José Cerbino Neto

Factors associated with the incidence of urban visceral leishmaniasis: an ecological study in Teresina, Piauí State, Brazil

The objective of this study was to identify socioeconomic and environmental factors associated with the incidence of visceral leishmaniasis in the city of Teresina, Piauí State, Brazil. This was an ecological study based on 1,744 cases reported from 1991 to 2000, and the citys neighborhoods served as the unit of analysis. Mean annual incidence rates were related to socioeconomic and demographic indicators and a vegetation index derived from remote sensing images by means of spatial multiple linear regression models. The neighborhoods with the highest incidence rates were mostly located in the citys peripheral areas. Multivariate analysis identified an interaction between population growth and the vegetation index, so that areas with high population growth and abundant vegetation showed the highest incidence rates. The percentage of households with piped water was inversely associated with visceral leishmaniasis incidence. Spatial distribution of visceral leishmaniasis in Teresina during the 1990s was heterogeneous, and incidence of the disease was associated with the peripheral neighborhoods with the heaviest vegetation cover, subject to rapid occupation and lack of adequate sanitation infrastructure.

Regional differences in mortality associated with pandemic Influenza A H1N1 in Brazil

The aim of this article is to examine regional differences in mortality associated with influenza from 2006 to 2010 in Brazil. Syndromic surveillance, which includes deaths from pneumonia and influenza recorded in the Mortality Information System, only showed an increase in mortality during the pandemic in the South, Southeast, and Central, regions. In these regions, especially in the South, this increase occurred from July to September 2009. A review of deaths from confirmed influenza cases reported to the Information System for Notifiable Diseases showed different temporal patterns in the South/Southeast and the North/Northeast, with an increase from July to November 2009 for all regions and another peak, only for the latter, in March 2010, before the vaccination campaign. The results show regional differences in the intensity and temporal distribution of pandemic influenza and highlight the need for specific surveillance tools and control strategies for regions of the country.

The evolution of the federal funding policies for the public health surveillance component of Brazil's Unified Health System (SUS)

Health surveillance (HS) is one of the key components of the Brazilian Unified Health System (SUS). This article describes recent changes in health surveillance funding models and the role these changes have had in the reorganization and decentralization of health actions. Federal law no. 8.080 of 1990 defined health surveillance as a fundamental pillar of the SUS, and an exclusive fund with equitable distribution criteria was created in the Basic Operational Norm of 1996 to pay for health surveillance actions. This step facilitated the decentralization of health care at the municipal level, giving local authorities autonomy to plan and provide services. The Health Pact of 2006 and its regulation under federal decree No. 3252 in 2009 bolstered the processes of decentralization, regionalization and integration of health care. Further changes in the basic concepts of health surveillance around the world and in the funding policies negotiated by different spheres of government in Brazil have been catalysts for the process of HS institutionalization in recent years.

Questões éticas no manejo de pacientes com doença pelo vírus Ebola

On October 10, 2014, the Evandro Chagas Na-tional Institute of Infectious Diseases of the Os-waldo Cruz Foundation (INI/Fiocruz) in Rio de Janeiro received the first suspected case of Ebola virus disease in Brazil. Twenty-four hours after admission, the result of the patient’s first poly-merase chain reaction (PCR) test came back negative. Following the prevailing protocol

Cuestiones éticas en el manejo de los pacientes con la enfermedad del virus Ebola

On October 10, 2014, the Evandro Chagas Na-tional Institute of Infectious Diseases of the Os-waldo Cruz Foundation (INI/Fiocruz) in Rio de Janeiro received the first suspected case of Ebola virus disease in Brazil. Twenty-four hours after admission, the result of the patient’s first poly-merase chain reaction (PCR) test came back negative. Following the prevailing protocol

Ethical issues in the management of patients with Ebola virus disease

On October 10, 2014, the Evandro Chagas Na-tional Institute of Infectious Diseases of the Os-waldo Cruz Foundation (INI/Fiocruz) in Rio de Janeiro received the first suspected case of Ebola virus disease in Brazil. Twenty-four hours after admission, the result of the patient’s first poly-merase chain reaction (PCR) test came back negative. Following the prevailing protocol

Diferencias regionales en la mortalidad asociada a la gripe A H1N1 pandémica en Brasil

The aim of this article is to examine regional differences in mortality associated with influenza from 2006 to 2010 in Brazil. Syndromic surveillance, which includes deaths from pneumonia and influenza recorded in the Mortality Information System, only showed an increase in mortality during the pandemic in the South, Southeast, and Central, regions. In these regions, especially in the South, this increase occurred from July to September 2009. A review of deaths from confirmed influenza cases reported to the Information System for Notifiable Diseases showed different temporal patterns in the South/Southeast and the North/Northeast, with an increase from July to November 2009 for all regions and another peak, only for the latter, in March 2010, before the vaccination campaign. The results show regional differences in the intensity and temporal distribution of pandemic influenza and highlight the need for specific surveillance tools and control strategies for regions of the country.

Diferenças regionais na mortalidade associada à influenza A H1N1 pandêmica no Brasil

The aim of this article is to examine regional differences in mortality associated with influenza from 2006 to 2010 in Brazil. Syndromic surveillance, which includes deaths from pneumonia and influenza recorded in the Mortality Information System, only showed an increase in mortality during the pandemic in the South, Southeast, and Central, regions. In these regions, especially in the South, this increase occurred from July to September 2009. A review of deaths from confirmed influenza cases reported to the Information System for Notifiable Diseases showed different temporal patterns in the South/Southeast and the North/Northeast, with an increase from July to November 2009 for all regions and another peak, only for the latter, in March 2010, before the vaccination campaign. The results show regional differences in the intensity and temporal distribution of pandemic influenza and highlight the need for specific surveillance tools and control strategies for regions of the country.