Several substantive observations formed the basis for this research. First, the observation of stagnating life expectancy in the United States over the first two decades of the 21st century, representing a dubious form of American exceptionalism. Second, evidence suggesting that novel measures of biological aging might provide allow for early evaluation of population-level health trajectories, based on direct observation of health status in still-living people. Third, the opportunity to apply these measures for study of population-level phenomena, using methods routinely used in the fields of sociology, demography, and economics. This dissertation represents a proof-of-concept work to support the application of biological aging measures to population health surveillance. In Chapter 2, I conduct a systematic literature review of novel measures and approaches to the quantification of population aging published since 2000, and identify 3 major classes of novel population aging measures. Biological-aging measures can be understood as a specific application of Sanderson and Scherbov’s α-ages approach, which indexes “true age” to the distribution of some aging-related characteristic in a reference sample. Relative to other novel measures and approaches, however, biological-aging algorithms hold particular promise in their ability to provide direct measures of pre-clinical, aging-related health risk across the entire adult age range of a population. In chapters 3 and 4, I apply published biological aging algorithms to blood-chemistry and organ-test data collected by the National Health and Nutrition Examination Surveys (NHANES) to test whether the U.S. population has grown biologically older over the past two decades, as some interpretations of life expectancy data would suggest, and to evaluate the extent to which selected social and environmental exposures might explain these trends. Formal age-period-cohort analysis revealed consistent period increases in biological aging from 1999-2018; while population aging slowed after the training cohort was measured in NHANES III (1988-1994), aging trajectories have reverted towards early-1990s levels since the turn of the century. Limited evidence of cohort effects was observed, with findings consistent regardless of age, race, and sex – although racial disparities in biological aging persisted over the entire study period. Kitagawa-Blinder-Oaxaca decomposition analysis of four candidate exposures (i.e., BMI, smoking status, blood lead, and urinary polycyclic aromatic hydrocarbon levels) suggested that changes in the distribution of behavioral and environmental risk factors accounted for a substantial proportion of observed period trends and/or racial disparities in biological aging over the first two decades of the 21st century. Broadly, these results suggest that measures of biological aging can provide earlier and more precise readouts of population health trajectories and their drivers, ultimately informing next-generation public health efforts to promote healthy aging and aging health equity.

In this paper, I will show how applying a spatially explicit context to an existing environmental health surveillance framework is vital for more complete surveillance of disease, and for disease prevention and intervention strategies. As a case study to test the viability of a spatial approach to this existing framework, the risk of human exposure to Lyme disease will be estimated. This spatially explicit framework divides the surveillance process into three components: hazard surveillance, exposure surveillance, and outcome surveillance. The components will be used both collectively and individually, to assess exposure risk to infected ticks. By utilizing all surveillance components, I will identify different areas of risk which would not have been identified otherwise. Hazard surveillance uses maximum entropy modeling and geographically weighted regression analysis to create spatial models that predict the geographic distribution of ticks in Texas. Exposure surveillance uses GIS methods to estimate the risk of human exposures to infected ticks, resulting in a map that predicts the likelihood of human-tick interactions across Texas, using LandScan 2008TM population data. Lastly, outcome surveillance uses kernel density estimation-based methods to describe and analyze the spatial patterns of tick-borne diseases, which results in a continuous map that reflects disease rates based on population location. Data for this study was obtained from the Texas Department of Health Services and the University of North Texas Health Science Center. The data includes disease data on Lyme disease from 2004-2008, and the tick distribution estimates are based on field collections across Texas from 2004-2008.

Internet technology has affected humans' lives in many disciplines. The search engine is one of the most important Internet tools in that it allows people to search for what they want. Search queries entered in a web search engine can be used to predict dengue incidence. This vector borne disease causes severe illness and kills a large number of people every year. This dissertation utilizes the capabilities of search queries related to dengue and climate to forecast the number of dengue cases. Several machine learning techniques are applied for data analysis, including Multiple Linear Regression, Artificial Neural Networks, and the Seasonal Autoregressive Integrated Moving Average. Predictive models produced from these machine learning methods are measured for their performance to find which technique generates the best model for dengue prediction. The results of experiments presented in this dissertation indicate that search query data related to dengue and climate can be used to forecast the number of dengue cases. The performance measurement of predictive models shows that Artificial Neural Networks outperform the others. These results will help public health officials in planning to deal with the outbreaks.

Introdução: A tuberculose (TB) é uma doença milenar que permanece como um grave problema de saúde pública, faz parte do ranking mundial das dez principais causas de morte no mundo. Objetivo: Identificar aglomerados espaciais de risco de mortes por tuberculose em Londrina/PR. Métodos: Trata-se de um estudo ecológico cujas unidades foram setores censitários urbanos de Londrina/PR definidos pelo Censo Demográfico de 2010, do Instituto Brasileiro de Geografia e Estatística (IBGE). A população do estudo foi composta dos casos de óbito por TB como causam básica e associada, registrados no Sistema de Informações sobre Mortalidade (SIM) no período de 2008 a 2015. A análise exploratória das variáveis sociodemográficas e clínico-epidemiológicas do SIM ocorreu por meio da estatística descritiva dos parâmetros quantitativos, sendo calculadas as frequências absolutas e relativas para as variáveis no software Statistica versão 12.0. O georreferenciamento dos endereços foi processado no software TerraView versão 4.2.2. Posteriormente, realizou-se a análise de área calculando-se as taxas brutas e bayesianas empíricas globais anuais de mortalidade. A dependência espacial da mortalidade por TB foi verificada pelo Índice de Moran Global (I). Utilizou-se a ferramenta Incremental Spatial Autocorrelation (ISA) para definir o raio de influência do estimador de intensidade Kernel, tais análises foram realizadas no software ArcGIS versão 10.5. Para detecção dos aglomerados espaciais foi aplicada a técnica Estatística de Varredura Espacial Tradicional e na versão Isotônica, a qual traz como novidade a visualização gradativa do Risco Relativo Espacial (RRE) no interior do aglomerado através dos Steps in Risk Function, utilizou-se o software SaTScan(TM) versão 9.4. Em todos os testes estatísticos foi fixado o nível de significância em 5% (p< 0,05). Resultados: Identificou-se 61 óbitos por TB, destes 40 (65,6%) eram causa básica e 21 (34,4%) causa associada. Observou-se que 27 casos (44,3%) apresentavam idade entre 40 e 59 anos; 49 (80,3%) eram homens, 39 (63,9%) da cor branca, 20 (32,8%) com ensino médio, 32 (52,4 %) apresentaram forma clínica pulmonar e 54 (88,5%) ocorreram em ambiente hospitalar. As maiores taxas bayesianas foram identificadas nos bairros, Alpes (2,5 por 100.000 hab./ano), Vila Recreio (2,6 por 100.000 hab./ano)e Aeroporto (2,7 por 100.000 hab./ano). A dependência espacial demonstrou-se baixa e positiva (I = 0,014 e p = 0,004), porém com alto z-score (2,83) nos aglomerados. O estimador de intensidade Kernel identificou as regiões Norte, Centro e Leste como sendo áreas quentes para a mortalidade por TB, assim como na Estatística de Varredura Espacial Tradicional e Isotônica. A versão tradicional identificou um aglomerado espacial de risco para 10% da população exposta com RRE =4,9 (IC95% 2,6-9,4), para 30% RRE=3,2 (IC95% 2,15,7) e para 50% RRE=3,2 (IC95% 2,1-5,7), na versão Isotônica encontrou-se para 10% da população expostas com RRE=2,8 (IC95% 1,5-5,1), para 30% RRE=2,7 (IC95% 1,6- 4,4) e para 50% RRE=2,2 (IC95% 1,4-3,9). Conclusão: A identificação do gradiente do RRE nas populações expostas, certamente, servirá como um indutor de mudanças em termos da melhoria do acesso aos serviços de saúde no intuito de promover ambientes saudáveis / Background: Tuberculosis (TB) is a millenial disease that remains a serious public health problem and is one of the world\'s top ten causes of death. Aim: Identify spatial clusters of risk for occurrence of tuberculosis mortality in Londrina/PR. Methods: This is an ecological study whose units of analysis were urban census sectors of Londrina/PR defined by the Demographic Census of 2010, of the Brazilian Institute of Geography and Statistics. The study\'s population was composed by deaths due to TB as a basic and associated cause, registered in the Mortality Information System (MIS) from 2008 to 2015. The exploratory analysis of the sociodemographic and clinical-epidemiological variables of the MIS occurred by means of the descriptive statistics of the quantitative parameters and calculated the absolute and relative frequencies for all the variables, using the Statistica (version 12.0) software. The geo-referencing technique of the cases was performed using the Terraview (version4.2.2) software. Subsequently, was calculate the TB mortality rate, it was smoothed by Empirical Bayes Method. Autocorrelation of TB mortality was analyzed by Moran Global Index (I). The Incremental Spatial Autocorrelation (ISA) tool was used to define the radius of influence of the Kernel estimator, such analyzes were performed in ArcGIS software version 10.5. For the detection of the spatial clusters we used the Standard Spatial Scan Statistics (SS) and Isotonic version (ISSS), which provides, as a novelty, the gradual visualization of the Spatial Relative Risk (SRR) inside the cluster through the Steps in Risk Function, these techniques were applied in SaTScan (TM) software version 9.4. It was defined level of significance at 5% as statistically significant (p <0.05) for all statistical tests. Results: We identified 61 deaths due to TB, of which 40 (65.6%) were per basic cause and 21 (34.4%) were associated causes. It was observed that 27 cases (44.3%) were aged between 40 and 59 years; 49 (80.3%) male, 39 (63.9%) white, 20 (32.8%) high school students, 32 (52.4%) had a pulmonary clinical form and 54 (88.5%) occurred in a hospital. The highest Bayesian rates were identified in the neighborhoods, Alpes (2.5 per 100,000 inhabitants/year), Vila Recreio (2.6 per 100,000 inhabitants/year) and Aeroporto (2.7 per 100,000 inhabitants/year). Spatial autocorrelation was low and positive (I = 0.014 and p = 0.004), but with a high z-score (2.83) in the clusters. The Kernel estimator identified the North, Center and East regions as hotspot areas for TB mortality, as well as in the Standard and Isotonic Space Scan Statistics. For the SS, spatial risk clusters were identified for 10% of the exposed population with SRR=4.9 (95%CI 2.6-9.4), for 30% SRR=3.2 (95%CI 2.1-5.7) and for 50% SRR=3.2 (95%CI 2.1-5.7), while for the ISSS spatial risk clusters were identified for 10% of the exposed population with SRR=2.8 (95%CI 1.5-5.1), for 30% SRR=2.7 (95%CI 1.6-4.4) and for 50% SRR=2.2 (95%CI 1.4-3.9). Conclusion: Identifying the RRE gradient in exposed populations, will certainly serve as an inducer of changes in terms of improving access to health services in order to promote healthy environments

Submitted by Fabíola Silva (fabiola.silva@famerp.br) on 2016-09-27T19:22:11Z No. of bitstreams: 1 maisacarlapereiraparra_dissert.pdf: 2990701 bytes, checksum: da1831165b9fd27a914bbd5aa5d8a630 (MD5) / Made available in DSpace on 2016-09-27T19:22:11Z (GMT). No. of bitstreams: 1 maisacarlapereiraparra_dissert.pdf: 2990701 bytes, checksum: da1831165b9fd27a914bbd5aa5d8a630 (MD5) Previous issue date: 2014-12-15 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Introduction: The dengue is the most important vector-borne worldwide. It’s caused by one of four serotypes of dengue virus (DENV1-4), which belong to Flavivirus genus. It is transmitted to humans by the bite of Aedes mosquitos, especially Aedes aegypti. This vector is adapted to human environments and water containers created by humans are their breeding sites. In this study, we performed a screening for the circulating serotypes of DENV in mosquitos from an area in São José do Rio Preto – SP (Brazil), associated with spatial analysis tools as entomological and epidemiological indexes for dengue. Materials and Methods: BG-Mosquitito and BG-Sentinel traps were installed at residences to capture mosquitos from the area. The mosquitos were pooled according to the gender and species and had the viral RNA extracted. The pools were tested by Multiplex-RT-PCR with Flavivirus generic primers followed by Nested assays with species-specific primers for DENV. Every sample was geocoded and weekly and fortnightly maps were created. Results: Nearly 3,000 trap collections were performed and 1,645 Aedes aegypti mosquitos (671 males and 974 females) were collected. The 893 pools presented 2.8% positivity for the DENV-4. We geocoded all collection addresses along the reported dengue cases in the neighborhood (confirmed as positive or negative by the laboratory exam). Conclusions: The use of traps to collect adult mosquitos was not sufficient for detecting the presence of infected mosquitos before the occurrence of human dengue cases. However, the use of geostatistical techniques associated with entomological indexes and dengue cases may provide the relative risk of dengue occurrence and together, they could be use in point of care interventions. / Introdução: A dengue é um dos maiores problemas de saúde pública em todo o mundo. É causada por um dos quatro sorotipos do vírus DENV (DENV1-4), pertencente ao gênero Flavivirus. É transmitida ao homem através da picada da fêmea de mosquitos do gênero Aedes, principalmente o Aedes aegypti. Este vetor está totalmente adaptado a ambientes humanos e se reproduz em recipientes com água, principalmente aqueles produzidos pelo homem. Os objetivos deste estudo foram identificar as espécies de mosquitos presentes em bairro com transmissão sustentada do DENV; avaliar se as armadilhas adulticidas podem ser usadas como indicadores de infestação vetorial na área; identificar as áreas do bairro com maiores índices de infestação vetorial e os sorotipos circulantes; avaliar o uso das armadilhas como possíveis Sistemas Sentinelas para a ocorrência de dengue na área; e avaliar a distribuição espacial do risco relativo para a ocorrência de dengue e a sua associação com os indicadores entomológicos do vetor no bairro. Materiais e Métodos: Armadilhas do tipo BG-Mosquitito e BG-Sentinel foram instaladas em residências do bairro para captura dos mosquitos. Os pools de mosquitos foram identificados e separados por gênero e espécie e tiveram o RNA total extraído. Foram testados por Multiplex-RT-PCR, com primers genéricos para Flavivirus com posterior Nested utilizando primers específicos para os quatros sorotipos do DENV. Todas as amostras foram geocodificadas e foram construídos mapas semanais e quinzenais. Resultados: Aproximadamente 3.000 armadilhas foram instaladas durante o estudo, as mesmas coletaram um total de 1.645 mosquitos Aedes aegypti, sendo 671 machos e 974 fêmeas. Foram analisados 893 pools de mosquitos, destes 2.8% foram positivos para o sorotipo DENV4. Todos os endereços das residências onde as armadilhas foram instaladas e também dos casos de dengue notificados no bairro (positivos ou negativos, confirmados por exame laboratorial) foram geocodificados. Conclusões: Concluímos que a utilização das armadilhas, associadas a ferramentas de biologia molecular, não foi suficiente para detectar a circulação viral na área antes da ocorrência de casos humanos. No entanto, quando associadas a ferramentas de análise espacial, as mesmas se mostraram como bons indicadores de áreas de risco para a transmissão da doença, podendo ser utilizadas em intervenções pontuais.

Submitted by Maria Aparecida (cidazen@gmail.com) on 2017-04-19T11:48:21Z No. of bitstreams: 1 Eulália carvalho.pdf: 6016176 bytes, checksum: 0a59893b28b2f78c565fbdf92edf617f (MD5) / Made available in DSpace on 2017-04-19T11:48:21Z (GMT). No. of bitstreams: 1 Eulália carvalho.pdf: 6016176 bytes, checksum: 0a59893b28b2f78c565fbdf92edf617f (MD5) Previous issue date: 2017-03-09 / Introduction: Historically, the field of food hygiene was more restricted to aspects such as the presence or absence of a particular contaminant. Today, the discussion surrounding this issue is extended, considering the risks involved in the different stages of production to consumption. This scenario reflects the advances arising with the Brazilian Sanitary Movement, the Industrial Revolution and women entering the labor market and the demand for collective food services and the provision of healthy and safe food with satisfactory hygienic and sanitary conditions. Objectives: To analyze the health profile of food services at the Hope Village neighborhood, Sao Luis - MA; categorize the food services; relate hygienic and sanitary conditions with the risk of food contamination and use of control measures (Good Manufacturing Practices); know the perception of the owners or technicians responsible about their working conditions. Methodology: it is a descriptive quantitative and qualitative, and an epidemiological and cross-sectional survey. Use It will be a checklist of federal health legislation - Ordinance 817/2013 and RDC n ° 216/2004, with interview 10 working in establishments in Hope Village neighborhood, 6 snack bars and 4 restaurants. In the analysis of the data will be used the Epi-info® 7 programs and Excel® 2013.Conclusion: This research aimed to categorization of food services Hope Village neighborhood in São Luís - MA, as allowed to characterize the variation of the sanitary quality of these establishments, among the 10 food service: 8 were categorized in group B (Good sanitary quality) and 2 were eliminated for lack of adequate water supply. / Introdução: Historicamente, o campo da higiene dos alimentos estava mais restrito a aspectos como a presença ou a ausência de determinado contaminante. Hoje, a discussão que envolve essa questão se amplia, contemplando os riscos envolvidos nas diferentes etapas de produção até o consumo. Esse cenário é reflexo dos avanços advindos com o Movimento Sanitário Brasileiro, a Revolução Industrial e da inserção da mulher no mercado de trabalho, bem como a demanda por serviços de alimentação coletivos e o fornecimento de alimentos saudáveis e seguros com condições higiênicossanitárias satisfatórias. Objetivos: analisar o perfil sanitário dos serviços de alimentação no bairro Vila Esperança, São Luís - MA; categorizar os serviços de alimentação; relacionar as condições higiênicossanitárias com os riscos de contaminação dos alimentos e uso das medidas de controles (Boas Práticas de Fabricação), e conhecer a percepção dos donos ou responsáveis técnicos sobre suas condições de trabalho. Metodologia: é uma pesquisa descritiva quanti-qualitativa, sendo um inquérito epidemiológico e transversal. Utilizou-se um check-list da legislação sanitária federal – Portaria 817/2013 e RDC n° 216/2004, com entrevista em 10 estabelecimentos em funcionamento no bairro Vila Esperança, 6 lanchonetes e 4 restaurantes. Na análise dos dados será utilizado os programas Epi-info® 7 e Excel® 2013. Conclusão: A presente pesquisa visou à categorização dos serviços de alimentação do bairro Vila Esperança, em São Luís - MA, pois permitiu caracterizar a variação da qualidade sanitária destes estabelecimentos, dentre os 10 serviços de alimentação: 8 foram categorizados no grupo B (Boa qualidade sanitária) e 2 foram eliminados por falta de abastecimento de água adequado.

La surveillance épidémiologique est le recueil systématique et continu d’informations sur l’état de santé des populations, leur analyse, leur interprétation et leur diffusion à tous les décideurs ayant besoin d’être informés. Un de ses objectifs est la détection des événements inhabituels, i.e. des épidémies, nécessitant la mise en place rapide de contre-mesures. Les objectifs de ce travail de thèse sont : (i) d’évaluer les principales méthodes statistiques de détection publiées et communément employées dans différents systèmes de surveillance épidémiologique, (ii) de proposer une nouvelle approche reposant sur la combinaison optimale de méthodes de détection statistique des épidémies et (iii) de développer une nouvelle méthode statistique d’analyse étiologique d’une épidémie à partir des données de surveillance épidémiologique collectées en routine par le système.Pour atteindre ces objectifs, nous évaluons les principales méthodes statistiques de la littérature, à partir d’un jeu publié de données simulées. Puis nous proposons une approche originale pour la détection des épidémies sur le principe de la combinaison de méthodes sélectionnées lors de l’étape précédente. Les performances de cette approche sont comparées aux précédentes selon la méthodologie utiliséeà la première étape. Enfin, nous proposons une méthode d’analyse étiologique d’une épidémie à partir des données de surveillance en employant des modèles statistiques adaptés aux séries chronologiques. / Public health surveillance is the ongoing, systematic collection, analysis, interpretation, and dissemination of data for use in public health action to reduce morbidity and mortality of health-related events and to improve health. One of its objectives is the detection of unusualevents, i.e. outbreaks, requiring the rapid implementation of countermeasures.The objectives of this work are: (i) to evaluate the main published statistical methods for outbreak detection commonly implemented in different public health surveillance systems, (ii) to propose a new approach based on the optimal combination of statistical methods foroutbreak detection and benchmark it to other methods; and (iii) develop a new statistical method for the etiological analysis of an outbreak from public health surveillance data routinely collected by the system. To achieve these objectives, as a first step, we evaluate the main statistical methods, from a published set of simulated public health surveillance data. Statistical methods have been evaluated for an operational purpose: for all simulated time series, we used the tuning parameters recommended by their authors for each algorithm when available. We propose sensitivity and specificity metrics suitable for these tools. Then we propose an original approach for outbreak detection based on combination of methods selected in the previous step. The performance of this approach is compared to the previous ones according to the methodology implemented in the first step.Finally, we propose a method for the etiological analysis of an outbreak from surveillance data by using statistical models suitable for time series analysis

<p>Liv och hälsa ung är en enkätundersökning bland ungdomar i skolår 7, 9 samt år 2 på gymnasiet i Örebro län. Barn och ungdomar är en prioriterad målgrupp för Sverige och Örebro län enligt regeringens folkhälsoproposition samt Örebro läns folkhälsoplan. I skolan har rektorn det yttersta ansvaret, i denna studie valdes rektorer ut för att ge ett ledarskapsperspektiv på ett användande. Uppsatsens syfte äratt undersöka hur resultatet från Liv och hälsa ung undersökningarna används avrektorer för skolår 7-9 i Örebro län. Studien är kvalitativ där nio stycken rektorer iÖrebro län har intervjuats. Datamaterialet analyserades med hjälp utav en kvalitativinnehållsanalys. Resultatet presenteras i form av fem stycken huvudkategorier;mottagning, spridning, nytta, styrning, hinder och 11 underkategorier. I diskussionen behandlas rektorernas användning utifrån studiens teoretiska referensram. Studien visar på ett komplext och varierat användande men företrädesvis används resultatet för att ge en omvärldsbild av ungdomars hälsa och livssituation till lärare och elevhälsa. Dock används resultatet från Liv och hälsaung sällan direkt i beslutsprocessen. Författarna ser möjligheter till vidare studier för att skapa en helhetssyn på användandet av Liv och hälsa ung resultatet bland Örebro läns kommuner.</p> / <p>”Liv och hälsa ung” is a survey among adolescents in school grade 7, 9 and schoolgrade 2 in upper secondary school in Örebro County. Children and youth is aprioritized target group for Sweden and Örebro County according to the government public health plan and in the public health guiding principles for Örebro County. A principal has the outermost responsibility at school, they where selected to give a leadership perspective. The aim of this study is to investigate utilization of how the result from “Liv och hälsa ung” is used by principals for school grade 7, 9 in Örebro County. The study is qualitative where nine principals in Örebro County have been interviewed. The data was analysed with a qualitative content theory analysis. The result is presented in five main categories; Reception, Dissemination, Benefit, Management, Obstacles and 11 sub categories. Thediscussion handled the principal’s utilization on the basis of the theoreticalframework of this study. The study shows a complex and miscellaneous utilizationof the result but it is mostly used to disseminate information about the adolescent’shealth and situation in life to teachers and the student health care. Although it israrely used in the decision process. The authors see possibilities for further studiesto create a whole image on the utilization of the “Liv och hälsa ung” results inÖrebro County and its municipalities.</p>

In spite of the remarkable development of modern medical treatment and technology, the threat of pandemic diseases such as anthrax, cholera, and SARS has not disappeared. As a part of emerging healthcare decision problems, many researchers have studied how to detect and contain disease outbreaks, and our research is aligned with this trend. This thesis mainly consists of two parts: epidemic simulation modeling for effective intervention strategies and spatiotemporal monitoring for outbreak detection. We developed a stochastic epidemic simulation model of a pandemic influenza virus (H1N1) to test possible interventions within a structured population. The possible interventions — such as vaccination, antiviral treatment, household prophylaxis, school closure and social distancing — are investigated in a large number of scenarios, including delays in vaccine delivery and low and moderate efficacy of the vaccine. Since timely and accurate detection of a disease outbreak is crucial in terms of preparation for emergencies in healthcare and biosurveillance, we suggest two spatiotemporal monitoring charts, namely, the SMCUSUM and RMCUSUM charts, to detect increases in the rate or count of disease incidents. Our research includes convenient methods to approximate the control limits of the charts. An analytical control limit approximation method for the SMCUSUM chart performs well under certain conditions on the data distribution and monitoring range. Another control limit approximation method for the RMCUSUM chart provides robust performance to various monitoring range, spatial correlation structures, and data distributions without intensive modeling of the underlying process.

Submitted by Jos? Henrique Henrique (jose.neves@ufvjm.edu.br) on 2018-03-20T22:51:47Z No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) cassio_almeida_lima.pdf: 1180731 bytes, checksum: 95f86fdaad149f5f97c975753999285b (MD5) / Approved for entry into archive by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2018-03-29T14:07:32Z (GMT) No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) cassio_almeida_lima.pdf: 1180731 bytes, checksum: 95f86fdaad149f5f97c975753999285b (MD5) / Made available in DSpace on 2018-03-29T14:07:32Z (GMT). No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) cassio_almeida_lima.pdf: 1180731 bytes, checksum: 95f86fdaad149f5f97c975753999285b (MD5) Previous issue date: 2017 / Este estudo teve como objetivo analisar a ocorr?ncia de acidentes e ?bitos provocados por animais pe?onhentos na regi?o Sudeste, Brasil. Trata-se de pesquisa epidemiol?gica, com delineamento ecol?gico e anal?tico. Efetuou-se uma busca no Sistema de Informa??o de Agravos de Notifica??o-NET, sobre a ocorr?ncia de acidentes e ?bitos por todos os tipos de animais pe?onhentos e aqueles causados por serpentes, escorpi?es e aranhas, ocorridos nas unidades federativas da regi?o Sudeste, no per?odo de 2005 a 2015. A organiza??o dos dados e an?lise estat?stica foram processadas por meio do Software IBM SPSS vers?o 22.0 para Windows?. A descri??o dos resultados foi apresentada em valores absolutos, percentuais, m?dias, desvio padr?o, m?nimo e m?ximo, al?m de s?rie hist?rica. Efetuaram-se an?lises bivariadas (teste Kolmogorov Smirnov) para comparar as m?dias entre as unidades federativas do Sudeste (p<0,05), bem como correla??es com indicadores sociais e de sa?de por meio da correla??o Spearman's. Considerou-se o n?vel de signific?ncia de 5% (p<0,05). Entre 2005 e 2015, observou-se um total de 47.1403 acidentes e de 684 ?bitos causados por animais pe?onhentos, com a maior parte dos acidentes registrada em 2014 (58.544), enquanto o maior n?mero de ?bitos ocorreu em 2015 (99). Na s?rie hist?rica, constatou-se uma ascens?o acentuada a partir de 2010. No Sudeste, o escorpi?o representou maior m?dia de acidentes e ?bitos: 5.694,14 e 7,45 respectivamente. Em todos os anos, Minas Gerais concentrou a maior quantidade de acidentes e ?bitos no geral; e em espec?fico pelos animais estudados, exceto quanto aos acidentes por aranhas. As correla??es, embora n?o tenham sido estatisticamente significantes (p>0,05), demonstraram rela??o entre maior quantidade de acidentes e ?bitos e menor ?ndice de Desenvolvimento Humano, menor n?mero de m?dicos e gastos em sa?de p?blica. O estudo evidenciou uma elevada frequ?ncia de acidentes e ?bitos provocados por animais pe?onhentos e a sua ascens?o ao longo da s?ria hist?rica analisada, principalmente em anos mais recentes. Delineou-se uma realidade preocupante que deve ser analisada com prud?ncia, considerando que diversos fatores podem estar envolvidos. Assim, ? imperativo que o problema estudado seja efetivamente gerenciado e n?o seja negligenciado. / Disserta??o (Mestrado Profissional) ? Programa de P?s-Gradua??o em Sa?de, Sociedade e Ambiente, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 2017. / This study aimed to analyze the occurrence of accidents and deaths caused by venomous animals in the Southeast region of Brazil. This is an epidemiological research with ecological and analytical design. A search in the Notification System Review of Information-NET on the frequency of accidents and dearth by all kinds of poisonous animals and those caused by snakes, scorpions and spiders on the period of 2005 to 2015 in the federation units of the southeast region was done. The organization and analysis of statistical data were processed through the IBM SPSS Software version 22.0 for Windows?. The description of the results was presented in absolute, percentage, average, standard deviation, minimum and maximum, besides historical values. Bivariated analysis were made (Kolmogorov Smirnov test) to compare the average among the federation units of the southeast (p<0.05), as well as to correlate the social and health indicators through Spearman?s correlation. The level of significance was considered of 5% (p<0.05). Between 2005 to 2015, a total of 47,1403 accidents and 684 deaths by poisonous animals were registered, with the majority of accidents registered in 2014 (58,544), and the greater number of deaths in 2015 (99). In the historic search, a steep rise was noticed from 2010. On the Southeast, the scorpion presented greater average of accidents and deaths: 5,694 and 7,45 respectively. In all the years, Minas Gerais reported the highest quantity of accidents and deaths in general; and specifically with the studied animals, with the exception of accidents with spiders. The correlations, although not significant to statistics (p>0.05), show relation among the greater quantity of accidents and deaths and the lower Index of Human Development, lower number of doctors and expenses in public health. The study put in evidence a high frequency of accidents and deaths by poisonous animals and the rise during the history that was analyzed, especially in the most recent years. A concerning reality was perceived and must be analyzed with prudence, considering that many factors may be involved. Thus, it is imperative that the studied problem be effectively managed and not be neglected.