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Objectives: To analyse spatial-temporal changes and spatial association of homicide rates with violence, sociodemographic, public security and human rights indicators in Brazilian municipalities., Study Design: An ecological study using homicide estimates from the Global Burden of Disease and population from the Brazilian Ministry of Health, 2000 to 2018. The explanatory variables come from the systems of mortality, notifications of violence and security, and the Brazilian Institute of Geography and Statistics., Methods: Moran indices and maps identified clusters of high and low risk for homicides in three trienniums (p < 0.05). Multivariate linear and spatial regressions estimated explanatory factors' contributions for the last triennium., Results: Municipalities with high rates of homicides (>34/100,000) doubled, reaching 21.5 %. Those rates were concentrated in big cities, and increased in smaller municipalities. Increases in critical areas were found in the Northeast and North regions: more than 40 % in the states of Sergipe, Bahia, Ceará, Rio Grande do Norte and Roraima. Decreases occurred in the Southeast and Midwest regions: more than 35 % in São Paulo and Rio de Janeiro states. The spatial model, with an 18.9 % higher R 2 (0.706), showed a positive association for records of violence, Blacks, low-level education, municipalities >50,000 inhabitants and municipalities with homicide and municipal police., Conclusions: An increase in and the interiorisation of homicide risk areas in Brazil was observed, with displacement among regions (from the Southeast to the North/Northeast). The level of violence was the main explanatory factor for homicides. Territorial space proved to be important to understand and prevent lethal crime., (Copyright © 2023 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.)

This study analyzes the spatial pattern of implementation of Primary Health Care (PHC) teams in Northern and Northeastern Brazil. This is an ecological study on the rates of Community Health Workers (ACS), Family Health Team (eSF), Oral Health Team (eSB), and Family Health Extended Center (NASF) based on data from the Ministry of Health (MoH). The analysis of the area data identified patterns of spatial dependence of the municipalities for the rates, using Moran indices and scatterplots to visualize critical areas' clusters (95% confidence). Municipalities of the North (n=450) and Northeast (n=1,794) had 132,174 ACS, 18,405 eSF, 13,017 eSB, and 2,205 NASF. The proportion of municipalities with rates within the recommended by the MoH were: ACS (>1.33), 96% in the North and 98.5% in the Northeast; eSF (>2.9/1,000), 54% and 80% in the respective regions; eSB (>2.9/10,000) 28% and 59% in these respective regions. NASF teams were deployed in 70% of the North and 89% of the Northeast. Except for ACS, the North was a critical team area, mainly in Pará, Rondônia, Amazonas, and Amapá. In the Northeast, these areas were smaller and concentrated mainly in western Bahia and eastern Maranhão. The Northeast showed a better composition of teams and a smaller extent of critical areas.

Background: Brazil leads the world in number of firearm deaths and ranks sixth by country in rate of firearm deaths per 100,000 people. This study aims to analyze trends in and burden of mortality by firearms, according to age and sex, for Brazil, and the association between these deaths and indicators of possession and carrying of weapons using data from the global burden of diseases, injuries, and risk factors study (GBD) 2017., Methods: We used GBD 2017 estimates of mortality due to physical violence and self-harm from firearms for Brazil to analyze the association between deaths by firearms and explanatory variables., Results: Deaths from firearms increased in Brazil from 25,819 in 1990 to 48,493 in 2017. Firearm mortality rates were higher among men and in the 20-24 age group; the rate was 20 times higher than for women in the same age group. Homicide rates increased during the study period, while mortality rates for suicides and accidental deaths decreased. The group of Brazilian federation units with the highest firearm collection rate (median = 7.5) showed reductions in the rate of total violent deaths by firearms. In contrast, the group with the lowest firearm collection rate (median = 2.0) showed an increase in firearm deaths from 2000 to 2017. An increase in the rate of voluntary return of firearms was associated with a reduction in mortality rates of unintentional firearm deaths (r = -0.364, p < 0.001). An increase in socio-demographic index (SDI) was associated with a reduction in all firearm death rates (r = -0.266, p = 0.008). An increase in the composite index of firearms seized or collected was associated with a reduction in rates of deaths by firearm in the subgroup of females, children, and the elderly (r = -0.269, p = 0.005)., Conclusions: There was a change in the trend of firearms deaths after the beginning of the collection of weapons in 2004. Federation units that collected more guns have reduced rates of violent firearm deaths.

The scope of this paper is to analyze the variation of the spatial pattern of the homicide rate in Brazil between 2000 and 2015. It is an ecological study by micro-regions of homicides taken from the Mortality Information System, using Moran indexes, and critical area clusters (95% CI). The rate increased by 6% (to 29.1/100,000 inhabitants (95% CI 28.9, 29.4), and in 80% of the micro regions between 2000 and 2015. The areas with high rates (> 38.2/100,000) increased 2.7-fold. In 2000, the highest rates were concentrated in areas in Pernambuco, São Paulo, Mato Grosso and Rio de Janeiro; by 2015, it will affect most states in the North and Northeast. The coastal regions of the Northeast and borders of Pará and Maranhão in the Amazon are critical areas. The lowest rate (19.1/100,000) is in São Paulo and Santa Catarina micro regions, with less critical clusters in the Southeast and South regions. Homicides have expanded into the interior of Brazil, with displacement between regions, mainly gravitating towards the poorest, which exhibit more critical areas in several scenarios, such as state borders and the coast. Conversely, there is marked contraction of homicides in states of highly developed regions with the presence of less critical areas. Key words Homicide.

Background: Unspecified causes of death are among the traditional indicators of quality of information., Objective: To verify the performance of the 60 cities in the Data for Health Initiative project and to analyze the reclassification of unspecified external causes of death (UEC)., Methods: Using the 2017 records from the Mortality Information System, the proportion and percent change in UEC were compared after investigation between project cities and other cities, and the percent of reclassification to specific external causes was calculated., Results: The project cities comprised 52% (n = 11,759) of the total UEC in Brazil, of which 64.5% were reclassified after investigation, whereas the other cities reclassified 31% of UEC. Results were similar for men, youth, blacks, metropolitan cities, the Southeast region, and deaths attested by forensic institutes. In the project cities, pedestrian traffic accidents were external causes with greater reclassification. In men, the UEC was reclassified to homicides (23.8%) and accident of terrestrial transportation (ATT) (11.1%), with motorcyclists (4.4%) and pedestrians (4.3%) being the most prominent. In women, these causes were changed to other accident causes (20.8%), ATT (10.6%) and homicides (7.9%). UEC changed to ATT (18.3%) in the age groups of 0-14 years old and to homicides (32.5%) in the age groups of 15-44 years., Conclusion: The project cities obtained better results after investigation of UEC, enabling analysis of the reclassification to specific causes by sex and age groups.

Objective:: To describe the global burden of disease due to road traffic accidents in Brazil and federated units in 1990 and 2015., Methods:: This is an analysis of secondary data from the 2015 Global Burden of Disease study estimates. The following estimates were used: standardized mortality rates and years of life lost by death or disability, potential years of life lost due to premature death, and years of unhealthy living conditions. The Mortality Information System was the main source of death data. Underreporting and redistribution of ill-defined causes and nonspecific codes were corrected., Results:: Around 52,326 deaths due to road traffic accidents were estimated in Brazil in 2015. From 1990 to 2015, mortality rates decreased from 36.9 to 24.8/100 thousand people, a reduction of 32.8%. Tocantins and Piauí have the highest mortality risks among the federated units (FU), with 41.7/100 and 33.1/100 thousand people, respectively. They both present the highest rates of potential years of life lost due to premature deaths., Conclusion:: Road traffic accidents are a public health problem. Using death- or disability-adjusted life years in studies of these causes is important because there are still no sources to know the magnitude of sequelae, as well as the weight of early deaths. Since its data are updated every year, the Global Burden of Disease study may provide evidence to formulate traffic security and health attention policies, which are guided to the needs of the federated units and of different groups of traffic users.

This is a retrospective study with ecological features that describes the epidemiological pattern and geographical distribution of American tegumentary leishmaniasis cases in Campinas, São Paulo, between 1992 and 2003. The probable infection locations were georeferenced by means of Global Position System and spatially described using Spring 4.01 Beta software from the Brazilian National Space Research Institute. A kernel estimator was applied to identify areas of case concentration, three epidemic areas with higher case intensity were found in the municipal area in 1993/1995 and 2002/2003. Socio-demographic (gender, age, occupation, residence time), closeness of domicile to forest, and clinical form of the disease were studied. Although socio-environment characteristics of the areas were different, epidemics profiles were similar. Age, sex and occupational distribution suggest peri-domestic transmission. Proximity to forest has been a risk factor.

Schistosomiasis control programs in Brazil have helped reduce prevalence and the severe forms of the disease, but have failed to prevent new foci from appearing, especially on the periphery of large cities. The current article aims to assess the prevalence of schistosomiasis and the presence of intermediates hosts for Schistosoma mansoni in the district of Ravena, Municipality of Sabará, Minas Gerais State, Brazil, 27 years after implementing water treatment and specific treatment for infected individuals. Ravena responded positively to schistosomiasis control measures, with a prevalence of 2.5%. However, the district remains a potential risk area, since it displays favorable environmental and ecological factors for maintenance of the disease. For the prevalence rates to continue low, it will be necessary to invest in sanitation and health education, in addition to treatment of infected individuals.

The objective of this study was to investigate the spatial distribution of reported hantavirus cases in São Paulo State, Brazil (n = 80), from 1993 to 2005 and identify local climatic patterns during this period. Kernel point estimation of density was used to show the highest concentrations in Ribeirão Preto, São Carlos, Franca, Tupi Paulista, and Greater São Paulo. Increase in the number of cases during this period suggests disease dissemination even when considering increased diagnostic capacity and higher sensitivity of the health services. There was a marked seasonal variation in hantavirus in the cerrado (savannah) areas; the common pattern is a higher incidence in drier months as compared to mean levels in the last 40 years. These coincide with periods of high rodent food source levels in grains, sugarcane, and other crops. Harvesting and storing grains increases human exposure to rodents. Climatic indicators together with ecological variables can be local transmission risk markers and should receive more attention in epidemiological monitoring and control of the disease.

Construction of the Tucuruí hydroelectric dam in Southeast Pará State, Brazil, in 1981, caused enormous environmental changes, deforestation, and human migration to the region. This study focuses on the influence of these changes and the appearance of malaria in the municipality of Jacundá, Pará, using remote sensing and geographic information systems. The variables used to construct maps were distances from roads, farming areas, rivers, the dam, streams, and the urban area. This study confirmed the elevation of malaria to the epidemic level since the construction of the Tucuruí dam. The study suggests that a seasonal pattern of malaria incidence is associated with the flooding season and exposure of workers during harvest. Malaria cases were related to the form of land occupation, especially in more densely populated areas.

The objective of this study, based on a systematic literature review, is to present the characteristics and potentialities of remote sensing as a useful environmental surveillance tool for applied research in the control of endemics in Brazil. Onboard satellite sensors allow for monitoring the territory, furnishing spatial and temporal information on various scales and regions in the electromagnetic spectrum. Based on the literature review on the application of this technology to the study of endemics and the identification of the potential of new sensors with better spectral, spatial, and temporal resolutions, this study highlights perspectives for the use of remote sensing in the study of important endemics for Brazil.