Dulce Gomes - Academia.edu (original) (raw)

Papers by Dulce Gomes

International journal of applied mathematics and statistics, 2020

Road accidents are now a major health problem worldwide, and particularly in Angola, where they a... more Road accidents are now a major health problem worldwide, and particularly in Angola, where they are currently one of the major causes of death in the country. Over the time horizon under study, from 2002 to 2015, the average growth rate of road accidents was 7.3% and for both deaths and injured was 11.7%. In the present work, we have characterize the trend of the road accidents, deaths and injured in Angola using an STL, Seasonal-Trend decomposition by Loess. Time series modeling techniques were used to estimate the mathematical model that best fits the original data, in order to explain the evolution of the series and to make predictions. We have used classic Seasonal ARIMA models in two different approaches, the first one treat all observations the same way. The second approach identifies outliers, taking into account its magnitude and estimates Seasonal ARIMA models for the series excluding the significant outliers. The most appropriate models (in terms of the usual validation criteria) were identified for the characterization of the time series variability relative to road accidents, deaths and injured in Angola, as well as for providing the best predictions.

BMC Public Health, Sep 28, 2022

Background Tuberculosis (TB) diagnosis and treatment delays increase the period of infectiousness... more Background Tuberculosis (TB) diagnosis and treatment delays increase the period of infectiousness, making TB control difficult and increasing the fatality rates. This study aimed to determine the evolution of health care service delay (time between the patient's first contact with the health service and the diagnosis/start of treatment) and patient delay (time between onset symptoms date and the date of first contact with health services) for Pulmonary Tuberculosis (PTB) in Portugal between 2008 and 2017 across different regions, age groups and gender. Methods An exploratory analysis was performed, trends of both delays were studied, and 36 months forecasts were generated. We used the permutation test to test differences between groups and the Seasonal and Trend decomposition using Loess (STL) method and Autoregressive Integrated Moving Average (ARIMA) models for forecasting for both Health and Patient delays. We used data from notified PTB cases in mainland Portugal between 2008 and 2017, provided by the national surveillance system. Results Health delays remained relatively constant while patient delays increased. Females had significantly higher health delays in some regions. Individuals older than 64 had higher health delays than younger individuals, while patient delay for working-age individuals between 15 and 64 years old, presents higher patient delay. Conclusions Forecasts presage that the upward trend of the delays is unlikely to fall in the coming years. It is important to understand the evolution of the delays and predict how these will evolve. Our understanding of the delays behaviours will contribute to better health policies and resources allocation.

International Journal of Tuberculosis and Lung Disease, Oct 1, 2014

(TB) is a global public health concern. Surveillance programmes present invaluable epidemiologica... more (TB) is a global public health concern. Surveillance programmes present invaluable epidemiological information regarding its temporal evolution, particularly for pulmonary tuberculosis (PTB), the most common form of TB and the one that presents the greatest challenge in public health.

BMC Public Health, Mar 14, 2023

Springer Nature remains neutral with regard to jurisdictional claims in published maps and instit... more Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

PLOS ONE, Jan 20, 2023

Despite considerable therapeutic advances in the care of people living with human immunodeficienc... more Despite considerable therapeutic advances in the care of people living with human immunodeficiency virus (HIV) and with the acquired immunodeficiency syndrome (AIDS) and an overall reduction of 47% in the AIDS mortality rate in the last decade, the AIDS-mortality rates remains high. The social determinants of health (SDH) have a direct influence on the dynamics of this phenomenon. However, changes in SDH caused by the implemented policies against HIV have been poorly investigated. Moreover, the Brazilian rainforest has had the highest and continuously increasing AIDS mortality rate in Brazil since the 1980s. In this study, AIDS mortality in a province of the Brazilian rainforest was examined by using temporal and spatial analyses. Methods. In this ecological study, data from 2007 to 2018 were extracted from the Mortality Information System provided by the State Department of Public Health of Pará. For the temporal analysis, the integrated autoregressive model of moving average (ARIMA) and locally weighted polynomial regression (STLF) were used to forecast AIDS mortality from 2019 to 2022. For the spatial analysis, spatial autocorrelation and geographically weighted regression (GWR) analyses were employed. Results. The samples consisted of 6,498 notifications for AIDS-related deaths. From 2007 to 2013, the AIDS mortality rates showed an upward trend, followed by a stabilization until 2018 and an upward forecasted trend from 2019 to 2022. High mortality rates and high-high clusters were found in economic pole municipalities. Furthermore, AIDS mortality risk was directly associated with per capita income and demographic density, except in the southwestern region of Pará, which exhibited an inverse association with population density. Conclusion. Although the policies against HIV may have contributed to the stabilization of AIDS mortality rates from 2013 in Pará, the upward forecasted trend until 2022 raises an alert and concern to health authorities to provide reinforcement of the policies. The geographic variability of AIDS mortality promoted by SDH provides subsidies to health authorities to implement SDH-focused strategies for AIDS mortality reduction.

BMC Infectious Diseases, Jun 2, 2022

Objectives: To identify risk-prone areas for the spread of tuberculosis, analyze spatial variatio... more Objectives: To identify risk-prone areas for the spread of tuberculosis, analyze spatial variation and temporal trends of the disease in these areas and identify their determinants in a high burden city. Methods: An ecological study was carried out in Ribeirão Preto, São Paulo, Brazil. The population was composed of pulmonary tuberculosis cases reported in the Tuberculosis Patient Control System between 2006 and 2017. Seasonal Trend Decomposition using the Loess decomposition method was used. Spatial and spatiotemporal scanning statistics were applied to identify risk areas. Spatial Variation in Temporal Trends (SVTT) was used to detect risk-prone territories with changes in the temporal trend. Finally, Pearson's Chi-square test was performed to identify factors associated with the epidemiological situation in the municipality. Results: Between 2006 and 2017, 1760 cases of pulmonary tuberculosis were reported in the municipality. With spatial scanning, four groups of clusters were identified with relative risks (RR) from 0.19 to 0.52, 1.73, 2.07, and 2.68 to 2.72. With the space-time scan, four clusters were also identified with

European Journal of Epidemiology, 2012

The increasing relevance of spatiotemporal epidemiology, enhanced by a greater availability of ge... more The increasing relevance of spatiotemporal epidemiology, enhanced by a greater availability of geographical information and the growing importance of knowing where, when and how the health phenomena occurred in a spatiotemporal context, promotes more scientifically robust and effective early intervention. The identification of critical areas, either in terms of their higher incidence of a disease, or their intensity of determinants, is crucial to assess them for priorities setting

Revista Portuguesa de Saúde Pública, 2008

O estudo da distribuição geográfica e temporal das doenças, dos seus determinantes e das caracter... more O estudo da distribuição geográfica e temporal das doenças, dos seus determinantes e das características básicas da população tem uma longa tradição em Epidemiologia. É indispensável visualizar e caracterizar essas distribuições, para controlar as doenças e promover a saúde, pelo que esse estudo, hoje, faz parte da missão desta área para o conhecimento e reforça a utilidade actual da Epidemiologia em Saúde Pública. O principal objectivo da descrição e da análise de dados geo-referenciados no âmbito da Saúde Pública é a melhor compreensão da história natural e da distribuição espacial dos fenómenos de saúde. Esta área temática específica tem-se desenvolvido, nas últimas décadas, com um enorme e crescente impacto e é usualmente concretizada em três abordagens interrelacionadas: (1) o mapeamento de doenças e seus determinantes, (2) o estudo de correlações geográficas e (3) o clustering, ou aglomeração, espácio-temporal. O presente trabalho debruça-se sobre esta última. Os métodos de clustering espácio-temporal permitem que a possível heterogeneidade de uma distribuição no espaço e/ou no tempo, visível nas representações gráficas clássicas, seja interpretada de uma forma rigorosa e consistente através de processos estocásticos, não dependendo dos possíveis artefactos de uma simples representação gráfica. O ganho em interpretação conseguido deve-se, essencialmente, à melhor capacidade de compreensão das distribuições probabilísticas espácio-temporais, sendo os resultados representados graficamente. Facilitam a distinção de distribuições visualmente ilusórias, produzidas por artefactos das técnicas tradicionais ou pelo acaso, de distribuições realmente explicáveis pelos próprios espaço ou tempo. Os métodos de clustering espácio-temporal têm alguma complexidade e limitações, parcialmente em comum com os métodos tradicionais. Contudo, a resultante final, quanto à sua aplicabilidade e interesse em Epidemiologia e em Saúde Pública, afigura-se francamente animadora. O ganho que deles se obtém vem a traduzir-se em maior precisão e segurança das decisões e da intervenção e, por isso, conduzem a maior efectividade em Saúde Pública. Palavras-chave: epidemiologia; saúde pública; clustering espácio-temporal; tuberculose; anomalias congénitas.

BMC Public Health, May 17, 2022

Background: Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis and i... more Background: Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis and is a public health problem worldwide. It is estimated that 90% of the patients diagnosed with TB live in vulnerable environments with limited health resources, such as individuals living in correctional facilities. This study aimed to identify the consumption of alcohol, tobacco, and other drugs among prisoners diagnosed with TB and the spatial determinants and time trends of the phenomenon in southern Brazil. Methods: A cross-sectional study using data from the Brazilian Notifiable Diseases Information System was carried out. TB cases confirmed from 2014 to 2018 in prisons located in Paraná, Brazil, were selected. The Prais-Winsten procedure was performed to identify time trends by calculating monthly rates and the percentage of monthly variation. The Seasonal-Trend by Loess decomposition method was used to verify the time series and trends. The spatial association was verified with the Getis-Ord Gi* technique, and the risk areas were identified using spatial scan statistics. Results: A total of 1,099 TB cases were found in the studied population. The consumption of tobacco (n = 460; 41.9%), illegal drugs (n = 451; 41.0%), and alcohol (n = 179; 16.3%) stood out. An ascending trend was found for the consumption of alcohol (+ 19.4%/mo. (95%CI: 12.20-23.03)), tobacco (+ 20.2%/mo. (95%CI: 12.20-28.82)), and illegal drugs (+ 62.2%/mo. (95%CI: 44.54-81.97)). Spatial analysis revealed clusters for the use of alcohol, tobacco, and illegal drugs. Conclusions: This study advances knowledge presenting the burden of drug use and its typology among individuals diagnosed with TB in the prison system. There is a growing trend among patients to use drugs, especially illegal drugs. The clusters show differences between the places where the prisons are located.

Research Square (Research Square), Aug 31, 2021

Background Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis and is a pu... more Background Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis and is a public health problem worldwide. It is estimated that 90% of the patients diagnosed with TB live in vulnerable environments with limited health resources, such as individuals living in correctional facilities. This study aimed to identify the consumption of alcohol, tobacco, and other drugs among prisoners diagnosed with tuberculosis and the spatial determinants and time trends of the phenomenon in southern Brazil. Methods An ecological study using data from the Brazilian Noti able Diseases Information System. Tuberculosis cases con rmed from 2014 to 2018 in prisons located in Paraná, Brazil, were selected. The Prais-Winsten procedure was performed to identify time trends by calculating monthly rates and the percentage of monthly variation. The Seasonal-Trend by Loess decomposition method was used to verify the time series and trends. The spatial association was veri ed with the Getis-Ord Gi* technique, and risk areas were identi ed using spatial scan statistics. Results A total of 1,099 TB cases were found in the studied population. The consumption of tobacco (n = 460; 41.9%), illegal drugs (n = 451; 41.0%), and alcohol (n = 179; 16.3%) stand out. An ascending trend was found for the consumption of alcohol [+ 19.4%/mo. (95%CI: 12.20-23.03)], tobacco [+ 20.2% (95%CI: 12.20-28.82)], and illegal drugs [+ 62.2%/mo. (95%CI: 44.54-81.97)]. Spatial analysis revealed clusters for the use of alcohol, tobacco, and illegal drugs. Conclusions This study advances knowledge presenting the burden of drug use and its typology among individuals diagnosed with tuberculosis in the prison system. There is a growing trend among patients to use drugs, especially illegal drugs. The clusters show differences between the places where the prisons are located. Tuberculosis within the prison system is already a complex disease, and it is even more challenging when drugs are consumed. The consumption of drugs increased threefold when tobacco and alcohol were considered. Background Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis [1] and is a public health problem worldwide, though developing countries are the most severely affected. Data show that 30 countries account for 87% of the disease burden, and Brazil ranks 19th [2]. Even though the TB burden declined in recent years before the COVID-19 pandemic, it is a disease di cult to control and eliminate due to co-infection with the Human Immunode ciency Virus (HIV), antimicrobial resistance, multidrug-resistant TB, and increased consumption of alcohol, tobacco, and/or other drugs. In addition, TB is associated with social determinants of health, such as social vulnerability, poverty, and social exclusion to which populations such as immigrants, refugees, the homeless, and Persons Deprived of Liberty (PDL) are exposed [3]. It is estimated that 90% of the patients diagnosed with TB live in vulnerable environments with limited health resources [4], such as individuals living in correctional facilities. The World Health Organization (WHO) estimates that the prevalence of TB among PDL is 100 times higher than in the population in general [5, 6, 7] the prison environment contributes to TB mortality rates, revealing that the control of the disease is a priority neglected throughout the world [8]. Due to the unhealthy condition to which this population is exposed, Brazilian prisons are considered an important reservoir of TB bacillus and, consequently, a source of transmission among prisoners, prison o cers, and their families [9]. A literature review, conducted with the following descriptors "incarcerated," "drug abuse and tuberculosis," and "temporal trends and clustering," revealed that few studies address the use of alcohol, tobacco, and other drugs among PDL diagnosed with TB, showing a need for further research. The development of studies addressing this population is crucial to promote equity and mitigate the effects of the TB burden, especially in a country like Brazil with a large contingent of prisoners. Therefore, this study's objective is to identify the use of alcohol, tobacco, and other drugs among PDL diagnosed with tuberculosis and the spatial determinants and time trends of the phenomenon in Brazil. Methods Study design Ecological study [10]. Study setting This study was conducted in the state of Paraná, in southern Brazil, divided into four health macro-regions (east, west, north, and northwest) with 399 cities and an estimated population of 11.34 million inhabitants. The 63 prison facilities distributed in 44 cities were considered in this study [11]. Figure 1 shows the spatial distribution of prisons in the state of Paraná according to the four health macro-regions.

Research Square (Research Square), Aug 17, 2021

Background: In the last decade, young men who have sex with men (MSM) have been highly affectedim... more Background: In the last decade, young men who have sex with men (MSM) have been highly affectedimpacted by the HIV. Much more than attributing the risk behavior to HIV uniquely to the individual, behaviors are shaped by social determinants of health (SDHs). Despite of the problem, there is a scarcity of studies evaluating the SHDs impact on HIV among young MSN. Therefore,. Iin this study,paper we analyzed the HIV epidemic among Amazonian young MSM byin employing temporal trendstrend and spatial analysis. The Brazilian Amazon region has the highest HIV/AIDS detection rate among all the other Brazilian regions. Methods: We conducted an ecologicalEcological study using reported cases of HIV/AIDS in young MSM living in Pará, the second largestlarger Brazilian Amazonian province, between 2007 and 2018. Data were obtained from the Information System for Noti able Diseases. ForTo the temporal analysis, we employed autoregressive integrated moving average models, and seasonality and trend decomposition using locally weighted polynomial regression. To the spatial analysis, Moran's spatial autocorrelation, spatial scan, and spatial regression techniques were used for spatial analysis.. Results: A total of 2,192 noti cations were included in the study. Greater variabilityvariabilities in HIV/AIDS incidence rates waswere found in the festive months. The HIV/AIDS incidence rates exhibitedpresented an upward trend from 2013. This, and this trend is forecasted to continue until 2022. Belém, the capital of Pará, presented the highest spatial risk for HIV/AIDS and was the only city to present spatiotemporal risk from, 2014 to 2018. The geographic variation of the epidemic was associated with the number of men with formal jobs, the average salary of men, and the percentage of people over 18 years old with elementary education. Conclusion: The upward trend of HIV/AIDS incidence forecasted until 2022 and the variability of the epidemic promoted by the social determinants of health signalsbrings an alert and subsidies to health authorities. Policies Subsidies to reinforce the policies to controlagainst HIV among young MSM are urgently required.

Women & Health, Apr 26, 2011

Full terms and conditions of use: http://www.informaworld.com/terms-and-conditions-of-access.pdf ... more Full terms and conditions of use: http://www.informaworld.com/terms-and-conditions-of-access.pdf This article may be used for research, teaching and private study purposes. Any substantial or systematic reproduction, redistribution , reselling , loan or sub-licensing, systematic supply or distribution in any form to anyone is expressly forbidden. The publisher does not give any warranty express or implied or make any representation that the contents will be complete or accurate or up to date. The accuracy of any instructions, formulae and drug doses should be independently verified with primary sources. The publisher shall not be liable for any loss, actions, claims, proceedings, demand or costs or damages whatsoever or howsoever caused arising directly or indirectly in connection with or arising out of the use of this material.

PLOS ONE

O objectivo deste estudo consiste em caracterizar os padrões espaciais e temporais das ocorrência... more O objectivo deste estudo consiste em caracterizar os padrões espaciais e temporais das ocorrências de anomalias congénitas, procurando identificar variáveis explicativas ou factores que possam influenciar os valores mais elevados, ou mais baixos, das respectivas taxas

Spatial2 Conference: Spatial Data Methods for Environmental and Ecological Processes, Foggia (IT), 1-2 September 2011, 2011

Since the mid-80s Tuberculosis declining trend became softer and even reversed in some countries.... more Since the mid-80s Tuberculosis declining trend became softer and even reversed in some countries. HIV/AIDS frequently appears as the main cause for the resurgence of Tuberculosis. This work aims at identifying critical areas for the joint occurrence of these conditions in Portugal, and at confirming the belief that HIV is not a major explanation for the slow Tuberculosis incidence decline. Based on correlation analyses and space-time scan statistics, a weak statistical correlation between HIV and TB incidence rates were observed (0.279; p<0.001). For both diseases, Oporto and Lisbon Metropolitan Areas were identified as critical locals, with relative risks of, respectively, 1.77 and 1.78 for TB, and 5.66 and 3.31 for HIV. Similar areas were identified with a multivariate scan.

Plantas de sorgo sacarino foram expostas a quatro níveis de condutividade eléctrica (0, 2, 4, 6 d... more Plantas de sorgo sacarino foram expostas a quatro níveis de condutividade eléctrica (0, 2, 4, 6 dS m-1) e três níveis de fertilização azotada (20%, 60% e 100%) na água de rega, num desenho experimental 4 × 3, com 6 repetições, num total de 78 vasos. Pretendeu-se, assim, avaliar o efeito da interacção entre os vários níveis de salinidade e de fertilização azotado na tolerância das plantas de sorgo à salinidade, pela avaliação de parâmetros fisiológicos e do crescimento das plantas. As plantas sujeitas a altas concentrações de sal (acima de 4 dS m-1) apresentaram decréscimos muito pronunciados nos parâmetros evapotranspiração (ET), condutância estomática (gs), teor relativo em clorofilas e taxa de fotossíntese líquida (A), o que se reflectiu numa redução da sua biomassa final. Para níveis de salinidade na água de rega baixos (da ordem de 2 dS m-1), os compostos azotados parecem beneficiar a tolerância ao sal. No entanto, nas plantas expostas a elevadas concentrações de sal (maior que ...

Tropical Medicine and Infectious Disease

Background: We aimed to visualize and classify the time series of COVID-19, tuberculosis (TB) not... more Background: We aimed to visualize and classify the time series of COVID-19, tuberculosis (TB) notification, and TB outcomes (cure, treatment abandonment, and death), verify the impact of the new coronavirus pandemic on these indices in Brazil, and verify the presence of spatial autocorrelation between COVID-19 and TB. Methods: This was an ecological time series study that considered TB and COVID-19 cases. Seasonal Trend Decomposition using Loess (STL) was used to trace the temporal trend, Prais–Winsten was used to classify the temporal trend, Interrupted Time Series (ITS) was used to verify the impact of COVID-19 on TB rates, and the Bivariate Moran Index (Global and Local) was used to verify the spatial autocorrelation of events. Results: Brazil and its macro-regions showed an increasing temporal trend for the notification of TB in the pre-pandemic period. Only the Northeast Region showed a decreasing temporal trend for cured cases. For treatment abandonment, all regions except for...

In this work, time series models are applied to explain and forecast the rate of traffic accident... more In this work, time series models are applied to explain and forecast the rate of traffic accidents, deaths and injureds in Luanda, Angola. Monthly Luanda data from 2002 to 2015 are used to fit models and to make predictions. Road accidents in Angola are currently one of the major causes of death in the country. Particularly Luanda, the capital, is the province that shows the highest rate in terms of accidents, deaths and injureds. However, in recent years there has been a decrease in the accidents rate, with average growth rates of -6.73%, 0.19% and -2.54% for accidents, deaths and injureds respectively. We have used classic Seasonal ARIMA models (SARIMA) in two different approaches, the first one treat all observations the same way. The second approach identifies outliers, taking into account its magnitude and estimates SARIMA models for the series excluding the significant outliers. A Seasonal-Trend decomposition based on a locally-weighted regression smoothing (Loess) approach wa...

The swimming marks in the 100 m men's freestyle long course are modelled using extreme value ... more The swimming marks in the 100 m men's freestyle long course are modelled using extreme value theory. Using the statistical package R, extreme value and generalized Pareto models were adjusted in order to estimate the left endpoint of these models. The left endpoint can be interpreted as the best mark that can ever be reached, admitting that swimming pool conditions, athlete's equipment and training methods remain the same