Resumen Marco contextual: Los datos que caracterizan a las personas con estomas en Portugal son escasos. Establecer estimaciones epidemiológicas puede mejorar el conocimiento sobre esta población y adaptar modelos sanitarios. Objetivos: Estimar la prevalencia y la incidencia de personas con estoma de eliminación en Portugal en 2021. Metodología: Estudio observacional, longitudinal y retrospectivo, basado en una base de datos de dispensaciones de dispositivos de ostomía. Resultados: En 2021, el número estimado de personas con al menos un estoma era de 22.045, de las cuales 19.793 [IC95%:19.599;19.994] tenían un estoma de eliminación. La mayoría de ellos eran hombres (61,4%), tenían una edad media de 70,5 años y vivían principalmente en el interior del país. El tipo de estoma de eliminación más frecuente era la colostomía (48,8%). La incidencia estimada de nuevos casos fue de 6.622, de los cuales 5.834 [IC95%:5.680;5.984] eran estomas de eliminación. Conclusión: Estos resultados han permitido caracterizar el perfil de las personas con estoma de eliminación en Portugal. Podrían ser útiles para ajustar los programas de prevención/seguimiento de la salud de esta población y para asignar recursos especializados.

Resumo Enquadramento: Dados que caracterizam as pessoas com estoma em Portugal são escassos. Estabelecer estimativas epidemiológicas pode melhorar o conhecimento sobre esta população e adaptar modelos de cuidados de saúde. Objetivos: Estimar a prevalência e incidência de pessoas com estoma de eliminação em Portugal em 2021. Metodologia: Estudo observacional, longitudinal e retrospetivo, a partir de uma base de dados de dispensa de dispositivos para ostomia. Resultados: Em 2021, o número estimado de pessoas com pelo menos um estoma foi de 22.045. Entre estes, 19.793 [IC95%:19.599;19.994] tinham um estoma de eliminação. Na sua maioria eram homens (61,4%), em média tinham 70,5 anos e residiam preferencialmente na região interior do país. O tipo de estoma de eliminação mais prevalente foi a colostomia (48,8%). A incidência estimada de novos casos foi de 6.622, sendo 5.834 [IC95%:5.680;5.984] referentes a estomas de eliminação. Conclusão: Estes resultados permitiram caracterizar o perfil das pessoas com estoma de eliminação em Portugal. Poderão ser úteis para ajustar os programas de prevenção/acompanhamento em saúde desta população e ainda alocar recursos especializados.

Abstract Background: Data characterizing individuals with a stoma in Portugal is limited. Establishing epidemiological estimates can enhance understanding of this population and facilitate the adaptation of healthcare models. Objectives: To estimate the prevalence and incidence of individuals in Portugal who have undergone intestinal or urinary ostomy in 2021. Methodology: Observational, longitudinal, and retrospective study using a stoma appliance dispensing database. Results: In 2021, an estimated 22,045 individuals had at least one stoma, with 19,793 [95%CI:19,599;19,994] having an intestinal/urinary stoma. Most of these individuals were men (61.4%) with a mean age of 70.5 years and resided in the inland region of Portugal. Colostomy was the most prevalent type of intestinal/urinary stoma (48.8%). The estimated incidence of new cases was 6,622, of which 5,834 [95%CI:5,680;5,984] were intestinal/urinary stomas. Conclusion: These results characterize the profile of individuals with intestinal and urinary stomas in Portugal. They may be useful in adjusting prevention and health monitoring programs for this population and allocating specialized resources.

Abstract The aim of this study was to examine the impact of both organic and inorganic nitrogen fertilizers on the intensity and epidemiological components of Cercospora leaf spot across three different canopies of cotton plants, specifically the variety DP ACALA 90, under field conditions. Fertilizers used in the study included bovine manure, Jatropha curcas seedcake, poultry manure, and urea (the latter serving as a control). These were applied at 20 days after plant emergence and then during the flowering stage until the total nitrogen (N) dose reached 50, 100, 150, or 200 kg N per hectare. The incidence and severity of the disease were assessed starting at the reproductive stage B1 (the first visible flower bud) across the lower, middle, and upper canopies of four cotton plants, with six evaluations conducted over time. To calculate the initial inoculum (Y 0 ) and the disease progress rate (r), the Exponential, Gompertz, and Logistic models were employed based on temporal data. The study was designed as a randomized complete block with a 4x4 factorial arrangement (fertilizer type x dose), and mean comparisons were made using Tukey's test (p ≤ 0.05). It was found that disease intensity within each canopy level varied in response to the type of nitrogen source and the applied dose, with the severity of the disease (including the area under the disease progress curve) being particularly influenced. A significant interaction between the type of fertilizer and the dose regarding the intensity of Cercospora leaf spot was observed. The Exponential model most accurately depicted the disease's temporal progression. Notably, poultry manure and urea were the fertilizers that most adversely influenced the intensity and initial inoculum (Y 0 ) of Cercospora leaf spot across the various canopies of the cotton plants. The findings suggest that the use of organic fertilizers in cotton cultivation could represent a viable sustainable management strategy.

RESUMEN El Consorcio Europeo-Latinoamericano contra el Cáncer de Vesícula Biliar (CVB) EULAT Eradicate GBC está recopilando datos y muestras de alta calidad en cuatro países latinoamericanos con una alta incidencia de esta enfermedad: Argentina, Bolivia, Chile y Perú (www.SaludVesiculaBiliar.org). Los objetivos del consorcio incluyen la creación de un biorepositorio único integrado en una plataforma informática a medida, la identificación, validación y caracterización funcional de nuevos biomarcadores de riesgo del CVB, y el desarrollo de modelos predictivos que integren factores de riesgo tanto epidemiológicos como genético-moleculares. Para facilitar la recolección y la calidad de los datos sociodemográficos, clínicos, sobre las muestras, de estilo de vida y nutricionales de los 15.000 participantes latinoamericanos que están siendo reclutados, decidimos desarrollar la aplicación EULAT eCollect para reducir el tiempo invertido por los participantes en el estudio, limitar el uso de papel y tinta, minimizar los costes y errores asociados a la cumplimentación de formularios escritos y su posterior digitalización, automatizando además el monitoreo de las tasas de reclutamiento y de la calidad de los datos en cada centro participante. Este artículo describe el diseño e implementación de la aplicación EULAT eCollect, desde la especificación de los requisitos funcionales y no funcionales, hasta la implementación y validación de los cuatro módulos de la aplicación: I Entrevista sociodemográfica, II Información sobre las muestras, III Formulario de informe de casos y IV Cuestionario de hábitos alimenticios. Además de nuestra experiencia con el software Open Data Kit, presentamos resultados tanto generales como técnicos que pueden ser de interés para futuros proyectos de investigación, especialmente los estudios de prevención personalizada del cáncer llevados a cabo en regiones con niveles de ingreso bajos y medios.

ABSTRACT The European-Latin American Consortium towards Eradication of Preventable Gallbladder Cancer (GBC) - EULAT Eradicate CVB is collecting high-quality data and samples in four Latin American countries with a high incidence of GBC: Argentina, Bolivia, Chile and Peru. The goal is to build a unique biorepository integrated with a customized informatics platform, identify, validate, and functionally characterize novel GBC risk biomarkers, and develop GBC prediction models integrating epidemiological and genetic-molecular risk factors. We decided to develop the electronic data collection application EULAT eCollect to facilitate the retrieval of socio-demographic, clinical, lifestyle, nutritional, and sample information from the 15,000 Latin Americans we are enrolling. The EULAT eCollect app reduces the time spent by study participants, limits the use of paper and ink, minimizes the costs and errors associated with completing written forms and their subsequent digitization, and allows close monitoring of local recruitment rates and data quality. We describe in this article the design and implementation of EULAT eCollect, which started with the specification of functional and non-functional requirements and ended with the implementation and subsequent validation of the four application modules: I Socio-demographic interview, II Sample information, III Case report form, and IV Food frequency questionnaire. We present both general and technical results and our experience with the Open Data Kit software, which may be of interest for future research projects, especially those on personalized cancer prevention conducted in low- and middle-income regions.

ABSTRACT The aim of this work is to analyze the impact of Covid-19 on indigenous populations in municipalities of Mexico. To analyze this relationship, Bayesian spatio-temporal models are used to capture the complex dynamics of epidemiological transmission in terms of spatial, temporal and joint spatio-temporal dependence. These models have the ability to include covariates, such as the percentage of indigenous population, which makes it possible to quantify the effect that the covariate has on the evolution of the epidemic. Likewise, the models allow us to identify spatio-temporal clusters with high and low incidence rates, showing health inequalities based on the proportion of the indigenous population residing in specific municipalities. Contrary to expectations, the results showed a protective effect on the incidence rate of COVID-19 for the indigenous population. Furthermore, a wide heterogeneity was observed in the distribution of COVID-19 incidence rates by municipality, with significant fluctuations over time. The incidence rates of COVID-19 in indigenous populations were low, which may be due to the fact that the indigenous population predominates in municipalities with low population density, less access to health services, and greater social marginalization. However, it is important to interpret these results with caution due to the high level of observed underreporting of COVID-19 cases found in indigenous populations.

RESUMEN El trabajo tiene por objetivo analizar el impacto del COVID-19 en poblaciones indígenas de los municipios de México. Para analizar dicha relación se utilizan modelos bayesianos espacio-temporales que permiten capturar la compleja dinámica de la transmisión epidemiológica en términos de dependencia espacial, temporal y espacio-temporal conjunta. Estos modelos tienen la capacidad de incluir covariables, como el porcentaje de población indígena, lo que permite cuantificar el efecto que la covariable ejerce sobre la evolución de la epidemia. Asimismo, los modelos permiten identificar clusters espacio-temporales con altas y bajas tasas de incidencia, evidenciando desigualdades en salud basadas en la proporción de población indígena residente en municipios específicos. Contrario a lo esperado, los resultados mostraron un efecto protector en la tasa de incidencia por COVID-19 para la población indígena. Además, se observó una amplia heterogeneidad en la distribución por municipio de las tasas de incidencia por COVID-19, con fluctuaciones importantes en el tiempo. Las tasas de incidencia de COVID-19 en poblaciones indígenas fueron bajas, lo que puede deberse a que la población indígena predomina en municipios de baja densidad poblacional, con menor acceso a los servicios de salud y mayor marginación social. Sin embargo, es importante interpretar estos resultados con cautela debido al elevado nivel observado de subregistro de casos de COVID-19 encontrado en poblaciones indígenas.

ABSTRACT Objective: The aim of this study was to analyze the temporal trends in vaccination coverage (VC) during the first year of life of children in Brazil. Methods: Data on VC for the first year of life from 2011 to 2020 for Bacille Calmette-Guerin (BCG), hepatitis B, polio, pentavalent, and triple viral vaccines at the national, regional, and state levels were obtained from the Information System of the National Immunization Program. Trends were analyzed using Prais-Winsten generalized linear regression models and average annual percent change (APC) estimates. Results: Decreasing trends were observed for the BCG (APC −3.58%; p<0.05), pentavalent (APC −4.10%; p<0.05), polio (APC −2.76%; p<0.05), and triple viral (APC −2.56%; p<0.05) vaccines in the country. Hepatitis B vaccine was the only vaccine that displayed stationary behavior (APC −4.22%; p>0.05). During the study period, no increasing trends were observed in any territory or vaccine. Conclusions: This study shows a recent significant reduction and decreasing trends in VC during the first year of life of children in Brazil, indicating the need for interventions to curb this ongoing phenomenon and to recover acceptable VC rates in the country. Objective (VC Brazil Methods 201 202 CalmetteGuerin Calmette Guerin BCG, , (BCG) national regional Program PraisWinsten Prais Winsten APC estimates Results −3.58% 358 3 58 p<0.05, p005 p p<0.05 0 05 −4.10% 410 4 10 −2.76% 276 2 76 −2.56% 256 56 country −4.22% 422 22 p>0.05. p>0.05 . p>0.05) period Conclusions 20 (BCG −3.58 35 5 p00 p<0.0 −4.10 41 1 −2.76 27 7 −2.56 25 −4.22 42 p>0.0 −3.5 p0 p<0. −4.1 −2.7 −2.5 −4.2 p>0. −3. p<0 −4. −2. p>0 −3 p< −4 −2 p> −

RESUMO Objetivo: Analisar a tendência temporal da cobertura vacinal (CV) em crianças com idade menor ou igual a um ano no Brasil. Métodos: Foram empregados dados da CV no primeiro ano de vida de 2011 a 2020 referentes às vacinas BCG, hepatite B, poliomielite, pentavalente e tríplice viral, obtidos do Sistema de Informação do Programa Nacional de Imunizações (SI-PNI). Os dados estão agregados em nível nacional, regional e estadual. Para a análise de tendência foi utilizado o modelo de regressão linear generalizado de Prais-Winsten e foi calculada a variação percentual média anual (APC). Resultados: As tendências de CV para as vacinas BCG (APC −3,58%; p<0,05), pentavalente (APC −4,10%; p<0,05), poliomielite (APC −2,76%; p<0,05) e tríplice viral (APC −2,56%; p<0,05) foram decrescentes no país. Apenas para a CV da vacina contra hepatite B foi identificado comportamento estacionário (APC −4,22%; p>0,05). Nenhum território ou vacina apresentou tendência crescente para cobertura vacinal no período estudado no Brasil. Conclusões: Este estudo alerta sobre a redução expressiva das CV no primeiro ano de vida nos últimos anos no Brasil e sua tendência decrescente, sendo imperativa a adoção de intervenções com o fim de frear o fenômeno em curso e de resgatar níveis aceitáveis de CV no país. Objetivo (CV Métodos 201 202 SIPNI. SIPNI SI PNI . (SI-PNI) nacional estadual PraisWinsten Prais Winsten APC. APC (APC) Resultados −3,58% 358 3 58 p<0,05, p005 p p<0,05 , 0 05 −4,10% 410 4 10 −2,76% 276 2 76 −2,56% 256 56 país −4,22% 422 22 p>0,05. p>0,05 p>0,05) Conclusões decrescente 20 (SI-PNI −3,58 35 5 p00 p<0,0 −4,10 41 1 −2,76 27 7 −2,56 25 −4,22 42 p>0,0 −3,5 p0 p<0, −4,1 −2,7 −2,5 −4,2 p>0, −3, p<0 −4, −2, p>0 −3 p< −4 −2 p> −

RESUMO Objetivos. Descrever as características e os desfechos dos casos de COVID-19 na Jamaica e explorar os fatores de risco associados à COVID-19 grave de 9 de março a 31 de dezembro de 2020. Métodos. Análise transversal de dados de vigilância nacional usando casos confirmados de COVID-19 na Jamaica. As definições de caso confirmado, gravidade da doença e morte foram baseadas nas recomendações da Organização Mundial da Saúde. Foram usados testes de qui-quadrado e exato de Fisher para determinar a associação com os desfechos. Modelos de regressão logística foram usados para determinar os preditores de COVID-19 grave. Resultados. Esta análise incluiu 12.169 casos de COVID-19 (idade mediana: 36 anos; 6 744 do sexo feminino [55,4%]), dos quais 512 casos (4,2%) apresentaram doença grave; desses, 318 pacientes (62,1%) morreram (idade mediana ao morrer: 71,5 anos). A doença grave estava associada a ser do sexo masculino (razão de chances [RC]: 1,4; intervalo de confiança de 95% [IC 95%]: 1,2–1,7) e ter 40 anos ou mais de idade (RC: 6,5; IC 95%: 5,1–8,2). A morte por COVID-19 também estava associada a ser sexo masculino (RC: 1,4; IC 95%: 1,1–1,7), ter 40 anos ou mais (RC: 17,9; IC 95%: 11,6–27,7) e estar na Região Sanitária Oeste em comparação com a Região Sanitária Sudeste (RC: 1,7; IC 95%: 1,2–2,3). Conclusões. Os achados desta análise transversal indicam que a probabilidade de casos confirmados de COVID-19 na Jamaica era maior em indivíduos do sexo feminino e mais jovens, ao passo que as mortes por COVID-19 ocorreram com mais frequência em indivíduos do sexo masculino e mais velhos. Há um risco maior de resultados desfavoráveis em relação à COVID-19 a partir dos 40 anos, e indivíduos do sexo masculino são desproporcionalmente mais afetados. A morte por COVID-19 também variou de acordo com a região geográfica. Essas evidências podem ser úteis para outros países com cenários semelhantes e para os formuladores de políticas encarregados de manejar surtos e gerenciar a saúde.

RESUMEN Objetivos. Describir las características y los resultados de los casos de COVID-19 en Jamaica y explorar los factores de riesgo asociados a la COVID-19 grave desde el 9 de marzo hasta el 31 de diciembre del 2020. Métodos. Se realizó un análisis transversal de datos nacionales de vigilancia a partir de los casos confirmados de COVID-19 en Jamaica. Las definiciones de caso confirmado, gravedad de la enfermedad y muerte se basaron en las directrices de la Organización Mundial de la Salud. Para determinar la asociación con los criterios de valoración se utilizó la prueba de χ2 y la prueba exacta de Fisher. Se usaron modelos de regresión logística para determinar los factores predictivos de la COVID-19 grave. Resultados. Se incluyeron en el análisis 12 169 casos de COVID-19 (mediana de edad, 36 años; 6 744 mujeres [55,4%]), de los que 512 (4,2%) fueron de enfermedad grave. De estos pacientes, 318 (62,1%) fallecieron (mediana de edad al morir, 71,5 años). Se observó una asociación de la enfermedad grave con el sexo masculino (OR de 1,4; IC del 95 %, 1,2-1,7) y con la edad igual o superior a 40 años (OR de 6,5; IC del 95 %, 5,1-8,2). La muerte por COVID-19 también mostró una asociación con el sexo masculino (OR de 1,4; IC del 95%, 1,1-1,7), con la edad igual o superior a 40 años (OR de 17,9; IC del 95%, 11,6-27,7) y con la Región de Atención de Salud Occidental en comparación con la Sudoriental (OR de 1,7; IC del 95%, 1,2-2,3). Conclusiones. Los resultados de este análisis transversal indican que los casos confirmados de COVID-19 en Jamaica correspondieron una mayor probabilidad a mujeres y personas más jóvenes, mientras que las muertes por COVID-19 fueron más frecuentes en varones y personas de mayor edad. Hay un mayor riesgo de evolución desfavorable de la COVID-19 a partir de los 40 años, que afecta de manera desproporcionada a los varones. Las muertes por COVID-19 también variaron según la región geográfica. Esta evidencia podría ser de utilidad para otros países con entornos similares y para los responsables de la formulación de políticas en materia de gestión de brotes y salud.

ABSTRACT Objectives. To describe the characteristics and outcomes of COVID-19 cases in Jamaica and to explore the risk factors associated with severe COVID-19 from 9 March to 31 December 2020. Methods. A cross-sectional analysis of national surveillance data was conducted using confirmed COVID-19 cases in Jamaica. Definitions of a confirmed case, disease severity, and death were based on World Health Organization guidelines. Chi-square and Fisher exact tests were used to determine association with outcomes. Logistic regression models were used to determine predictors of severe COVID-19. Results. This analysis included 12 169 cases of COVID-19 (median age, 36 years; 6 744 females [ 55.4%]) of which 512 cases (4.2%) presented with severe disease, and of those, 318 patients (62.1%) died (median age at death, 71.5 years). Severe disease was associated with being male (OR 1.4; 95% CI, 1.2-1.7) and 40 years or older (OR, 6.5; 95% CI, 5.1-8.2). COVID-19 death was also associated with being male (OR, 1.4; 95% CI, 1.1-1.7), age 40 years or older (OR, 17.9; 95% CI, 11.6-27.7), and in the Western versus South East Health Region (OR 1.7; 95% CI, 1.2-2.3). Conclusions. The findings of this cross-sectional analysis indicate that confirmed cases of COVID-19 in Jamaica were more likely to be female and younger individuals, whereas COVID-19 deaths occurred more frequently in males and older individuals. There is increased risk of poor COVID-19 outcomes beginning at age 40, with males disproportionately affected. COVID-19 death also varied by geographic region. This evidence could be useful to other countries with similar settings and to policymakers charged with managing outbreaks and health.

Abstract In this paper, we use a Bayesian method to estimate the effective reproduction number ( R ( t )), in the context of monitoring the time evolution of the COVID-19 pandemic in Brazil at different geographic levels. The focus of this study is to investigate the similarities between the trends in the evolution of such indicators at different subnational levels with the trends observed nationally. The underlying question addressed is whether national surveillance of such variables is enough to provide a picture of the epidemic evolution in the country or if it may hide important localized trends. This is particularly relevant in the scenario where health authorities use information obtained from such indicators in the design of non-pharmaceutical intervention policies to control the epidemic. A comparison between R ( t ) estimates and the moving average (MA) of daily reported infections is also presented, which is another commonly monitored variable. The analysis carried out in this paper is based on the data of confirmed infected cases provided by a public repository. The correlations between the time series of R ( t ) and MA in different geographic levels are assessed. Comparing national with subnational trends, higher degrees of correlation are found for the time series of R ( t ) estimates, compared to the MA time series. Nevertheless, differences between national and subnational trends are observed for both indicators, suggesting that local epidemiological surveillance would be more suitable as an input to the design of non-pharmaceutical intervention policies in Brazil, particularly for the least populated states. , )) COVID19 COVID 19 COVID-1 nationally nonpharmaceutical non pharmaceutical (MA presented variable repository assessed Nevertheless states COVID1 1 COVID-

Abstract This essay addresses the conflicting relation between the theoretical and applied epidemiological health services instruments, including the difficulties in apprehending the social determination linked to the neoliberal model and workers’ subjectivities in their creative process of resisting the model of exploitation of their workforce that characterizes the current world of work. The role of Epidemiology in the following theoretical frameworks of the relations between health and work from the 1970s onward is described and discussed: Occupational Medicine, Occupational Health, and Worker’s Health. Despite the criticisms, studies from the beginning of the 2000s showed methodological advances when research turned to a more conservative set of instruments that insufficiently contextualized the social determinations of the work process. Even with legal support in Brazil, the operationalization of Epidemiology at the service of Workers’ Health in the Unified Health System still adopts approaches toward measuring risks. Such approaches lie far from the models that apprehend the reflexes of social organization proposed by researchers from Latin America, which are yet to be expressed in the studies and services of Worker’s Health in Brazil. workers s discussed Medicine Workers Worker criticisms Brazil risks America

Resumo Este ensaio aborda a relação conflituosa entre o instrumental epidemiológico teórico e o aplicado nos serviços de saúde, incluindo as dificuldades em se apreender a determinação social ligada ao modelo neoliberal e às subjetividades do trabalhador no seu processo criativo de resistir ao modelo de exploração da força de trabalho, que caracteriza o atual mundo laboral. É apresentado e discutido o papel da Epidemiologia no âmbito dos marcos teóricos da relação entre saúde e trabalho a partir da década de 1970: Medicina do Trabalho, Saúde Ocupacional e Saúde do Trabalhador. Embora existam críticas, identificou-se avanço metodológico nas publicações até o início dos anos 2000, quando as pesquisas se voltaram para um instrumental mais conservador e insuficiente para contextualizar as determinações sociais do processo de trabalho. No Brasil, ainda que haja suporte legal, a operacionalização da Epidemiologia a serviço da Saúde do Trabalhador no Sistema Único de Saúde (SUS) ainda adota abordagens voltadas para mensuração de riscos. Tais abordagens se distanciam dos modelos que apreendem os reflexos da organização social, propostos por investigadores da América Latina, os quais ainda não se expressam nas publicações e nos serviços de Saúde do Trabalhador do Brasil. laboral 1970 Trabalho críticas identificouse identificou 2000 Brasil legal SUS (SUS riscos Latina 197 200 19 20 1 2

ABSTRACT OBJECTIVE To evaluate, using spatial analysis, the occurrence of American Cutaneous Leishmaniasis (ACL) and analyze its association with the municipal human development index (MHDI) and deforestation in the state of Amazonas, Brazil, from 2016 to 2020. METHODS This ecological study, carried out from January 2016 to December 2020, included the 62 municipalities of the state of Amazonas. The incidence rate of ACL was determined in space and time. Using Multiple Linear Regression by Ordinary Least Squares (OLS) and Spatial Autoregressive Regression (SAR) models, the relationship between incidence rates and Human Development Index (HDI) and deforestation was analyzed., The high- and low-risk clusters were identified by employing the Getis-Ord Gi* statistic. RESULTS A total of 7,499 cases of ACL were registered in all 62 municipalities in the state. Most cases were in male (n=5,924; 79.24%), with the greatest frequency in the population aged from 20 to 39 years (n=3,356; 44.7%). The incidence rate in the state of Amazonas was 7.34 cases per 100,000 inhabitants-year, with the municipalities of Rio Preto da Eva and Presidente Figueiredo showing the highest rates (1,377.5 and 817.5 cases per 100,000 population-year, respectively). The ACL cases were clustered into specific areas related to those municipalities with the highest incidence rates. The SAR model revealed a positive relationship between ACL and deforestation. CONCLUSIONS The occurrence of ACL was evident in a variety of patterns in the state of Amazonas; the high incidence rates and persistence of this disease in this state were linked to deforestation. The temporal distribution showed variations in the incidence rates during each year. Our results can help optimize the measures needed to prevent and control this disease in the state. evaluate analysis (ACL MHDI (MHDI Brazil 201 2020 study 6 time OLS (OLS (SAR models HDI (HDI analyzed analyzed. lowrisk low risk GetisOrd Getis Ord Gi statistic 7499 7 499 7,49 n=5,924 n5924 n 5 924 (n=5,924 79.24%, 7924 79.24% , 79 24 79.24%) 2 3 n=3,356 n3356 356 (n=3,356 44.7%. 447 44.7% . 44 44.7%) 734 34 7.3 100000 100 000 100,00 inhabitantsyear, inhabitantsyear inhabitants year, year inhabitants-year 1,377.5 13775 1 377 (1,377. 8175 817 817. populationyear, populationyear population-year respectively. respectively respectively) 202 749 49 7,4 n=5,92 n592 92 (n=5,92 792 79.24 n=3,35 n335 35 (n=3,35 44.7 4 73 7. 10000 10 00 100,0 1,377. 1377 37 (1,377 81 74 7, n=5,9 n59 9 (n=5,9 79.2 n=3,3 n33 (n=3,3 44. 1000 0 100, 1,377 137 (1,37 8 n=5, n5 (n=5, 79. n=3, n3 (n=3, 1,37 13 (1,3 n=5 (n=5 n=3 (n=3 1,3 (1, n= (n= 1, (1 (n (

ABSTRACT OBJECTIVE To evaluate, using spatial analysis, the occurrence of American Cutaneous Leishmaniasis (ACL) and analyze its association with the municipal human development index (MHDI) and deforestation in the state of Amazonas, Brazil, from 2016 to 2020. METHODS This ecological study, carried out from January 2016 to December 2020, included the 62 municipalities of the state of Amazonas. The incidence rate of ACL was determined in space and time. Using Multiple Linear Regression by Ordinary Least Squares (OLS) and Spatial Autoregressive Regression (SAR) models, the relationship between incidence rates and Human Development Index (HDI) and deforestation was analyzed., The high- and low-risk clusters were identified by employing the Getis-Ord Gi* statistic. RESULTS A total of 7,499 cases of ACL were registered in all 62 municipalities in the state. Most cases were in male (n=5,924; 79.24%), with the greatest frequency in the population aged from 20 to 39 years (n=3,356; 44.7%). The incidence rate in the state of Amazonas was 7.34 cases per 100,000 inhabitants-year, with the municipalities of Rio Preto da Eva and Presidente Figueiredo showing the highest rates (1,377.5 and 817.5 cases per 100,000 population-year, respectively). The ACL cases were clustered into specific areas related to those municipalities with the highest incidence rates. The SAR model revealed a positive relationship between ACL and deforestation. CONCLUSIONS The occurrence of ACL was evident in a variety of patterns in the state of Amazonas; the high incidence rates and persistence of this disease in this state were linked to deforestation. The temporal distribution showed variations in the incidence rates during each year. Our results can help optimize the measures needed to prevent and control this disease in the state.

ABSTRACT The objective of this paper is to provide possible scenarios for the evolution of Coronavirus Disease-19 (COVID-19) from the application of optimal control strategies. Provided that data on the novel coronavirus (SARS-CoV-2) are fraught of uncertainty or even lack of information, interval mathematical models are feasible for the study of epidemiological models related to COVID-19. Thus, the interval SI epidemiological model and the corresponding interval optimal control problem were proposed. The solution of the interval optimal control problem illustrates pessimistic and optimistic scenarios for the evolution of the pandemic in Brazil. Two decision-making criterias under uncertainty have been considered and they can assist the decision making process by public health workers. Both criterias take into account costs associated with the decision-making. Disease19 Disease 19 Disease-1 COVID19 COVID (COVID-19 strategies SARSCoV2 SARSCoV SARS CoV 2 (SARS-CoV-2 information COVID19. 19. COVID-19 Thus proposed Brazil decisionmaking workers decisionmaking. making. Disease1 1 Disease- COVID1 (COVID-1 (SARS-CoV- COVID-1 (COVID- (SARS-CoV COVID- (COVID

RESUMO O objetivo deste trabalho é fornecer cenários possíveis da evolução da pandemia ocasionada pela COVID-19 a partir da aplicação de estratégias de controle ótimo. Uma vez que os dados sobre o coronavírus SARS-CoV-2 são repletos de incerteza ou mesmo falta de informação, a modelagem matemática intervalar é viável para o estudo de modelos epidemiológicos relacionados à COVID-19. Assim, foi proposto o modelo epidemiológico SI intervalar e o problema de controle ótimo intervalar correspondente. A solução do problema de controle ótimo intervalar ilustra cenários pessimistas e otimistas para a evolução da pandemia no Brasil. Dois critérios de tomada de decisão sob incerteza foram considerados e podem auxiliar os agentes de saúde pública. Ambos os critérios levam em consideração custos associados à tomada de decisão. COVID19 COVID 19 COVID-1 SARSCoV2 SARSCoV SARS CoV 2 SARS-CoV- informação COVID19. 19. Assim correspondente Brasil pública COVID1 1 COVID- SARS-CoV

ABSTRACT Objective: To assess the incidence of tuberculosis in Brazil between 2001 and 2022 and estimate the monthly incidence forecast until 2030. Methods: This is a time-series study based on monthly tuberculosis records from the Notifiable Diseases Information System and official projections of the Brazilian population. The monthly incidence of tuberculosis from 2001 to 2022 was evaluated using segmented linear regression to identify trend breaks. Seasonal autoregressive integrated moving average (Sarima) was used to predict the monthly incidence from 2023 to 2030, deadline for achieving the sustainable development goals (SDGs). Results: There was a decrease in incidence between January/2001 and December/2014 (4.60 to 3.19 cases-month/100,000 inhabitants; β=-0.005; p<0.001), followed by an increase between January/2015 and March /2020 (β=0.013; p<0.001). There was a sharp drop in cases in April/2020, with the onset of the pandemic, and acceleration of the increase in cases since then (β=0.025; p<0.001). A projection of 124,245 cases in 2030 was made, with an estimated incidence of 4.64 cases-month/100,000 inhabitants, levels similar to those in the 2000s. The Sarima model proved to be robust, with error of 4.1% when removing the pandemic period. Conclusion: The decreasing trend in tuberculosis cases was reversed from 2015 onwards, a period of economic crisis, and was also impacted by the pandemic when there was a reduction in records. The Sarima model can be a useful forecasting tool for epidemiological surveillance. Greater investments in prevention and control need to be made to reduce the occurrence of tuberculosis, in line with the SDGs.

RESUMO Objetivo: Avaliar a incidência de tuberculose no Brasil entre 2001 e 2022 e estimar a previsão de incidência mensal até 2030. Métodos: Trata-se de estudo de série temporal que partiu de registros mensais de tuberculose do Sistema de Informação de Agravos de Notificação e projeções oficiais da população brasileira. Avaliou-se a incidência mensal de tuberculose entre 2001 e 2022 por meio de regressão linear segmentada para identificar quebras de tendências. Utilizou-se o modelo autorregressivo integrado de médias móveis sazonais (Sarima) para prever a incidência mensal de 2023 a 2030, prazo para alcançar os objetivos de desenvolvimento sustentável (ODS). Resultados: Observou-se diminuição da incidência entre janeiro/2001 e dezembro/2014 (de 4,60 para 3,19 casos-mês/100 mil habitantes; β=-0,005; p<0,001), seguida de aumento entre janeiro/2015 e março/2020 (β=0,013; p<0,001). Houve queda abrupta de casos em abril/2020, com início da pandemia e aceleração do aumento de casos desde então (β=0,025; p<0,001). Projetaram-se 124.245 casos de tuberculose em 2030, com incidência estimada em 4,64 casos-mês/100 mil habitantes, patamares da década de 2000. O modelo Sarima mostrou-se robusto, com erro de 4,1% ao remover o período pandêmico. Conclusão: A tendência decrescente nos casos de tuberculose foi revertida a partir de 2015, período de crises econômicas, e foi também impactada pela pandemia quando houve redução nos registros. O modelo Sarima pode ser uma ferramenta de previsão útil para a vigilância epidemiológica. Maiores investimentos na prevenção e controle precisam ser aportados para reduzir a ocorrência de tuberculose, em linha com os ODS.

ABSTRACT Objective: To assess the incidence of tuberculosis in Brazil between 2001 and 2022 and estimate the monthly incidence forecast until 2030. Methods: This is a time-series study based on monthly tuberculosis records from the Notifiable Diseases Information System and official projections of the Brazilian population. The monthly incidence of tuberculosis from 2001 to 2022 was evaluated using segmented linear regression to identify trend breaks. Seasonal autoregressive integrated moving average (Sarima) was used to predict the monthly incidence from 2023 to 2030, deadline for achieving the sustainable development goals (SDGs). Results: There was a decrease in incidence between January/2001 and December/2014 (4.60 to 3.19 cases-month/100,000 inhabitants; β=-0.005; p<0.001), followed by an increase between January/2015 and March /2020 (β=0.013; p<0.001). There was a sharp drop in cases in April/2020, with the onset of the pandemic, and acceleration of the increase in cases since then (β=0.025; p<0.001). A projection of 124,245 cases in 2030 was made, with an estimated incidence of 4.64 cases-month/100,000 inhabitants, levels similar to those in the 2000s. The Sarima model proved to be robust, with error of 4.1% when removing the pandemic period. Conclusion: The decreasing trend in tuberculosis cases was reversed from 2015 onwards, a period of economic crisis, and was also impacted by the pandemic when there was a reduction in records. The Sarima model can be a useful forecasting tool for epidemiological surveillance. Greater investments in prevention and control need to be made to reduce the occurrence of tuberculosis, in line with the SDGs. Objective 200 202 Methods timeseries time series population breaks (Sarima SDGs . (SDGs) Results January2001 January January/200 December2014 December 2014 December/201 4.60 460 4 60 (4.6 319 3 19 3.1 casesmonth/100,000 casesmonth100000 casesmonth month/100,000 month 100 000 cases-month/100,00 inhabitants β=0.005 β0005 β β= 0.005 0 005 β=-0.005 p<0.001, p0001 p p<0.001 , 001 p<0.001) January2015 January/201 2020 /202 β=0.013 β0013 013 (β=0.013 p<0.001. April2020 April April/2020 β=0.025 β0025 025 (β=0.025 124245 124 245 124,24 203 464 64 4.6 2000s s robust 41 1 4.1 Conclusion 201 onwards crisis surveillance 20 (SDGs January200 January/20 December201 December/20 46 6 (4. 31 3. casesmonth/100,00 casesmonth10000 month100000 month/100,00 10 00 cases-month/100,0 β=0.00 β000 0005 0.00 β=-0.00 p000 p<0.00 January201 /20 β=0.01 β001 01 (β=0.01 April202 April/202 β=0.02 β002 02 (β=0.02 12424 12 24 124,2 4. 2 January20 January/2 December20 December/2 (4 casesmonth/100,0 casesmonth1000 month10000 month/100,0 cases-month/100, β=0.0 β00 0.0 β=-0.0 p00 p<0.0 /2 (β=0.0 April20 April/20 1242 124, January2 January/ December2 December/ ( casesmonth/100, casesmonth100 month1000 month/100, cases-month/100 β=0. β0 0. β=-0. p0 p<0. / (β=0. April2 April/2 casesmonth/100 casesmonth10 month100 month/100 cases-month/10 β=0 β=-0 p<0 (β=0 April/ casesmonth/10 casesmonth1 month10 month/10 cases-month/1 β=- p< (β= casesmonth/1 month1 month/1 cases-month/ (β casesmonth/ month/ cases-month

RESUMO Objetivo: Avaliar a incidência de tuberculose no Brasil entre 2001 e 2022 e estimar a previsão de incidência mensal até 2030. Métodos: Trata-se de estudo de série temporal que partiu de registros mensais de tuberculose do Sistema de Informação de Agravos de Notificação e projeções oficiais da população brasileira. Avaliou-se a incidência mensal de tuberculose entre 2001 e 2022 por meio de regressão linear segmentada para identificar quebras de tendências. Utilizou-se o modelo autorregressivo integrado de médias móveis sazonais (Sarima) para prever a incidência mensal de 2023 a 2030, prazo para alcançar os objetivos de desenvolvimento sustentável (ODS). Resultados: Observou-se diminuição da incidência entre janeiro/2001 e dezembro/2014 (de 4,60 para 3,19 casos-mês/100 mil habitantes; β=-0,005; p<0,001), seguida de aumento entre janeiro/2015 e março/2020 (β=0,013; p<0,001). Houve queda abrupta de casos em abril/2020, com início da pandemia e aceleração do aumento de casos desde então (β=0,025; p<0,001). Projetaram-se 124.245 casos de tuberculose em 2030, com incidência estimada em 4,64 casos-mês/100 mil habitantes, patamares da década de 2000. O modelo Sarima mostrou-se robusto, com erro de 4,1% ao remover o período pandêmico. Conclusão: A tendência decrescente nos casos de tuberculose foi revertida a partir de 2015, período de crises econômicas, e foi também impactada pela pandemia quando houve redução nos registros. O modelo Sarima pode ser uma ferramenta de previsão útil para a vigilância epidemiológica. Maiores investimentos na prevenção e controle precisam ser aportados para reduzir a ocorrência de tuberculose, em linha com os ODS. Objetivo 200 202 2030 Métodos Tratase Trata se brasileira Avaliouse Avaliou tendências Utilizouse Utilizou (Sarima ODS . (ODS) Resultados Observouse Observou janeiro2001 janeiro janeiro/200 dezembro2014 dezembro 2014 dezembro/201 460 4 60 4,6 319 3 19 3,1 casosmês/100 casosmês100 casosmês mês/100 mês 100 casos-mês/10 habitantes β=0,005 β0005 β β= 0,005 0 005 β=-0,005 p<0,001, p0001 p p<0,001 , 001 p<0,001) janeiro2015 2015 janeiro/201 março2020 março 2020 março/202 β=0,013 β0013 013 (β=0,013 p<0,001. abril2020 abril abril/2020 β=0,025 β0025 025 (β=0,025 Projetaramse Projetaram 124245 124 245 124.24 464 64 2000 mostrouse mostrou robusto 41 1 4,1 pandêmico Conclusão econômicas epidemiológica 20 203 (ODS janeiro200 janeiro/20 dezembro201 201 dezembro/20 46 6 4, 31 3, casosmês/10 casosmês10 mês100 mês/10 10 casos-mês/1 β=0,00 β000 0005 0,00 00 β=-0,00 p000 p<0,00 janeiro201 março202 março/20 β=0,01 β001 01 (β=0,01 abril202 abril/202 β=0,02 β002 02 (β=0,02 12424 12 24 124.2 2 janeiro20 janeiro/2 dezembro20 dezembro/2 casosmês/1 casosmês1 mês10 mês/1 casos-mês/ β=0,0 β00 000 0,0 β=-0,0 p00 p<0,0 março20 março/2 (β=0,0 abril20 abril/20 1242 124. janeiro2 janeiro/ dezembro2 dezembro/ casosmês/ mês1 mês/ casos-mês β=0, β0 0, β=-0, p0 p<0, março2 março/ (β=0, abril2 abril/2 β=0 β=-0 p<0 (β=0 abril/ β=- p< (β= (β

BACKGROUND Kissing bugs are the vectors of Trypanosoma cruzi, the etiological agent of Chagas disease (CD). Despite their epidemiological relevance, kissing bug species are under sampled in terms of their diversity and it is unclear what biases exist in available kissing bug data. Under climate change, range maps for kissing bugs may become less accurate as species shift their ranges to track climatic tolerance. OBJECTIVES Quantify inventory completeness in available kissing bug data. Assess how well range maps are at conveying information about current distributions and potential future distributions subject to shift under climate change. Intersect forecasted changes in kissing bug distributions with contemporary sampling gaps to identify regions for future sampling of the group. Identify whether a phylogenetic signal is present in expert range knowledge as more closely related species may be similarly well or lesser understood. METHODS We used species distribution models (SDM), specifically constructed from Bayesian additive regression trees, with Bioclim variables, to forecast kissing bug distributions into 2100 and intersect these with current sampling gaps to identify priority regions for sampling. Expert range maps were assessed by the agreement between the expert map and SDM generated occurrence probability. We used classical hypothesis testing methods as well as tests of phylogenetic signal to meet our objectives. FINDINGS Expert range maps vary in their quality of depicting current kissing bug distributions. Most expert range maps decline in their ability to convey information about kissing bug occurrence over time, especially in under sampled areas. We found limited evidence for a phylogenetic signal in expert range map performance. MAIN CONCLUSIONS Expert range maps are not a perfect account of species distributions and may degrade in their ability to accurately convey distribution knowledge under future climates. We identify regions where future sampling of kissing bugs will be crucial for completing biodiversity inventories. cruzi CD. CD . (CD) relevance data change tolerance group understood SDM, , (SDM) trees variables 210 probability objectives time areas performance climates inventories (CD (SDM 21 2

Abstract The study aimed to estimate the prevalence of alcohol use disorder (AUD) and associated factors in Brazilian adults that reported chronic noncommunicable diseases (NCDs), mental disorders (MDs), and infectious diseases (IDs). This was a secondary analysis of the 3rd National Survey on Drug Use by the Brazilian Population in which the principal outcome was presence of AUD. Prevalence of AUD was estimated for three subgroups: individuals that reported NCDs, MDs, and IDs. Factors associated with AUD in each group were analyzed using logistic regression models. Of the 15,645 adults interviewed, 30.5% (95%CI: 29.4-31.5) reported NCDs, 17.6% (95%CI: 16.5-18.7) MDs, and 1.6% (95%CI: 1.2-1.9) IDs. Considering comorbidities, the analytical sample was 6,612. No statistically significant difference was found in the prevalence of AUD between individuals with NCDs (7.5% [95%CI: 6.1- 8.7]), MDs (8.4% [95%CI: 6.7-10.2]), and IDs (12.4% [95%CI: 7.0-17.8]). The main factors associated with AUD in all the groups were male sex and young adult age. Considering the high prevalence of AUD in all the groups, systematic screening of AUD is necessary in health services that treat NCDs, MDs, and IDs.

Resumo O objetivo do artigo é estimar a prevalência de transtornos relacionados ao uso de álcool (TRA) e fatores associados entre indivíduos da população brasileira que reportaram doenças crônicas não-transmissíveis (DCNT), transtornos mentais (TM) e doenças infeciosas (DI). Análise secundária do III Levantamento Nacional sobre o Uso de Drogas pela População Brasileira, cujo desfecho principal foi a presença de TRA. A prevalência de TRA foi estimada para três subgrupos: indivíduos que reportaram DCNT, TM e DI. Os fatores associados a TRA dentro de cada grupo foram analisados utilizando modelos de regressão logística. Dos 15.645 adultos entrevistados, 30,5% (IC95%: 29,4-31,5) reportaram DCNT, 17,6% (IC95%: 16,5-18,7) TM e 1,6% (IC95%: 1,2-1,9) DI. Considerando as comorbidades, a amostra analítica foi de 6.612. Não foi encontrada diferença estatisticamente significativa na prevalência de TRA entre indivíduos com DCNT (7,5% [IC95% 6,1-8,7]), TM (8,4% [IC95% 6,7-10,2]) e DI (12,4% [IC95% 7,0-17,8]). Os principais fatores associados a TRA, em todos os grupos, foram ser do sexo masculino e jovem. Considerando a alta prevalência de TRA em todos os grupos é necessário seu rastreio sistemático em serviços de saúde que atendam DCNT, TM e DI.