RESUMO A leptospirose é um problema de saúde pública mundial. No Brasil, ela é uma doença de notificação compulsória e está relacionada a áreas com precárias condições sanitárias. Foi realizado um estudo ecológico retrospectivo para observar a distribuição espacial e temporal de casos confirmados da leptospirose em escala nacional no período entre 2007 e 2017. A espacialização da leptospirose utilizou técnicas de geoprocessamento por análise de padrões pontuais e por mapas de densidade Kernel. Os resultados revelaram que, no período, foram registrados 42.310 casos confirmados de leptospirose no País, com média anual de 3.846 casos e prevalência de 1,9 a cada 100 mil habitantes. As localidades com mais casos prevalentes foram as regiões Sul e Norte. O Sudeste apresentou taxa de prevalência inferior à taxa nacional em virtude da alta densidade demográfica. O método Kernel se mostrou útil na análise global da situação epidemiológica da leptospirose nas regiões do Brasil.

ABSTRACT Leptospirosis is a worldwide public health problem. In Brazil, leptospirosis is a disease of compulsory notification and is related to areas with precarious sanitary conditions. A retrospective ecological study was conducted to observe the spatial and temporal distribution of confirmed cases of leptospirosis on national scale in the period between 2007 and 2017. The spatialization of leptospirosis used geoprocessing techniques by analysis of point patterns and by Kernel density maps. The results showed that within the analyzed period, 42,310 confirmed cases of Leptospirosis were recorded in the country, with an annual average of 3,846 cases and prevalence of 1.9 per 100,000 inhabitants. The regions with the most prevalent cases are the South and the North. The southeast presented a prevalence rate lower than the national rate due to the high demographic density. The Kernel method proved to be useful in the global analysis of the epidemiological situation of leptospirosis in the regions of Brazil.

RESUMO A leptospirose é um problema de saúde pública mundial. No Brasil, ela é uma doença de notificação compulsória e está relacionada a áreas com precárias condições sanitárias. Foi realizado um estudo ecológico retrospectivo para observar a distribuição espacial e temporal de casos confirmados da leptospirose em escala nacional no período entre 2007 e 2017. A espacialização da leptospirose utilizou técnicas de geoprocessamento por análise de padrões pontuais e por mapas de densidade Kernel. Os resultados revelaram que, no período, foram registrados 42.310 casos confirmados de leptospirose no País, com média anual de 3.846 casos e prevalência de 1,9 a cada 100 mil habitantes. As localidades com mais casos prevalentes foram as regiões Sul e Norte. O Sudeste apresentou taxa de prevalência inferior à taxa nacional em virtude da alta densidade demográfica. O método Kernel se mostrou útil na análise global da situação epidemiológica da leptospirose nas regiões do Brasil.

ABSTRACT Leptospirosis is a worldwide public health problem. In Brazil, leptospirosis is a disease of compulsory notification and is related to areas with precarious sanitary conditions. A retrospective ecological study was conducted to observe the spatial and temporal distribution of confirmed cases of leptospirosis on national scale in the period between 2007 and 2017. The spatialization of leptospirosis used geoprocessing techniques by analysis of point patterns and by Kernel density maps. The results showed that within the analyzed period, 42,310 confirmed cases of Leptospirosis were recorded in the country, with an annual average of 3,846 cases and prevalence of 1.9 per 100,000 inhabitants. The regions with the most prevalent cases are the South and the North. The southeast presented a prevalence rate lower than the national rate due to the high demographic density. The Kernel method proved to be useful in the global analysis of the epidemiological situation of leptospirosis in the regions of Brazil.

Abstract Objective The aim of the present study was to obtain information about deaths due to sepsis in São Paulo from 2004 to 2009 and their relationship with geographical distribution. Methods Causes of death, both main and secondary, were defined according to the codes of the International Classification of Disease version 10 (ICD-10) contained in the database. Sepsis, septic shock, multiple organ failure, pneumonia, urinary tract infection, peritonitis and other intraabdominal infections, skin and soft tissue infections (including surgical wound infection) and meningitis were considered as immediate cause of death or as the condition leading to the immediate cause of death related or associated to sepsis. Results In the analyzed period, there was a 15.3% increase in the absolute number of deaths from sepsis in São Paulo. The mean number of deaths during this period was 28,472 ± 1566. Most deaths due to sepsis and sepsis-related diseases over the studied period occurred in a hospital or health care facility, showing that most of the patients received medical care during the event that led to death. We observed a significant concentration of deaths in the most populous regions, tending more toward the center of the city. Conclusions Georeferencing data from death certificates or other sources can be a powerful tool to uncover regional epidemiological differences between populations. Our study revealed an even distribution of sepsis all over the inhabited areas of São Paulo.

A sepse tem alta incidência, alta letalidade e custos elevados, sendo a principal causa de mortalidade em unidades de terapia intensiva. Está claramente demonstrado que pacientes reconhecidos e tratados precocemente tem melhor prognóstico. Nesse sentido, a abordagem precoce do agente infeccioso, tanto no sentido do controle do foco infeccioso como da antibioticoterapia adequada são fundamentais para a boa evolução do paciente. A presente diretriz aborda as evidências disponíveis na literatura em relação às principais estratégias para controle e tratamento.

Sepsis is a common and lethal condition that carries a substantial financial burden. In addition, it is the main cause of death in intensive care units. Early diagnosis and treatment of patients has been clearly shown to improve prognosis. Therefore, early diagnosis of the infecting agent, control of the primary infection site and the use of appropriate antibiotic therapy are fundamental to improving outcomes. This guideline reviews the available evidence in the literature concerning infection control and therapy strategies

A sepse tem alta incidência, alta letalidade e custos elevados, sendo a principal causa de mortalidade em unidades de terapia intensiva. Está claramente demonstrado que pacientes reconhecidos e tratados precocemente tem melhor prognóstico. Nesse sentido, a abordagem precoce do agente infeccioso, tanto no sentido do diagnóstico como no controle do foco infeccioso são fundamentais para a boa evolução do paciente. A presente diretriz aborda as evidências disponíveis na literatura em relação às principais estratégias para esse diagnóstico.

Sepsis is a common and lethal condition that carries a substantial financial burden and is the primary cause of death in intensive care units. Early diagnosis and treatment of patients has been clearly shown to improve prognosis. Therefore, early diagnosis of infections and control of the primary infection site are fundamental to improving patients' prognosis. This guideline reviews the available evidence concerning the primary strategies for the diagnosis of infection