<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1679-4974</journal-id>
<journal-title><![CDATA[Epidemiologia e Serviços de Saúde]]></journal-title>
<abbrev-journal-title><![CDATA[Epidemiol. Serv. Saúde]]></abbrev-journal-title>
<issn>1679-4974</issn>
<publisher>
<publisher-name><![CDATA[Secretaria de Vigilância em Saúde e Ambiente - Ministério da Saúde do Brasil]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1679-49742023000201400</article-id>
<article-id pub-id-type="doi">10.1590/s2237-96222023000200020</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Investigation of an outbreak of disease compatible with scurvy in a male penitentiary in the state of Ceará, Brazil, 2019-2020: a case-control study]]></article-title>
<article-title xml:lang="es"><![CDATA[Investigación de un brote de enfermedad compatible con escorbuto en una penitenciaría masculina en el estado de Ceará, Brasil, 2019-2020: un estudio de casos y controles]]></article-title>
<article-title xml:lang="pt"><![CDATA[Investigação de surto de doença compatível com escorbuto em uma penitenciária masculina do Ceará, 2019-2020: um estudo de caso-controle]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Freitas]]></surname>
<given-names><![CDATA[Leonardo José Alves de]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Camelo]]></surname>
<given-names><![CDATA[Fernanda Sindeaux]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Borges]]></surname>
<given-names><![CDATA[Maria Júlia Araújo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gomes]]></surname>
<given-names><![CDATA[Ricristhi Gonçalves de Aguiar]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Almeida]]></surname>
<given-names><![CDATA[Magda Moura de]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Silva]]></surname>
<given-names><![CDATA[Danniely Carolinne Soares da]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Garcia]]></surname>
<given-names><![CDATA[Márcio Henrique de Oliveira]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Santos]]></surname>
<given-names><![CDATA[Elizabeth David dos]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Ministério da Saúde Programa de Treinamento em Epidemiologia Aplicada aos Serviços do Sistema Único de Saúde ]]></institution>
<addr-line><![CDATA[Brasília DF]]></addr-line>
<country>Brazil</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Secretaria da Saúde do Ceará Secretaria Executiva de Vigilância em Saúde ]]></institution>
<addr-line><![CDATA[Fortaleza CE]]></addr-line>
<country>Brazil</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Universidade Federal do Ceará Departamento de Saúde Comunitária ]]></institution>
<addr-line><![CDATA[Fortaleza CE]]></addr-line>
<country>Brazil</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Ministério da Saúde Coordenação-Geral de Vigilância de Zoonoses e Doenças de Transmissão Vetorial ]]></institution>
<addr-line><![CDATA[Brasília DF]]></addr-line>
<country>Brazil</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2023</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2023</year>
</pub-date>
<volume>32</volume>
<numero>2</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.iec.gov.br/scielo.php?script=sci_arttext&amp;pid=S1679-49742023000201400&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iec.gov.br/scielo.php?script=sci_abstract&amp;pid=S1679-49742023000201400&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iec.gov.br/scielo.php?script=sci_pdf&amp;pid=S1679-49742023000201400&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Objective:  to identify the occurrence of an outbreak compatible with scurvy and exposure factors associated with typical signs/symptoms of hypovitaminosis that occurred in a male penitentiary in Ceará, Brazil between 2019-2020.  Methods:  this was a population-based case-control study; we used clinical records and interviews with compatible cases - based on sign/symptom onset during the study period - and with controls; we carried out multivariate analysis.  Results:  out of 62 cases, mean age was 40.6 years (SD = 10.8); main signs/symptoms were edema and pain in the lower limbs (100.0%), difficulty in walking (91.9%), hematoma/ecchymosis in the lower limbs (90.3%) and fever (88.7%); we identified being over 40 years old as an associated factor (aOR = 1.10; 95%CI 1.05;1.17; p-value = 0.001); and as protective factors: working (aOR = 0.11; 95%CI 0.03;0.36; p-value &lt; 0.001) and taking part in classes (aOR = 0.21; 95%CI 0.08;0.59; p-value = 0.003) in the prison.  Conclusion:  we considered the penitentiary outbreak to be compatible with scurvy due to characteristic signs/symptoms, associated with the identified factors; we recommended regular provision of a diet rich in vitamin C to all male inmates and clinical follow-up of cases.]]></p></abstract>
<abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Objetivo:  identificar la ocurrencia del brote compatible con escorbuto y los factores de exposición asociados con signos/síntomas típicos de hipovitaminosis que ocurrieron en una penitenciaría masculina en Ceará, Brasil entre 2019-2020.  Métodos:  estudio poblacional de casos y controles; se utilizaron historias clínicas y entrevistas con casos compatibles, con inicio de signos/síntomas durante el período de estudio, y controles; se realizó análisis multivariable.  Resultados: de los 62 casos, edad media fue 40,6 años (DE = 10,8); principales signos/síntomas fueron edema y dolor en miembros inferiores (100,0%), dificultad para caminar (91,9%), hematoma/equimosis en miembros inferiores (90,3%) y fiebre (88,7%); la edad mayor de 40 años se identificó como factor asociado (ORa = 1,10; IC95% 1,05;1,17; p-valor = 0,001); y como factores protectores: trabajo (ORa = 0,11; IC95% 0,03;0,36; p-valor &lt; 0,001) y participación en clases (ORa = 0,21; IC95% 0,08;0,59; p-valor = 0,003) dentro del centro penitenciario.  Conclusión: el brote en centro penitenciario fue considerado compatible con escorbuto debido a los signos/síntomas característicos, asociados a los factores identificados; se recomendó oferta regular de dieta rica en vitamina C a todos los internos y seguimiento clínico de los casos.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[RESUMO  Objetivo:  identificar ocorrência de surto compatível com escorbuto e fatores de exposição associados aos sinais/sintomas típicos de hipovitaminose, em penitenciária masculina, Ceará, Brasil, 2019-2020.  Métodos:  estudo de caso-controle populacional; foram utilizados registros clínicos e entrevistas com casos compatíveis - sinais/sintomas iniciados no período - e com controles; realizou-se análise multivariável.  Resultados:  62 casos; idade média de 40,6 anos (DP = 10,8); principais sinais/sintomas foram edema e dor em membros inferiores (100,0%), dificuldade para deambular (91,9%), hematoma/equimose em membros inferiores (90,3%), febre (88,7%); identificou-se, como fator de exposição, média de idade &gt; 40 anos (ORa = 1,10; IC95% 1,05;1,17; p-valor = 0,001); e como fatores protetores, trabalho (ORa = 0,11; IC95% 0,03;0,36; p-valor &lt; 0,001) e participação em aulas (ORa = 0,21; IC95% 0,08;0,59; p-valor = 0,003) dentro da penitenciária.  Conclusão:  surto da penitenciária compatível com escorbuto pelos sinais/sintomas característicos, associados aos fatores identificados; recomendou-se oferta regular de dieta rica em vitamina C para todos os internos e acompanhamento clínico dos casos.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Scurvy]]></kwd>
<kwd lng="en"><![CDATA[Hypovitaminosis]]></kwd>
<kwd lng="en"><![CDATA[Prisons]]></kwd>
<kwd lng="en"><![CDATA[Field epidemiology]]></kwd>
<kwd lng="en"><![CDATA[Disease outbreaks]]></kwd>
<kwd lng="en"><![CDATA[Case-control studies]]></kwd>
<kwd lng="es"><![CDATA[Escorbuto]]></kwd>
<kwd lng="es"><![CDATA[Hipovitaminosis]]></kwd>
<kwd lng="es"><![CDATA[Prisiones]]></kwd>
<kwd lng="es"><![CDATA[Epidemiología de campo]]></kwd>
<kwd lng="es"><![CDATA[Brotes de enfermedades]]></kwd>
<kwd lng="es"><![CDATA[Estudios de casos y controles]]></kwd>
<kwd lng="pt"><![CDATA[Escorbuto]]></kwd>
<kwd lng="pt"><![CDATA[Hipovitaminose]]></kwd>
<kwd lng="pt"><![CDATA[Penitenciária]]></kwd>
<kwd lng="pt"><![CDATA[Epidemiologia de Campo]]></kwd>
<kwd lng="pt"><![CDATA[Surtos de Doenças]]></kwd>
<kwd lng="pt"><![CDATA[Estudos de Casos e Controles]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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