This presentation was designed by Antonio Lima for the VERDAS consortium workshop held on Thursday 2 March at the University of Valle in Cali, Colombia.
The workshop was the Verdas Consortium presentation of its research results, a synthesis of knowledge on urban health interventions for the prevention and control of vector-borne diseases.
Assessment of the Spatial and Temporal Trend of the COVID-19 Pandemic in SenegalAI Publications
Following the declaration of COVID-19 as a global pandemic and the reporting of one case in Senegal, the number of regions with confirmed cases of infection increased considerably, with the disease now being reported throughout the country after 3 months of evolution. It is therefore necessary to assess the evolution of the disease in the country as the situation evolves in order to rapidly identify best practices for adoption. The objective of this paper is to make a preliminary spatial and temporal assessment and comparison of the results of the COVID-19 pandemic in the regions of Senegal. Data on the evolution of COVID-19 (confirmed cases of infection, deaths, recoveries), population, density and area of each region were analysed using a set of statistical tools. The results show that the COVID-19 pandemic has spread stubbornly in Senegal. In the space of 112 days (from March 2 to June 21), Senegal reached a number of 5888 infected cases for 3919 cured, 1885 active and 84 deaths for a total of 67855 tests performed. About 40 people out of 10,000 have been tested so far and 4 out of 10,000 have tested positive. The Mann-Kendall test indicates that the number of confirmed daily cases is slowly increasing, with the slope of Sen estimated at about 1.2 person/day across the country. In addition, the Pettitt test indicates a sharp change in the upward trend across the country on April 26, 2020. Among the main affected regions, Dakar, Thies and Touba are noted with an extremely high rate of increase. Principal component analysis and hierarchical ascending classification have made it possible to divide Senegal's 14 regions into 3 groups in terms of the number of confirmed cases, active cases, recovered cases and reported deaths, and the population, area and density of the region. The 1st group concerns the Dakar region, the 2nd Diourbel and Thies and the 3rd the other regions. Furthermore, statistics related to COVID-19 in the regions of Senegal are highly correlated with population size and density. This study revealed convincing spatial differences in the evolution of the pandemic between the regions of Senegal. The study recommends that the approaches adopted by regions that have achieved very low levels of COVID-19 be incorporated into health care management plans for the pandemic throughout the country, even as the situation evolves.
Shigellosis outbreaks associated with sexual transmission among men who have sex with men (MSM) have been reported in recent years from the United Kingdom, Germany and Spain, with severe infections among HIV-positive MSM.
Poster at ESCAIDE conference 2016, Stockholm.
In 2013, 64 844 cases of TB were reported in 30 EU/EEA countries, which was 6% less than in 2012, reflecting a decrease in 19 countries. The EU/EEA notification rate was 12.7 per 100 000 population, continuing a long-term decreasing trend. The seventh report launched jointly by ECDC and the WHO Regional Office for Europe indicates that, despite notable progress in the past decade, tuberculosis (TB) is still a public health concern in many countries across Europe.
Assessment of the Spatial and Temporal Trend of the COVID-19 Pandemic in SenegalAI Publications
Following the declaration of COVID-19 as a global pandemic and the reporting of one case in Senegal, the number of regions with confirmed cases of infection increased considerably, with the disease now being reported throughout the country after 3 months of evolution. It is therefore necessary to assess the evolution of the disease in the country as the situation evolves in order to rapidly identify best practices for adoption. The objective of this paper is to make a preliminary spatial and temporal assessment and comparison of the results of the COVID-19 pandemic in the regions of Senegal. Data on the evolution of COVID-19 (confirmed cases of infection, deaths, recoveries), population, density and area of each region were analysed using a set of statistical tools. The results show that the COVID-19 pandemic has spread stubbornly in Senegal. In the space of 112 days (from March 2 to June 21), Senegal reached a number of 5888 infected cases for 3919 cured, 1885 active and 84 deaths for a total of 67855 tests performed. About 40 people out of 10,000 have been tested so far and 4 out of 10,000 have tested positive. The Mann-Kendall test indicates that the number of confirmed daily cases is slowly increasing, with the slope of Sen estimated at about 1.2 person/day across the country. In addition, the Pettitt test indicates a sharp change in the upward trend across the country on April 26, 2020. Among the main affected regions, Dakar, Thies and Touba are noted with an extremely high rate of increase. Principal component analysis and hierarchical ascending classification have made it possible to divide Senegal's 14 regions into 3 groups in terms of the number of confirmed cases, active cases, recovered cases and reported deaths, and the population, area and density of the region. The 1st group concerns the Dakar region, the 2nd Diourbel and Thies and the 3rd the other regions. Furthermore, statistics related to COVID-19 in the regions of Senegal are highly correlated with population size and density. This study revealed convincing spatial differences in the evolution of the pandemic between the regions of Senegal. The study recommends that the approaches adopted by regions that have achieved very low levels of COVID-19 be incorporated into health care management plans for the pandemic throughout the country, even as the situation evolves.
Shigellosis outbreaks associated with sexual transmission among men who have sex with men (MSM) have been reported in recent years from the United Kingdom, Germany and Spain, with severe infections among HIV-positive MSM.
Poster at ESCAIDE conference 2016, Stockholm.
In 2013, 64 844 cases of TB were reported in 30 EU/EEA countries, which was 6% less than in 2012, reflecting a decrease in 19 countries. The EU/EEA notification rate was 12.7 per 100 000 population, continuing a long-term decreasing trend. The seventh report launched jointly by ECDC and the WHO Regional Office for Europe indicates that, despite notable progress in the past decade, tuberculosis (TB) is still a public health concern in many countries across Europe.
Powepoint On Epidemiological INDICES OF TB
Suitable For Community Medicine Students - KUHS
KERALA MEDICAL BOARD
Prepared By A Student from
Mount Zion Medical College , Chayalode Adoor
Prevention strategies tackling hepatitis B virus (HBV) in European Union (EU)/European Economic Area (EEA) countries are centred around universal or targeted vaccination programmes.
Poster at ESCAIDE 2016, Stockholm
Data and trends on hepatitis B and C for the countries of the European Union and European Economic Area.
2015 data.
See also ECDC's Annual Epidemiological Report: https://ecdc.europa.eu/en/annual-epidemiological-reports
Based on ECDC surveillance report on Sexually transmitted infections in Europe 2013, these slides describes the epidemiological features and basic trends of the five STI under EU surveillance: chlamydia trachomatis infection, gonorrhoea, syphilis, congenital syphilis, and lymphogranuloma venereum. It covers the years 2004 to 2013.
The world’s biggest multi-sport event summer Olympics Games 2016 officially known as the Games of the XXXI Olympiad, and commonly known as Rio 2016 due to take place Rio de Janeiro, Brazil, from 5th to 21st August, 2016. More than 10,500 athletes from 206 National Olympic committees (NOCs) will take part.[1] These sporting events will take place at 33 venues in the host city Rio de Janeiro and at least 5 venues in the cities of Säo Paulo, Belo Horizonte, Salvador, Manaus and Brazil’s capital Brasilia. International Olympic Committee (IOC) have predicted around 4,80,000 tourists will arrive at Rio de Janeiro for this mega event.[2] Similar to the other tropical countries the tourists will be at risk of acquiring gastrointestinal illnesses and vector-borne infections.
ECDC presentation at the 15th Conference of the International Society of Travel Medicine, 15 May 2017.
Presenter: Teymur Noori
Questions?
Contact info@ecdc.europa.eu
Is Europe ready for elimination of hepatitis B and C? The World Health Organization (WHO) will launch a global strategy on viral hepatitis in 2016 with the aim to eliminate hepatitis B and C as public health threats by 2030. The joint poster from ECDC, EMCDDA and WHO/Euro looks at the current availability of data for each of the core indicators and how existing gaps in data availability could be addressed.
Presentation by ECDC HIV expert Anastasia Pharris on epidemiological challenges for the HIV response in Europe.
Presented at: 16th European AIDS Conference, 26 October 2017, Milan.
Surveillance data from 2013 show high numbers of newly diagnosed hepatitis B and C cases notified across Europe. Chronic cases dominate across both diseases with a marked variation between countries: in 2013, 19 930 cases of hepatitis B virus infection were reported in 28 EU/EEA Member States, a crude rate of 4.4 per 100 000 population. 26 EU/ EEA Member States recorded 32 512 cases of hepatitis C resulting in a crude rate of 9.9 per 100 000 population.
Data and trends from the ECDC Annual Epidemiological reports for 2016 on:
Chlamydia (http://bit.ly/AERch16)
Lymphogranuloma venereum (http://bit.ly/AERLGV16)
Gonorrhoea (http://bit.ly/AERsy16)
Syphilis (http://bit.ly/AERsy16)
Congenital syphilis (http://bit.ly/AERcs16)
See also: https://ecdc.europa.eu/en/annual-epidemiological-reports
In 2014, over 57 000 new cases of hepatitis B and C were reported. 22 442 cases of hepatitis B virus infection were reported in 30 EU/EEA Member States and 35 321 cases of hepatitis C were reported from 28 EU/EEA Member States.
Sri Lanka faced an unpredicted outbreak of dengue fever. It is a tropical country with two monsoon seasons. With each monsoon brings in two peaks of dengue fever making it an endemic disease in Sri Lanka.
Meningococcal carriage in the African meningitis belt and the impact of MenAfriVac: an overview of the MenAfriCar project
http://www.meningitis.org/conference2015
Powepoint On Epidemiological INDICES OF TB
Suitable For Community Medicine Students - KUHS
KERALA MEDICAL BOARD
Prepared By A Student from
Mount Zion Medical College , Chayalode Adoor
Prevention strategies tackling hepatitis B virus (HBV) in European Union (EU)/European Economic Area (EEA) countries are centred around universal or targeted vaccination programmes.
Poster at ESCAIDE 2016, Stockholm
Data and trends on hepatitis B and C for the countries of the European Union and European Economic Area.
2015 data.
See also ECDC's Annual Epidemiological Report: https://ecdc.europa.eu/en/annual-epidemiological-reports
Based on ECDC surveillance report on Sexually transmitted infections in Europe 2013, these slides describes the epidemiological features and basic trends of the five STI under EU surveillance: chlamydia trachomatis infection, gonorrhoea, syphilis, congenital syphilis, and lymphogranuloma venereum. It covers the years 2004 to 2013.
The world’s biggest multi-sport event summer Olympics Games 2016 officially known as the Games of the XXXI Olympiad, and commonly known as Rio 2016 due to take place Rio de Janeiro, Brazil, from 5th to 21st August, 2016. More than 10,500 athletes from 206 National Olympic committees (NOCs) will take part.[1] These sporting events will take place at 33 venues in the host city Rio de Janeiro and at least 5 venues in the cities of Säo Paulo, Belo Horizonte, Salvador, Manaus and Brazil’s capital Brasilia. International Olympic Committee (IOC) have predicted around 4,80,000 tourists will arrive at Rio de Janeiro for this mega event.[2] Similar to the other tropical countries the tourists will be at risk of acquiring gastrointestinal illnesses and vector-borne infections.
ECDC presentation at the 15th Conference of the International Society of Travel Medicine, 15 May 2017.
Presenter: Teymur Noori
Questions?
Contact info@ecdc.europa.eu
Is Europe ready for elimination of hepatitis B and C? The World Health Organization (WHO) will launch a global strategy on viral hepatitis in 2016 with the aim to eliminate hepatitis B and C as public health threats by 2030. The joint poster from ECDC, EMCDDA and WHO/Euro looks at the current availability of data for each of the core indicators and how existing gaps in data availability could be addressed.
Presentation by ECDC HIV expert Anastasia Pharris on epidemiological challenges for the HIV response in Europe.
Presented at: 16th European AIDS Conference, 26 October 2017, Milan.
Surveillance data from 2013 show high numbers of newly diagnosed hepatitis B and C cases notified across Europe. Chronic cases dominate across both diseases with a marked variation between countries: in 2013, 19 930 cases of hepatitis B virus infection were reported in 28 EU/EEA Member States, a crude rate of 4.4 per 100 000 population. 26 EU/ EEA Member States recorded 32 512 cases of hepatitis C resulting in a crude rate of 9.9 per 100 000 population.
Data and trends from the ECDC Annual Epidemiological reports for 2016 on:
Chlamydia (http://bit.ly/AERch16)
Lymphogranuloma venereum (http://bit.ly/AERLGV16)
Gonorrhoea (http://bit.ly/AERsy16)
Syphilis (http://bit.ly/AERsy16)
Congenital syphilis (http://bit.ly/AERcs16)
See also: https://ecdc.europa.eu/en/annual-epidemiological-reports
In 2014, over 57 000 new cases of hepatitis B and C were reported. 22 442 cases of hepatitis B virus infection were reported in 30 EU/EEA Member States and 35 321 cases of hepatitis C were reported from 28 EU/EEA Member States.
Sri Lanka faced an unpredicted outbreak of dengue fever. It is a tropical country with two monsoon seasons. With each monsoon brings in two peaks of dengue fever making it an endemic disease in Sri Lanka.
Meningococcal carriage in the African meningitis belt and the impact of MenAfriVac: an overview of the MenAfriCar project
http://www.meningitis.org/conference2015
Aedes aegypti and Aedes albopictus are the vectors
The four DENV serotypes (1, 2, 3, and 4) in Sri Lanka >30 years.
Main serotypes DEN-2 and 3 - DHF
The new genotype of DENV-1 has replaced an old genotype.
The emergence of new clades of DENV-3 in recent past coincided with an abrupt increase in the number of dengue fever (DF)/dengue hemorrhagic fever (DHF) cases, implicating in severe epidemics.
Abstract—The frequent occurrence of epidemics even after the launching of the Integrated Diseases Surveillance Programme (IDSP) was an indication toward inadequacy of the control system. These epidemics/outbreaks may be identified if disease status analysis is done properly. The aim of the this study was to find out status of some of major diseases included in the IDSP in a tertiary level hospital of western Rajasthan. It was a record-based analysis carried out in hospitals attached to SMS medical College, Jaipur (Rajasthan) India. Weekly report of IDSP in 'L' Form was collected of year 2015 from SMS Medical College, Hospitals. Data related to major diseases of IDSP were gathered from these reports. These reports were analysed in percentage and proportion. It was observed among major six diseases studied in this present study, majority of cases were of Swine flue followed by Dengue, Scrub Typhus and Malaria. There was no case of Chikungunia and Enteric Fever. When deaths due to these major six diseases were observed it was found that majority of deaths occurred due to Swine flue followed by Dengue, Scrub Typhus and Malaria. Malaria death was due to Plasmodiun Falcifarrum. Maximum PCR was of Swine flue (42.32%) followed by Dengue (29.16 %), Scrub Typhus (21.87%) and Malaria (6.65%). Maximum PDR was of Swine flue (93.08%) followed by Dengue (3.08%), Scrub Typhus (3.08%) and Malaria (0.77%). Overall Case Fatality (CFR) of these diseases was found 9.2%. Regarding variation CFR of these diseases it was found that maximum CFR was of Swine flue (20.23%) followed by Scrub Typhus (1.29%), Dengue (1.06%) and Malaria (0.97%). This variation of CFR as per the type of diseases was found with significant variation (p<0.001).So more emphasis should be given to more fatal disease like swine flue.
The International Journal of Engineering & Science is aimed at providing a platform for researchers, engineers, scientists, or educators to publish their original research results, to exchange new ideas, to disseminate information in innovative designs, engineering experiences and technological skills. It is also the Journal's objective to promote engineering and technology education. All papers submitted to the Journal will be blind peer-reviewed. Only original articles will be published.
The papers for publication in The International Journal of Engineering& Science are selected through rigorous peer reviews to ensure originality, timeliness, relevance, and readability.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
The Gram stain is a fundamental technique in microbiology used to classify bacteria based on their cell wall structure. It provides a quick and simple method to distinguish between Gram-positive and Gram-negative bacteria, which have different susceptibilities to antibiotics
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
1. VERDAS Workshop
Cali, Colombia. March 1st
and 2nd
2017
Dengue & Chikungunya Surveillance in Fortaleza
Antonio Silva Lima Neto, MD MSc
Coordinator of Epidemiologic Surveillance
Health Municipal Secretary of Fortaleza
Assistant Professor - University of Fortaleza (UNIFOR)
tanta26@yahoo.com / asneto@sms.fortaleza.ce.gov.br
Cali, Colombia
2. OBJECTIVES
• To Make a few comments about the demographics and epidemiological
trends of Fortaleza;
• To List daily activities of epidemiological arbovirus surveillance;
• Present Fortaleza Dengue/Zika/CHIK online Monitoring Information
System (SIMDA) as an important tool to detect outbreaks (early) and
to reorient health care and vector control activities;
• To Describe the epidemiology of Dengue and Chikungunya in Fortaleza
(1986-2016);
• To Present data from three Rapid Routine Surveys for Aedes Aegypti -
LIRAa (2015);
• To Present Chalenges, Research gaps (from our perspective) and
potential Incorporation of New Technologies on Vector Control.
4. FORTALEZA
• Estimated Population of 2,571,896 in 2014 (5th largest city in
Brasil)
• Total area – 331.14 km²
• Population Density – 7,767 inhab/km² (most densely
populated capital city in Brazil)
• 119 neighborhoods
• Fortaleza is divided into six (6) Health Districts
• 109 Primary Health Care Units (PHUs)
5. FORTALEZA
• According to a recente UN report (2010), Fortaleza was the 5th most
unequal city in the world (income inequality);
• Rapid urbanization, poor sanitation (sewage and water supply),
inadequate garbage collection, low education, huge slum areas
(densely populated) are important social determinants for the
infectious diseases burden in Fortaleza, particularly for the Vector-
Borne Diseases (VBDs);
• Exponential increase of violence is one of the most important
public health problem in Fortaleza at the moment;
• Dengue, Chikungunya Fever, Tuberculosis, Leishmaniasis, Hanseniasis
and Leptospirosis are endemic in Fortaleza (expected new cases every
year).
7. Effective surveillance of dengue/chik cases is essential:
i.To detect outbreaks in order to initiate timely and effective
control measures;
ii.Monitor the trends of incidence including temporal and geographic
distribution of cases;
iii.To monitor chronic cases and deaths of Chik and number of
dengue severe cases and deaths;
iv.To assess and confirm possibility of outbreaks;
v.To monitor the impact of control interventions.
Epidemiological surveillance requires on the following indicators
i.Suspected (clinical) cases of dengue/zika/chik;
ii.Confirmed (laboratory-tested) cases of dengue/zika/chik;
iii.Circulating serotypes (DEN-1,-2,-3 or -4), CHIKV, ZIKAV;
Source: WHO, 2015
8. Dengue & Chikungunya are a notifiable diseases. A form
should be filled out for every suspected case on the
Notifiable Diseases Information System (SINAN online)
9. In order to integrate information from SINAN and those
produced by vector control department, the Fortaleza
Arbovirus on-line Monitoring System (SIMDA) was
developed in 2009. Initially only for dengue.
SIMDA provides tables, graphs and dynamic maps which
are updated on a daily basis.
http://tc1.sms.fortaleza.ce.gov.br/simda
SIMDA is free to access. Only personal information (name
and address) is password protected.
The data that will be presented today are available on
SIMDA
11. Total Dengue Cases, Incidence Rates, Predominant Serotype.
Fortaleza, 1986 - 2016
Fonte: SMS Fortaleza/Célula de Vigilância Epidemiológica/SINAN ONLINE
Over the past 8 years Fortaleza
had four major epidemics
DENV1
DENV2 DENV3
DENV2 DENV1
DENV1
DENV4
DENV4
12. Comments
• Since the re-emergence of dengue fever in 1986, Fortaleza has
experienced five (5) major outbreaks with more than 20,000 cases
per year (1994, 2008, 2011, 2012, 2015);
• Large outbreaks were usually caused by the introduction (1994,
2012) and reintroduction (2011) of serotypes. The exception was the
2015 & 2016 outbreaks (Were Zika cases in 2015 and Chik cases in
2016 wrongly classified as Dengue?);
• DENV3 was not associated to a “large outbreak” but was the
predominat serotype for six consecutive years;
• As a consequence of successive epidemics, Seroprevalence of
Dengue Virus antibodies (IgG) in Fortaleza is estimated in more than
75% (unpublished data).
13. . Total number of cases, Non–severe and Severe cases,
Deaths, Fatality Rates. Fortaleza 1986 – 2016
Fonte: SMS Fortaleza/Célula de Vigilância Epidemiológica/SINAN ONLINE
Dengue Classification / Case Fatality Rates n
Non Severe Dengue cases 302.015
Severe Dengue Cases (Includes all forms of Severe
Dengue including DSS and DHF)
3.329 (11%)
Total Dengue Cases 305.344
Deaths 244
Case Fatality Rate (all cases) 0,08%
Case Fatality Rate (severe cases) 7,3%
15. Proportion of Dengue cases confirmed by laboratory tests
(RT-PCR, NS1, Elisa-IgM, Immunohistochemistry ).
Fortaleza 2010 - 2016
Fonte: SMS Fortaleza/Célula de Vigilância Epidemiológica/SINAN ONLINE
*Brazilian Ministry of Health recomends that at least 10% of the cases should be confirmed by
laboratory tests in epidemic years
16. Dengue: Control Charts for City of Fortaleza
Epidemic years (2008, 2011, 2012 & 2015)
Fonte: SMS Fortaleza/Célula de Vigilância Epidemiológica/SINAN ONLINE
Dengue Incidence by Epidemiological Week:
Green line: moving averages
Blue line: Upper limit
Red line: Specific year (Weekly dengue incidences)
Control Charts (Epidemic Curve / Control Diagram)
To detect outbreaks: three
consecutive weeks higher
than upper limit
2008 2011
2012 2015
17. Dengue: Control Charts for City of Fortaleza
Non epidemics years (2010, 2013, 2014 & 2016)
Fonte: SMS Fortaleza/Célula de Vigilância Epidemiológica/SINAN ONLINE
Dengue Incidence by Epidemiological Week:
Green line: moving averages
Blue line: Upper limit
Red line: Specific year (Weekly dengue incidences)
2010
2014
2016
2013
18. Dengue Cases and Deaths by epidemiological week. Fortaleza,
2012 (N=21) and 2013 (N=38)
Fonte: SMS Fortaleza/Célula de Vigilância Epidemiológica/SINAN ONLINE
2012
2013
19. MAR Tx_inc: n_caso/pop*100000 - quantil
Dengue Incidence Rate/100,000 inhab by Neighborhood in
Fortaleza, 2015.
Fonte: SMS Fortaleza/Célula de Vigilância Epidemiológica/SINAN ONLINE
20. n. 2229
BONSUCESSO – 56 = 2,51%
PICI – 57 = 2,55%
MONDUBIM – 132 = 5,92 %
SIQUEIRA – 68 = 3,05%
JANGURUSSU – 70 = 3,14%
Kernel Density Estimation of Dengue Cases by Neighborhood.
Fortaleza, 2016
Fonte: SMS Fortaleza/Célula de Vigilância Epidemiológica/SINAN ONLINE
21. Spatio-temporal distribution of confirmed Dengue cases
in Fortaleza by month, 2016.
Fonte: SMS Fortaleza/Célula de Vigilância Epidemiológica/SINAN ONLINE
23. n. 446
JAN FEV
MAR
n. 443
n. 376
n. 617
MAR
Cases of Dengue and Chikungunya by Epidemiological
Week, 2016
Fonte: SMS Fortaleza/Célula de Vigilância Epidemiológica/SINAN ONLINE
24. n. 446
JAN FEV
MAR
n. 443
n. 376
n. 617
MAR
Fonte: SMS Fortaleza/Célula de Vigilância Epidemiológica/SINAN ONLINE
Histogram of Chikungunya Cases, 2016 (per day)
Nº Cases=17,384
Deaths=21
26. MAR
Kernel Density Estimation of Chikungunya Cases by
Neighborhood. Fortaleza, 2016
Fonte: SMS Fortaleza/Célula de Vigilância Epidemiológica/SINAN ONLINE
28. Positive strategic points* (around 3000 points) for Aedes aegypti
related to the cases of Dengue Fever, Fortaleza, 2016
• Scrap car (junkyards), tyre repair, construction sites, cemeteries, sewer, etc.
• Strategic points are visited every two weeks (fortnight)
Fonte: SMS Fortaleza/Célula de Vigilância Epidemiológica/SINAN ONLINE
29. JAN FEV
MAR
n. 376
n. 617
MAR
LIRa2 (July)
LIRAa3 (October)
DENGUE_LIRAa 2 and 3: Spatial distribution of Aedes Aegypti
Positive Households (properties) by neighborhood. Fortaleza,
2016
LIRAa1 (January)
30. A2 –barrel, cask, tub, clay deposits (filters, jars, pots), tanks, water tanks, tanker
B – Vases / bottles with water, dishes, returnable bottles, defrost containers in
refrigerators, water dispensers in general, small ornamental fountains, construction
materials deposits (stocked toilets, pipes, etc.), religious objects, etc
C –tire repair and vegetable gardens, gutters, drains, sanitary unused, untreated pools,
broken glass on walls, etc.
D2 – plastic containers, PET bottles, cans, scraps, construction debris
E - leaves, holes in trees and rocks, animal remains (shells)
31. n. 446
JAN FEV
MAR
n. 443
n. 376
n. 617
MAR
Spatial distribution of Positive Households for Aedes
Aegypti and Dengue Cases by neighborhood (LIRAa).
Fortaleza, July, 2015
32. CASO
n. 194
n. 137
IMOV POS
Spatial distribution of Positive Households for Aedes Aegypti and
Dengue Cases by neighborhood. Health District 3, Fortaleza, 2014