Spatial distribution of schistosomiasis foci on Itamaracá Island, Pernambuco, Brazil

Acute cases of schistosomiasis have been found on the coastal area of Pernambuco, Brazil, due to environmental disturbances and disorderly occupation of the urban areas. This study identifies and spatially marks the main foci of the snail host species, Biomphalaria glabrata on Itamaracá Island. The chaotic occupation of the beach resorts has favoured the emergence of transmission foci, thus exposing residents and tourists to the risk of infection. A database covering five years of epidemiological investigation on snails infected by Schistosoma mansoni in the island was produced with information from the geographic positioning of the foci, number of snails collected, number of snails tested positive, and their infection rate. The spatial position of the foci were recorded through the Global Positioning System (GPS), and the geographical coordinates were imported by AutoCad. The software packages ArcView and Spring were used for data processing and spatial analysis. AutoCad 2000 was used to plot the pairs of coordinates obtained from GPS. Between 1998 and 2002 5009 snails, of which 12.2% were positive for S. mansoni, were collected in Forte Beach. A total of 27 foci and areas of environmental risk were identified and spatially analyzed allowing the identification of the areas exposed to varying degrees of risk

Geographical Analysis for Detecting High-Risk Areas for Bovine/Human Rabies Transmitted by the Common Hematophagous Bat in the Amazon Region, Brazil

The common hematophagous bat, Desmodus rotundus, is one of the main wild reservoirs of rabies virus in several regions in Latin America. New production practices and changed land use have provided environmental features that have been very favorable for D. rotundus bat populations, making this species the main transmitter of rabies in the cycle that involves humans and herbivores. In the Amazon region, these features include a mosaic of environmental, social, and economic components, which together creates areas with different levels of risk for human and bovine infections, as presented in this work in the eastern Brazilian Amazon.We geo-referenced a total of 175 cases of rabies, of which 88% occurred in bovines and 12% in humans, respectively, and related these cases to a number of different geographical and biological variables. The spatial distribution was analyzed using the Kernel function, while the association with independent variables was assessed using a multi-criterion Analytical Hierarchy Process (AHP) technique.The spatiotemporal analysis of the occurrence of rabies in bovines and humans found reduction in the number of cases in the eastern state of Pará, where no more cases were recorded in humans, whereas high infection rates were recorded in bovines in the northeastern part of the state, and low rates in the southeast. The areas of highest risk for bovine rabies are found in the proximity of rivers and highways. In the case of human rabies, the highest concentration of high-risk areas was found where the highway network coincides with high densities of rural and indigenous populations.The high-risk areas for human and bovine rabies are patchily distributed, and related to extensive deforested areas, large herds of cattle, and the presence of highways. These findings provide an important database for the generation of epidemiological models that could support the development of effective prevention measures and controls

Bacterial Resistance and Mortality in an Intensive Care Unit

The goal was to identify risk factors for healthcare-associated infections by resistant microorganisms and patient mortality in an Intensive Care Unit. A prospective and descriptive epidemiological research was conducted from 2005 till 2008, involving 2300 patients. Descriptive statistics, bivariate and multivariate logistic regression analysis were used. In bivariate analysis, infection caused by resistant microorganism was significantly associated to patients with community-acquired infection (p=0.03; OR=1.79) and colonization by resistant microorganism (pSe objetivó identificar factores de riesgo para el desarrollo de infecciones relacionadas al cuidar en salud, por microorganismos resistentes, y también investigar su relación con la mortalidad de los pacientes en un centro de terapia intensiva. Se trata de un estudio epidemiológico prospectivo realizado entre 2005 y 2008, envolviendo 2.300 pacientes. Se utilizó la estadística descriptiva y el análisis de regresión logístico bivariado y multivariado. En el análisis bivariado, la infección por microorganismos resistentes estuvo significativamente asociada a pacientes con infección comunitaria (p=0,03; OR=1,79) y a la colonización por microorganismo resistente (pObjetivou-se identificar fatores de risco para o desenvolvimento de infecções, relacionadas ao cuidar em saúde, por microrganismos resistentes e a mortalidade dos pacientes em um centro de terapia intensiva. Trata-se de estudo epidemiológico prospectivo, realizado entre 2005 e 2008, envolvendo 2.300 pacientes. Utilizou-se estatística descritiva, análise de regressão logística bivariada e multivariada. Na análise bivariada, a infecção por microrganismo resistente esteve significativamente associada a pacientes com infecção comunitária (p=0,03; OR=1,79) e colonização por microrganismo resistente (p<0,01; OR=14,22). Na análise multivariada, severidade clínica C (p=0,03; OR=0,25) e colonização por microrganismo resistente (p<0,01; OR=21,73) foram significativas. Para óbitos, observou-se, como fator de risco: tipo de paciente, severidade clínica e uso de ventilação mecânica. A constatação da relação entre microrganismo resistente e óbitos evidencia a necessidade de monitorização da adesão às medidas de controle de infecção, no sentido de melhorar a qualidade da assistência e, sobretudo, a sobrevida de pacientes críticos