Palavras-chave: Hanseníase; Epidemiologia Descritiva; Criança; Adolescente

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.

El Niño is a climate phenomenon of major relevance to public health, particularly in territorially extensive, socially unequal and environmentally diverse countries such as Brazil. Its effects on temperature, rainfall patterns, droughts, floods, wildfires, water availability, fauna, vectors and territorial dynamics can modify disease transmission patterns, increase social vulnerabilities and place pressure on health services. This narrative review discusses how Brazilian epidemiological surveillance should prepare for the effects of El Niño, considering climate-sensitive diseases and events, information systems of the Unified Health System, the One Health approach, epizootic surveillance, intersectoral response, risk communication and core capacities under the International Health Regulations. The literature shows associations between climate variability, arboviruses, malaria, leptospirosis, diarrheal diseases, respiratory conditions, heat-related events, psychosocial suffering and changes in human-animal-environment interfaces. As an applied contribution, this article proposes an operational model for climate-informed epidemiological surveillance structured around five axes: anticipating, integrating, prioritizing, responding and evaluating. Preparedness for El Niño should be permanent, territorialized, federative, risk-oriented and connected to the Unified Health System, Civil Defense, sanitation, primary health care, laboratories, environmental agencies, veterinary services and situation rooms.

Objective: Describe the epidemiological profile of patients seen in an outpatient clinic in a region of the Amazon. Methodology: A cross-sectional, exploratory, descriptive survey with a quantitative approach, conducted in an outpatient clinic of health specialties of a Private Higher Education Institution (HEI) of Belém-Pará, from February to March 2019. With a range of 100 participants. From the application of a form on the socio-demographic, health and food profile. The data were analyzed by Bioestat version 5.3. Results: 65% female, average age 43, 67% up to a minimum wage, 54% single, 51% with complete high school, 86% from the metropolitan region of Belém, 76% own a home, 75% have basic sanitation, 56% have running water, 50% with a family group of 4 to 6 members, 81% are not smokers, 59% are not alcoholics, 93% have no health plan, 42% in medical treatment, 72% report complete immunization, 79% 3 to 4 meals/day, 59% do not consume canned food, 62% consume fried food weekly, 52% consume fruit and vegetables daily, 60% consume red meat weekly, 51% consume white meat weekly, 50% do not consume soft drinks, 37% do not practice physical activities. Conclusion: Are young adults, with low schooling, low income, inadequate nutrition, who do not engage in physical activities, however most of them have a current vaccination picture, and inadequate basic sanitation. These are determining factors in the quality of life of these individuals, being characteristics of a developing country, and that health interventions and policies should be implemented to promote health.

Objective: To investigate the clinical, demographic, and healthcare factors associated with death from Respiratory Syncytial Virus (RSV) in children under 5 years of age in Brazil during 2024. Methods: Retrospective cohort study using real-world data (SIVEP-Gripe), following the RECORD protocol. A cohort of 24,022 confirmed cases was analyzed. Multivariate logistic regression was used to estimate Adjusted Odds Ratios (aOR), accompanied by sensitivity analysis (E-value) and predictive accuracy (ROC Curve). Results: Hospital lethality was 1.02%. In the multivariate analysis, age was not an independent predictor of death ( p = 0.951). The main factors associated with mortality were invasive ventilatory support (aOR 8.08; 95%CI 5.28–12.38; E-value 15.64), Down Syndrome (aOR 3.21; 95%CI 1.54–6.71), Heart Disease (aOR 2.57; 95%CI 1.42–4.66), and co-infection with 3 or more viruses (aOR 2.36; 95%CI 1.16–4.79). The presence of cough showed a protective effect (aOR 0.68; p = 0.029). The model showed excellent discriminatory capacity (AUC-ROC: 0.814). Conclusion: RSV mortality in hospitalized children in Brazil is driven by healthcare severity and specific comorbidities, regardless of chronological age. Immunization strategies and intensive support should prioritize biologically highly vulnerable groups, such as children with Down Syndrome and heart disease.