ERICA: prevalence of asthma in Brazilian adolescents

ABSTRACT OBJECTIVE To describe the prevalence of asthma and physician-diagnosed asthma in Brazilian adolescents. METHODS Cross-sectional, national, school-based study with adolescents from 12 to 17 years old, participants in the Study of Cardiovascular Risks in Adolescents (ERICA). The study stratified the sample by region and grouped according to schools and classes with representativeness to the set of cities with more than 100,000 inhabitants of the Country, macro-regions, capitals, and Federal District. A questionnaire collected data through a self-filled in method. We calculated the prevalences and their confidence intervals of 95% (95%CI) according to sex, age group, type of school and skin color. RESULTS Between 2013 and 2014, 74,589 adolescents were evaluated, 55.3% of the female sex. The total prevalence of active asthma was of 13.1% (95%CI 12.1-13.9), being higher in girls (14.8%; 95%CI 13.7-16.0) when compared to boys (11.2%; 95%CI 10.3-12.2) in all geographical strata examined. It was also higher between students of private schools (15.9%; 95%CI 14.2-17.7) when compared to public ones (12.4%; 95%CI 11.4-13.4). It was higher in the Southeast region (14.5%; 95%CI 12.9-16.1), and in the city of Sao Paulo (16.7%; 95%CI 14.7-18.7). The lowest prevalence was observed in North region (9.7%; 95%CI 9.7-10.5), and in Teresina (6.3%; 95%CI 4.9-7.7). The prevalence of physician-diagnosed asthma was of 8.7% (95%CI 8.2-9.1); higher in the North region (13.5%; 95%CI 12.7-14.2), and in Porto Alegre (19.8%; 95%CI 17.5-22.3). It was lower in the Midwest (6.9%; 95%CI 6.0-7.8), and in Cuiaba (4.8%; 95%CI 3.8-5.9). We found no significant difference in the expression of this rate between the sexes, as well as in other variables evaluated by the study. CONCLUSIONS The prevalence of asthma in Brazilian adolescents is high. Rates of active asthma and physician-diagnosed asthma vary widely in different regions and capitals evaluated by the ERICA. These results may assist in the preparation of preventive programs and policies on health and a better understanding of the factors associated with asthma in this age group.

SEROPREVALENCE OF CHAGASIC INFECTION IN YOUNG INDIVIDUALS IN A BLOOD CENTER IN THE STATE OF SAO PAULO, BRAZIL

SUMMARY This study aimed at estimating the number of cases of non-negative serological reactions to Chagas disease in blood donors at the Blood Center of Botucatu, São Paulo, Brazil, from 2003 to 2010 and at relating them to their cities of origin. Five hundred and seventy-four non-negative results for Chagas disease were evaluated. Of these, 371 (64.8%) were reagent, and 203 (35.4%) were inconclusive. The prevalence of Chagas disease in blood donors was 0.05%. There were, on average, 72 cases/year, and a prevalence of males was observed (64.8%). Forty-three (7.49%) individuals were 18 to 30 years old; 92 (16.02%) were 31 to 40; 147 (25.61%) 41 to 50, and 292 (50.87%) were older than 50 years. It was observed that 29.3% of females with reagent serology were at their fertile age (18 and 45 years). The majority of donors were originally from cities in the southwestern and central regions of São Paulo, but individuals from other states contributed with 20%. The provenance of most donors was the city of Botucatu/SP, followed by the city of Taquarituba/SP. Therefore, the profile of donors at this blood center favors the occurrence of a larger number of non-negative serological reactions. Although there has been a significant reduction in the number of new cases/year for this disease, it is still a public-health problem, and results suggest the need for new epidemiological assessments in the studied region.

A first case of protease codon 35 amino acid insertion in a HIV-1 subtype B sequence detected in the Bauru region, state of São Paulo, Brazil: case report

Amino acid insertions in the protease have rarely been described in HIVinfected patients. One of these insertions has recently been described in codon 35, although its impact on resistance remains unknown. This study presents a case of an HIV variant with an insertion in codon 35 of the protease, described for the first time in Bauru, State of Sao Paulo, Brazil, circulating in a 38-year-old caucasian male with asymptomatic HIV infection since 1997. The variant isolated showed a codon 35 insertion of two amino acids in the protease: a threonine and an aspartic acid, resulting in the amino acid sequence E35E_TD.

Spatial and seasonal distribution of Lutzomyia longipalpis in Dracena, a city in the western region of the State of São Paulo, Brazil, that is endemic with visceral leishmaniasis

Introduction Vector seasonality knowledge is important for monitoring and controlling of vector-borne diseases. Lutzomyia longipalpis (Lu. longipalpis) is the main vector of Leishmania (Leishmania) infantum Nicolle, 1908, which is the causative agent of visceral leishmaniasis in the Americas. Methods Lu. longipalpis was monitored for 3 consecutive nights each month using light traps from the Centers for Disease Control in the peridomiciles and intradomiciles of 18 residences from January 2005 to December 2012 in the urban area of Dracena, a medium-sized city located in the western region of São Paulo, Brazil. Results A total of 54,820 Lu. longipalpis specimens were collected, and the proportion of positive samples was significantly higher in the peridomiciles than in the intradomiciles (p<0.05) in all 8 years of the study, except for 2005. The vector was present in all study years in the 9 sub-regions of the city, and the male/female ratio ranged from 3.19 to 4.26. The greatest vector abundance occurred in the first semester and peaked in March, confirming its seasonality. Conclusions The maintenance of this high abundance over an 8-year surveillance period demonstrates the vector adaptation to the urban conditions of the city. These characteristics present a major challenge for preventing human and canine contact with the vector and, consequently, controlling the spread of disease.

Midwest Transportation Consortium Annual Program Report, October 2000

The MTC’s main focus is on education and human capital. This focus is in recognition of the fact that the transportation industry, both public and private, in the region served by the MTC faces a serious shortage of well-trained human capital. For this reason, the MTC is in volved in creating totally new transportation education programs at two of its member universities. The University of Northern Iowa (UNI) in Cedar Falls Iowa had no courses or students in transportation when the MTC grant began. During the first year of the grant, UNI’s Geography Department took the lead in developing courses, attracting students, an getting involved a a partner in transportation activities in its service region. A similar start-up effort is now underway at Lincoln University in Jefferson City, Missouri. The MTC has also been able to strengthen and add quality to transportation education efforts at universities in the region that were already leaders in transportation.

Midwest Transportation Consortium Annual Program Report, October 2002

The MTC’s main focus is on education and human capital. This focus is in recognition of the fact that the transportation industry, both public and private, in the region served by the MTC faces a serious shortage of well-trained human capital. For this reason, the MTC is in volved in creating totally new transportation education programs at two of its member universities. The University of Northern Iowa (UNI) in Cedar Falls Iowa had no courses or students in transportation when the MTC grant began. During the first year of the grant, UNI’s Geography Department took the lead in developing courses, attracting students, an getting involved a a partner in transportation activities in its service region. A similar start-up effort is now underway at Lincoln University in Jefferson City, Missouri. The MTC has also been able to strengthen and add quality to transportation education efforts at universities in the region that were already leaders in transportation.

Midwest Transportation Consortium Annual Program Report, October 2004

The MTC’s main focus is on education and human capital. This focus is in recognition of the fact that the transportation industry, both public and private, in the region served by the MTC faces a serious shortage of well-trained human capital. For this reason, the MTC is in volved in creating totally new transportation education programs at two of its member universities. The University of Northern Iowa (UNI) in Cedar Falls Iowa had no courses or students in transportation when the MTC grant began. During the first year of the grant, UNI’s Geography Department took the lead in developing courses, attracting students, an getting involved a a partner in transportation activities in its service region. A similar start-up effort is now underway at Lincoln University in Jefferson City, Missouri. The MTC has also been able to strengthen and add quality to transportation education efforts at universities in the region that were already leaders in transportation.

Geographical distribution of American cutaneous leishmaniasis and its phlebotomine vectors (Diptera: Psychodidae) in the state of Sao Paulo, Brazil

Background: American cutaneous leishmaniasis (ACL) is a re-emerging disease in the state of Sao Paulo, Brazil. It is important to understand both the vector and disease distribution to help design control strategies. As an initial step in applying geographic information systems (GIS) and remote sensing (RS) tools to map disease-risk, the objectives of the present work were to: (i) produce a single database of species distributions of the sand fly vectors in the state of Sao Paulo, (ii) create combined distributional maps of both the incidence of ACL and its sand fly vectors, and (iii) thereby provide individual municipalities with a source of reference material for work carried out in their area. Results: A database containing 910 individual records of sand fly occurrence in the state of Sao Paulo, from 37 different sources, was compiled. These records date from between 1943 to 2009, and describe the presence of at least one of the six incriminated or suspected sand fly vector species in 183/645 (28.4%) municipalities. For the remaining 462 (71.6%) municipalities, we were unable to locate records of any of the six incriminated or suspected sand fly vector species (Nyssomyia intermedia, N. neivai, N. whitmani, Pintomyia fischeri, P. pessoai and Migonemyia migonei). The distribution of each of the six incriminated or suspected vector species of ACL in the state of Sao Paulo were individually mapped and overlaid on the incidence of ACL for the period 1993 to 1995 and 1998 to 2007. Overall, the maps reveal that the six sand fly vector species analyzed have unique and heterogeneous, although often overlapping, distributions. Several sand fly species - Nyssomyia intermedia and N. neivai - are highly localized, while the other sand fly species - N. whitmani, M. migonei, P. fischeri and P. pessoai - are much more broadly distributed. ACL has been reported in 160/183 (87.4%) of the municipalities with records for at least one of the six incriminated or suspected sand fly vector species, while there are no records of any of these sand fly species in 318/478 (66.5%) municipalities with ACL. Conclusions: The maps produced in this work provide basic data on the distribution of the six incriminated or suspected sand fly vectors of ACL in the state of Sao Paulo, and highlight the complex and geographically heterogeneous pattern of ACL transmission in the region. Further studies are required to clarify the role of each of the six suspected sand fly vector species in different regions of the state of Sao Paulo, especially in the majority of municipalities where ACL is present but sand fly vectors have not yet been identified.

Evaluation of thermal simulation of households in the metropolitan region of So Paulo, Brazil

This paper aims at assessing the performance of a program of thermal simulation (Arquitrop) in different households in the city of Sao Paulo, Brazil. The households were selected for the Wheezing Project which followed up children under 2 years old to monitor the occurrence of respiratory diseases. The results show that in all three study households there is a good approximation between the observed and the simulated indoor temperatures. It was also observed a fairly consistent and realistic behavior between the simulated indoor and the outdoor temperatures, describing the Arquitrop model as an efficient estimator and good representative of the thermal behavior of households in the city of Sao Paulo. The worst simulation is linked to the poorest type of construction. This may be explained by the bad quality of the construction, which the Architrop could not simulate adequately.

Health surveys and use of maternal and child health care services in three municipalities within the Sao Paulo metropolitan area

Objectives. To describe the changes in the use of maternal and child health care services by residents of three municipalities-Embu, Itapecerica da Serra, and Taboao da Serra-in the Sao Paulo metropolitan area, 12 years after the implementation of the Unified Health System (SUS) in Brazil, and to analyze the potential of population-based health care surveys as sources of data to evaluate these changes. Methods. Two population-based, cross-sectional surveys were carried out in 1990 and 2002 in municipalities located within the Sao Paulo metropolitan area. For children under 1 year of age, the two periods were compared in terms of outpatient services utilization and hospital admission; for the mothers, the periods were compared in terms of prenatal care and deliveries. In both surveys, stratified and multiple-stage conglomerate sampling was employed, with standardization of interview questions. Results. The most important changes observed were regarding the location of services used for prenatal care, deliveries, and hospitalization of children less than 1 year of age. There was a significant increase in the use of services in the surrounding region or hometown, and decrease in the utilization of services in the city of Sao Paulo (in 1990, 80% of deliveries and almost all admissions for children less than 1 year versus 32% and 46%, respectively, in 2002). The use of primary care units and 24-hour walk-in clinics also increased. All these changes reflect care provided by public resources. In the private sector, there was a decrease in direct payments and payments through company-paid health insurance and an increase in payments through self-paid health insurance. Conclusions. The major changes observed in the second survey occurred simultaneous to the changes that resulted from the implementation of the SUS. Population-based health surveys are adequate for analyzing and comparing the utilization of health care services at different times.

Aflatoxins and cyclopiazonic acid in feed and milk from dairy farms in Sao Paulo, Brazil

The occurrence of aflatoxins (AF) B(1), B(2), G(1), G(2) and cyclopiazonic acid (CPA) in feeds, and AFM(1) and CPA in milk was determined in dairy farms located in the northeastern region of Sao Paulo state, Brazil, between October 2005 and February 2006. AF and CPA determinations were performed by HPLC. AFB(1) was found in 42% of feed at levels or 1.0-26.4 mu g kg(-1) (mean: 7.1 +/- 7.2 mu g kg(-1)). The concentrations of AFM(1) in raw milk varied between 0.010 and 0.645 mu g l(-1) (mean: 0.104 +/- 0.138 mu g l(-1)). Only one sample was above the tolerance limit adopted in Brazil (0.50 mu g l(-1)) for AFM(1) in milk. Regarding CPA in feed, six (12%) samples showed concentrations of 12.5-1533 mu g kg(-1) (mean: 57.6 +/- 48.7 mu g kg(-1)). CPA was detected in only three milk samples (6%) at levels of 6.4, 8.8 and 9.1 mu g l(-1). Concentrations of aflatoxins and CPA in feed and milk were relatively low, although the high frequency of both mycotoxins indicates the necessity to continuously monitor dairy farms to prevent contamination of feed ingredients.

Downwelling solar irradiance in the biomass burning region of the southern Amazon: Dependence on aerosol intensive optical properties and role of water vapor

The sensitivity of solar irradiance at the surface to the variability of aerosol intensive optical properties is investigated for a site (Alta Floresta) in the southern portion of the Amazon basin using detailed comparisons between measured and modeled irradiances. Apart from aerosol intensive optical properties, specifically single scattering albedo (omega(o lambda)) and asymmetry parameter (g(lambda)), which were assumed constant, all other relevant input to the model were prescribed based on observation. For clean conditions, the differences between observed and modeled irradiances were consistent with instrumental uncertainty. For polluted conditions, the agreement was significantly worse, with a root mean square difference three times larger (23.5 Wm(-2)). Analysis revealed a noteworthy correlation between the irradiance differences (observed minus modeled) and the column water vapor (CWV) for polluted conditions. Positive differences occurred mostly in wet conditions, while the differences became more negative as the atmosphere dried. To explore the hypothesis that the irradiance differences might be linked to the modulation of omega(o lambda) and g(lambda) by humidity, AERONET retrievals of aerosol properties and CWV over the same site were analyzed. The results highlight the potential role of humidity in modifying omega(o lambda) and g(lambda) and suggest that to explain the relationship seen between irradiances differences via aerosols properties the focus has to be on humidity-dependent processes that affect particles chemical composition. Undoubtedly, there is a need to better understand the role of humidity in modifying the properties of smoke aerosols in the southern portion of the Amazon basin.

Can the Deforestation Breeze Change the Rainfall in Amazonia? A Case Study for the BR-163 Highway Region

The authors simulated the effects of Amazonian mesoscale deforestation in the boundary layer and in rainfall with the Brazilian Regional Atmospheric Modeling System (BRAMS) model. They found that both the area and shape (with respect to wind incidence) of deforestation and the soil moisture status contributed to the state of the atmosphere during the time scale of several weeks, with distinguishable patterns of temperature, humidity, and rainfall. Deforestation resulted in the development of a three-dimensional thermal cell, the so-called deforestation breeze, slightly shifted downwind to large-scale circulation. The boundary layer was warmer and drier above 1000-m height and was slightly wetter up to 2000-m height. Soil wetness affected the circulation energetics proportionally to the soil dryness (for soil wetness below similar to 0.6). The shape of the deforestation controlled the impact on rainfall. The horizontal strips lined up with the prevailing wind showed a dominant increase in rainfall, significant up to about 60 000 km(2). On the other hand, in the patches aligned in the opposite direction (north-south), there was both increase and decrease in precipitation in two distinct regions, as a result of clearly separated upward and downward branches, which caused the precipitation to increase for patches up to 15 000 km(2). The authors` estimates for the size of deforestation impacting the rainfall contributed to fill up the low spatial resolution in other previous studies.

Downward longwave radiation estimates for clear and all-sky conditions in the Sertozinho region of So Paulo, Brazil

The accurate estimate of the surface longwave fluxes contribution is important for the calculation of the surface radiation budget, which in turn controls all the components of the surface energy budget, such as evaporation and the sensible heat fluxes. This study evaluates the performance of the various downward longwave radiation parameterizations for clear and all-sky days applied to the Sertozinho region in So Paulo, Brazil. Equations have been adjusted to the observations of longwave radiation. The adjusted equations were evaluated for every hour throughout the day and the results showed good fits for most of the day, except near dawn and sunset, followed by nighttime. The seasonal variation was studied by comparing the dry period against the rainy period in the dataset. The least square linear regressions resulted in coefficients equal to the coefficients found for the complete period, both in the dry period and in the rainy period. It is expected that the best fit equation to the observed data for this site be used to produce estimates in other regions of the State of So Paulo, where such information is not available.

Assessing the diurnal evolution of surface radiation balance over the western region of Tropical Atlantic Ocean using in situ measurements carried out during the FluTuA balance Project

In this work, the diurnal evolution of the radiation balance components over the tropical Atlantic Ocean is described and analysed. The analysis is based on measurements carried Out on board a Brazilian Navy ship during the observational campaign of the FluTuA Project (`Fluxos Turbulentos sobre o Atlantico`), from 15 to 23 May 2002. The observations indicated that the albedo responds its expected to atmospheric attenuation effects with a diurnal evolution similar to the Fresnel albedo. In general, the observed longwave radiation values agreed better with the estimated values obtained without longwave reflection. In agreement with the literature, the average surface emissivity was around 0.97. The net radiation, estimated from published equations for albedo, atmospheric transmissivity and surface emissivity, agreed with the observations, indicating that these parameters are representative of the radiometric properties of the air-sea interface in the region between Natal (6 degrees S, 35.2 degrees W) and the Sao Pedro and Sao Paulo Archipelago (1 degrees N, 29.3 degrees W). Copyright (C) 2008 Royal Meteorological Society