Cardoso M.A.,University of Sao Paulo |
Scopel K.K.G.,Federal University of Juiz de fora |
Muniz P.T.,Federal University of Acre |
Villamor E.,University of Michigan |
Ferreira M.U.,University of Sao Paulo
PLoS ONE | Year: 2012
Background: Although iron deficiency is considered to be the main cause of anemia in children worldwide, other contributors to childhood anemia remain little studied in developing countries. We estimated the relative contributions of different factors to anemia in a population-based, cross-sectional survey. Methodology: We obtained venous blood samples from 1111 children aged 6 months to 10 years living in the frontier town of Acrelândia, northwest Brazil, to estimate the prevalence of anemia and iron deficiency by measuring hemoglobin, erythrocyte indices, ferritin, soluble transferrin receptor, and C-reactive protein concentrations. Children were simultaneously screened for vitamin A, vitamin B12, and folate deficiencies; intestinal parasite infections; glucose-6-phosphate dehydrogenase deficiency; and sickle cell trait carriage. Multiple Poisson regression and adjusted prevalence ratios (aPR) were used to describe associations between anemia and the independent variables. Principal Findings: The prevalence of anemia, iron deficiency, and iron-deficiency anemia were 13.6%, 45.4%, and 10.3%, respectively. Children whose families were in the highest income quartile, compared with the lowest, had a lower risk of anemia (aPR, 0.60; 95%CI, 0.37-0.98). Child age (<24 months, 2.90; 2.01-4.20) and maternal parity (>2 pregnancies, 2.01; 1.40-2.87) were positively associated with anemia. Other associated correlates were iron deficiency (2.1; 1.4-3.0), vitamin B12 (1.4; 1.0-2.2), and folate (2.0; 1.3-3.1) deficiencies, and C-reactive protein concentrations (>5 mg/L, 1.5; 1.1-2.2). Conclusions: Addressing morbidities and multiple nutritional deficiencies in children and mothers and improving the purchasing power of poorer families are potentially important interventions to reduce the burden of anemia. © 2012 Cardoso et al.
Da Silva A.R.,Federal University of Acre |
D'Andretta Tanaka A.C.,University of Sao Paulo
Maturitas | Year: 2013
Objective To determine the frequency and severity of menopausal symptoms and associated factors in middle-aged Brazilian women. Methods A cross-sectional study was carried out involving 1415 women aged 35-65 years attended at the Outpatient unit of the Clinicas Hospital of Rio Branco, Acre state, Brazil. The Menopause Rating Scale (MRS) was used to assess the severity of menopause symptoms. The Stata 10 statistical package was used for all data analysis whereas Pearson's x2 nonparametric association test was used for bivariate analysis, adopting a level of statistical significance of 5%. On the multivariate analysis, independent variables positively associated with the dependent model were retained in the final model (p < 0.005). Results Overall, 54.1% of participants were premenopausal, 10.1% perimenopausal, and 35.8% postmenopausal. Irritability was the most frequent symptom (78.3%), followed by joint and muscular discomfort (74.8%), and anxiety (72.7%). Mean total MRS score was 15.6 + 8.8 (median 15). After adjusting for confounding factors, the logistic regression analysis found low educational level (OR:1.53; [95% CI:1.21-1.95]; p < 0.001); self-perceived poor/very poor health (OR:4.48; [95% CI: 3.53-5.69]; p < 0.001), and menopausal transition phase (OR:1.73; [95% CI:1.18-2.53]; p = 0.005) to be statistically significantly associated with more severe menopausal symptoms. Conclusion Among Brazilian women, atypical symptoms of the menopause were the most frequently reported. Severe menopausal symptoms were more likely in women with low educational level, self-perceived poor health and at the menopausal transition phase. © 2013 Elsevier Ireland Ltd.
Ferreira M.U.,University of Sao Paulo |
Silva-Nunes M.D.,Federal University of Acre
Journal of Infection in Developing Countries | Year: 2010
Despite intensive control efforts over the past decades, Brazil still accounts for more than 50% of the malaria burden in the Americas and the Caribbean, with 458,041 slide-confirmed cases reported countrywide in 2007. The reason malaria has proved so difficult to control in this middle-income country with a reasonable health infrastructure remains unclear. Here we examine whether four strategies that were largely successful in other countries (aggressive active case detection, improved anti-relapse therapy for P. vivax infections, distribution of insecticide-treated bed nets, and selective house spraying with residual insecticides) are likely to work in Brazil. We review evidence from field and laboratory studies and identify gaps in our knowledge that require further investigation with well-designed large-scale trials. © 2010 Ferreira and da Silva-Nunes.
da Silva Rocha G.,Federal University of Acre |
Schor N.,University of Sao Paulo
Ciencia e Saude Coletiva | Year: 2013
The scope of this paper is to assess traffic accidents involving motorcycles, the victims involved and the increase in the fleet compared with other vehicles in Rio Branco, State of Acre. It is an epidemiological, descriptive and transversal study of accidents between 2005 and 2008 recorded by the Acre State Highway Department. There were 3,582 motorcycle accidents and 3,768 victims in the period. The motorcycle fleet increased by 72.8%, with involvement in accidents increasing by 42.2%, while accidents involving other vehicles only increased by 9.2%. As regards victims, there is a predominance of men, with rates of 561.1, with the age groups of between 20 and 29 and 30 and 39 being the highest, with 755.4 and 542.2, respectively. With reference to accident characteristics, the highest number of accidents - 32.4% - occurred in the afternoon, followed by the morning with 29.2% and the evening with 28.9%. 18.3% occurred on Saturdays and 15.7% on Sundays. Collisions were the commonest kind of accident, with 3,036 (84.8%) occurrences. The conclusion drawn is that it is essential to stage ongoing preventive programs and ensure greater integration among the institutions involved, with planning and campaigns to reverse the current situation.
Fujimoto D.E.,Federal University of Acre |
Koifman S.,Fundacao Oswaldo Cruz Fiocruz
Revista Brasileira de Hematologia e Hemoterapia | Year: 2014
Background: Dengue is an infectious disease with a recurring incidence, especially in developing countries. Despite recent economic growth, success in disease control has not been achieved, and dengue has evolved from cyclic epidemic outbreaks to a lack of seasonality. The lack of scientific basis for the proper management of cases with hemorrhagic manifestations, especially regarding transfusion procedures, might contribute to the high death rate in potentially avoidable cases. Objective: The aim of the study was to identify the clinical and laboratory manifestations in hemorrhagic dengue fever treated at the emergency services in Rio Branco, AC, Brazil, as well as to describe transfusion characteristics of patients and identify possible prognostic factors. Methods: A retrospective descriptive study was performed to analyze the distribution of relative frequencies of clinical and laboratory variables. The study was carried out in Rio Branco with confirmed dengue fever cases. Secondary data were obtained by Acre Epidemiological Surveillance teams of cases with bleeding or platelet counts under 100.0 × 109/L. The patients' clinical, laboratory and transfusion data were obtained from hospital records. Results: A total of 90,553 dengue cases were reported of which 7,447 had serologic confirmation; 267 cases had hemorrhagic manifestations and 193 patients were located. Nearly half of the patients had anemia and the mean of the lowest platelet count of these patients was 26.4 × 109/L. Platelet concentrate was transfused in 22.3% of cases with a mean of 7.5 IU/patient, fresh frozen plasma in 21.2% with a mean of 5.2 IU/patient and just 2.6% of patients received concentrated red blood cells with a mean of 3.2 IU/patient. Bleeding led to transfusions. Signs of plasma leakage and cardiopulmonary dysfunction were correlated to unfavorable outcomes. Conclusion: The pattern of clinical and laboratory criteria observed in this investigation does not differ from the literature. Transfusions were used as part of the treatment of dengue hemorrhagic fever manifestations. Some of the clinical manifestations may be related to unfavorable outcomes. © 2014 Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular All rights reserved.
Ramalho A.A.,Federal University of Acre |
Dalamaria T.,Federal University of Acre |
de Souza O.F.,Federal University of Acre
Cadernos de Saude Publica | Year: 2012
This cross-sectional study with university students examined the prevalence of regular consumption of fruits and vegetables and associated factors among students at a Federal university in Rio Branco, Acre State, Brazil. 863 undergraduates were interviewed in 2010. Overall prevalence of regular consumption of fruits and vegetables was 14.8%. Factors associated with regular consumption of fruits and vegetables were: socioeconomic classes A and B (PR = 1.70; 95%CI: 1.10-2.62), living with a partner (PR = 1.53; 95%CI: 1.02-2.29), regular physical activity (PR = 1.69; 95%CI: 1.11- 2.56), and consumption of fast food twice a week or less (PR = 1.49; 95%CI: 1.04-2.13). A minority of the students met the recommendation to consume fruits and vegetables 5 or more days a week. Regular fruit and vegetable consumption was associated with socioeconomic status and healthy habits such as physical exercise and low consumption of fast food.
Guilherme E.,Federal University of Acre
Revista Brasileira de Ornitologia | Year: 2012
The Brazilian state of Acre borders Peru and Bolivia to the west and south, and the Brazilian states of Amazonas and Rondônia to the north and east, respectively. The state is located within the lowlands of the western Amazon basin, adjacent to the foothills of the Andes, within a "megadiverse" region of the Brazilian Amazon basin. Despite its diversity, the region is still only poorly known in scientific terms, and is considered to be a priority for future biological surveys. Given this situation, the present study aims to contribute to the scientific knowledge of the avian fauna of southwestern Amazonia, by evaluating the following questions - (a) how many and which bird species occur in the state of Acre?; (b) how are these species distributed within the state?; and (c) what are the priority areas for new ornithological surveys within the state of Acre? My methodological procedures included (a) a wide literature search; (b) two years of field surveys, including observation records and the collection of voucher specimens; map the distribution of avian taxa within the two main interfuvial regions (east and west of the Purus River) of the state; and the identification of contact and possible hybridization zones, based on the distribution of parapatric sister taxa. Te literature search and fieldwork resulted in the compilation of 9550 avian records, encompassing 4763 specimens, of which 2457 (51.5%) were collected during the past five years. A total of 667 species were confirmed for the state of Acre, representing 75 families and 23 orders. A total of 64 migratory species were also recorded, of which 46.8% (n=30) are Nearctic migrants, 15 (23.4%) were considered to be intratropical migrants, and 19 (29.6%) were classified as austral migrants. Overall, 41 of the recorded species and subespecies were endemic to the Inambari center of endemism. Of all forest avian taxa present year round in the state, 79% are distributed in both main interfuvial regions, 16% were recorded only in the central-western sub-region (west of the Purus), and 5% only in the eastern sub-region (east of the Purus). At least five pairs of purported sister taxa presented allopatric distributions, whereas 15 had parapatric distribution within the state. Two zones of secondary contact (east and west) were identified, which coincided with two possible hybridization zones. Te main conclusions of this study are: (a) the total number of species recorded in the state is high but will probably increase as new surveys are conducted; (b) neither of the state's major rivers-the Purus and the Juruá-act as physical barriers to the dispersal of most of the resident species found in the state; (c) the zones of secondary contact found do not coincide with the basins of these two major rivers, which supports the idea that factors other than physical barriers to dispersal determine the present distribution of some of the resident bird taxa of Acre; and (d) birds restricted to the white-sand forests (campinas and campinaranas) found only in the western portion of the state, as well as those found only in the dense forests of eastern Acre, constitute together the most threatened elements of the state's avifauna since no conservation units protect these specific habitats.
De Melo T.N.,Federal University of Acre
Bulletin of the British Ornithologists' Club | Year: 2016
Aspects of the foraging behaviour of Rufous-breasted Piculet Picumnus rufiventris are described for the first time, as well as a nest of the species. The observations were made in Rio Branco, Acre, in westernmost Brazil. The species used culms and branches of bamboo and vines as foraging substrates, and was observed consuming adult ants and their larvae. In early June 2013, an apparently recently fledged juvenile was observed accompanied by two adults near a hole in a dead tree, 1.14 m above ground. The characteristics of the presumed nest are described and compared to those of congenerics. © 2016 The Authors; Journal compilation © 2016 British Ornithologists' Club.
Bernarde P.S.,Federal University of Acre |
de Oliveira Gomes J.,Federal University of Acre
Acta Amazonica | Year: 2012
Despite the importance of accidents involving snakebites, research on this theme in Brazil is relatively rare, especially in the Amazon region. Due to the poor number of studies about ophidism in the state of Acre and to the importance of this type of research in public health, epidemiological works on snake bite accidents are of great relevance. This study presents the list of species of poisonous snakes and the epidemiological aspects of snakebites in Cruzeiro do Sul, region of Alto Juruá (State of Acre, Brazil), in order to verify the snake genera responsible for the bites, and the main aspects involving the accidents and hospital attending. The epidemiologic data were collected from SINAN (National Databank of Major Causes of Morbidity) in the sector of epidemiologic vigilance of Hospital Regional do Juruá, in Cruzeiro do Sul. Seven species of poisonous snakes were recorded in Cruzeiro do Sul: three viperids (Bothrops atrox, Bothriopsis bilineata and Lachesis muta) and four elapids (Micrurus hemprichii, M. lemniscatus, M. remotus and M. surinamensis). During a two-year period (August 2007 to July 2009) 195 cases of snakebites were recorded. Fifty-one percent of the accidents were classified as lachetic (Lachesis), followed by bothropic (Bothrops and Bothriopsis) with 38% and crotalic (Crotalus) with 2%. In 9% of cases the snake genus involved was not informed. The majority of the accidents involved adult males living in rural areas, mainly affected in the lower limbs. The cases occurred most frequently from November to April, coinciding with the highest pluviometric levels. Most snakebites were equivocally attributed to L. muta, and were probably caused by B. atrox.
Lino M.Z.R.,Federal University of Acre |
Muniz P.T.,Federal University of Acre |
Siqueira K.S.,Federal University of Acre
Cadernos de Saude Publica | Year: 2011
Population studies in Brazil have shown an increased prevalence of overweight and obesity in adult populations in all regions of the country. The objective was to estimate prevalence and identify risk factors associated with overweight among adults in Rio Branco, Acre State, Brazil. The study included a cross-sectional population- based sample of 1,469 adults. Multivariate analysis was performed using Poisson regression, taking overweight (BMI ≥ 25kg/m2) as the dependent variable. Prevalence of overweight was 46.9%, higher among women. Overweight tended to increase with age in both men and women. Overweight was associated with socioeconomic, demographic, and morbidity variables such as hypertension and dyslipidemia. The high prevalence of overweight in adults of both sexes suggests a public health problem. Control measures and prevention of health risks associated with excess weight are necessary.