Abstract Background: Leprosy still represents a negleted public health problem in Brazil. Early and adequate treatment of leprosy, carried out in a primary health network is essential to reduce morbidity and sequelae. Objective: To analyze the therapeutic management of leprosy patients referred from primary healthy services to a specialized service. Methods: An analytical retrospective study using medical records and the Notifiable Diseases Information System. Patients diagnosed with leprosy, referred to a specialized outpatient clinic, between 2016 and 2017, in Goiás state, were included. The treatment carried out in the primary health services was compared to the Ministry of Health guidelines. Results: Two-hundred twenty-five leprosy patients were included, of whom 33.3% were referred by leprosy reactions, 27.1% by sequelae, and 10.2% by suspected recurrence or reinfection. Reviewing the therapeutic management, 123 (54.7%) were considered inadequate, 92 (40.9%) adequate, and 10 (4.4%) inconclusive. Of the 200 multibacillary patients, 39.5% had adequate management. In contrast, 12 (85.1%) out of 14 paucibacillary patients had adequate management (χ2= 11.43 and p < 0.001). Regarding the leprosy reactions and sequelae management, 56.9% and 19.5% were considered inadequate, respectively. There was no difference between the percentage of adequate or inadequate management when considering the Goiás health macroregions (χ2= 7.23; 4 degrees of freedom; p = 0.12). Study limitations: Use of recorded data, with incomplete medical records and lack of patient follow-up. Conclusions: The study demonstrated the equivocal multibacillaryleprosy management conducted in healthy primary care, with an emphasis on leprosy reactions and sequelae. Training and monitoring the medical staff in the primary healthy services could reduce the morbidity and sequelae of leprosy.

Abstract INTRODUCTION: Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease of the central nervous system caused by reactivation of JC virus (JCV). METHODS: We described the profile of laboratory-confirmed PML cases among AIDS patients. RESULTS: A total of 43 HIV patients with clinical conditions compatible with PML were obtained; 5 cases were confirmed by JCV testing. The main clinical finding was mental confusion. Median CD4 count was 54 cells/mm³. CONCLUSIONS: Three of the five confirmed PML cases died; the time between diagnosis and death was 2, 5, and 6 months. It is important to consider JCV infection as a differential diagnosis.

Resumo Objetivo: Analisar a tendência temporal e a distribuição espacial de sífilis gestacional (SG) e sífilis congênita (SC) em Goiás, Brasil, no período 2007-2017. Métodos: Estudo ecológico de série temporal com dados do Sistema de Informação de Agravos de Notificação. Utilizou-se a regressão de Prais-Winsten para analisar a tendência dos indicadores, por macrorregião de saúde. Realizou-se análise espacial descritiva para verificar a distribuição espacial dos casos, em três anos da série. Resultados: Foram registrados 7.679 casos de SG e 1.554 de SC no período. Observou-se tendência crescente das taxas de detecção de SG (variação percentual anual [VPA] de 18,0 – intervalo de confiança de 95% [IC95%] de 15,3 a 20,8) e de SC (VPA=16,8 – IC95% 20,1;33,8); e um acréscimo de 326% no número de municípios com taxa de incidência de SC >0,5/1 mil nascidos vivos. Conclusão: Foi identificado crescimento das taxas de detecção da sífilis gestacional e congênita e do número de municípios notificantes.

Abstract Objective: To analyze temporal trend and spatial distribution of syphilis in pregnancy and congenital syphilis in Goiás State, Brazil, between 2007 and 2017. Methods: This was an ecological time series and spatial distribution study with data obtained from the Notifiable Health Conditions Information System. Prais-Winsten Regression was used to analyze indicator trends by health macro-region. Descriptive spatial analysis was performed to verify case distribution in three different years in the period. Results: Between 2007 and 2017, 7,679 cases of syphilis in pregnancy and 1,554 congenital syphilis cases were reported. A rising trend was found in the rates of syphilis in pregnancy (annual percent change [APC] = 18.0 – 95% confidence interval [95%CI] 15.3;20.8) as well as in congenital syphilis rates (APC=16.8 – 95%CI 20.1;33.8); and a 326% increase in the number of municipalities with a congenital syphilis incidence rate >0.5/1,000 live births. Conclusion: Growth in syphilis in pregnancy and congenital syphilis detection rates was identified, as was growth in the number of municipalities reporting cases.

Resumen Objetivo: Analizar la tendencia temporal y distribución espacial de la sífilis gestacional (SG) y la sífilis congénita (SC) en Goiás, Brasil, entre 2007 y 2017. Métodos: Estudio de series temporales y enfoque espacial con datos del Sistema de Información para Enfermedades de Notificación. Se utilizó la regresión de Prais-Winsten para analizar la tendencia de los indicadores por macroregión de salud. Fue realizado un análisis espacial para verificar la distribución espacial de los casos en tres años de la serie. Resultados: Se registraron 7.679 casos de sífilis gestacional y 1.554 casos de congénita. Hubo una tendencia creciente en las tasas de detección de SG con (Variación Porcentual Anual [VPA] de 18,0 – intervalo de confianza del 95% [IC95%] de 15,3 a 20,8) y de SC (VPA=16,8 – IC95% 20,1; 33,8); y un aumento del 326% en el número de municipios con una tasa de incidencia de sífilis congénita >0,5/1000 nacidos vivos. Conclusión: Se identificó um aumento creciente de sífilis gestacional y sífilis congénita y del número de municipios notificantes en Goiás.

Resumo Objetivo: Analisar a tendência temporal e a distribuição espacial de sífilis gestacional (SG) e sífilis congênita (SC) em Goiás, Brasil, no período 2007-2017. Métodos: Estudo ecológico de série temporal com dados do Sistema de Informação de Agravos de Notificação. Utilizou-se a regressão de Prais-Winsten para analisar a tendência dos indicadores, por macrorregião de saúde. Realizou-se análise espacial descritiva para verificar a distribuição espacial dos casos, em três anos da série. Resultados: Foram registrados 7.679 casos de SG e 1.554 de SC no período. Observou-se tendência crescente das taxas de detecção de SG (variação percentual anual [VPA] de 18,0 – intervalo de confiança de 95% [IC95%] de 15,3 a 20,8) e de SC (VPA=16,8 – IC95% 20,1;33,8); e um acréscimo de 326% no número de municípios com taxa de incidência de SC >0,5/1 mil nascidos vivos. Conclusão: Foi identificado crescimento das taxas de detecção da sífilis gestacional e congênita e do número de municípios notificantes.

Abstract Objective: To analyze temporal trend and spatial distribution of syphilis in pregnancy and congenital syphilis in Goiás State, Brazil, between 2007 and 2017. Methods: This was an ecological time series and spatial distribution study with data obtained from the Notifiable Health Conditions Information System. Prais-Winsten Regression was used to analyze indicator trends by health macro-region. Descriptive spatial analysis was performed to verify case distribution in three different years in the period. Results: Between 2007 and 2017, 7,679 cases of syphilis in pregnancy and 1,554 congenital syphilis cases were reported. A rising trend was found in the rates of syphilis in pregnancy (annual percent change [APC] = 18.0 – 95% confidence interval [95%CI] 15.3;20.8) as well as in congenital syphilis rates (APC=16.8 – 95%CI 20.1;33.8); and a 326% increase in the number of municipalities with a congenital syphilis incidence rate >0.5/1,000 live births. Conclusion: Growth in syphilis in pregnancy and congenital syphilis detection rates was identified, as was growth in the number of municipalities reporting cases.

Resumen Objetivo: Analizar la tendencia temporal y distribución espacial de la sífilis gestacional (SG) y la sífilis congénita (SC) en Goiás, Brasil, entre 2007 y 2017. Métodos: Estudio de series temporales y enfoque espacial con datos del Sistema de Información para Enfermedades de Notificación. Se utilizó la regresión de Prais-Winsten para analizar la tendencia de los indicadores por macroregión de salud. Fue realizado un análisis espacial para verificar la distribución espacial de los casos en tres años de la serie. Resultados: Se registraron 7.679 casos de sífilis gestacional y 1.554 casos de congénita. Hubo una tendencia creciente en las tasas de detección de SG con (Variación Porcentual Anual [VPA] de 18,0 – intervalo de confianza del 95% [IC95%] de 15,3 a 20,8) y de SC (VPA=16,8 – IC95% 20,1; 33,8); y un aumento del 326% en el número de municipios con una tasa de incidencia de sífilis congénita >0,5/1000 nacidos vivos. Conclusión: Se identificó um aumento creciente de sífilis gestacional y sífilis congénita y del número de municipios notificantes en Goiás.

Objective. To analyze temporal trend and spatial distribution of syphilis gestational and congenital syphilis among live-born infants in Goiás State, Brazil, between 2007 and 2017. Methods. Ecological time series and spatial distribution study with data obtained from the Notifiable Diseases Information System. Prais-Winstein Regression was used to analyze the trend of indicators by health macro-region. Descriptive spatial analysis was performed to verify distribution from three years of that period. Results. Between 2007 and 2017, 7,679 cases of syphilis gestational and 1,554 of congenital syphilis were reported. There was a linear increase in detection rates of syphilis gestational VariationPercentualAnnual: 18.0 – confidence interval 95% [95%CI] of 15.3 to 20.8) and congenital (VPA=16.8 – 95%CI 20.1;33.8); and a 326% increase in the number of municipalities with a congenital syphilis incidence rate &gt;0.5/1,000 live births. Conclusion. A continuous increase in syphilis gestational and congenital syphilis was identified in different health regions from Goiás.

Objetivo. Analisar a tendência temporal e distribuição espacial de sífilis gestacional (SG) e sífilis congênita (SC) em Goiás, Brasil, no período 2007-2017. Métodos. Estudo ecológico de série temporal com dados do Sistema de Informação de Agravos de Notificação. Utilizou-se a regressão de Prais-Winstein para analisar a tendência dos indicadores, por macrorregião de saúde. Realizou-se análise espacial descritiva para verificar a distribuição espacial dos casos, em três anos da série. Resultados. Foram registrados 7.679 casos de SG e 1.554 de SC no período. Observou-se tendência crescente das taxas de detecção de SG (variação percentual anual [VPA] de 18,0 – intervalo de confiança de 95% [IC95%] de 15,3 a 20,8) e de SC (VPA=16,8 – IC95% 20,1;33,8); e um acréscimo de 326% no número de municípios com taxa de incidência de SC &gt;0,5/1000 nascidos vivos. Conclusão. Foi identificado crescimento das taxas de detecção da sífilis gestacional e congênita e do número de municípios notificantes.

Resumo Objetivo: analisar a incidência de sífilis em gestante (SG) e sífilis congênita (SC) e a correlação desses indicadores com a cobertura da Estratégia Saúde da Família (ESF) em Goiás, Brasil, de 2007 a 2014. Métodos: estudo ecológico utilizando dados do Sistema de Informação de Agravos de Notificação (Sinan) e do Departamento de Atenção Básica (DAB)/Ministério da Saúde; utilizou-se a correlação de Spearman para avaliar a relação entre cobertura da ESF e a incidência de sífilis. Resultados: a incidência de SG passou de 2,8 para 9,5/mil nascidos vivos, e a de SC, de 0,3 para 2,5/mil nascidos vivos (p<0,05), no período 2007-2014; houve aumento significativo de casos de SC nos municípios que apresentaram percentuais de cobertura da ESF inferiores a 75% (p<0,001). Conclusão: o aumento concomitante da incidência de SG e de SC sugere falhas na prevenção da transmissão vertical da sífilis, sobretudo nas regiões com menor cobertura da ESF.

Abstract Objective: to analyze the incidence of syphilis in pregnant women (SPW) and congenital syphilis (CS) and the correlation of these indicators with Family Health Strategy (FHS) coverage in Goiás, Brazil, from 2007 to 2014. Methods: this was an ecological study using Notifiable Diseases Information System (SINAN) data and data from the Health Ministry’s Department of Primary Care; Spearman's correlation was used to evaluate the relationship between FHS coverage and syphilis incidence. Results: SPW incidence increased from 2.8 to 9.5/1,000 live births, while CS incidence increased from 0.3 to 2.5/1,000 live births (p<0.05) in the period 2007-2014; there was a significant increase in CS cases in municipalities with percentage FHS coverage below 75% (p<0.001). Conclusion: the concomitant increase in SPW and CS incidence suggests failures in the prevention of vertical transmission of syphilis, especially in regions with lower FHS coverage.

Resumen Objetivo: analizar la incidencia de sífilis en gestante (SG) y sífilis congénita (SC) y la correlación de esos indicadores con la cobertura de la Estrategia Salud de la Familia (ESF) en Goiás, Brasil, de 2007 a 2014. Métodos: estudio ecológico utilizando datos del Sistema de Información de Agravamientos de Notificación (Sinan) y del Departamento de Atención Básica (DAB)/Ministerio de la Salud; se utilizó la correlación de Spearman para evaluar la relación entre la cobertura de la ESF y la incidencia de sífilis. Resultados: la incidencia de SG pasó de 2,8 a 9,5/1.000 nacidos vivos, y la de SC, de 0,3 a 2,5/1.000 nacidos vivos (p<0,05) en el período 2007-2014; hubo un aumento significativo de casos de SC en los municipios que presentaron un porcentaje de cobertura de la ESF inferior al 75% (p<0,001). Conclusión: el aumento concomitante de la incidencia de SG y de SC sugiere fallas en la prevención de la transmisión vertical de la sífilis, sobre todo en las regiones con menor porcentaje de cobertura de la ESF.

Resumo Objetivo: analisar a incidência de sífilis em gestante (SG) e sífilis congênita (SC) e a correlação desses indicadores com a cobertura da Estratégia Saúde da Família (ESF) em Goiás, Brasil, de 2007 a 2014. Métodos: estudo ecológico utilizando dados do Sistema de Informação de Agravos de Notificação (Sinan) e do Departamento de Atenção Básica (DAB)/Ministério da Saúde; utilizou-se a correlação de Spearman para avaliar a relação entre cobertura da ESF e a incidência de sífilis. Resultados: a incidência de SG passou de 2,8 para 9,5/mil nascidos vivos, e a de SC, de 0,3 para 2,5/mil nascidos vivos (p<0,05), no período 2007-2014; houve aumento significativo de casos de SC nos municípios que apresentaram percentuais de cobertura da ESF inferiores a 75% (p<0,001). Conclusão: o aumento concomitante da incidência de SG e de SC sugere falhas na prevenção da transmissão vertical da sífilis, sobretudo nas regiões com menor cobertura da ESF.

Abstract Objective: to analyze the incidence of syphilis in pregnant women (SPW) and congenital syphilis (CS) and the correlation of these indicators with Family Health Strategy (FHS) coverage in Goiás, Brazil, from 2007 to 2014. Methods: this was an ecological study using Notifiable Diseases Information System (SINAN) data and data from the Health Ministry’s Department of Primary Care; Spearman's correlation was used to evaluate the relationship between FHS coverage and syphilis incidence. Results: SPW incidence increased from 2.8 to 9.5/1,000 live births, while CS incidence increased from 0.3 to 2.5/1,000 live births (p<0.05) in the period 2007-2014; there was a significant increase in CS cases in municipalities with percentage FHS coverage below 75% (p<0.001). Conclusion: the concomitant increase in SPW and CS incidence suggests failures in the prevention of vertical transmission of syphilis, especially in regions with lower FHS coverage.

Resumen Objetivo: analizar la incidencia de sífilis en gestante (SG) y sífilis congénita (SC) y la correlación de esos indicadores con la cobertura de la Estrategia Salud de la Familia (ESF) en Goiás, Brasil, de 2007 a 2014. Métodos: estudio ecológico utilizando datos del Sistema de Información de Agravamientos de Notificación (Sinan) y del Departamento de Atención Básica (DAB)/Ministerio de la Salud; se utilizó la correlación de Spearman para evaluar la relación entre la cobertura de la ESF y la incidencia de sífilis. Resultados: la incidencia de SG pasó de 2,8 a 9,5/1.000 nacidos vivos, y la de SC, de 0,3 a 2,5/1.000 nacidos vivos (p<0,05) en el período 2007-2014; hubo un aumento significativo de casos de SC en los municipios que presentaron un porcentaje de cobertura de la ESF inferior al 75% (p<0,001). Conclusión: el aumento concomitante de la incidencia de SG y de SC sugiere fallas en la prevención de la transmisión vertical de la sífilis, sobre todo en las regiones con menor porcentaje de cobertura de la ESF.

Resumo Objetivo: investigar em pessoas vivendo com HIV/aids (PVHA) a prevalência de excesso de peso, obesidade abdominal e fatores associados. Método: estudo transversal com 270 PVHA. Aplicou-se questionário para investigar características sociodemográficas, clínicas e estilo de vida. Coletaram-se peso, altura e circunferência de cintura. Consideraram-se excesso de peso o IMC ≥25 kg/m2 e obesidade abdominal a circunferência de cintura ≥102 cm para homens e ≥88 cm para mulheres. Utilizou-se regressão de Poisson múltipla com nível de significância de 5%. Resultados: a prevalência de excesso de peso foi de 33,7% e de obesidade abdominal foi de 12,6%, sendo 37,9% nas mulheres e 5,7% nos homens (p<0,001). Excesso de peso foi associado com idade de 40 a 49 anos e ≥50 anos, não uso de terapia antirretroviral (TARV) e menor tercil de consumo de alimentos de risco. Obesidade abdominal se associou com sexo feminino, idade de 40 a 49 anos e ≥50 anos, renda própria maior que quatros salários mínimos e contagem de linfócitos T CD4+ >350 células/mm3. Conclusão: constatou-se elevada prevalência de excesso de peso e obesidade abdominal, associados a condições sociodemográficas, clínicas e consumo de alimentos de risco. Esse panorama sinaliza a necessidade de reorientação do foco de atenção à saúde dessa população.

Summary Objective: To investigate the prevalence of overweight, abdominal obesity and associated factors in people living with HIV/AIDS (PLWHA). Method: Cross-sectional study with 270 PLWHA. A questionnaire was applied to investigate sociodemographic, clinical and lifestyle characteristics. Weight, height and waist circumference were measured. BMI ≥25 kg/m2 was considered overweight, while abdominal obesity referred to waist circumference ≥102 cm for men and ≥88 cm for women. The authors used multiple Poisson regression with 5% significance level. Results: The prevalence of overweight and abdominal obesity was 33.7% and 12.6%, respectively, referring to 37.9% of women and 5.7% of men (p<0.001). Overweight was associated with age of 40-49 years and ≥50 years, non-use of ARV therapy, and lower tertile of consumption of risk foods. Abdominal obesity was associated with: female gender, age of 40-49 years and ≥50 years, income greater than four times the minimum wage, and CD4+ lymphocyte count >350 cells/mm3. Conclusion: There was a high prevalence of overweight and abdominal obesity associated with sociodemographic and clinical conditions, and consumption of risk foods. This scenario indicates the need for reorientation of the health care focus in this population.

This study aimed to estimate the prevalence of infection by the hepatitis B virus (HBV) and hepatitis C virus (HCV) in people infected by the human immunodeficiency virus (HIV) and analyze sociodemographic and behavioral factors associated with such co-infection. A cross-section study was performed in 495 individuals treated at a public center in the city of Goiânia. Participants were interviewed and blood collected for evaluation of serological and molecular markers for HBV and HCV. The rate of exposure to HBV was 33.5% (95% CI 29.4-37.9). Nineteen patients (3.8%) were diagnosed as HBV carriers, of whom 68.4% were HBV DNA positive. The prevalence of anti-HCV was 9.7% (95% CI 7.3-12.7). Genotype 1a was identified in 72.7% of the PCR samples positive for HCV. Co-infection by all three viruses was 4.4% (95% CI 2.9-6.8). Being, male, aged ≥40 years, history of sexually transmitted disease (STD), and having homosexual practices were independently associated with the presence of markers of HBV exposure. A history of injectable drugs use and STDs showed association with HCV seropositivity. Approximately 50% of participants were not aware of their HBV and HCV serostatus. The results obtained may contribute to assess the burden of viral hepatitis in people living with HIV and to guiding preventive measures for more vulnerable groups.

INTRODUÇÃO: O absenteísmo-doença, enquanto falta ao trabalho justificada por licença médica, é um importante indicador das condições de saúde dos trabalhadores. Em geral, características sociodemográficas e ocupacionais situam-se entre os principais fatores associados ao absenteísmo-doença. A administração pública é responsável por 21,8% dos empregos formais no Brasil. Esta população permite o estudo de uma grande variedade de categorias profissionais. OBJETIVO: Analisar o perfil e os indicadores de absenteísmo-doença entre servidores municipais de Goiânia, no Estado de Goiás, Brasil. Métodos: Estudo transversal das licenças certificadas para tratamento de saúde superiores a três dias, de todos os servidores, desde janeiro de 2005 a dezembro de 2010. Foram calculadas as prevalências, utilizando como critérios o número de indivíduos, os episódios e os dias de afastamento. RESULTADOS: Foram concedidas 40.578 licenças certificadas para tratamento de saúde a 13.408 servidores numa população média anual de 17.270 pessoas, o que resultou em 944.722 dias de absenteísmo. A prevalência acumulada de licença no período foi de 143,7%, com média anual de 39,2% e duração de 23 dias por episódio. A prevalência acumulada de absenteísmo-doença foi maior entre mulheres (52,0%) com idade superior a 40 anos (55,9%), com companheiro (49,9%), de baixa escolaridade (54,4%), profissionais de educação (54,7%), > 10 anos de serviço (61,9%) e múltiplos vínculos profissionais (53,7%). Os grupos de diagnósticos (CID-10) com as maiores prevalências acumuladas de licenças foram os do capítulo de transtornos mentais (26,5%), doenças osteomusculares (25,1%) e lesões (23,6%). CONCLUSÕES: Os indicadores de absenteísmo-doença expressam a magnitude desse fenômeno no serviço público e podem auxiliar no planejamento das ações de saúde do trabalhador, priorizando os grupos ocupacionais mais vulneráveis.

BACKGROUND: Sickness absence, as work absenteeism justified by medical certificate, is an important health status indicator of the employees and, overall, sociodemographic and occupational characteristics are among the main factors associated with sickness absence. Public administration accounts for 21.8% of the formal job positions in Brazil. This population allows the study of a wide range of professional categories. OBJECTIVE: To assess the profile and indicators of sickness absence among public workers from the municipality of Goiania, in the State of Goiás, Brazil. METHODS: A cross-sectional study on certified sick leaves, lasting longer than three days, of all civil servants from January 2005 to December 2010. Prevalence rates were calculated using as main criteria the number of individuals, episodes and sick days. RESULTS: 40,578 certified sick leaves were granted for health treatment among 13,408 public workers, in an annual average population of 17,270 people, which resulted in 944,722 days of absenteeism. The cumulative prevalence of sick leave for the period was of 143.7%, with annual average of 39.2% and duration of 23 days per episode. The cumulative prevalence of sickness absence was higher among women (52.0%), older than 40 years old (55.9%), with a partner (49.9%), low schooling (54.4%), education professionals (54.7%), > 10 years of service (61.9%), and with multiple work contracts (53.7%). Diagnoses groups (ICD-10) with higher cumulative prevalence of sick leaves were those with mental disorders (26.5%), musculoskeletal diseases (25.1%), and injuries (23.6%). CONCLUSIONS: Indicators of sickness absence express the magnitude of this phenomenon in the public sector and can assist in planning health actions for the worker, prioritizing the most vulnerable occupational groups.

INTRODUÇÃO: O absenteísmo-doença, enquanto falta ao trabalho justificada por licença médica, é um importante indicador das condições de saúde dos trabalhadores. Em geral, características sociodemográficas e ocupacionais situam-se entre os principais fatores associados ao absenteísmo-doença. A administração pública é responsável por 21,8% dos empregos formais no Brasil. Esta população permite o estudo de uma grande variedade de categorias profissionais. OBJETIVO: Analisar o perfil e os indicadores de absenteísmo-doença entre servidores municipais de Goiânia, no Estado de Goiás, Brasil. Métodos: Estudo transversal das licenças certificadas para tratamento de saúde superiores a três dias, de todos os servidores, desde janeiro de 2005 a dezembro de 2010. Foram calculadas as prevalências, utilizando como critérios o número de indivíduos, os episódios e os dias de afastamento. RESULTADOS: Foram concedidas 40.578 licenças certificadas para tratamento de saúde a 13.408 servidores numa população média anual de 17.270 pessoas, o que resultou em 944.722 dias de absenteísmo. A prevalência acumulada de licença no período foi de 143,7%, com média anual de 39,2% e duração de 23 dias por episódio. A prevalência acumulada de absenteísmo-doença foi maior entre mulheres (52,0%) com idade superior a 40 anos (55,9%), com companheiro (49,9%), de baixa escolaridade (54,4%), profissionais de educação (54,7%), > 10 anos de serviço (61,9%) e múltiplos vínculos profissionais (53,7%). Os grupos de diagnósticos (CID-10) com as maiores prevalências acumuladas de licenças foram os do capítulo de transtornos mentais (26,5%), doenças osteomusculares (25,1%) e lesões (23,6%). CONCLUSÕES: Os indicadores de absenteísmo-doença expressam a magnitude desse fenômeno no serviço público e podem auxiliar no planejamento das ações de saúde do trabalhador, priorizando os grupos ocupacionais mais vulneráveis.

BACKGROUND: Sickness absence, as work absenteeism justified by medical certificate, is an important health status indicator of the employees and, overall, sociodemographic and occupational characteristics are among the main factors associated with sickness absence. Public administration accounts for 21.8% of the formal job positions in Brazil. This population allows the study of a wide range of professional categories. OBJECTIVE: To assess the profile and indicators of sickness absence among public workers from the municipality of Goiania, in the State of Goiás, Brazil. METHODS: A cross-sectional study on certified sick leaves, lasting longer than three days, of all civil servants from January 2005 to December 2010. Prevalence rates were calculated using as main criteria the number of individuals, episodes and sick days. RESULTS: 40,578 certified sick leaves were granted for health treatment among 13,408 public workers, in an annual average population of 17,270 people, which resulted in 944,722 days of absenteeism. The cumulative prevalence of sick leave for the period was of 143.7%, with annual average of 39.2% and duration of 23 days per episode. The cumulative prevalence of sickness absence was higher among women (52.0%), older than 40 years old (55.9%), with a partner (49.9%), low schooling (54.4%), education professionals (54.7%), > 10 years of service (61.9%), and with multiple work contracts (53.7%). Diagnoses groups (ICD-10) with higher cumulative prevalence of sick leaves were those with mental disorders (26.5%), musculoskeletal diseases (25.1%), and injuries (23.6%). CONCLUSIONS: Indicators of sickness absence express the magnitude of this phenomenon in the public sector and can assist in planning health actions for the worker, prioritizing the most vulnerable occupational groups.

This study aimed to determine the excess length of stay, extra expenditures, and attributable mortality to healthcare-associated S. aureus bloodstream infection (BSI) at a teaching hospital in central Brazil. The study design was a matched (1:1) case-control. Cases were defined as patients > 13 years old, with a healthcare-associated S. aureus BSI. Controls included patients without an S. aureus BSI, who were matched to cases by gender, age (± 7 years), morbidity, and underlying disease. Data were collected from medical records and from the Brazilian National Hospital Information System (Sistema de Informações Hospitalares do Sistema Único de Saúde - SIH/SUS). A Wilcoxon rank sum test was performed to compare length of stay and costs between cases and controls. Differences in mortality between cases and controls were compared using McNemar's tests. The Mantel-Haenzel stratified analysis was performed to compare invasive device utilization. Data analyses were conducted using Epi Info 6.0 and Statistical Package for Social Sciences (SPSS 13.0). 84 case-control pairs matched by gender, age, admission period, morbidity, and underlying disease were analyzed. The mean lengths of hospital stay were 48.3 and 16.2 days for cases and controls, respectively (p < 0.01), yielding an excess hospital stay among cases of 32.1 days. the excess mortality among cases compared to controls that was attributable to s. aureus bloodstream infection was 45.2%. Cases had a higher risk of dying compared to controls (OR 7.3, 95% CI 3.1-21.1). Overall costs of hospitalization (SIH/SUS) reached US$ 123,065 for cases versus US$ 40,247 for controls (p < 0.01). the cost of antimicrobial therapy was 6.7 fold higher for cases compared to controls. healthcare-associated s. aureus BSI was associated with statistically significant increases in length of hospitalization, attributable mortality, and economic burden. Implementation of measures to minimize the risk of healthcare-associated bacterial infections is essential.

Highly active antiretroviral therapy (HAART) reduces AIDS-related morbidity and mortality, however it has been associated with metabolic abnormalities. This study estimated the prevalence of lipid abnormalities and related factors among patients on HAART. A cross-sectional study was conducted on adult patients, in central Brazil. Patients were interviewed, and blood obtained for lipids measurement. Dyslipidemia was defined as total cholesterol (TC) > 240 mg/dL, low-density lipoprotein (LDL) > 160 mg/dL, triglycerides (TG) > 200 and/or high-density lipoprotein (HDL) < 40 mg/dL. Multiple logistic regression analyses were performed (SPSS 13.0). One hundred and thirteen patients were recruited. Mean age was 39.3 years; 68.1% were males; 50.4% were on nucleoside reverse transcriptase inhibitors (NRTI) in combination with non-nucleoside reverse transcriptase inhibitors (NNRTI), while 42.5% were on NRTI in combination with protease inhibitors (PIs). The prevalence of dyslipidemia was 66.7%. Low HDL was the most frequent abnormality (53.5%), followed by high TG (36.1%). Patients on a PI regimen had a 5.2-fold higher risk (95% CI: 1.8-14.8) of dyslipidemia, even after adjusting for sex, age, and duration of HIV infection/AIDS. The study discloses a high prevalence rate of dyslipidemia and points out a need for intervention programs to reduce future cardiovascular events in patients, on HAART.