Equity in health: tuberculosis in the Bolivian immigrant community of Sao Paulo, Brazil

Objectives To analyse the profile of tuberculosis (TB) among Bolivian immigrants, investigate the impact that this population has on the trends of TB and assess equity in access to TB treatment, in the city of Sao Paulo, Brazil. Methods Descriptive study of the epidemiological profile of TB in four city districts with large Bolivian populations, comparing cases among Brazilians and Bolivians, during the 19982008 period was carried out. We used logistic regression to adjust the treatment outcome for potential confounders. Results We identified 2056 new TB cases: 65.7% in Brazilians, 32.1% in Bolivians and 2.2% among other nationalities. Although TB incidence remained stable (high) over the study period, the annual proportion of cases among Bolivians increased from 15.0% to 53.0%. In comparison with the Brazilians, the Bolivians were younger (median age, 24 vs. 40 years; P < 0.0001) and presented a lower unemployment rate (3.1%vs. 11.6%; P < 0.0001), a lower rate of HIV co-infection (1.5%vs. 28.5%; P < 0.001), a higher proportion of individuals receiving supervised treatment (81.5%vs. 62.0%; P < 0.0001) and a higher proportion of cures (71.6%vs. 63.2%; P < 0.0001). After having been adjusted for potential confounder, cure after treatment was not associated with nationality. Conclusions Bolivian immigrants influenced the incidence but not the trends of TB among Brazilians in the study area. We found no significant differences between Bolivians and Brazilians regarding healthcare access or treatment outcome. Guaranteed universal health care access for all, including undocumented individuals, contributes to health equity. Specific intervention strategies are warranted for immigrants with tuberculosis.

CHEMICAL AND BIOCHEMICAL PROPERTIES OF ARAUCARIA ANGUSTIFOLIA (BERT.) KTZE. FOREST SOILS IN THE STATE OF SAO PAULO

Araucaria angustifolia, commonly named Araucaria, is a Brazilian native species that is intensively exploited due to its timber quality. Therefore, Araucaria is on the list of species threatened by extinction. Despite the importance of soil for forest production, little is known about the soil properties of the highly fragmented Araucaria forests. This study was designed to investigate the use of chemical and biological properties as indicators of conservation and anthropogenic disturbance of Araucaria forests in different sampling periods. The research was carried out in two State parks of Sao Paulo: Parque Estadual Turistico do Alto do Ribeira and Parque Estadual de Campos de Jordao. The biochemical properties carbon and nitrogen in microbial biomass (MB-C and MB-N), basal respiration (BR), the metabolic quotient (qCO(2)) and the following enzyme activities: beta-glucosidase, urease, and fluorescein diacetate hydrolysis (FDA) were evaluated. The sampling period (dry or rainy season) influenced the results of mainly MB-C, MB-N, BR, and qCO(2). The chemical and biochemical properties, except K content, were sensitive indicators of differences in the conservation and anthropogenic disturbance stages of Araucaria forests. Although these forests differ in biochemical and chemical properties, they are efficient in energy use and conservation, which is shown by their low qCO(2), suggesting an advanced stage of succession.

Mapping of risk and susceptibility of shallow-landslide in the city of Sao Paulo, Brazil

In the city of Sao Paulo, where about 11 million people live, landslides and flooding occur frequently, especially during the summer. These landslides cause the destruction of houses and urban equipment, economic damage, and the loss of lives. The number of areas threatened by landslides has been increasing each year. The objective of this article is to analyze the probability of risk and susceptibility to shallow landslides in the Limoeiro River basin, which is located at the head of the Aricanduva River basin, one of the main hydrographic basins in the city of Sao Paulo. To map areas of risk, we created a cadastral survey form to evaluate landslide risk in the field. Risk was categorized into four levels based on natural and anthropogenic factors: R1 (low risk), R2 (average risk), R3 (high risk), and R4 (very high risk). To analyze susceptibility to shallow landslides, we used the SHALSTAB (Shallow Landsliding Stability) mathematical model and calculated the Distribution Frequency (DF) of the susceptibility classes for the entire basin. Finally, we performed a joint analysis of the average Risk Concentration (RC) and Risk Potential (RP). We mapped 14 risk sectors containing approximately 685 at-risk homes, more than half of which presented a high (R3) or very high (R4) probability of risk to the population. In the susceptibility map, 41% of the area was classified as stable and 20% as unconditionally unstable. Although the latter category accounted a smaller proportion of the total area, it contained a concentration (RC) of 41% of the mapped risk areas with a risk potential (RP) of 12%. We found that the locations of areas predicted to be unstable by the model coincided with the risk areas mapped in the field. This combination of methods can be applied to evaluate the risk of shallow landslides in densely populated areas and can assist public managers in defining areas that are unstable and inappropriate for occupation. (C) 2012 Elsevier B.V. All rights reserved.

PCBs, PBDEs and organochlorine pesticides in crabs Hepatus pudibundus and Callinectes danae from Santos Bay, State of Sao Paulo, Brazil

The occurrence of persistent organic pollutants (POPS) as polychlorinated biphenyls (PCBs), organochlorine pesticides (OCPs) and polybrominated diphenyl ethers (PBDE) in crabs Hepatus pudibundus and Callinectes danae was assessed from two different places inside of the Santos Bay and Moela Island near one of the most economically important metropolitan areas in Southern Brazil. Among POPs analyzed, Sigma PCBs (222-923 ng g(-1) lipid weight) and Sigma DDTs (154-410 ng g(-1) lw) exhibited the highest concentrations in the crabs. Sigma HCHs ranged from 10.3 to 30.9 ng g(-1), lw and were found in all individuals. Other OCPs found in lower concentration was Mirex (7.6-41.6 ng g(-1) lw) and HCB (5.83-16.9 ng g(-1) lw). Sigma PBDEs (24.1 ng g(-1) lw) were only found in one male individual from the species C. danae collected near to the submarine sewage of Santos. Male crabs showed higher POP concentrations than female crabs for those two species. (C) 2011 Elsevier Ltd. All rights reserved.

Status of Aceria guerreronis Keifer (Acari: Eriophyidae) as a Pest of Coconut in the State of Sao Paulo, Southeastern Brazil

The coconut mite, Aceria guerreronis Keifer, is one of the main pests of coconut palms (Cocos nucifera) in northeastern Brazil. The objective of this study was to evaluate the levels of the coconut mite and other mites on coconut palms in the state of So Paulo and to estimate the possible role of predatory mites in the control of this pest. The effect of cultivated genotypes and sampling dates on the mite populations was also estimated. We sampled attached fruits, leaflets, inflorescences, and fallen fruits. The coconut mite was the main phytophagous mite found on attached and fallen fruits, with average densities of 110.0 and 20.5 mites per fruit, respectively. The prevalent predatory mites on attached and fallen fruits were Proctolaelaps bulbosus Moraes, Reis & Gondim Jr. and Proctolaelaps bickleyi (Bram), both Melicharidae. On leaflets, the tenuipalpids Brevipalpus phoenicis (Geijsks) and Tenuipalpus coyacus De Leon and the tetranychid Oligonychus modestus (Banks) were the predominant phytophagous mites. On both leaflets and inflorescences, the predominant predatory mites belonged to the Phytoseiidae. Neoseiulus baraki (Athias-Henriot) and Neoseiulus paspalivorus (De Leon), predators widely associated with the coconut mite in northeastern Brazil and several other countries, were not found. The low densities of the coconut mite in So Paulo could be related to prevailing climatic conditions, scarcity of coconut plantations (hampering the dispersion of the coconut mite between fields), and to the fact that some of the genotypes cultivated in the region are unfavorable for its development.

Genotyping of polymorphisms in the prnp gene in Santa Ines sheep in the State of Sao Paulo, Brazil

Santos C.R., Mori E., Leao D.A. & Maiorka P.C. 2012. [Genotyping of polymorphisms in the prnp gene in Santa Ines sheep in the State of Sao Paulo, Brazil.] Genotipagem de polimorfismos no gene prnp em ovinos Santa Ines no Estado de Sao Paulo. Pesquisa Veterinaria Brasileira 32(3):221-226. Laboratorio de Neuropatologia Experimental e Comparada, Departamento de Patologia, Faculdade de Medicina Veterinaria e Zootecnia, Universidade de Sao Paulo, Av. Prof. Dr. Orlando Marques de Paiva 87, Cidade Universitaria, Sao Paulo, SP 05508-270, Brazil. E-mail: caio-patologia@usp.br Enzootic paraplexia or scrapie is a fatal neurodegenerative disease affecting mainly sheep and rarely goats. The disease is influenced by polymorphisms at codons 136, 154 and 171 of prnp gene that encodes the prion protein. The animals may be susceptible or resistant to the development of the disease according to the allelic sequences observed in these codons. In Brazil there were only cases of scrapie in imported animals, therefore the country is considered free of the disease. This study performed the genotyping of different polymorphisms associated to the development of scrapie. Then, based on these findings the animals were categorized in resistant and susceptible. A total of 118 samples were sequenced from the Santa Ines sheep raised on properties located in the State of Sao Paulo. From these samples, 6 alleles and 11 genotypes were identified (ARQ / ARQ, ARR / ARQ, ARQ / AHQ, ARQ / VRQ, AHQ / AHQ, ARR / ARR, ARR / AHQ, VRQ / VRQ, ARQ / TRQ, TRR / TRR, TRQ / TRQ), the genotype ARQ / ARQ presented a frequency of 56.7%. It was also detected the presence of tyrosine at codon 136, which may be considered a rare observation, since there is no report regarding Santa Ines breeding presenting this polymorphism. These results showed the great genetic variability in Santa Ines in Sao Paulo and only 1,69% of the genotypes observed are extremely resistant to scrapie. These data demonstrate that the Santa Ines sheep can be considered potentially susceptible to scrapie.

Scientific research output evaluation of professors of Sao Paulo State University, Marilia/SP

In this work, an analysis of scientific bibliographic productivity was made using the Faculdade de Filosofia e Ciencias, Universidade Estadual Paulista (FFC-UNESP) as example. It is composed by nine departments which offer altogether nine undergraduate courses: 1) Archival, 2) Library, 3) Speech Therapy, 4) Pedagogy, 5) International Relations, 6) Physiotherapy, 7) Occupational Therapy, 8) Philosophy, 9) Social Sciences and six graduate programs leading to M. S. and Ph.D. degrees. Moreover, when analyzing the different courses of FFC-UNESP, they represent typical academic organization in Brazil and Latin America and could be taken as a model for analyzing other Brazilian research institutions. Using data retrieved from the Lattes Plataform database (Curriculum Lattes) we have quantitatively the scientific productivity percentage of professors at UNESP. We observed that bibliometric evaluations using the Curriculum Lattes (CL) showed that the professors published papers in journal are not indexed by ISI and SCOPUS. This analysis was made using: 1) the total number of papers (indexed in Curriculum Lattes database), 2) the number of papers indexed by Thomson ISI Web of Science database and SCOPUS database, and 3) the Hirsch (h-index) by ISI and SCOPUS. Bibliometric evaluations of departments showed a better performance of Political Science and Economics Department when compared to others departments, in relation total number of papers (indexed in Curriculum Lattes database). We also analyzed the academic advisory (Master's Thesis and Ph. D. Thesis) by nine departments of FFC/UNESP. The Administration and School Supervision Department presented a higher academic advisory (concluded and current) when compared to the others departments.

Spatial regimes: dynamics of intentional homicides in the city of Sao Paulo between 2000 and 2008

Objective. To identify the existence of spatial and temporal patterns in the occurrence of intentional homicides in the municipality of Sao Paulo (MSP), Brazil, and to discuss the analytical value of taking such patterns into account when designing studies that address the dynamics and factors associated with the incidence of homicides. Methods. A longitudinal ecological study was conducted, having as units of analysis 13 205 census tracts and the 96 census districts that congregate these sectors in Sao Paulo. All intentional homicides reported in the city between 2000 and 2008 were analyzed. The gross homicide rates per 100 000 population was calculated as well as the global and local Bayesian estimates for each census tract during the study period. To verify the possibility of identifying different patterns of the spatial distribution of homicides, we used BoxMap and Moran's I index. Results. The homicide trends in the city of Sao Paulo in the last decade were not homogeneous and systematic. Instead, seven patterns of spatial distribution were identified; that is, seven spatial regimes for the occurrence of intentional homicides, considering the homicide rates within each census tract as well as the rates in adjacent tracts. These spatial distribution regimes were not contained within the limits of the census tracts and districts. Conclusions. The results show the importance of analyzing the spatial distribution of social phenomena without restriction of political and administrative boundaries.

Relations between Depression, Alcohol and Gender in the Metropolitan Region of Sao Paulo, Brazil

As part of the GENACIS project, this paper sought to assess the prevalence of depression in an urban sample in the city of Sao Paulo, Brazil, as well as the association between depression and alcohol abuse according to gender. To achieve this, an epidemiological survey was conducted using a stratified probability sample, including 2,083 adults. CIDI SF was used to identify depression. The Rao Scott test and multivariate logistic regression were used for statistical analysis. The response rate was 74.9%. Females (58.3%) under 40 years of age (52%) were predominant. The prevalence of depression was 28.3% for women and 12.7% for men. Most men declared being drinkers (61.1%) in the last year. Depression was associated with an alcohol drinking pattern, mostly binge drinking, in addition to the occurrence of problems derived from alcohol use. Most women declared being abstainers (69.5%). Depression was associated with cohabiting with spouses with alcohol-related problems. Results reveal that the association between depression and alcohol consumption is distinct between genders.

Family Health Support Centers: challenges and opportunities from the perspective of primary care professionals in the city of Sao Paulo, Brazil

Family Health Support Centers (NASF) were created in Brazil to increase the case-resolution capacity of primary healthcare. Prior to their implementation in the West Side of the city of Sao Paulo, Brazil, a series of workshops were held for primary healthcare professionals to prepare a proposal for such centers. Hermeneutic analysis was used to study the transcribed material. The thematic categories were: role, constitution, and functioning of the NASF, relationship with family health teams, and interdisciplinarity. The participants' expected the NASF to be an empowering device for comprehensiveness of care, intervening in an existing culture of unnecessary referrals while fostering linkage with other levels of care. The participants also expected the NASF to contribute to the discussion on health professionals' training and stimulating reflection with policy-makers on health indicators based exclusively on the number of consultations. These indicators fail to reflect the impact on the services' activities and the quality of care offered to the population in the coverage area.

Spatio-temporal patterns of tuberculosis incidence in Ribeirao Preto, State of Sao Paulo, southeast Brazil, and their relationship with social vulnerability: a Bayesian analysis

Introduction: The purpose of this ecological study was to evaluate the urban spatial and temporal distribution of tuberculosis (TB) in Ribeirao Preto, State of Sao Paulo, southeast Brazil, between 2006 and 2009 and to evaluate its relationship with factors of social vulnerability such as income and education level. Methods: We evaluated data from TBWeb, an electronic notification system for TB cases. Measures of social vulnerability were obtained from the SEADE Foundation, and information about the number of inhabitants, education and income of the households were obtained from Brazilian Institute of Geography and Statistics. Statistical analyses were conducted by a Bayesian regression model assuming a Poisson distribution for the observed new cases of TB in each area. A conditional autoregressive structure was used for the spatial covariance structure. Results: The Bayesian model confirmed the spatial heterogeneity of TB distribution in Ribeirao Preto, identifying areas with elevated risk and the effects of social vulnerability on the disease. We demonstrated that the rate of TB was correlated with the measures of income, education and social vulnerability. However, we observed areas with low vulnerability and high education and income, but with high estimated TB rates. Conclusions: The study identified areas with different risks for TB, given that the public health system deals with the characteristics of each region individually and prioritizes those that present a higher propensity to risk of TB. Complex relationships may exist between TB incidence and a wide range of environmental and intrinsic factors, which need to be studied in future research.

Spatio-temporal variability of sugarcane yield efficiency in the state of Sao Paulo, Brazil

The objective of this work was to assess the spatial and temporal variability of sugarcane yield efficiency and yield gap in the state of Sao Paulo, Brazil, throughout 16 growing seasons, considering climate and soil as main effects, and socioeconomic factors as complementary. An empirical model was used to assess potential and attainable yields, using climate data series from 37 weather stations. Soil effects were analyzed using the concept of production environments associated with a soil aptitude map for sugarcane. Crop yield efficiency increased from 0.42 to 0.58 in the analyzed period (1990/1991 to 2005/2006 crop seasons), and yield gap consequently decreased from 58 to 42%. Climatic factors explained 43% of the variability of sugarcane yield efficiency, in the following order of importance: solar radiation, water deficit, maximum air temperature, precipitation, and minimum air temperature. Soil explained 15% of the variability, considering the average of all seasons. There was a change in the correlation pattern of climate and soil with yield efficiency after the 2001/2002 season, probably due to the crop expansion to the west of the state during the subsequent period. Socioeconomic, biotic and crop management factors together explain 42% of sugarcane yield efficiency in the state of Sao Paulo.

Determinants of cognitive performance among community dwelling older adults in an impoverished sub-district of Sao Paulo in Brazil

Determinants of cognitive performance in old age have received limited attention in Latin America. We investigated the association of socio-demographic and health-related variables with cognitive performance in a sample of older adults with limited educational experience living in a poor subdistrict of the city of Sao Paulo. This was a cross-sectional population-based study which included a sample of 384 seniors 65 years and older. Cognition was assessed by the Mini-Mental State Examination (MMSE) and the Brief Cognitive Screening Battery (BCSB) (episodic memory test with 10 pictures, verbal fluency (VF), Clock Drawing Test (CDT)). Results indicated that age, sex, schooling, depressive symptoms, and systolic blood pressure (SBP) level had a significant impact on the cognitive performance of the sample. Therefore, pharmacological and psychosocial interventions with a focus on improving mood and controlling hypertension may have beneficial effects on cognition among seniors with similar socio-demographic characteristics. (C) 2011 Elsevier Ireland Ltd. All rights reserved.

Self-reported hearing loss among elderly individuals in the city of Sao Paulo, Brazil: prevalence and associated factors (SABE Study, 2006)

This article describes the prevalence of self-reported hearing loss in an elderly population in the city of Sao Paulo, Brazil, and associated factors, based on a cross-sectional descriptive and quantitative study. The sample consisted of individuals over 65 years of age selected from census tracts in two stages, with replacement and probability proportional to the population 75 years of age or older. Statistical analysis used Stata 10 with weighted data, Rao-Scott test, and backward stepwise Poisson regression. 1,115 elders were interviewed. Prevalence of self-reported hearing loss was 30.4%, and higher levels were associated with age over 75 years, male gender, self-reported musculoskeletal conditions, dizziness, visual impairment, and difficulty using the telephone. Increased knowledge of factors associated with hearing loss would support public policies on hearing. The high prevalence found in this study underlines the importance of addressing this issue among the elderly.

Clinical, epidemiological and molecular features of the HIV-1 subtype C and recombinant forms that are circulating in the city of Sao Paulo, Brazil

Background: The city of Sao Paulo has the highest AIDS case rate, with nearly 60% in Brazil. Despite, several studies involving molecular epidemiology, lack of data regarding a large cohort study has not been published from this city. Objectives: This study aimed to describe the HIV-1 subtypes, recombinant forms and drug resistance mutations, according to subtype, with emphasis on subtype C and BC recombinants in the city of Sao Paulo, Brazil. Study design: RNA was extracted from the plasma samples of 302 HIV-1-seropositive subjects, of which 211 were drug-naive and 82 were exposed to ART. HIV-1 partial pol region sequences were used in phylogenetic analyses for subtyping and identification of drug resistance mutations. The envelope gene of subtype C and BC samples was also sequenced. Results: From partial pol gene analyses, 239 samples (79.1%) were assigned as subtype B, 23 (7.6%) were F1, 16 (5.3%) were subtype C and 24 (8%) were mosaics (3 CRF28/CRF29-like). The subtype C and BC recombinants were mainly identified in drug-naive patients (72.7%) and the heterosexual risk exposure category (86.3%), whereas for subtype B, these values were 69.9% and 57.3%, respectively (p = 0.97 and p = 0.015, respectively). An increasing trend of subtype C and BC recombinants was observed (p < 0.01). Conclusion: The HIV-1 subtype C and CRFs seem to have emerged over the last few years in the city of Sao Paulo, principally among the heterosexual population. These findings may have an impact on preventive measures and vaccine development in Brazil.