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Habilitation Thesis
DOI
10.11606/T.17.2007.tde-29112007-070303
Document
Author
Full name
Antonio Luiz Rodrigues Júnior
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
Ribeirão Preto, 2007
Committee
Santos, Jair Licio Ferreira (President)
Buchalla, Cassia Maria
Rocha, Juan Stuardo Yazlle
Rohm, Sergio Antonio
Wunsch Filho, Victor
Title in Portuguese
Geoepidemiologia da AIDS e das doenças oportunistas transmissíveis na faixa de fronteira brasileira.
Keywords in Portuguese
AIDS
Estudos ecológicos
Faixa de fronteira
Geoepidemiologia
Abstract in Portuguese
Foi realizado um estudo ecológico da epidemia brasileira de aids e das doenças oportunistas, nos municípios da faixa de fronteira interna do Brasil. Um sistema de informações geográficas foi constituído, a partir da divisão político-administrativa de municípios da Faixa de Fronteira brasileira, que foram estratificados segundo as “áreas de fome” de Josué de Castro (Amazônica, Centro-Oeste e Extremo-Sul), além de dezenove sub-regiões culturais. O coeficiente de incidência de aids, em cada município, foi adotado como medida epidemiológica, de 1990 até 2003, formando séries temporais trimestrais para o estudo de tendências; foram adotados os coeficientes de ataques secundários para estudar as coinfecções; a idade e a categoria de transmissão de cada caso também foram consideradas; e as doenças oportunistas infecciosas detectadas foram observadas, que foram agrupadas em doenças transmitidas pelo ar, transmitidas pela ingestão de água e/ou alimentos contaminados e transmitidas pelo contato humano. A avaliação descritiva mostrou o fenômeno de heterossexualização (57,8%); a predominância de casos do sexo feminino na categoria heterossexual e de casos do sexo masculino na categoria de transmissão UDI, na faixa etária de 13 a 43 anos; houve predomínio de casos do sexo masculino na categoria de transmissão ignorada. A análise temporal da incidência de aids mostrou que houve tendências crescentes nas três áreas, sendo a área Extremo-Sul a que apresentou o maior crescimento; o uso de testes laboratoriais para diagnosticar os portadores de HIV/aids diminuiu a detecção das doenças oportunistas da aids, apesar das doenças transmitidas pelo contato humano serem freqüentes. Dentre as doenças oportunistas transmitidas pelo ar, a tuberculose apresentou os maiores coeficientes de ataque; dentre as transmitidas pela ingestão de água e/ou alimentos contaminados, a toxoplasmose foi a mais freqüente; dentre as transmitidas pelo contato humano, a candidíase foi mais importante. A análise espacial nas três áreas identificou os municípios mais susceptíveis à epidemia de aids.
Title in English
Geoepidemiology of AIDS and transmittible opportunistic diseases in the brazilian bordeland.
Keywords in English
AIDS
Boderland
Ecological study
Geoepidemiology
Abstract in English
An ecologic study was made to evaluate Brazilian epidemic of aids and its opportunistic diseases on municipalities at internal country border. A geographical information system was built using official division of municipalities located on international territory boundaries that were grouped according to Josué de Castro´s “hunger areas” (Amazonic, Center-West, and Southern) and by nineteen cultural subregions. The incidence rate of aids by municipality was taken as epidemiologic measure from 1990 to 2003, giving a quarterly time series for trend analysis; it was used secondary attack rate to evaluate co-infection; age and aids transmission category from each registered case were also admitted in the study, besides every detected transmittable diseases, which were grouped into transmitted by air diseases, transmitted by contaminated water and/or food diseases and transmitted by human relationship diseases. Descriptive evaluation showed great amount of heterosexual transmission (57,8%); from 13 to 43 year age, females were prevailing on heterosexual category and males were prevailing on injected drug users and prevailing incidence of male; males were also prevailing among not-detectable transmission category. Time trend analysis showed incidence rate increase on three “hunger areas”; Southern area showed the higher slope; the progressive use of laboratorial test for HIV/aids diagnose affected others transmittable diseases, although transmitted by human relationship diseases have been observed. Tuberculosis was the highest secondary attack levels among transmitted by air diseases; toxoplasmosis was the most important among those transmitted by contaminated water and/or food diseases; candidiasis was mostly observed among transmitted by human relationship diseases. Spatial analysis showed most susceptible locations to aids epidemic.
 
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Publishing Date
2007-11-29
 
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