The thesis is based on using dynamical systems theories and techniques to study the qualitative dynamics of herpes simplex virus type 2 (HSV-2), a sexually-transmitted disease of major public health significance. A deterministic model for the interaction of the virus with the immune system in the body of an infected individual (in vivo) is designed first of all. It is shown, using Lyapunov function and LaSalle's Invariance Principle, that the virus-free equilibrium of the model is globally-asymptotically stable whenever a certain biological threshold, known as the reproduction number, is less than unity. Furthermore, the model has at least one virus-present equilibrium when the threshold quantity exceeds unity. Using persistence theory, it is shown that the virus will always be present in vivo whenever the reproduction threshold exceeds unity. The analyses (theoretical and numerical) of this model show that a future HSV-2 vaccine that enhances cell-mediated immune response will be effective in curtailling HSV-2 burden in vivo. A new single-group model for the spread of HSV-2 in a homogenously-mixed sexually-active population is also designed. The disease-free equilibrium of the model is globally-asymptotically stable when its associated reproduction number is less than unity. The model has a unique endemic equilibrium, which is shown to be globally-stable for a special case, when the reproduction number exceeds unity. The model is extended to incorporate an imperfect vaccine with some therapeutic benefits. Using centre manifold theory, it is shown that the resulting vaccination model undergoes a vaccine-induced backward bifurcation (the epidemiological importance of the phenomenon of backward bifurcation is that the classical requirement of having the reproduction threshold less than unity is, although necessary, no longer sufficient for disease elimination. In such a case, disease elimination depends upon the initial sizes of the sub-populations of the model). Furthermore, it is shown that the use of such an imperfect vaccine could lead to a positive or detrimental population-level impact (depending on the sign of a certain threshold quantity). The model is extended to incorporate the effect of variability in HSV-2 susceptibility due to gender differences. The resulting two-group (sex-structured) model is shown to have essentially the same qualitative dynamics as the single-group model. Furthermore, it is shown that adding periodicity to the corresponding autonomous two-group model does not alter the dynamics of the autonomous two-group model (with respect to the elimination of the disease). The model is used to evaluate the impact of various anti-HSV control strategies. Finally, the two-group model is further extended to address the effect of risk structure (i.e., risk of acquiring or transmitting HSV-2). Unlike the two-group model described above, it is shown that the risk-structured model undergoes backward bifurcation under certain conditions (the backward bifurcation property can be removed if the susceptible population is not stratified according to the risk of acquiring infection). Thus, one of the main findings of this thesis is that risk structure can induce the phenomenon of backward bifurcation in the transmission dynamics of HSV-2 in a population.

A new sampling method that decouples spatial and environmental correlations was developed and applied to a temperate forest understory. Data were used to contrast niche theory with neutral theory, and only showed support for niche theory. A spatial and environmental partitioning analysis indicated that the effects of dispersal are primarily important within the spatial extent of environments suitable for a given species. The same sampling data were used to test correlates of non-native species invasion at a species level and as a group. The distributions of non-native plant species are also better explained by the niche model; however, non-native species do not appear to negatively impact native species, nor to be negatively impacted by native species. Together, these results suggest that the forest understory is strongly niche-structured, but likely not saturated. Diversity in this forest appears to be primarily determined by regional processes, and only secondarily by local species interactions.

The thesis is based on using dynamical systems theories and techniques to study the qualitative dynamics of herpes simplex virus type 2 (HSV-2), a sexually-transmitted disease of major public health significance. A deterministic model for the interaction of the virus with the immune system in the body of an infected individual (in vivo) is designed first of all. It is shown, using Lyapunov function and LaSalle's Invariance Principle, that the virus-free equilibrium of the model is globally-asymptotically stable whenever a certain biological threshold, known as the reproduction number, is less than unity. Furthermore, the model has at least one virus-present equilibrium when the threshold quantity exceeds unity. Using persistence theory, it is shown that the virus will always be present in vivo whenever the reproduction threshold exceeds unity. The analyses (theoretical and numerical) of this model show that a future HSV-2 vaccine that enhances cell-mediated immune response will be effective in curtailling HSV-2 burden in vivo. A new single-group model for the spread of HSV-2 in a homogenously-mixed sexually-active population is also designed. The disease-free equilibrium of the model is globally-asymptotically stable when its associated reproduction number is less than unity. The model has a unique endemic equilibrium, which is shown to be globally-stable for a special case, when the reproduction number exceeds unity. The model is extended to incorporate an imperfect vaccine with some therapeutic benefits. Using centre manifold theory, it is shown that the resulting vaccination model undergoes a vaccine-induced backward bifurcation (the epidemiological importance of the phenomenon of backward bifurcation is that the classical requirement of having the reproduction threshold less than unity is, although necessary, no longer sufficient for disease elimination. In such a case, disease elimination depends upon the initial sizes of the sub-populations of the model). Furthermore, it is shown that the use of such an imperfect vaccine could lead to a positive or detrimental population-level impact (depending on the sign of a certain threshold quantity). The model is extended to incorporate the effect of variability in HSV-2 susceptibility due to gender differences. The resulting two-group (sex-structured) model is shown to have essentially the same qualitative dynamics as the single-group model. Furthermore, it is shown that adding periodicity to the corresponding autonomous two-group model does not alter the dynamics of the autonomous two-group model (with respect to the elimination of the disease). The model is used to evaluate the impact of various anti-HSV control strategies. Finally, the two-group model is further extended to address the effect of risk structure (i.e., risk of acquiring or transmitting HSV-2). Unlike the two-group model described above, it is shown that the risk-structured model undergoes backward bifurcation under certain conditions (the backward bifurcation property can be removed if the susceptible population is not stratified according to the risk of acquiring infection). Thus, one of the main findings of this thesis is that risk structure can induce the phenomenon of backward bifurcation in the transmission dynamics of HSV-2 in a population.

[Truncated abstract] Weeds which invade native communities can have major impacts on biodiversity and ecosystem processes. However, these impacts are rarely quantified, and the mechanisms behind these impacts are rarely investigated. Asparagus asparagoides (L.) Druce (Asparagaceae; common name: bridal creeper), a plant native to southern Africa, is a significant environmental weed in southern Australia. Bridal creeper can invade both disturbed and undisturbed native ecosystems and then dominate native communities. As is the case for many environmental weeds, there has been little work conducted on the impacts of this plant. This lack of knowledge has hampered restoration efforts of invaded areas because very little is known about the potential for invaded communities to recover prior to undertaking weed management. There is a need to improve our understanding of how to manage ecosystem recovery during and after weed control. This can be achieved by (i) determining the impacts caused by the weed; (ii) assessing the condition of invaded communities; and (iii) predicting the impacts that weed management itself will have on the native communities. These three prerequisites to environmental weed control have been determined across sites invaded by bridal creeper in southern Australia. The impacts of this invasive geophyte have been determined through multi-site comparisons, weed removal experiments and controlled glasshouse and laboratory experiments. ... Without additional restoration, we will see those species that readily germinate and those that respond positively to increased soil fertility, replacing bridal creeper after control. This will be dominated by other weeds as the invaded sites have large exotic seed banks that will readily germinate. The tuberous mats of older bridal creeper plants will also leave a legacy as they will remain many years after control and still impact on vegetation, even if control has killed the plant. These impacts will be highest at sites where bridal creeper has dominated over the longer term. Environmental weeds, such as bridal creeper, that are capable of altering ecosystem functions can lead to substantial declines in biodiversity. Therefore, it was fortunate that bridal creeper became a target for biocontrol in Australia even though the impacts of the weed were not quantified when this decision was made. There are areas in southern Australia that are still free of bridal creeper or have sparse populations, and it is highly likely that this biological control programme has lead to the protection of these areas. This protection would not have been possible if other control measures were chosen over biological control, given that biocontrol agents can self-disperse and are able to give continuous control. This means that biological control of weeds in conservation areas can be very effective and is the only economically viable option for the control of widespread environmental weeds such as bridal creeper.

[Truncated abstract] Fire ephemerals are pioneer species that germinate in large numbers after fire and generally live for between six months and four years. Seeds produced during the short life span of these plants persist in the soil seedbank until a subsequent fire. This study examined the dormancy characteristics and germination requirements of ten Australian fire ephemeral species from five families. Seeds of four species germinated at one or more incubation temperatures in the laboratory, indicating that a proportion of their seedlots were non-dormant at the time of testing. Austrostipa compressa and Austrostipa macalpinei (Poaceae) produced >80% germination at 10?C and Alyogyne hakeifolia and Alyogyne huegelii (Malvaceae) produced 30-40% and 35-50% germination respectively at 10 to 25°C. In each of the Alyogyne species approximately 50% of seeds were impermeable to water, but scarification did not enable germination of all viable seeds suggesting that seeds which did not germinate, may have possessed physiological dormancy as well as physical dormancy. Remaining species had water permeable seeds. ... Germination of both Alyogyne species declined after six months of winter burial but was enhanced by heat treatments after a further six months of summer burial. Actinotus leucocephalus and Tersonia cyathiflora seeds exhibited annual dormancy cycling over two years of burial. Dormancy was alleviated over summer, allowing seeds of both species to germinate in smoke water when seeds were exhumed in autumn, and reimposed over winter, suppressing germination in spring. In Actinotus leucocephalus these dormancy changes were induced in the laboratory by warm (≥15°C) and cold (5°C) temperatures, alleviating and re-imposing dormancy, respectively. Wetting and drying seeds stored at 37°C further accelerated the rate of dormancy release. This dormancy cycling would increase the likelihood of seeds germinating when moisture availability in south-western Australia is greatest for seedling survival. It also explains the variation in germination response to smoke water observed in many species. Thus under natural conditions dormancy levels of fire ephemerals were altered during soil storage which enabled them to respond to fire-related cues such as heat and smoke water, and germinate in autumn. This information will assist in the use of these species in land rehabilitation and ornamental horticulture, and in the conservation of rare or endangered fire ephemerals.

Looking at the use of plants as food reflects how humankind has fashioned nature. There has been a significant change in production patterns from hunter-gathering through subsistence agriculture to technologically advanced commercial agriculture with a subsequent reduction in the diversity of plants used as food. A parallel trend in consumption patterns has occurred, from home-based food processing for subsistence through small- scale production to large-scale industrial processing and the commodification of food. The overall result of such trends is a narrowing of the food resource base and an increasing reliance on processed foods at the expense of traditional diets, accompanied by increasing diet-related health risks. This research is an ethnographic case study on the use of indigenous food plants by the community of Tuku A village in the Eastern Cape using interviews and observations as the main data collecting strategies. A nutritional analysis of some wild food plants was also carried out. An inventory of more than 70 food plant species was compiled, with the knowledge of such plants found among both the elderly and the youth. The incorporation of this knowledge into education systems is recommended. Of the wild food plants documented, some were non-indigenous indicating the dynamic nature of indigenous knowledge. Some wild spinach were left to grow amongst cultivated food plants, hinting at some form of ‘domestication’ in process. This observation together with the observation that wild fruit trees were selectively conserved highlights the possibility of the continued use of wild food contributing to conservation of botanical diversity. Community use of indigenous food was found to be diminishing. Stigmatisation of indigenous food plants, urbanisation, formal education, changes in lifestyle, and media were some of the factors possibly influencing this dietary shift. The community made links between diet and health, which correspond to modern scientific knowledge, with modern diet being lamented for ill health. The nutritional analysis revealed that wild food plants do contain essential dietary nutrients, an area recommended for further research.

Submitted by Mario Mesquita (mbarroso@fiocruz.br) on 2014-11-10T15:54:17Z No. of bitstreams: 1 Claudia_Almeida_EPSJV_Mestrado_2012.pdf: 4597494 bytes, checksum: b79ca3aac48688166ae47f21eba2468d (MD5) / Approved for entry into archive by Mario Mesquita (mbarroso@fiocruz.br) on 2014-11-10T18:48:43Z (GMT) No. of bitstreams: 1 Claudia_Almeida_EPSJV_Mestrado_2012.pdf: 4597494 bytes, checksum: b79ca3aac48688166ae47f21eba2468d (MD5) / Made available in DSpace on 2014-11-10T18:48:43Z (GMT). No. of bitstreams: 1 Claudia_Almeida_EPSJV_Mestrado_2012.pdf: 4597494 bytes, checksum: b79ca3aac48688166ae47f21eba2468d (MD5) Previous issue date: 2012 / Fundação Oswaldo Cruz. Escola Politécnica de Saúde Joaquim Venâncio. Programa de Pós-Graduação em Educação Profissional em Saúde. / Nesta dissertação, discute-se a Educação Profissional do trabalhador de nível médio sem formação específica em saúde - o Agente de Controle de Endemias (ACE). Além disso, numa perspectiva de complementaridade, são abordados os conceitos de qualificação e de competência profissional. A formação foi tratada do ponto de vista histórico, sendo necessária a discussão de alguns aspectos das políticas sociais, além dos modelos de gestão em saúde que embasaram a política de Educação Permanente em Saúde no Sistema Único de Saúde (SUS). Verifica-se na metodologia desta política a identificação e validação de um conjunto de competências profissionais num sistema complexo de trabalho. O estudo incidiu sobre os ACE no município de Niterói/RJ e permitiu concluir pela existência de uma dimensão bastante complexa entre a formação e a exigência prática do trabalho, enquanto elementos políticos estruturantes da Vigilância em Saúde. Apontamos que, na década de 2000, foi executada uma política de formação num padrão de excelência pelo PROFORMAR/EPSJV/FIOCRUZ. / This dissertation discusses the Professional Education of the average worker without specific training in health – Agent of Endemic Disease Control (ACE). In addition, a complementary perspective, discusses the concepts of qualification and professional competence. The training was handled in the historical point of view, it was necessary to discuss some aspects of social policies, and management models that support the health policy of Permanent Education in Health System Health Checks on the methodology of this policy identification and validation of a set of professional skills in a complex system of work. The study focused on the agents of ACE in country city Niterói/RJ, and concluded that there is a very complex dimension between training and work practice requirements, whil e structuring the political elements of Surveillance in Health points out that in 2000s, ran a training policy in a standard of excellence by PROFORMAR EPSJV/FIOCRUZ.

Orientador: Mariangela Ribeiro Resende / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-09T21:35:03Z (GMT). No. of bitstreams: 1 Barao_SandraCristina_D.pdf: 3775784 bytes, checksum: ffb11ed337f2da69883370a4bf0d4b32 (MD5) Previous issue date: 2007 / Resumo: As informações que existem acerca da leishmaniose visceral humana, provêm em sua maioria das notificações realizadas nas áreas de alta endemicidade. Por isso, ainda há muitos aspectos a respeito da transmissão urbana e dos quadros de infecção assintomática que precisam ser elucidados. O dimensionamento real da prevalência da infecção por Leishmania chagasi pode contribuir para a definição e avaliação do impacto das medidas de controle. Com o objetivo de determinar a prevalência da infecção por L. chagasi em área de autoctonia recente, município de Araçatuba e, avaliar os fatores associados em relação aos casos humanos de leishmaniose visceral notificados, foi realizado um estudo transversal, com amostra estratificada de fase única, realizada em duas áreas urbanas de níveis sócio-econômicos distintos, designadas A1 (periférica, menor nível sócio-econômico) e A2 (central, melhor nível sócio-econômico). A soroprevalência foi avaliada com a utilização do teste imunocromatográfico com antígeno recombinante K39 (Ag-RK39). A prevalência observada foi de 18,4% (23/125) em A1 e 4,8% (6/125) em A2. A proporção entre indivíduos assintomáticos e casos de doença ativa nas áreas 1 e 2 foram respectivamente 1,35:1 e 2:1. Não houve diferença significativa da soropositividade na distribuição por idade, nem por sexo, entre as áreas. Contudo, foi observada diferença na proporção de casos assintomáticos entre as áreas, possivelmente associada aos níveis sócio-econômicos e intensidade de transmissão. Também houve relação com a presença canina nos últimos dois anos e a soropositividade para o Ag-rK39. As informações obtidas sugerem a associação da soroprevalência à presença canina nos dois últimos anos e reforça a estratégia de controle adotada / Abstract: Many information exist about human visceral leishmaniasis are origin to thepontificated cases, moreover, almost all data substantiating derive high levels transmission. So, there are many aspects about the urban transmission and asymptomatic infection to need to elucidated. The real comprehensive measurements about the Leishmania chagasi infection to be able to contribute to improve the assessment impact about the measures control. The objective to this study was determining the prevalence of asymptomatic visceral leishmaniasis infection in Araçatuba city, a recent autoctone area. This was a cross-sectional survey on a random sample of the population in two urban different areas, called A1 (outskirts, low social-economic condition) and A2 (central, good social-economic condition). The seroprevalence was assessing by the Immunochromatographic test with recombinant antibody K39 dipstick. The prevalence was 18.4% (23/125) in A1 and 4.8% (6/125) in A2. And the proportion between the asymptomatic and active disease in areas 1 and 2 was 1.35:1 and 2:1, respectively. There was no significant difference in age, nor gender, distribution of seropositivity between the areas. But we observed a difference in asymptomatic infection rates between the two areas, possibly associated with socioeconomic levels and transmission intensity. The data from this study suggest an associate between the human symptomatic seroprevalence and the presence of dogs in last two years old / Doutorado / Ciencias Basicas / Doutor em Clínica Médica

Submitted by Luciana Ferreira (lucgeral@gmail.com) on 2017-05-17T12:31:09Z No. of bitstreams: 2 Dissertação - David Antonio Costa Barros - 2017.pdf: 4071063 bytes, checksum: ddb294c71acfa6cbe5dc316e1b8f74ec (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2017-05-17T12:31:41Z (GMT) No. of bitstreams: 2 Dissertação - David Antonio Costa Barros - 2017.pdf: 4071063 bytes, checksum: ddb294c71acfa6cbe5dc316e1b8f74ec (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2017-05-17T12:31:42Z (GMT). No. of bitstreams: 2 Dissertação - David Antonio Costa Barros - 2017.pdf: 4071063 bytes, checksum: ddb294c71acfa6cbe5dc316e1b8f74ec (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2017-03-15 / This study aims at assessing the risk of Chagas disease transmission in two risk endemic Municipalities after the local implementation of Triatoma infestans Eradication Program (PETI). To that end, a epidemiological, entomological and serological assessment of PETI was carried out in loco in the Municipalities researched. In the epidemiological context of Chagas disease, according to serological investigation conducted in 1980, seroprevalence amongst the population researched was around 0,82% in São Luís dos Montes Belos (SLMB) and 2,35% in Novo Brasil (NB). At present, a serological survey is underway in the region. In the first stage of serological investigation, about to be concluded, samples from 103 children residing in Novo Brasil rural area and from 303 children residing in São Luís dos Montes Belos rural area were collected on filter paper, and the results were negative; later, 60 test-tube samples were collected in both Municipalities for performing more specific techniques. The domiciliary infestation index in SLMB (rural area) raised from 8,80% to 10,6% (2004-2005), and from 0,84% (2004) to 0,39% (January-July 2005) in NB (rural area). The population under contagion risk is around 4109 inhabitants in SLMB and 1153 inhabitants in NB, due to the presence of vectors. Endemic zones are concentrated in rural area, where potential vectors such as Triatoma sordida are found (around 90% of the species captured in SLMB and 50% in NB in 2005). Health education is jointly conducted in São Luís dos Montes Belos and Novo Brasil by the National Health Foundation (FUNASA), the Family Health Program (PSF) and both Municipal Secretariats of Education, by means of expositions, consultations and the Minimum Surveillance Unit (UMV), which is also applied in the indoor detection of traces of Triatominae. In conclusion, the control of Chagas disease transmission lies on the joint effects of seroepidemiological surveillance, continuous sprinkling of residual insecticides and the implementation of housing improvement program in endemic areas, as well as the continuance and strengthening of Health Education efforts through Family Health Program (PSF). / A doença de Chagas transmitida pelo Trypanosoma cruzi (Chagas, 1909) era uma enzootia restrita ao ambiente silvestre (mamíferos e triatomíneos em perfeito equilíbrio). No Brasil, há evidências de que a doença humana surgiu após seu descobrimento, embora tenha sido encontrada uma múmia datada de ± 1200 anos. O relato mais antigo de triatomíneos (também chamados de “vinchuca”) no Brasil foi feito pelos jesuítas (1590). Sua introdução ocorreu possivelmente através da Argentina ou Uruguai. O “engasgo” (megaesôfago) e a “hidropsia” (constipação) (Saint-Hilaire, 1819; Longgaard, 1865) já existiam endemicamente no interior de Goiás e Minas Gerais. Embora a doença de Chagas tenha sido descoberta em 1909, somente a partir de 1960 seu controle foi pensado de forma profissional. Entretanto, efetivamente, apenas a partir de 1970 foram dados os primeiros passos com essa finalidade. Portanto, as medidas de controle devem dirigir-se à eliminação desses insetos do ambiente humano. Das mais de 120 espécies conhecidas, 48 foram identificadas no Brasil, das quais 30 já foram capturadas no ambiente domiciliar. Em Goiás, com a finalidade de realizar um estudo clínico-epidemiológico da doença de Chagas, em áreas onde a espécie vetora era o Triatoma infestans, foi montado o Projeto Mambaí. Iniciado em 1974, com o estudo eco-epidemiológico da região. Posteriormente, em 1979, após o levantamento triatomínico e devido ao requerimento do Projeto, foi solicitada a colaboração da SUCAM/ Ministério da Saúde, que forneceu apoio e infra-estrutura para a implementação de um sistema de controle e vigilância da doença de Chagas (ZAPATA, 1990). Hoje, com a estratégia de monitoramento entomológico, ações de combate utilizando inseticidas específicos, assim como as melhorias habitacionais realizadas nas áreas endêmicas, a doença encontra-se sob controle de acordo com o certificado da OMS, mas o risco de transmissão continua. No contexto epidemiológico da doença, Goiás ocupava a terceira colocação pelo inquérito nacional realizado em 1980. Com a implantação do Programa de Eliminação do Triatoma infestans em 1992, que é um projeto que faz parte do Programa de Controle da Doença de Chagas no Estado de Goiás, o índice de 7,4% de prevalência da doença, caiu consideravelmente e hoje o principal vetor não é detectado ou é encontrado em índices muito baixos em alguns municípios do Estado. No contexto epidemiológico da doença de Chagas, conforme o inquérito sorológico realizado em 1980, em São Luís dos Montes Belos (SLMB) a soroprevalência estava em torno de 0,82% e em Novo Brasil (NB) em torno de 2,35% dos pesquisados. O levantamento sorológico em escolares nascidos após a fase de controle nas regiões mostrou nenhuma delas estava com sorologia positiva para a moléstia. Nas 236 Unidades Domiciliares pesquisadas (150 em São Luís dos Montes Belos e 86 em Novo Brasil), todas infestadas por triatomíneos e nenhum triatomíneo capturado positivo para Trypanosoma cruzi. O objetivo deste estudo foi avaliar o risco de transmissão da doença de Chagas em dois municípios endêmicos de risco após a implantação do Sistema Único de Saúde (SUS). Para tal, foi realizado in locus uma avaliação sorológica, entomológica e epidemiológica do Programa de Erradicação do Triatoma infestans (PETI) nos municípios pesquisados. Os objetivos deste trabalho foram determinar o nível de conhecimentos, atitudes, práticas da população sobre o controle da doença de Chagas e seus vetores em uma população de crianças em fase escolar de uma zona endêmica dos municípios de risco em Goiás, Brasil. Através deste pretende-se implantar medidas alternativas de controle e vigilância e justificar a implantação das Unidades de Vigilância Longitudinal, para um combate mais abrangente da doença de Chagas no Estado. Apesar do controle do Triatoma infestans existe o considerável aumento dos vetores secundários como o Triatoma sordida, merecendo constante estado de Vigilância epidemiológica dentro do contexto do atual Sistema Único de Saúde (SUS) e da sua potencial inserção na rotina do Programa de Saúde da Família.

Focos geográficos bem definidos de pênfigo prevalecem no mundo todo, inclusive no Brasil. Nas últimas décadas vem sendo estudada a possibilidade de fatores ambientais participarem do desencadeamento da doença. A região nordeste do Estado de São Paulo, onde localizam-se três Bacias Hidrográficas, apresenta prevalência de duas formas clínicas do pênfigo, pênfigo vulgar (PV) e pênfigo foliáceo endêmico (PFE) sendo uma importante área para o estudo da doença. Nesse estudo, foi utilizado um Sistema de Informação Geográfica (SIG) para descrever a distribuição espacial e o comportamento temporal de PV e PFE nessa região do Estado de São Paulo nas últimas cinco décadas e caracterizar o uso e ocupação do solo no município com maior número de ocorrências de pênfigo. Os pacientes foram identificados baseados nos prontuários médicos entre 1965 e 2014. Os mapas temáticos foram desenvolvidos com o software ArcGIS 10.2. Para representar a distribuição espacial do pênfigo, os mapas foram organizados em décadas de 1965 a 2014. Para o município com maior número de ocorrências de PV e PFE, o uso e ocupação do solo, de acordo com a hidrografia, a vegetação nativa, à área agrícola, o solo exposto e a área urbana, foi analisado em um raio de 2 km no entorno da residência dos pacientes no momento do surgimento dos sintomas. Como análise adicional, mapas ilustrando a distribuição dos casos de pênfigo de acordo com as classes hipsométricas, declividade do solo e densidade populacional por distrito do município (Norte, Sul, Leste, Oeste e Central) foram também desenvolvidos. Quatrocentos e vinte e seis casos foram analisados. Os casos de PFE predominaram, com 285 (67%) dos casos. De acordo com a distribuição espacial e evolução temporal, PV não foi reportado de 1965 a 1974, entretanto, os casos de PV tiveram um aumento contínuo nas próximas décadas e ultrapassou o número de casos de PFE na última década. Analisando de forma acumulada os casos, tanto o PV quanto o PFE tiveram aumento ao longo do período estudado, revelando uma expansão espacial. A Bacia Hidrográfica do Rio Pardo teve o maior número de casos com um total de 153 (41% PV e 59% PFE). No período de 1965 a 2014 o número de cidades com registros de casos de PV e PFE aumentou de 0 para 49 e de 13 para 60, respectivamente, com Ribeirão Preto e Batatais sendo os principais focos geográficos de PV e PFE, respectivamente. Ribeirão Preto foi o município com maior ocorrência de pênfigo (35 casos de PV e 37 casos de PFE). A área agrícola (42%) e o solo exposto (33,2%) foram os usos do solo que predominam no município. Além disso, todos os pacientes com PV ou PFE moram perto de rios e área agrícola. Em Ribeirão Preto, os casos de pênfigo estão concentrados nos distritos norte e oeste, os casos de PFE estão distribuídos em baixas altitudes quando comparadas com o PV e tanto o PV quanto o PFE predominam em áreas com baixa porcentagem de declividade do solo. No contexto da saúde pública, o SIG se tornou uma importante ferramenta que ajuda os pesquisadores entenderem a ocorrência e tendência de certos eventos, conduzindo nas melhores estratégias de controle de doenças. As análises de distribuição espacial e evolução temporal mostraram que os casos de PV e PFE aumentaram na região nordeste do Estado de São Paulo nas últimas cinco décadas. Esse monitoramento também ajudou a identificar os principais focos geográficos de pênfigo nessa região. A predominância de agricultura e solo exposto em Ribeirão Preto e a proximidade dos casos com rios e agricultura reforça a hipótese de que os fatores ambientais desempenham um importante papel na etiopatogênese do pênfigo / Defined foci of pemphigus prevalence worldwide, including Brazil, raise the possibility that environmental factors trigger the onset of this disease. The northeastern region of the state of São Paulo is located within three Watersheds and is an appropriate site to investigate pemphigus because this disease is prevalent in both clinical forms--endemic pemphigus foliaceus (PFE) and pemphigus vulgaris (PV)--therein. In this study, we have used Geographic Information Systems (GIS) to describe the spatial distribution and temporal behavior of PV and PFE in this region of the state of São Paulo over the last five decades; we have also characterized land use in the city with the highest number of cases. Patients were identified based on patients\' medical records between 1965 and 2014. Thematic maps were developed with the ArcGIS 10.2 software. To represent the spatial distribution of pemphigus, maps were organized in decades from 1965 to 2014. For the city with the highest occurrence of PFE and PV cases, land use regarding hydrography, native vegetation, agriculture, exposed soil, and urbanization was analyzed within a 2-km buffer surrounding from the patients\' residencies considering the address where the pemphigus clinical signs and symptoms started. For additional analysis, thematic maps illustrating the distribution of pemphigus cases according to hypsometric classes, soil declivity, and population density by sector (North, South, East, West, and Central) were designed. Four hundred and twenty-six cases were analyzed. PFE cases predominated: they corresponded to 285 or 67% of the cases. Regarding spatial distribution and temporal evolution, PV was not reported from 1965 to 1974; notwithstanding, PV rose in the following four decades and overcame the number of PFE cases in the last decade. Regarding cumulative cases, both PV and PFE increased throughout the studied period, which revealed spatial expansion. The Pardo River Basin had the highest number of cases with a total of 153 (41% PV and 59% PFE). In the studied period, the number of cities with recorded cases of PV and PFE increased from 0 to 49 and from 13 to 60, respectively, with Ribeirão Preto and Batatais being the main geographical foci of PV and PFE, respectively. Ribeirão Preto was the city with the highest occurrence of pemphigus--35 PV cases and 37 PFE cases. Agricultural area (42%) and exposed soil (33.2%) were the land uses that predominated in the city. In addition, all patients with PV and PFE lived close to rivers and agricultural areas. In Ribeirão Preto, pemphigus cases were concentrated in the northern and western sectors; PFE cases were distributed at lower altitudes as compared to PV; and both PV and PFE predominated in areas with lower percentage of declivity. In the context of public health, GIS has become a powerful tool that helps researchers to understand the occurrence and trend of some events, leading to improved interventional strategies and disease control. The spatial distribution and temporal evolution analyses showed PV and PFE increased in the northeastern region of the state of São Paulo over the last five decades. This monitoring also helped to identify the main geographical foci of pemphigus. The predominance of agriculture and exposed soil in Ribeirão Preto and the proximity of the cases to rivers and agriculture reinforced the hypothesis that environmental factors play a role in pemphigus etiopathogenesis