.

Identification of Risk Areas for Visceral Leishmaniasis in Teresina, Piaui State, Brazil

There were studied cases of meningitis notified and investigated by a public hospital's epidemiology service from tousing the National Information System of Notifiable Diseases SINAN as part of the local routine of epidemiologic surveillance.

When to control endemic infections by focusing on high-risk groups. This study showed that VL incidence rates and socioeconomic and demographic indicators are spatially correlated, indicating that disease foci are associated with precarious living conditions. Statistics analysis included multivariate logistic regression. De uma forma geral, a letalidade foi elevada para quase todas as etiologias.

The most frequent etiologies were: Support Center Support Center. Inthere was also an important reduction in VL intensity in the urban area as a whole, but jedronho was a new medium-risk foci in northern and southern regions. Several features contributed to the spread of the Aedes aegypti to these regions.

Formats and Editions of Epidemiologia. []

This article has been cited by other articles in PMC. Trans Inst Br Geogr. Association between the tumor necrosis factor locus and the clinical outcome of Leishmania chagasi infection. Abstract This study used spatial analysis to identify areas at greatest risk of visceral leishmaniasis VL in the urban area of Teresina, Brazil during — Up to now, unfortunately, the modulation of the epidemic process has been a function of group immunity and not medronh efficient vector control.

Because there are no other centers for treatment of VL cases near Teresina and because VL is a serious disease for which diagnosed cases must be reported before health services release the specific medication, which is only supplied by the Municipal Health Department, underreporting is believed to be relatively low. The bivariate global Moran's I index for — is shown in Table 1.

The smoothing function used was the quartic kernel, which assigns greater weight to closer events and less weight to more distant ones, but with a gradual decrease. Thus, although VL is a serious disease subject to mandatory reporting and the treatment of which is only provided by government health servicesthe available data are based on epidemiolkgia case detection, and one cannot rule out the possibility of case underreporting.

Rio de Janeiro, RJ, Brasil. Thus, although the study design did not enable establishing causal nexuses, it is plausible to suppose that the introduction, maintenance, and spread of VL in Teresina are linked to the environmental conditions typically found in poorer areas with less urban infrastructure, including worse sanitation.

This could help the adoption of measures of containment by eipdemiologia suspect cases opportunely.

[The Brazilian Hospital Information System and the acute myocardial infarction hospital care].

Heterogeneities in the transmission of infectious agents: Lutzomyia longipalpis Diptera, Psychodidae, Phlebotominae and urbanization of visceral leishmaniasis in Brazil.

This situation persisted intoexcept in the southeastern region.

The great complexity of this anthropic environment makes it essential to rethink the disease control strategy. Introduction The urbanization process has raised new challenges for endemic disease control programs, particularly in the case of visceral leishmaniasis VL.

Van Nostrand Reinhold; The High-High pattern indicates hot-spots of high incidence of disease.