Healthcare-associated infections are a major cause of morbidity-mortality among hospitalized patients. The aim of this epidemiological study was to determine mortality and risks related to death in adult patients with healthcare-associated infections admitted to a teaching hospital in one year. Patient data were collected from infection medical reports. The mortality rate associated with infections was 38.4%, and it was classified as a contributing factor to deaths in 87.1% of death cases. The correlation between healthcare-associated infection and death was statistically significant among clinical patients (41.3%) presenting comorbidities related to the diagnosis (55.8%), cardiovascular infection (62.2%), pneumonia (48.9%), developing sepsis (69.0%), as well as patients who had been colonized (45.2%) and infected (44.7%) by multidrug resistance microorganisms.

Although the detection rate is decreasing, the proportion of new cases with WHO grade 2 disability (G2D) is increasing, creating concern among policy makers and the Brazilian government. This study aimed to identify spatial clustering of leprosy and classify high-risk areas in a major leprosy cluster using the SatScan method. Data were obtained including all leprosy cases diagnosed between January 2006 and December 2013. In addition to the clinical variable, information was also gathered regarding the G2D of the patient at diagnosis and after treatment. The Scan Spatial statistic test, developed by Kulldorff e Nagarwalla, was used to identify spatial clustering and to measure the local risk (Relative Risk—RR) of leprosy. Maps considering these risks and their confidence intervals were constructed. A total of 434 cases were identified, including 188 (43.31%) borderline leprosy and 101 (23.28%) lepromatous leprosy cases. There was a predominance of males, with ages ranging from 15 to 59 years, and 51 patients (11.75%) presented G2D. Two significant spatial clusters and three significant spatial-temporal clusters were also observed. The main spatial cluster (p = 0.000) contained 90 census tracts, a population of approximately 58,438 inhabitants, detection rate of 22.6 cases per 100,000 people and RR of approximately 3.41 (95%CI = 2.721–4.267). Regarding the spatial-temporal clusters, two clusters were observed, with RR ranging between 24.35 (95%CI = 11.133–52.984) and 15.24 (95%CI = 10.114–22.919). These findings could contribute to improvements in policies and programming, aiming for the eradication of leprosy in Brazil. The Spatial Scan statistic test was found to be an interesting resource for health managers and healthcare professionals to map the vulnerability of areas in terms of leprosy transmission risk and areas of underreporting. Brazil has still not achieved the goal of leprosy elimination established by the World Health Organization. The diagnosis and treatment of leprosy are available and the country is striving to fully integrate leprosy services into the existing general health services. Access to information, diagnosis and treatment with multidrug therapy (MDT) remain key elements in the strategy to eliminate the disease as a public health problem, defined as reaching a prevalence of less than 1 leprosy case per 10,000 inhabitants. Thus, this study aimed to identify spatial clustering of leprosy and to classify high-risk areas in a major leprosy cluster. A total of 434 cases were identified, with 188 (43.31%) being of borderline leprosy and 101 (23.28%) lepromatous leprosy. There was a predominance of males, with ages ranging from 15 to 59 years, and 51 patients (11.75%) presented G2D. Two significant spatial clusters and three significant spatial-temporal clusters were also observed. These results can assist health services and policy makers to improve the health conditions of the Brazilian population, advancing towards the goal of elimination in Brazil.

Keywords: Syphilis; Prevalence; Serological Tests

The present study aimed to investigate the epidemiological situation of leprosy (Hansen’s Disease), in a hyperendemic metropolis in the Central-West region of Brazil. We studied trends over eleven years, both in the detection of the disease and in disabilities, analyzing disparities and/or differences regarding gender and age. This is an ecological time series study conducted in Cuiabá, capital of the state of Mato Grosso. The population consisted of patients diagnosed with leprosy between the years 2008 and 2018. The time series of leprosy cases was used, stratifying it according to gender (male and female), disability grade (G0D, G1D, G2D, and not evaluated) and age. The calendar adjustment technique was applied. For modeling the trends, the Seasonal-Trend decomposition procedure based on Loess (STL) was used. We identified 9.739 diagnosed cases, in which 58.37% were male and 87.55% aged between 15 and 59 years. Regarding detection according to gender, there was a decrease among women and an increase in men. The study shows an increasing trend in disabilities in both genders, which may be related to the delay in diagnosis. There was also an increasing number of cases that were not assessed for disability at the time of diagnosis, which denotes the quality of the services.

(1) Background: Tuberculosis presents an epidemiological trend toward inequality, especially among people in social exclusion and situations of vulnerability. This study aimed to analyze territories with a concentration of people diagnosed with tuberculosis in a street situation and who partake in chronic use of alcohol, tobacco, and illicit drugs. We also analyzed trends in this health condition in southern Brazil. (2) Methods: Ecological study, developed in the 399 municipalities of Paraná, southern Brazil, with all tuberculosis cases in the homeless population registered in the Information System of Notifiable Diseases between 2014 and 2018. For data analysis, we used descriptive statistics, the Prais–Winsten autoregression method for the time series, and the Getis-Ord Gi technique* for spatial analysis. (3) Results: in total, 560 cases were reported. We found a predominance of alcohol, smoking, and illicit drug users, with an increasing trend in the state and clusters of spatial risk in the East health macro-region. (4) Conclusions: We observed territories with critical levels of highly vulnerable people who use psychoactive substances and are in a street situation. The results highlight the importance of incorporating public policies of social protection for these individuals and resolutive health services that receive these cases and assist in eradicating TB.

Objective: To analyze the HIV care continuum from the diagnosis in an HIV/AIDS Counseling and Testing Center (CTC), and the sociodemographic, clinical, and laboratory characteristics related to gender. Method: Epidemiological study, conducted with data of individuals assisted at a Counseling and Testing Center, and followed in an outpatient clinic for HIV/AIDS. Pearson’s Chi-square test and binary logistic regression were used to obtain odds ratios, considering alpha value <0.05. Results: The prevalence of HIV among 5,229 users was 5%. The highest chance of positive results was among men, aged 14 to 33 years old, who were not in a domestic partnership. In the analysis of TCD4+ lymphocytes and viral load (VL) of 238 cases, 56.1% had a late diagnosis. We have identified gaps in the care cascade, especially linkage to the care, retention in care, and viral load suppression. Conclusion: The results suggest a late diagnosis for both genders, as well as difficulty in reaching the viral suppression goal.