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Vaccination coverage in children in the period before and during the COVID-19 pandemic in Brazil: a time series analysis and literature review
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Domingues, Carla Magda Allan S

; Teixeira, Antônia Maria da Silva

; Moraes, José Cássio de

Jornal de Pediatria

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apr 2023, Volume 99 Suppl. 1 Pages S12 - S21

Abstract: En | Text: En | PDF: En

Abstract Objective: To evaluate the behavior of VCR and VCH, per municipality and per vaccines offered at the NVC, to identify priority areas for intervention. Methods: Descriptive study of a time series, using secondary data and accompanied by a narrative review of the literature evaluating VCR and VCH. Vaccines offered to children under one year and to those aged one year in the pre-pandemic period of COVID-19 (2015 to 2019) were selected and compared to those offered during the pandemic period (2020 and 2021 ). Results and discussions: The decrease in VCR and VCH is a process that precedes the COVID-19 pandemic but was intensified during this period. In 2021, the VCR was around 70% for most vaccines. This phenomenon encompasses the entire country; however, it is more intense in the states/municipalities located in the north and northeast regions, suggesting greater difficulty in accessing health services. Conclusion: Low and heterogeneous VCR requires the adoption of practices that were previously implemented, establishing partnerships with governmental and non-governmental institutions, with adequate communication, active search for non-compliance and non-adherence to the regular vaccination program, adopting intra- and extramural vaccination strategies, to reverse the current situation and reduce the risk of recurrence of diseases that have been already controlled and eliminated.

https://doi.org/10.1016/j.jped.2022.11.004

National Vaccine Coverage Survey 2020: methods and operational aspects
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Barata, Rita Barradas

; França, Ana Paula

; Guibu, Ione Aquemi

; Vasconcellos, Maurício Teixeira Leite de

; Moraes, José Cássio de

; Teixeira, Maria da Gloria Lima Cruz

; Domingues, Carla Magda Alan

; Borges, Maria Fernanda de Souza Oliveira

; de Azevedo, Roberta Nogueira Calandrini

; de Oliveira, Consuelo Silva

; Oliveira, Andrea de Nazaré Marvão

; Canales, Ivy Thereza

; Nascimento, Valdir

; Queiroz, Rejane Christine de Souza

; Lima, Luísa Helena de Oliveira

; Ramos Jr, Alberto Novaes

; Barbosa, Jaqueline Caracas

; Mirabal, Isabelle Ribeiro Barbosa

; Meira, Meiruska

; Antunes, Maria Bernadete de Cerqueira

; Teixeira, Maria Denise de Castro

; Gurgel, Ricardo Queiroz

; de Carvalho, Martha Suely Itaparica

; Cesar, Tayñana

; Maciel, Ethel Leonor Noia

; da Gama, Silvana Granado Nogueira

; Luhm, Karin Regina

; Boing, Antônio Fernando

; Mengue, Sotero Serrate

; de Oliveira, Sandra Maria do Valle Leone

; Lima, Jaqueline Costa

; Teles, Sheila Araújo

; Caetano, Karlla Antonieta Amorim

; de Araújo, Wildo Navegantes

Revista Brasileira de Epidemiologia

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2023, Volume 26 elocation e230031

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Objetivo: Inquérito nacional de cobertura vacinal aos 12 e 24 meses de idade foi realizado para investigar as quedas nas coberturas a partir de 2016. Métodos: Amostra de 37.836 nascidos vivos das coortes de 2017 e 2018 residentes nas capitais, Distrito Federal (DF) e 12 cidades com mais de 100 mil habitantes, acompanhados nos primeiros 24 meses por registros nas cadernetas de vacinação. Setores censitários foram estratificados segundo condições socioeconômicas, e o mesmo número de crianças foi incluído para cada estrato. Calcularem-se coberturas vacinais de cada vacina e coberturas completas aos 12 e 24 meses, doses aplicadas, válidas e oportunas. Fatores familiares, maternos e da criança associados à cobertura foram pesquisados. Os motivos para não vacinar analisados foram: contraindicações médicas, dificuldades de acesso, problemas no funcionamento do programa e hesitação vacinal. Resultados: Os resultados preliminares mostram que menos de 1% das crianças não foram vacinadas, as coberturas pelo esquema completo são menores que 75% em todas as capitais e no DF, as vacinas com mais de uma dose perdem cobertura progressivamente, há diferenças entre os estratos socioeconômicos, favoráveis aos estratos mais altos em algumas cidades e aos estratos mais baixos em outras. Conclusão: Houve realmente redução da cobertura vacinal em todas as capitais e no DF para as crianças nascidas em 2017 e 2018, denotando piora na execução do Programa Nacional de Imunizações durante os anos de 2017 a 2019. O inquérito realizado não mensurou os impactos da pandemia de COVID-19 que podem ter reduzido ainda mais as coberturas vacinais.

ABSTRACT Objective: The national vaccination coverage survey on full vaccination at 12 and 24 months of age was carried out to investigate drops in coverage as of 2016. Methods: A sample of 37,836 live births from the 2017 or 2018 cohorts living in capital cities, the Federal District, and 12 inner cities with 100 thousand inhabitants were followed for the first 24 months through vaccine record cards. Census tracts stratified according to socioeconomic levels had the same number of children included in each stratum. Coverage for each vaccine, full vaccination at 12 and 24 months and number of doses administered, valid and timely, were calculated. Family, maternal and child factors associated with coverage were surveyed. The reasons for not vaccinating analyzed were: medical contraindications, access difficulties, problems with the program, and vaccine hesitancy. Results: Preliminary results showed that less than 1% of children were not vaccinated, full coverage was less than 75% at all capitals and the Federal District, vaccines requiring more than one dose progressively lost coverage, and there were inequalities among socioeconomic strata, favorable to the highest level in some cities and to the lowest in others. Conclusion: There was an actual reduction in full vaccination in all capitals and the Federal District for children born in 2017 and 2018, showing a deteriorating implementation of the National Immunization Program from 2017 to 2019. The survey did not measure the impacts of the COVID-19 pandemic, which may have further reduced vaccination coverage.

https://doi.org/10.1590/1980-549720230031

National Vaccine Coverage Survey 2020: methods and operational aspects
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Barata, Rita Barradas

; França, Ana Paula

; Guibu, Ione Aquemi

; Vasconcellos, Maurício Teixeira Leite de

; Moraes, José Cássio de

; Teixeira, Maria da Gloria Lima Cruz

; Domingues, Carla Magda Alan

; Borges, Maria Fernanda de Souza Oliveira

; de Azevedo, Roberta Nogueira Calandrini

; de Oliveira, Consuelo Silva

; Oliveira, Andrea de Nazaré Marvão

; Canales, Ivy Thereza

; Nascimento, Valdir

; Queiroz, Rejane Christine de Souza

; Lima, Luísa Helena de Oliveira

; Ramos Jr, Alberto Novaes

; Barbosa, Jaqueline Caracas

; Mirabal, Isabelle Ribeiro Barbosa

; Meira, Meiruska

; Antunes, Maria Bernadete de Cerqueira

; Teixeira, Maria Denise de Castro

; Gurgel, Ricardo Queiroz

; de Carvalho, Martha Suely Itaparica

; Cesar, Tayñana

; Maciel, Ethel Leonor Noia

; da Gama, Silvana Granado Nogueira

; Luhm, Karin Regina

; Boing, Antônio Fernando

; Mengue, Sotero Serrate

; de Oliveira, Sandra Maria do Valle Leone

; Lima, Jaqueline Costa

; Teles, Sheila Araújo

; Caetano, Karlla Antonieta Amorim

; de Araújo, Wildo Navegantes

Revista Brasileira de Epidemiologia

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2023, Volume 26 elocation e230031

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

https://doi.org/10.1590/1980-549720230031

Topical Oxygen Jet Therapy (TOJT) for treating infected chronic surgical wounds
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Otaviano, Maria Helena

; Salles, Mauro

; Ching, Ting Hui

; Dettoni, Josilene Lopes

; Coulibaly, Ieda Guedes Simões

; Fukunaga, Erika Tiemi

; Gamba, Mônica Antar

; Moraes, José Cássio de

Brazilian Journal of Infectious Diseases

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2021, Volume 25 N. 2 elocation 101547

Abstract: En | Text: En | PDF: En

ABSTRACT Objectives: To evaluate the effectiveness of Topical Oxygen Jet Therapy (TOJT) in the treatment of surgical wounds in adult patients who has clinical signs of infection for over 30 days; and to identify the pathogens causing complicated skin and soft tissue infections. Method: Parallel, randomized clinical trials randomly divided into “Control Group” (CG) and “Treatment Group” (TG), which were followed up for 10 consecutive days. Venous antibiotics and dressings were used in both groups. In addition, TOJT were used on the wounds in the TG. The outcome criteria were based on clinical indicators: Pressure Ulcer Scale for Healing (PUSH) and Visual Analog Scale Pain (VAS). The paired t-test or Wilcoxon, chi-squared or Fisher’s exact test, and Student’s t-test or Mann–Whitney tests were used with a significance level of 5%. Results: 73 inpatients were included and followed up: 39 in TG and 34, CG. There were no significant differences in socio-demographic variables or of initial laboratory tests, except for blood glucose that was higher in TG than in CG (p = 0.044). Ten days into treatment, both the area of PUSH wounds (p < 0.001) and the pain scale (p = 0.029) were significantly reduced in TG. Staphylococcus aureus was the most prevalent pathogen (40%) with no significant difference between the two groups. Discussion: Although the follow-up time was of only ten days, a significant improvement was observed in TG. As a limitation of the study, the small sample size precluded the comparison of S. aureus infections between the two groups. Conclusion: TOJT accelerated the healing process, reduced pain and contributed to an improvement in the clinical status of the wounds when compared to CG. These findings demonstrate the effectiveness and relevance of the employed technique. It can be easily incorporated as a routine procedure in hospitals without extra investment.

https://doi.org/10.1016/j.bjid.2021.101547 96 downloads

Cuidadores de crianças e adolescentes com transtornos mentais: mudanças na vida social, familiar e sexual
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Daltro, Manuela Carla de Souza Lima

; Moraes, José Cássio de

; Marsiglia, Regina Giffoni

Saúde e Sociedade

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jun 2018, Volume 27 N. 2 Pages 544 - 555

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Com o processo de desinstitucionalização psiquiátrica, as famílias passaram a ser as principais provedoras de cuidados aos pacientes. Essa mudança marcou uma alteração no modo como a família vinha participando do cuidado ao doente mental, mas as dificuldades enfrentadas no desempenho do papel de cuidador têm contribuído para transformações na sua vida. Esta pesquisa objetivou observar quais mudanças ocorrem nos âmbitos social, familiar e sexual de cuidadores de crianças e adolescentes com transtornos mentais atendidos em Centro de Atenção Psicossocial Infantojuvenil (CAPSi). Participaram da pesquisa 64 cuidadores de crianças e adolescentes com transtornos mentais que frequentam um CAPSi. Os dados foram coletados por meio de questionário semiestruturado e analisados com base no programa estatístico Statistical Package for the Social Sciences. Os resultados demonstram que ser cuidador de criança ou adolescente com transtorno mental impacta a vida nos contextos social, conjugal e sexual, observando que 85,9% dos cuidadores abandonaram o emprego para cuidar de criança ou adolescente; somente 34,4% têm momentos de lazer; 81,3% tiveram mudanças na sua vida conjugal, sendo a maioria (98,1%) para pior; e 31,3% não possuem relações sexuais. Concluindo-se esta análise, percebe-se que essa população merece maior atenção das políticas públicas e da sociedade, e os resultados deste estudo poderão influir na adequação dos serviços de saúde mental, uma vez que a saúde de criança ou adolescente depende da saúde do cuidador.

Abstract The process of psychiatric deinstitutionalization led families to become the main caregivers of patients. This changed how the family participates in the care for the mentally ill, but the difficulties faced when performing the caregiving role contributed to changes in their lives. This research sought to find what changes occur in the social, family and sexual aspects of caregivers of children and adolescents with mental disorders attended at a Psychosocial Care Center. The participants were 64 caregivers of children and adolescents with mental disorders who attend one of these centers. Data from samples were obtained through a semi-structured questionnaire and analyzed using the software Statistical Package for Social Sciences. The results show that caregivers of a child or adolescent with a mental disorder have their lives impacted on social, marital and sexual aspects, noting that 85.9% of caregivers left their job to care for the child or adolescent; only 34.4% have leisure, 81.3% had changes in their marriage and, for the most part, 98.1%, to worse, and 31.3% do not have sex. From this analysis, it can be concluded that this population deserves more attention from public policies and from society, and that the results of this study may influence the adequacy of mental health services, since the health of children and adolescents depends on the health of the caregiver.

https://doi.org/10.1590/s0104-12902018156194 65 downloads

Cuidadores de crianças e adolescentes com transtornos mentais: mudanças na vida social, familiar e sexual
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Daltro, Manuela Carla de Souza Lima

; Moraes, José Cássio de

; Marsiglia, Regina Giffoni

Saúde e Sociedade

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jun 2018, Volume 27 N. 2 Pages 544 - 555

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.1590/s0104-12902018156194 3905 downloads

Evaluation of the impact of serogroup C meningococcal disease vaccination program in Brazil and its regions: a population-based study, 2001-2013
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Moraes, Camile de

; Moraes, José Cássio de

; Silva, Gabriela Drummond Marques da

; Duarte, Elisabeth Carmen

Memórias do Instituto Oswaldo Cruz

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apr 2017, Volume 112 N. 4 Pages 237 - 246

Abstract: En | Text: En | PDF: En

BACKGROUND Meningococcal C conjugate (MenC) vaccine was introduced as part of the Brazilian National Immunisation Program in 2010 for children < 1 year of age. OBJECTIVES The study objective was to evaluate the impact of this vaccination strategy. METHODS An observational, mixed ecological and analytical study was conducted, based on time series panel data from surveillance records (2001-2013). FINDINGS A total of 37,538 of meningococcal disease cases were recorded during the study period. Of these, 19,997 were attributed to serogroup C. A decrease in meningococcal disease serogroup C (MDC) incidence among children aged < 1 year [65.2%; 95% confidence interval (CI): 20.5-84.7%] and 1-4 years (46.9%; 95%CI: 14.6-79.1%) were found in the three years following vaccination introduction. Vaccination impact on the reduction of MDC incidence varied from 83.7% (95%CI: 51.1-100.0%) in the Midwest region to 56.7% (95%CI: 37.4-76.0%) in the Northeast region. MAIN CONCLUSIONS Vaccination against MDC in Brazil had a positive impact on the population of children aged < 1 year, across all regions, and on the 1-4 year-old cohort. Nevertheless, in our view there is scope for improving the vaccination strategy adopted in Brazil.

https://doi.org/10.1590/0074-02760160173 1242 downloads

Main characteristics of patients of primary health care services in Brazil
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Guibu, Ione Aquemi

; Moraes, José Cássio de

; Guerra Junior, Augusto Afonso

; Costa, Ediná Alves

; Acurcio, Francisco de Assis

; Costa, Karen Sarmento

; Karnikowski, Margô Gomes de Oliveira

; Soeiro, Orlando Mario

; Leite, Silvana Nair

; Álvares, Juliana

Revista de Saúde Pública

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2017, Volume 51 Suppl. 2 elocation 17s

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO OBJETIVO Caracterizar os usuários dos serviços de atenção primária à Saúde segundo aspectos demográficos, socioeconômicos, hábitos e estilo de vida, condições de saúde referidas e demanda aos serviços de saúde e medicamentos. MÉTODOS Foram utilizados dados da Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços, um estudo transversal, exploratório, de natureza avaliativa, realizado entre 2014 e 2015. As entrevistas foram realizadas com usuários maiores de 17 anos, com questionário padronizado, em serviços de atenção primária de amostra representativa de municípios, estratificada pelas regiões do Brasil. A análise realizada foi para amostras complexas e ponderada de acordo com o tamanho da população de cada região. RESULTADOS No total foram entrevistados 8.676 usuários, sendo 75,8% mulheres, a maioria de 18 a 39 anos de idade; 24,2% homens, e entre estes, a maioria de 40 a 59 anos; 53,7% com ensino fundamental; 50,5% se autodeclararam pardo, 39,7% branco e 7,8% preto. Metade dos usuários foi classificada como classe C e 24,8% recebia bolsa-família. Apenas 9,8% possuía plano de saúde, com maior proporção no Sul e menor no Norte e no Centro-Oeste. A proporção de homens que consumia bebida alcóolica foi maior que entre mulheres, assim como os fumantes. A autoavaliação de saúde mostrou que 57% acreditavam ser muito boa ou boa, com menor proporção no Nordeste. As prevalências de doenças/condições crônicas como hipertensão (38,6%), dislipidemia (22,7%), artrites/reumatismo (19,4%), depressão (18,5%), diabetes (13,6%) e outras são maiores nesses usuários que na população geral. Os medicamentos eram predominantemente procurados no próprio serviço ou em farmácias do Sistema Único de Saúde. CONCLUSÕES Foi possível caracterizar o perfil dos usuários da Atenção Básica, mas o ineditismo da pesquisa e sua abrangência nacional dificulta a comparação dos resultados com dados oficiais ou de outros artigos.

ABSTRACT OBJECTIVE To characterize patients of primary health care services according to demographic and socioeconomic aspects, habits and lifestyle, health condition, and demand for health services and medicines. METHODS This study is part of the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines – Services), a cross-sectional study carried out between 2014 and 2015. Interviews were conducted with patients over the age of 17 years, with a standardized questionnaire, in primary health care services of a representative sample of cities, stratified by regions of Brazil. The analysis was performed for complex samples and weighted according to the population size of each region. RESULTS A total of 8,676 patients were interviewed, being 75.8% women, most of them aged from 18 to 39 years; 24.2% men, most of them aged from 40 to 59 years; 53.7% with elementary school; 50.5% reported to be of mixed race ethnicity, 39.7%, white, and 7.8%, black. Half of patients were classified as class C and 24.8% received the Bolsa Familia benefit. Only 9.8% had health insurance, with higher proportion in the South and lower in the North and Midwest. The proportion of men who consumed alcohol was higher than among women, as well as smokers. The self-assessment of health showed that 57% believed it to be very good or good, with lower proportion in the Northeast. The prevalence of chronic diseases/conditions, such as hypertension (38.6%), dyslipidemia (22.7%), arthritis/rheumatism (19.4%), depression (18.5%), diabetes (13.6%), and others are higher in these patients them among the general population. Medicines were predominantly sought in the health care service or in pharmacies of the Brazilian Unified Health System. CONCLUSIONS It was possible to characterize the profile of patients of Primary Health Care, but the originality of the research and its national scope hinders the comparison of results with official data or other articles.

https://doi.org/10.11606/s1518-8787.2017051007070 11910 downloads

Main characteristics of patients of primary health care services in Brazil
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Guibu, Ione Aquemi

; Moraes, José Cássio de

; Guerra Junior, Augusto Afonso

; Costa, Ediná Alves

; Acurcio, Francisco de Assis

; Costa, Karen Sarmento

; Karnikowski, Margô Gomes de Oliveira

; Soeiro, Orlando Mario

; Leite, Silvana Nair

; Álvares, Juliana

Revista de Saúde Pública

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2017, Volume 51 Suppl. 2 elocation 17s

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.11606/s1518-8787.2017051007070 120 downloads

10.

Risk analysis for the reintroduction and transmission of measles in the post-elimination period in the Americas
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Lemos, Daniele Rocha Queiroz

; Franco, Aidee Ramirez

; Garcia, Márcio Henrique de Oliveira

; Pastor, Desireé

; Bravo-Alcântara, Pâmela

; Moraes, José Cássio de

; Domingues, Carla

; Cavalcanti, Luciano Pamplona de Góes

Revista Panamericana de Salud Pública

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2017, Volume 41 elocation e157

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

RESUMO Objetivo Elaborar e testar um modelo para analisar o risco de reintrodução e transmissão do vírus do sarampo ao nível municipal no período pós-eliminação nas Américas. Métodos Um estudo analítico-ecológico foi realizado com base nos dados da epidemia de sarampo ocorrida em 2013–2015 no nordeste do Brasil. As variáveis para análise foram selecionadas após extensa revisão da literatura científica sobre o risco de importação de casos de sarampo. Uma análise univariada considerando a presença ou a ausência de casos confirmados de sarampo em 184 municípios no Estado do Ceará foi conduzida para avaliar a associação entre a variável dependente e 23 variáveis independentes divididas em quatro grupos: 1) características dos municípios, 2) indicadores de qualidade dos programas de vacinação e da vigilância epidemiológica, 3) estrutura organizacional para resposta em saúde pública e 4) indicadores de impacto selecionados. Um nível de significância de 5% foi definido. Todas as variáveis com P < 0,200 foram analisadas por regressão logística multivariada e, segundo os resultados, os municípios foram categorizados em quatro níveis de risco: baixo, intermediário, alto e muito alto. Resultados A sensibilidade do modelo foi de 95% para concordância entre os municípios categorizados como “risco alto” e “risco muito alto” e os que registraram a ocorrência de epidemia entre 2013 e 2015 no Ceará. Dos 38 municípios onde ocorreu uma epidemia, 76% (29/38) apresentaram “risco alto” e “risco muito alto” de reintrodução e transmissão do vírus do sarampo e 146 municípios não notificaram casos (P < 0,0002). Conclusão Diante do risco iminente de reintrodução da circulação do vírus do sarampo no período pós-eliminação nas Américas, este modelo pode servir para identificar as áreas de maior risco de reintrodução e transmissão contínua do vírus do sarampo. Conhecer as áreas vulneráveis incentiva a adoção de procedimentos adequados de vigilância e monitoramento a fim de prevenir a transmissão sustentada.

ABSTRACT Objective To propose and test a model for analyzing municipalities’ level of risk of reintroduction and transmission of the measles virus in the post-elimination period in the Americas. Methods An ecological-analytical study was conducted using data on the measles epidemic that occurred in 2013–2015 in northeastern Brazil. The variables for analysis were selected after an extensive review of scientific literature on the risk of importation of measles cases. A univariate analysis considering the presence or absence of confirmed cases of measles in 184 municipalities in the state of Ceará, Brazil, was carried out to evaluate the association between the dependent variable and 23 independent variables, grouped into four categories: 1) characteristics of the municipalities; 2) quality indicators for immunization programs and epidemiological surveillance; 3) organizational structure for the public health response; and 4) selected impact indicators. A P value < 0.05 was considered significant. All variables with P < 0.200 were analyzed using multivariate logistic regression. Based on the results, the municipalities were categorized by four levels of risk (“low,” “medium,” “high,” and “very high”). Results The model sensitivity was 95% for concordance between municipalities classified as “high risk” and “very high risk” and those that had an epidemic between 2013 and 2015 in Ceará. Of the 38 municipalities that had an epidemic, 76% (29/38) were classified as “high risk” and “very high risk”; 146 municipalities did not report cases (P < 0.0002). Conclusions Given the imminent risk of reintroduction of measles circulation in the post-elimination period in the Americas, this model may be useful in identifying areas at greater risk for reintroduction and continued transmission of measles. Knowledge of vulnerable areas could trigger appropriate surveillance and monitoring to prevent sustained transmission.

RESUMEN Objetivo Proponer y poner a prueba un modelo para analizar el nivel de riesgo de reintroducción y transmisión del virus del sarampión que existe en los municipios durante el período posterior a la eliminación en la Región de las Américas. Métodos Se realizó un estudio ecológico y analítico empleando datos sobre la epidemia de sarampión que afectó al noreste del Brasil del 2013 al 2015. Las variables para el análisis se seleccionaron después de efectuar un amplio examen de las publicaciones científicas sobre el riesgo de importación de casos de sarampión. Se llevó a cabo un análisis con una sola variable considerando la presencia o ausencia de los casos de sarampión confirmados en 184 municipios del estado de Ceará (Brasil) para evaluar la asociación entre la variable dependiente y 23 variables independientes, que se agruparon en cuatro categorías: 1) características de los municipios; 2) indicadores de calidad de los programas de vacunación y la vigilancia epidemiológica; 3) estructura de organización de la respuesta de salud pública, y 4) indicadores del impacto seleccionados. Se consideró significativo un valor de P < 0,05. Todas las variables con un valor P < 0,200 se analizaron empleando una regresión logística con varias variables. Teniendo en cuenta los resultados, los municipios se clasificaron en función de cuatro niveles de riesgo (“bajo”, “medio”, “alto” y “muy alto”). Resultados El modelo tenía una sensibilidad de 95% en el caso de la concordancia entre los municipios clasificados dentro de las categorías de “riesgo alto” y “riesgo muy alto” y los que tuvieron una epidemia entre el 2013 y el 2015 en Ceará. De los 38 municipios que tuvieron una epidemia, 76% (29/38) se clasificaron dentro de las categorías de “riesgo alto” y “riesgo muy alto”; 146 municipios no notificaron casos (P < 0,0002). Conclusiones Dado el riesgo inminente de reintroducción de la circulación del sarampión durante el período posterior a la eliminación en la Región de las Américas, este modelo puede ser útil para reconocer las zonas en las que existe un mayor riesgo de reintroducción y transmisión continua del sarampión. El conocimiento de las zonas vulnerables podría desembocar en actividades de vigilancia y seguimiento apropiadas para evitar la transmisión sostenida.

https://doi.org/10.26633/rpsp.2017.157 219 downloads

11.

Avaliação da função sexual em mulheres após a menopausa portadoras de síndrome metabólica
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Silva, Gustavo Maximiliano Dutra da

; Lima, Sônia Maria Rolim Rosa

; Moraes, José Cássio de

Revista Brasileira de Ginecologia e Obstetrícia

Journal Metrics
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jul 2013, Volume 35 N. 7 Pages 301 - 308

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

OBJETIVO: Avaliar a função sexual de mulheres após a menopausa com diagnóstico de síndrome metabólica. MÉTODOS: Estudo caso-controle, incluindo 195 mulheres após o período da menopausa (amenorreia ≥1 ano, FSH ≥30 mUI/mL e idade entre 43 a 69 anos), atendidas no Departamento de Obstetrícia e Ginecologia da Faculdade de Ciências Médicas da Santa Casa de São Paulo e nas Unidades Básicas de Saúde do Programa de Saúde da Família da cidade de São Paulo. Foram coletados dados clínicos e avaliados o índice de massa corpórea e a circunferência abdominal. Na análise bioquímica foram solicitadas dosagens de colesterol total, HDL e LDL colesterol, triglicerídeos e glicemia de jejum. Foram consideradas com síndrome metabólica as mulheres que apresentaram três ou mais critérios diagnósticos: circunferência abdominal maior do que 88 cm; triglicerídeos ≥150 mg/dL; HDL colesterol <50 mg/dL; pressão arterial ≥130/85 mmHg e glicemia de jejum≥110 mg/dL. As participantes foram divididas nos Grupos Controle (n=87) e Síndrome Metabólica (n=108). Empregou-se o questionário Female Sexual Function Index (FSFI) para avaliar a função sexual. RESULTADOS: A média de idade foi de 54,0±4,7 anos. O índice de disfunção sexual em mulheres com síndrome metabólica foi significativamente superior ao do Grupo Controle, quando considerado o FSFI <26,5 (90/108 [83,3%] versus 42/87 [48,2%], p<0,001) ou FSFI <23 (62/108 [57,4%] versus 16/87 [18,39%], p<0,001). Os domínios desejo, excitação, lubrificação, orgasmo (p<0,001) e satisfação (p=0,002) apresentaram escores inferiores nas mulheres portadoras da síndrome metabólica. Para o escore de dor não houve diferença significante (p=0,57). Todos os componentes do diagnóstico da síndrome metabólica estiveram associados a maiores níveis de disfunção sexual (p<0,001). CONCLUSÃO: Mulheres após a menopausa com síndrome metabólica apresentam mais frequentemente disfunção sexual do que aquelas na mesma faixa etária que não são portadoras da síndrome.

PURPOSE: To evaluate sexual function in postmenopausal women diagnosed with metabolic syndrome. METHODS: Case-control study with 195 postmenopausal women (amenorrhea ≥1 year, FSH≥30 mIU/mL, aged 43 to 69 years) seen at the Department of Obstetrics and Gynecology, School of Medical Sciences of Santa Casa de São Paulo and in the Basic Units of the Family Health Program of São Paulo. Clinical data were collected, and body mass index and waist circumference were evaluated. Total cholesterol, HDL and LDL cholesterols, triglycerides, and fasting glucose were determined for biochemical analysis. We considered women to have the metabolic syndrome when they met three or more diagnostic criteria: waist circumference>88 cm and triglycerides ≥150 mg/dL; cholesterol HDL <50 mg/dL; blood pressure ≥130/85 mmHg, and fasting glucose ≥110 mg/dL. The participants were divided into Control Group (n=87) and Metabolic Syndrome Group (n=108). The Female Sexual Function Index (FSFI) was employed to assess the sexual function. RESULTS: Mean age was 54.0±4.7 years. The rate of sexual dysfunction was significantly higher in women with the metabolic syndrome than in the Control Group, both when considering FSFI <26.5 (90/108 [83.3%] versus 42/87 [48.2%], p<0.0001) and FSFI <23 (62/108 [57.4%] versus 16/87 [18.39%], p<0.001). The domains desire, arousal, lubrication, orgasm (p<0.001), and satisfaction (p=0.002) had lower scores in women with the metabolic syndrome. For the pain scores, there was no significant difference (p=0.57) between groups. All components of the metabolic syndrome diagnosis were associated with higher levels of sexual dysfunction (p<0.001). CONCLUSION: Postmenopausal women with metabolic syndrome present more frequently sexual dysfunction than those of the same age who do not have it.

5115 downloads Cited 1 time in SciELO

12.

Contribuição teórico-conceitual para a pesquisa avaliativa no contexto de vigilância da saúde
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Arreaza, Antônio Luis Vicente

; Moraes, José Cássio de

Ciência & Saúde Coletiva

Journal Metrics
- Sobre o periódico
- SciELO Analytics

aug 2010, Volume 15 N. 5 Pages 2627 - 2638

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

O presente artigo revisita inicialmente alguns dos elementos conceituais e operacionais sobre pesquisa avaliativa, em consonância com uma concepção ampliada de qualidade, reunindo saberes e campos de ação no âmbito das práticas de Saúde Pública. Em seguida, buscamos viabilizar o desenho de um modelo teórico tendo em vista a proposta de implementação das ações de vigilância da saúde, como na definição de uma imagem-objetivo da organização e integração das políticas e práticas de saúde sob uma lógica hierarquizada e regionalizada. Por fim, refletimos sobre os devires e desafios em torno da importância da teoria no campo da avaliação em saúde, produzindo saberes e abordagens para construção de modelos lógicos que relevem a complexidade dos objetos de intervenção e sua natureza de prática social transformadora.

Initially this article revises some of the conceptual and operational elements on evaluative research by gathering knowledge and action fields on public health practices. Such concepts are taken according to a wider conception of quality. Then, the article intends to arrange a theoretical model design considering the proposition for implementation of health surveillance actionsAn image-objective definition of organization and integration of health polices and practices based on hierarchic and local logic also take place. Finally, becomings and challenges around the theory in the health evaluation field turn to be the aim of our reflection in order to enable the production of knowledge and approaches to construct logic models which reveals the complexity of interventionist objects as well as its transforming nature of social practices.

1469 downloads

13.

Contribuição teórico-conceitual para a pesquisa avaliativa no contexto de vigilância da saúde
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Arreaza, Antônio Luis Vicente

; Moraes, José Cássio de

Ciência & Saúde Coletiva

Journal Metrics
- Sobre o periódico
- SciELO Analytics

aug 2010, Volume 15 N. 5 Pages 2627 - 2638

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

7644 downloads

14.

Vigilância da saúde: fundamentos, interfaces e tendências
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Arreaza, Antonio Luis Vicente

; Moraes, José Cássio de

Ciência & Saúde Coletiva

Journal Metrics
- Sobre o periódico
- SciELO Analytics

jul 2010, Volume 15 N. 4 Pages 2215 - 2228

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

O presente artigo resgata inicialmente as formas, conteúdo e projeção operacional da vigilância epidemiológica como instrumento indispensável para o campo do saber e práticas da saúde pública. Em seguida, verificamos que o modelo de vigilância da saúde estabelece uma ampliação desse conceito operacional de vigilância, ao integrar as práticas coletivas e individuais em diferentes dimensões das necessidades de saúde, que incluem além do controle de riscos e danos, os determinantes ecossociais. Na sequência, buscamos dimensionar os distintos níveis de atuação desta prática sanitária articulados às intervenções de promoção, proteção e recuperação, sob uma lógica regionalizada e integralizada do Sistema Único de Saúde brasileiro. Por fim, argumentamos que todo o arcabouço conceitual-operacional de vigilância da saúde se constitui como uma base política e sanitária para a consolidação do paradigma da promoção da saúde no campo da Saúde Coletiva.

The present article rescues initially the forms, content and operational projection of the epidemiological surveillance as indispensable tool for the knowledge field and public health practices. After that, we verify that the health surveillance model establishes an enlargement of this operational concept of surveillance by integrating the collectives and individuals practices in different health necessities dimensions, which includes beyond of the risks and damages control also the eco-socials determinants. In the sequence, we search to dimension the distinct levels of actuation of this sanitary practice articulated to the interventions of promotion, protection and recovery under a located and integrated logic of the unique system of Brazilian health. Finally, we argue that all the conceptual-operational model framework of public health surveillance itself constitutes as a politics and sanitary base for the consolidation of the health promotion paradigm in the collective health field.

5460 downloads Cited 4 times in SciELO

15.

Vigilância da saúde: fundamentos, interfaces e tendências
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Arreaza, Antonio Luis Vicente

; Moraes, José Cássio de

Ciência & Saúde Coletiva

Journal Metrics
- Sobre o periódico
- SciELO Analytics

jul 2010, Volume 15 N. 4 Pages 2215 - 2228

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

43161 downloads Cited 4 times in SciELO

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