Instruments for evaluating the quality of services in chronic diseases: scoping review.

OBJECTIVE: to map the scientific literature on the validity of instruments for evaluating the quality of services provided in primary health care for chronic diseases related to systemic arterial hypertension, diabetes mellitus, leprosy and tuberculosis. METHOD: scoping review, following the Joanna Briggs Institute method and described in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. 13 databases and gray literature were included. The selection of studies was carried out after removing duplicates and individual and paired evaluation. The data was extracted based on an elaborate script and presented in tables and charts. RESULTS: the analysis of 28 selected studies showed that the majority were from Brazil, followed by China and Malaysia. Almost half of the validated instruments were generic, and the specific ones covered the evaluation of diabetes mellitus and leprosy. The types of validation carried out were content and construct. CONCLUSION: there is a need to construct specific instruments due to the scarcity of studies on the process of validating instruments for evaluating the quality of services provided by primary health care for chronic diseases. HIGHLIGHTS: (1) Validated instruments for evaluating services in chronic diseases.(2) Possibility of carrying out new studies on adaptations of PCAT and PACIC.(3) No evaluation was identified for minors under 18 years of age with chronic diseases.(4) Use of a generic instrument to evaluate specific chronic diseases.

Prevalence of comorbidities in patients and mortality cases affected by SARS-CoV2: a systematic review and meta-analysis.

The new coronavirus, COVID-19 was declared a pandemic by the World Health Organization on March 11, 2020. Risk factors associated with this disease are age, sex, and the presence of comorbidities, the most common being hypertension, diabetes, and heart disease. The aim of this meta-analysis was to calculate the prevalence and geographical distribution of comorbidities in all patients admitted to intensive care units (ICUs), and the mortality rate of COVID-19. We selected studies based upon epidemiological and clinical descriptions of the patients and mortality from the disease to determine the pooled prevalence of comorbidities in all patients and in mortality cases due to COVID-19. The pooled prevalence was estimated using the random effects model, and odds ratios were used to measure the probability of death for a patient with a comorbidity. The total prevalence of comorbidities in patients with COVID-19 was 42% (95% CI: 25-60), 61% (95% CI: 42-80) in those admitted to the ICU, and 77% (95% CI: 68-86) among death cases; males were the most affected. Hypertension was the most prevalent comorbidity in all three groups studied, accounting for 32%, 26%, and 35%, respectively. The odds ratio of death for a patient with a comorbidity compared to one with no comorbidity was 2.4 (P < 0.0001). The higher the prevalence of comorbidities the higher the odds that the COVID-19 patient will need intensive care or will die, especially if the pre-existing disease is hypertension, heart disease, or diabetes.

Chronic heart diseases as the most prevalent comorbidities among deaths by COVID-19 in Brazil.

Age, sex and presence of comorbidities are risk factors associated with COVID-19. Hypertension, diabetes and heart disease are the most common comorbidities in patients with COVID-19. The objective of this study was to estimate the prevalence of patients with comorbidities who died of COVID-19 in Brazil. Searches of data were carried out on the official pages of the 26 State health departments and the federal district. The random-effect method was used to calculate the prevalence of patients with comorbidities who died. From the beginning of the pandemic in Brazil until May 20, 2020, 276,703 cases of COVID-19 were notified in Brazil, 6.4% died, 58.6% of whom were male. The prevalence of comorbidities among deaths was 83% (95% CI: 79 - 87), with heart disease and diabetes being the most prevalent. To our knowledge, this study represents the first large analysis of cases of patients with confirmed COVID-19 in Brazil. There is a high prevalence of comorbidities (83%) among patients who died from COVID-19 in Brazil, with heart disease being the most prevalent. This is important considering the possible secondary effects produced by drugs such as hydroxychloroquine.

Prevalence of Blastocystis sp. infection in several hosts in Brazil: a systematic review and meta-analysis.

BACKGROUND: Blastocystis sp. affects a wide variety of animals and is the most common protozoan in human fecal samples with potential pandemic distribution. In the present study, a systematic review and meta-analysis were conducted to determine the prevalence and distribution of Blastocystis sp. in different classes of hosts in Brazil. METHODS: Studies that analyzed hosts of various classes, including humans, domestic animals, wild animals or captive animals, were considered. The pooled prevalence of Blastocystis sp. infection was estimated by random effects models. RESULTS: For humans, similar prevalence rates were found for males (31.0%, 95% CI: 17.0-45.0%; weight 10%) and females (28.0%, 95% CI: 16.0-41.0%; weight 10%); the state of Mato Grosso do Sul showed the highest prevalence, with 41.0% positivity (95% CI: 36.0-46.0%; weight 2.9%). The prevalence among immunocompromised patients was 5.0% (95% CI: 3.0-7.0%; weight 10%), and the most common cause of immunosuppression was hemodialysis, with 23.0% (95% CI: 17.0-29.0%; weight 12.4%). Among classifications according to interaction with humans, wild and domestic animals presented values of 19.0% (95% CI: 7.0-31.0%; weight 42.6%) and 17.0% (95% CI: 13.0-21.0%; weight 29.6%), respectively. Among these animals, mammals (39.0%, 95% CI: 21.0-56.0%; weight 47.3%) and birds (18.0%, 95% CI: 10.0-27.0%; weight 39.3%) exhibited the highest prevalence. Phylogenetic analysis of Blastocystis sp. revealed greater genetic diversity for clades of subtypes (STs) ST1, ST2 and ST3. CONCLUSIONS: The overall prevalence of Blastocystis sp. in the Brazilian human population was 24%, which reflects the reality in the South, Southeast and Midwest regions, where prevalence rates of up to 40% were found. Among animals, mammals and birds exhibited the highest prevalence.

Diagnostic accuracy of Enzyme-Linked Immunosorbent Assays to detect anti-Leishmania antibodies in patients with American Tegumentary Leishmaniasis: a systematic review.

American Tegumentary leishmaniasis (ATL) is an infectious disease caused by several species of Leishmania . Even though the direct detection of parasites has low sensitivity, it is still the gold standard for the laboratory diagnosis of ATL. Recent studies have shown promising results of Enzyme-Linked Immunosorbent Assays ( ELISAs) using recombinant antigens. The aim of this study is to compare the accuracy of ELISAs using novel antigens with the standard ELISA based on soluble antigens of Leishmania (SLA) to diagnose ATL. Studies that analyzed patients with ATL and studies that evaluated the diagnostic accuracy of ELISAs using novel antigens and SLA were included. The Fourteen studies from PubMed, Regional Portal of the Virtual Health Library (BVS), Brazilian Society of Dermatology, Virtual Health Library (IBECS), Literature in the Health Sciences in Latin America and the Caribbean (LILACS), Medical Literature Analysis and Retrieval System Online (Medline), Elsevier Embase, Cochrane Library, The National Institute for Health and Care Excellence (NICE), and Cumulative Index to Nursing and Allied Health Literature (CINAHL) were included. The novel ELISA antigens showed a high sensitivity (93.8%-100%) and specificity (82.5-100%), a better diagnostic performance than SLA-based ELISAs (1-97.4% and 57.5-100%, respectively). Only 10 studies analyzed cross-reactions in serum samples from patients with Chagas disease, and only two studies reported a percentage of cross-reactivity. In this systematic review, the novel ELISA antigens showed better sensitivity and specificity with respect to SLA-based ELISAs. However, a meta-analysis should be performed to confirm this finding.

Instruments for evaluating the quality of services in chronic diseases: scoping review / Instrumentos para avaliação da qualidade de serviços em doenças crônicas: revisão de escopo / Instrumentos para evaluar la calidad de los servicios en enfermedades crónicas: revisión de alcance

Abstract Objective: to map the scientific literature on the validity of instruments for evaluating the quality of services provided in primary health care for chronic diseases related to systemic arterial hypertension, diabetes mellitus, leprosy and tuberculosis. Method: scoping review, following the Joanna Briggs Institute method and described in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. 13 databases and gray literature were included. The selection of studies was carried out after removing duplicates and individual and paired evaluation. The data was extracted based on an elaborate script and presented in tables and charts. Results: the analysis of 28 selected studies showed that the majority were from Brazil, followed by China and Malaysia. Almost half of the validated instruments were generic, and the specific ones covered the evaluation of diabetes mellitus and leprosy. The types of validation carried out were content and construct. Conclusion: there is a need to construct specific instruments due to the scarcity of studies on the process of validating instruments for evaluating the quality of services provided by primary health care for chronic diseases.

Resumo Objetivo: mapear a literatura científica sobre a validação de instrumentos para a avaliação da qualidade dos serviços prestados na atenção primária à saúde em doenças crônicas relacionadas com hipertensão arterial sistêmica, diabetes mellitus, hanseníase e tuberculose. Método: revisão de escopo, seguindo o método do Instituto Joanna Briggs e descrito de acordo com o Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. Foram incluídas 13 bases de dados e literatura cinzenta. A seleção dos estudos foi realizada após a remoção de duplicatas e avaliação individual e em pares. Os dados foram extraídos com base em um roteiro elaborado e apresentados em forma de quadros e tabelas. Resultados: a análise de 28 estudos selecionados mostrou que a sua maioria era do Brasil, seguidos pela China e Malásia. Quase a metade dos instrumentos validados eram genéricos, e os específicos eram sobre avaliação em diabetes mellitus e hanseníase. Os tipos de validação realizados foram de conteúdo e de construto. Conclusão: há necessidade de construção de instrumentos específicos devido à escassez de estudos sobre o processo de validação de instrumentos para a avaliação da qualidade dos serviços prestados pela atenção primária à saúde em doenças crônicas.

Resumen Objetivo: mapear la literatura científica sobre la validación de instrumentos para evaluar la calidad de los servicios prestados en la atención primaria de salud para enfermedades crónicas relacionadas con la hipertensión arterial sistémica, diabetes mellitus, lepra y tuberculosis. Método: revisión de alcance, siguiendo el método del Instituto Joanna Briggs y descrito de acuerdo con el Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. Se incluyeron 13 bases de datos y literatura gris. La selección de los estudios se realizó previa eliminación de duplicados y evaluación individual y pareada. Los datos se extrajeron basándose en un guión elaborado y se presentaron en cuadros y tablas. Resultados: el análisis de 28 estudios seleccionados mostró que la mayoría era de Brasil, seguidos de China y Malasia. Casi la mitad de los instrumentos validados eran genéricos, y los específicos cubrían la evaluación de diabetes mellitus y lepra. Los tipos de validación realizados fueron de contenido y de constructo. Conclusión: existe la necesidad de construir instrumentos específicos debido a la escasez de estudios sobre el proceso de validación de instrumentos para evaluar la calidad de los servicios prestados por la atención primaria de salud para enfermedades crónicas.