In Brazil, the incidence of dengue greatly increased in the last two decades and there are several factors impeding the control of the disease. The present study focused on describing the space-time evolution of dengue in Brazil from 2001 to 2012 and analyzing the relationship of the reported cases with socio-demographic and environmental factors. The analytic units used in the preparation of thematic maps were municipalities. Statistical tests and multilevel regression models were used to evaluate the association between dengue incidence and the following factors: climate, diagnostic period, demographic density, percentage of people living in rural areas, Gross Domestic Product, Gini index, percentage of garbage collection and the rate of households with a sewage network. The largest accumulation of dengue cases in Brazil was concentrated on the Atlantic coast and in the interior part of São Paulo State. The risk of dengue in subtropical and tropical climates was 1.20–11 times lower than that observed in semi-arid climates. In 2009–2010 and 2011–2012, the risks were ten and six times higher than in 2003–2004, respectively. Dengue is a common infection in the Brazilian population, with the largest accumulation of dengue cases concentrated on the Atlantic coast and in the interior area of São Paulo State. The high dengue rates observed in the Brazilian coastal region suggest that the cases imported from neighboring countries contribute to the spread of the disease in the country. Our results suggest that several socio-demographic and environmental factors resulted in the increase of dengue in the country over time. This is likely applicable to the occurrence of other arboviruses like Zika and chikungunya. To reverse the situation, Brazil must implement effective public policies that offer basic services such as garbage collection and sanitation networks as well as reduce vector populations.

Dengue epidemics have occurred in the city of Rio de Janeiro (Brazil) since 1986. In the year 2015, Zika and chikungunya viruses were introduced in the city, causing sequential and simultaneous epidemics. Poor socioeconomic conditions have been suggested as contributing factors of arboviral infection. To describe the spatial distribution of human cases of symptomatic arboviral infections and to identify risk factors for infection in a poor community of Rio de Janeiro in the years 2015 and 2016. We built thematic maps of incidence rates for 78 micro-areas in the Manguinhos neighborhood. The micro-areas congregate about 600 inhabitants. Simple and multiple multilevel logistic regression models were used to evaluate the association between the incidence of arboviral diseases and socio-demographic factors at both the individual and micro-area levels. From 2015 to 2016, 370 human cases of arbovirus infection were reported in the Manguinhos community: 123 in 2015 and 247 in 2016. There was a significant difference in the risk of arbovirus diseases among different micro-areas, but this was not explained by water and sanitation indicators. The cumulative incidence rate was 849/100,000 in two years. The incidence was greater in those individuals with familiar vulnerability (1,156/100,000 vs. 794/100,000). The multilevel adjusted model showed that the odds of acquiring an arbovirus infection was 55% greater in those with familiar vulnerability. Arbovirus infections cause a high burden of disease in Brazilian urban centers. Our results suggest that even in poor neighborhoods, there is a high spatial variability in the risk of acquiring an arbovirus infection. The conditions that favor vector proliferation and infection by arboviruses are complex and involve both individual and environmental characteristics that vary from place to place. To reduce the burden of arboviral diseases, continued public health policies and basic services should be provided to the communities at risk that consider specific local needs.

COVID-19 serosurveys allow for the monitoring of the level of SARS-CoV-2 transmission and support data-driven decisions. We estimated the seroprevalence of anti-SARS-CoV-2 antibodies in a large favela complex in Rio de Janeiro, Brazil. A population-based panel study was conducted in Complexo de Manguinhos (16 favelas) with a probabilistic sampling of participants aged ≥1 year who were randomly selected from a census of individuals registered in primary health care clinics that serve the area. Participants answered a structured interview and provided blood samples for serology. Multilevel regression models (with random intercepts to account for participants’ favela of residence) were used to assess factors associated with having anti-S IgG antibodies. Secondary analyses estimated seroprevalence using an additional anti-N IgG assay. 4,033 participants were included (from Sep/2020 to Feb/2021, 22 epidemic weeks), the median age was 39·8 years (IQR:21·8-57·7), 61% were female, 41% were mixed-race (Pardo) and 23% Black. Overall prevalence was 49·0% (95%CI:46·8%-51·2%) which varied across favelas (from 68·3% to 31·4%). Lower prevalence estimates were found when using the anti-N IgG assay. Odds of having anti-S IgG antibodies were highest for young adults, and those reporting larger household size, poor adherence to social distancing and use of public transportation. We found a significantly higher prevalence of anti-S IgG antibodies than initially anticipated. Disparities in estimates obtained using different serological assays highlight the need for cautious interpretation of serosurveys estimates given the heterogeneity of exposure in communities, loss of immunological biomarkers, serological antigen target, and variant-specific test affinity. Fundação Oswaldo Cruz, Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Fundação de Amparo a Pesquisa do Estado do Rio de Janeiro (FAPERJ), the European Union's Horizon 2020 research and innovation programme, Royal Society, Serrapilheira Institute, and FAPESP.

SUMMARY INTRODUCTION Teenage pregnancy is a universal phenomenon, with higher prevalence in developing countries. Although there has been a reduction in Brasil since the year 2000, the age-specific fertility rate for this age group remains high. OBJECTIVE To evaluate the frequency of adolescence pregnancy in in Brasil from 2006 to 2015 and its association with the Human Development Index (HDI). METHODS A descriptive epidemiological study, conducted by searching the database of the Department of Informatics of the Unified Health System (DATASUS), using information from the Information System on Live Births (SINASC) for the five Brazilian regions. RESULTS There was a reduction in the percentage of live births (LB) from adolescent mothers (10 to 19 years old) in Brasil by 13.0% over the last ten years. This decline was observed in all Brazilian regions among mothers aged 15 to 19 years. The number of LB increased by 5.0% among mothers aged 10 to 14 years in the North and decreased in the other regions, with higher rates in the South (18.0%). The specific fertility rate for the 15-19-year-old group decreased from 70.9/1,000 to 61.8/1,000 in the period. The proportion of LB is inversely associated with the HDI, except in the Northeast (the lowest HDI in the country), where there was a significant reduction (18.0%) among mothers aged 15-19 and 2% among those aged 10-14 years. CONCLUSION Teenage pregnancy in Brasil is in slow decline, especially among mothers aged 10-14 years and is inversely associated with the HDI, except in the Northeast.

RESUMO O câncer do colo uterino é uma importante causa de morte no Brasil. O objetivo deste estudo é avaliar a mortalidade por esse câncer na população brasileira, entre 2012 e 2016, conhecendo a mortalidade nos grupos etários e nas diferentes regiões. Foi realizado um estudo de corte transversal descritivo. Os dados foram obtidos pelo Sistema de Informações sobre Mortalidade. Entre 2012 e 2016, o total de óbitos por câncer do colo do útero foi de 27.716 casos. A taxa de mortalidade específica para o Brasil passou de 6,86 para 7,18. O crescimento do coeficiente de mortalidade foi de 4,6%. Nas mulheres abaixo de 25 anos, observaram-se 189 mortes, o que equivale a 0,68% do total. Entre 25 e 64 anos, houve 18.574 óbitos (67,02%), e 8.950 mortes no grupo acima de 64 anos (32,29%). O maior percentual de óbitos ocorreu na faixa etária de 50-54 anos. A região Norte apresentou os maiores índices de óbitos e taxas de mortalidade, e o Sul o maior índice de crescimento. A mortalidade por câncer do colo uterino no Brasil apresentou crescimento durante os anos observados, com mais óbitos entre 50-54 anos. A região Sul apresentou o maior crescimento nas taxas de mortalidade.

The aim of this study was to evaluate the frequency of teenage pregnancy in all Brazilian regions and states in the period of 2000-2019 among two age groups, namely, 10-14 and 15-19 years old, and correlate it with the human development index. A cross-sectional study was performed by using the data from the Live Birth Info System from the National Health System's database. The percentage of live births from teenage mothers (age 10-19 years) in Brazil decreased by 37.2% (i.e., 23.4 in 2000 to 14.7% in 2019) in all regions. Amazonas and Maranhão were the only states to show increased fertility rates for teens in the age group of 10-14 years. The fertility index decreased from 80.9-48% in all states among mothers aged 15-19 years. Only the Southeast and South regions showed levels below the Brazilian average (i.e., 38.2 and 39%, respectively). The proportion of live birth showed an inversely proportional trend to the human development index score. Brazil shows a decline in the percentage of live birth among adolescent mothers and the fertility rate. Live birth is inversely proportional to the human development index score. However, the teenage pregnancy numbers are still high, with great regional inequality in the country.