Ananindeua city, State of Pará, North of Brazil, is a hyperendemic area for tuberculosis (TB), with a cure rate below the recommendation by the Brazilian Ministry of Health. We aimed to describe: (I) the TB incidence coefficient of Ananindeua municipality comparatively against Brazilian data; (II) TB treatment outcomes; (III) to compare the socioeconomic and epidemiological characteristics of abandonment versus cure outcome; and (IV) to evaluate the risk factors associated with TB treatment abandonment in Ananindeua city, from 2017 to 2021. This is a retrospective, descriptive, and cross-sectional epidemiological study which used secondary TB entries. Data were analyzed by linear regression, descriptive statistics, and associations were made using the Chi-square test and G-test, followed by univariate and multivariate logistic regression analyses. Cure rates ranged from 28.7% to 70.1%, abandonment between 7.3% and 11.8%, deaths from the disease ranged from 0% to 1.6%, and drug-resistant tuberculosis (TB-DR) rates had frequencies from 0% to 0.9%. Patient transfer rates to other municipalities were between 4.9% and 12.5%. The multivariate analysis showed that alcohol is almost 2 times more likely to lead an individual to abandon treatment and use of illicit drugs was almost 3 times more likely. Individuals between 20 and 59 years of age were also more likely to abandon treatment almost twice as often. Finally, data obtained in the present report is of great relevance to strengthen epidemiological surveillance and minimize possible discrepancies between the information systems and the reality of public health in high endemicity areas.

In 2018, an outbreak of human rabies caused by the hematophagous bat Desmodus rotundus hit the Brazilian Amazon Basin community of Melgaço, Brazil, resulting in the death of 10 people, 9 of them children. The incidence of rabies has been on the rise among populations in conditions of vulnerability in this ecosystem due to human expansion into sylvatic environments and limited access to public health services. To address this issue, in September 2019, a collaborative effort from national, local, and international institutions promoted and executed a pilot for pre-exposure prophylaxis of a population in high-risk areas for hematophagous bat-mediated rabies. This measure is usually only implemented in response to outbreaks. The pilot was conducted in Portel, in a nearby location to the previous outbreak, with the use of fluvial transportation, and 2987 individuals in 411 dwellings were successfully vaccinated. It established a methodology for pre-exposure prophylaxis for populations in conditions of vulnerability, identifying logistics and costs, as well as characterizing the target riverine population regarding risk factors associated with bites by hematophagous bats. This approach offers a proactive measure to prevent future outbreaks and provides valuable insights into how to address the issue of rabies in remote and difficult-to-reach areas.

Os fatores antropogênicos como deslocamento de populações, aglomerações e o processo acelerado e precário de urbanização em consonância aos fatores climáticos criam condições para aumento rápido de doenças transmissíveis, principalmente as de origem infecciosa. Este estudo corrobora com a ideia de que as variações do clima podem causar efeitos indesejáveis sobre o estado saudável do homem, de formato direto e/ou indireto. O objetivo da presente revisão foi investigar e analisar os estudos existentes na literatura acerca da relação existente entre as variantes climáticas e as doenças de origem infecciosa. Trata-se de uma revisão bibliográfica qualitativa, descritiva, do tipo Revisão Integrativa da Literatura, baseada em investigações científicas divulgadas entre 2015 a 2020. Efetuou-se buscas nas bases de dados: SciELO, LILACS e MEDLINE. A coleta dos estudos foi posta a um instrumento do formulário autenticado por Ursi e Galvão (2015) adaptado. Para análise das informações, foi utilizada a Análise de Conteúdo Temático de Bardin (ACTB). Identificaram-se no total 220 publicações, sendo 203 no MEDLINE, 14 no LILACS e 03 na SciELO. Amostra final foram de 13 produções. O quantitativo de pesquisas brasileiras acerca da temática foi inferior ao esperado, o que é capaz de ser justificado, talvez, pela escolha das palavras-chave. A temperatura, a umidade, a intervenção antropogênica entre outros, alteram ou influenciam de alguma forma na disseminação desta infecção, isto acende advertência para a importância de uma aproximação inter e multidisciplinar, mas partindo uma perspectiva ética sustentável e justa que permita a convivência digna e equilibrada com todos os seres vivos.

Introduction: Tuberculosis (TB) is an infection caused by bacteria from the Mycobacterium tuberculosis complex, transmitted through airborne aerosols, released during coughing, talking, or sneezing. Despite advancements in TB control and the availability of established treatments for over 40 years, there are still ten million new cases, and 1.5 million deaths reported annually worldwide. Methods: A descriptive and ecological study was performed on all TB-related deaths reported between 2010 and 2022, in Pará, Brazil. Data were obtained from Notifiable diseases Information System. The study have analyzed clinical, epidemiological and sociodemographic characteristics, as well as geographical and statistical trends in mortality, using binary logistic regression. Results: A total of 1,253 TB-related deaths were reported in Pará. There was a significant increasing trend in the mortality rate, with the highest value observed in the metropolitan mesoregion. The mean age was 52.1 years, most were male, brown, without elementary education and lived in the urban area. New TB cases were the most frequently recorded, with the pulmonary clinical form accounting for 84% of cases and 15.5% of cases reported from alcoholism. The most common diagnosis was sputum smear microscopy, however, follow-up sputum smear microscopies were infrequently and directly observable treatment was rarely performed (19.2%). The multivariate analysis of deaths by mesoregion revealed significant differences with each mesoregion exhibiting distinct contributing variables. Conclusions: Our results show the need for epidemiological surveillance professionals to implemente different surveillance measures and strategies for each mesoregion. Strengthening municipal healthcare system is a critical step to ensure early diagnosis and appropriate treatment for each clinical case. In addition, public policies should aim to improve socio-environmental and economic conditions addressing regional disparities to better serve the community.

Introdução: A utilização de tecnologias baseadas nos sistemas de informações geográficas, como a análise espacial, contribui para o entendimento da dinâmica de distribuição dos casos da doença, uma vez que facilita a identificação das áreas ou locais de risco e, assim, constitui instrumento para o gerenciamento e planejamento de políticas ou programas de saúde, subsidiando estratégias de controle e de prevenção da tuberculose (TB). Objetivo: sintetizar as evidências científicas sobre a análise espacial no controle da TB no Brasil em diferentes cenários. Método: trata-se de uma Revisão Integrativa da Literatura, com base na metodologia de PICo. As bases de dados utilizadas foram: Scopus, Web Of Science (WOS), Literatura Latina Americana e do Caribe em Ciências da Saúde (LILACS) e a National Center for Biotechnology Information (PUBMED). As palavras utilizadas para a busca nas bases de dados, a partir dos Descritores em Ciências da Saúde (DeCS), foram: “Tuberculosis”; “Spatial Analysis”; e “Brazil”. Resultados: Foram selecionados 14 artigos; sendo 35,71% na Região Nordeste, 21,42% Região Sudeste, 14,28% na Região Norte, 7,14% na Região Sul, 7,14% na Região Centro-oeste e 14,28% com abrangência nacional. Identificaram-se três categorias temáticas: Técnicas de Análise Espacial; Determinantes socioeconômicos; e Áreas prioritárias e Vulnerabilidades Sociais. Conclusão: As tecnologias de geoprocessamento podem ser utilizadas como ferramentas eficazes na vigilância da TB no Brasil, possibilitando o direcionamento do planejamento, implementação e avaliação de ações de saúde voltadas à população acometido, de forma específica e eficaz, conforme a distribuição territorial da doença.