Spatio-temporal patterns of tuberculosis incidence in Ribeirão Preto, State of São 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 Ribeirão Preto, State of São 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 Ribeirão 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.

Space-temporal dynamics of limnological variables in a floodplain wetland located at Ribeira do Iguape Valley (São Paulo, Brazil) at different hydrological periods

AIM: The main goal of this research was to investigate the influence of the hydrological pulses on the space-temporal dynamics of physical and chemical variables in a wetland adjacent to Jacupiranguinha River (São Paulo, Brazil); METHODS: Eleven sampling points were distributed among the wetland, a tributary by its left side and the adjacent river. Four samplings were carried out, covering the rainy and the dry periods. Measures of pH, dissolved oxygen, electrical conductivity and redox potential were taken in regular intervals of the water column using a multiparametric probe. Water samples were collected for the nitrogen and total phosphorus analysis, as well as their dissolved fractions (dissolved inorganic phosphorus, total dissolved phosphorus, ammoniacal nitrogen and nitrate). Total alkalinity and suspended solids were also quantified; RESULTS: The Multivariate Analysis of Variance showed the influence of the seasonality on the variability of the investigated variables, while the Principal Component Analysis gave rise in two statistical significant axes, which delimited two groups representative of the rainy and dry periods. Hydrological pulses from Jacupiranguinha River, besides contributing to the inputs of nutrients and sediments during the period of connectivity, accounted for the decrease in spatial gradients in the wetland. This "homogenization effect" was evidenced by the Cluster Analysis. The research also showed an industrial raw effluent as the main point source of phosphorus to the Jacupiranguinha River and, indirectly, to the wetland; CONCLUSIONS: Therefore, considering the scarcity of information about the wetlands in the study area, this research, besides contributing to the understanding of the influence of hydrological pulses on the investigated environmental variables, showed the need for adoption of conservation policies of these ecosystems face the increase anthropic pressures that they have been submitted, which may result in lack of their ecological, social and economic functions.