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    Deforestation, drainage network, indigenous status, and geographical differences of malaria in the State of Amazonas
    (Malaria Journal, 2015) Terrazas, Wagner Cosme Morhy; Sampaio, Vanderson de Souza; Castro, Daniel Barros de; Pinto, Rosemary Costa; Albuquerque, Bernardino Cláudio de; Sadahiro, Megumi; Passos, Ricardo Augusto dos; Braga, José Ueleres
    Background: Malaria is a major public health problem worldwide. In Brazil, an average of 420,000 cases of malaria have been reported annually in the last 12 years, of which 99.7 % occurred in the Amazon region. This study aimed to analyse the distribution of malaria in the State of Amazonas and the influence of indigenous malaria in this scenario, to evaluate the correlation between incidence rates and socio-economic and environmental factors, and to evaluate the performance of health surveillance services. Methods: This ecological study used secondary data obtained from the SIVEP-MALARIA malaria surveillance programme. The relationship between demographic, socio-economic and environmental factors, the performance of health surveillance services and the incidence of malaria in Amazonas, a multiple linear regression model was used. Results: The crude rate of malaria in Amazonas was 4142.72 cases per 100,000 inhabitants between 2003 and 2012. The incidence rates for the indigenous and non-indigenous populations were 12,976.02 and 3749.82, respectively, with an indigenous population attributable fraction of only 8 %. The results of the linear regression analysis indicated a negative correlation between the two socio-economic indicators (municipal human development index (MHDI) and poverty rate) and the incidence of malaria in the period. With regard to the environmental indicators (average annual deforestation rate and percentage of areas under the influence of watercourses), the correlation with the incidence rate was positive. Conclusions: The findings underscore the importance of implementing economic and social development policies articulated with strategic actions of environmental protection and health care for the population. Keywords: Malaria, Deforestation, Drainage network, Indigenous status, Brazilian Amazon
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    The Socioeconomic Factors and the Indigenous Component of Tuberculosis in Amazonas
    (PloS One, 2016) Castro, Daniel Barros de; Pinto, Rosemary Costa; Albuquerque, Bernardino Cláudio de; Sadahiro, Megumi; Braga, José Ueleres
    Despite the availability of tuberculosis prevention and control services throughout Amazonas, high rates of morbidity and mortality from tuberculosis remain in the region. Knowledge of the social determinants of tuberculosis in Amazonas is important for the establishment of public policies and the planning of effective preventive and control measures for the disease. To analyze the relationship of the spatial distribution of the incidence of tuberculosis in municipalities and regions of Amazonas to the socioeconomic factors and indigenous tuberculosis component, from 2007 to 2013. An ecological study was conducted based on secondary data from the epidemiological surveillance of tuberculosis. A linear regression model was used to analyze the relationship of the annual incidence of tuberculosis to the socioeconomic factors, performance indicators of health services, and indigenous tuberculosis component. The distribution of the incidence of tuberculosis in the municipalities of Amazonas was positively associated with the Gini index and the population attributable fraction of tuberculosis in the indigenous peoples, but negatively associated with the proportion of the poor and the unemployment rate. The spatial distribution of tuberculosis in the different regions of Amazonas was heterogeneous and closely related with the socioeconomic factors and indigenous component of tuberculosis.