Use of an application on the measles vaccine for Warao indigenous refugees in Brazil.

OBJECTIVE: To evaluate the need to develop an application with information about the measles vaccine for Warao indigenous people. METHODS: This was a quantitative study conducted at the Espaço de Acolhimento Tapanã refugee shelter in the city of Belém, Pará, Brazil. The study sample was selected for convenience. Data were analyzed descriptively using Bioestat 5.0 software. RESULTS: Twenty-one Warao indigenous individuals were interviewed. It was identified that 91% (n=20) had lost their vaccination card; 91% (n=20) stated they had lost their vaccination card more than three times, and 91% expressed interest in an application to store their vaccination information. CONCLUSIONS: The research provided important information for the development of a health application named WaraoMedI (Warao Measles Diversity Indigenous), as well as offered nursing professionals evidence about the challenges Warao indigenous refugees face in self-managing their vaccination information.

Educational technology on tuberculosis: construction shared with Primary Health Care nurses.

OBJECTIVE: to develop, in a participatory way, an educational technology to assist nurses in the management of tuberculosis cases in Primary Health Care. METHODS: methodological research with a qualitative approach. Data were collected between June and October 2022, in 25 Basic Health Units, with 41 nurses interviewed individually. Thematic content analysis was carried out to guide technology elaboration. RESULTS: three empirical categories were organized, demonstrating the facilities and difficulties in tuberculosis management, the conceptions about educational technology as a facilitator of the teaching-learning process in Primary Health Care and participatory development of technology. Nurses were in favor of constructing an instructional guide technology, and made suggestions to encourage its creation and use in daily service routine. FINAL CONSIDERATIONS: the participatory process made it possible to create technology to assist nurses in the teaching-learning process in Primary Health Care about caring for people with tuberculosis.

Incidence of malaria among indigenous people associated with the presence of artisanal mining.

OBJECTIVE: To analyze the incidence of malaria among indigenous people associated with the presence of artisanal miningin the state of Pará. METHOD: Analytical, cross-sectional study conducted with 20,774 cases of malaria in indigenous people in the state of Pará (2011 to 2020). The data came from the Malaria Epidemiological Surveillance Information System, obtained from the Pará State Department of Public Health. In the analysis, Spearman's correlation coefficient was used, with a significance of 5% (p < 0.05). RESULTS: Incidence rates were high, especially in the Tapajós River Indigenous Special Health District (372.2/1,000 inhabitants). There was association between the incidence of malaria and the presence of indigenous people in artisanalmining activities on the Tapajós River (p=0.0008). CONCLUSION: The occurrence of malaria is unequal among the Special Indigenous Health Districts, being more frequent in those with greater mining activity, configuring exposure to the disease. It is necessary to adopt intersectoral measures, especially in areas of vulnerability to illness.

Knowledge and practices about health among Quilombola men: contributions to health care.

OBJECTIVE: to analyze health knowledge and practices among Quilombola men. METHODS: a qualitative, descriptive study, carried out with 40 men from two Quilombola communities in Santa Izabel do Pará, state of Pará, Brazil. Individual interviews were carried out using a semi-structured script. Text corpus was subjected to analysis with Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires 0.6, alpha 3, through Descending Hierarchical Classification. RESULTS: among participants, eight (20.00%) were aged 55 to 59 years. 382 text segments were identified, with 299 (78.27%) being used, generating five lexical classes, which made up two subcorpora. The classes were organized into four thematic axes, covering knowledge about health and practices to prevent and solve health problems. FINAL CONSIDERATIONS: men highlighted popular/traditional wisdom permeated by biomedical knowledge, translating their understanding of how to act to remain or become healthy.

Human immunodeficiency virus infection in pregnant women and its correlation with socioeconomic determinants.

OBJECTIVE: To analyze the spatial pattern of human immunodeficiency virus infection in pregnant women and its correlation with socioeconomic determinants. METHOD: Ecological study, carried out with cases of human immunodeficiency virus infection in pregnant women in the state of Pará, Brazil, from 2010 to 2017. Rate analysis was performed using the empirical Bayesian method and univariate local Moran. Bivariate analyses were used to examine the correlation between infection and socioeconomic determinants. RESULTS: High rates of infection were observed in municipalities in the mesoregions of Southeast of Pará and Metropolitan area of Belém. A significant spatial correlation was found between human immunodeficiency virus infection rates in pregnant women and human development index indicators (I = 0.2836; p < 0.05), average income (I = 0.6303; p < 0.05), and illiteracy rate (I = 0.4604; p < 0.05). CONCLUSION: The spatial pattern of human immunodeficiency virus infection in pregnant women correlated to socioeconomic determinants highlights the need to restructure public policies for the control and prevention of AIDS virus that take into account the socioeconomic factors of this specific population and locoregional disparities in Pará.

Social representations of pregnant women about high-risk pregnancy: repercussions for prenatal care.

OBJECTIVE: To analyze the Social Representations of pregnant women about high-risk pregnancy and its repercussions for prenatal care. METHOD: Qualitative study, based on the procedural aspect of the Theory of Social Representations, carried out with 62 high-risk prenatal pregnant women at a High Complexity Maternity, in Belém, PA, Brazil. Data from semi-structured interviews were processed by the software Interface de R pour les Analyzes Multidimensionnelles de Textes et de Questionnaires. RESULTS: Four categories emerged, in which three dimensions of the Theory composing the genesis of Social Representations are considered: the affective dimension, the biological dimension and the sociocultural dimension. CONCLUSION: Affects, negative feelings, and adaptations were revealed, with high-risk pregnancy being represented as an unusual and uncomfortable event, influenced by common sense and science, communication means, and dialogues with health professionals, with family support being considered of paramount importance. and prenatal care a propitious moment for establishing bonds with the health professional, seen as essential for their adherence to the care offered.

Access of people with pulmonary tuberculosis to government programs: Primary Care professionals' perceptions.

OBJECTIVE: to analyze Primary Health Care professionals' perceptions about the access of people with pulmonary tuberculosis to government social support and income transfer programs. METHODS: multicenter/qualitative study, carried out in Family Health Units in four Brazilian capitals: Belém/Pará, Campo Grande/Mato Grosso do Sul, Recife/Pernambuco and Rio de Janeiro/Rio de Janeiro. Fifty-eight professionals participated (social workers, dentists, nurses, pharmacists, physicians and nursing technicians), who provided assistance to people with pulmonary tuberculosis. Individual interviews were conducted, and the content analysis technique was used. RESULTS: among the participants, 45/77.6% were women and 33/56.9% were between 25 and 40 years old. Two thematic categories were organized, demonstrating the perceptions about the possibilities of access to government programs by people with pulmonary tuberculosis in vulnerable situations and the obstacles inherent to this context. FINAL CONSIDERATIONS: it is necessary to move forward in improving patient access to social programs.

Geospatialization of tuberculosis and income transfer programs among Indigenous peoples in an endemic territory.

OBJECTIVE: To analyze the spatial pattern of tuberculosis in Indigenous peoples from the State of Pará and its correlation with income transfer. METHODS: Ecological study, with 340 cases reported in Indigenous peoples in the State of Pará, Brazil, in the period 2016-2020. The study performed a descriptive analysis and calculation of incidence rates with smoothing by the local empirical Bayesian method. The Global Moran index assessed the autocorrelation of the rates with income transfer data, p<0,05. RESULTS: The Marajó and metropolitan mesoregions of Belém had the highest tuberculosis rates, and a reduced number of people benefited from income transfer (high-low correlation). The study identified high rates, and a significant number of people benefited from financial aid (high correlation high), I=0.399, p=0.027 in the Southwest. CONCLUSIONS: The spatial autocorrelation between tuberculosis and access to income transfer programs constitutes a relevant subsidy for the formulation of social protection policies and may impact the disease control actions in Indigenous territories, valuing the epidemiological heterogeneity identified in the mesoregions.

Access to government social programs and the tuberculosis control program: a multicenter study.

OBJECTIVES: to analyze government social initiatives aimed at people with tuberculosis and the possibilities of access to government social programs and income transfers through the perception of tuberculosis program managers. METHODS: descriptive, qualitative study with 19 managers from Belém, Recife, Campo Grande, and Rio de Janeiro, Brazil. Thematic content analysis was used. RESULTS: there is no specific government social support for people with tuberculosis; the benefits are intended for people in social vulnerability. There are partnerships between the institutions of the secondary social healthcare network, social assistance, and community institutions. FINAL CONSIDERATIONS: the support of official bodies is important for the control of tuberculosis; however, the profile of people's vulnerability is a determining factor for access to/destination of resources from these government social support programs.

HIV infection in pregnant women and its challenges for the prenatal care.

OBJECTIVE: To analyze the epidemiological profile of HIV infections in pregnant women. METHODS: Analytical study with a quantitative approach. RESULTS: The HIV rate in pregnant women increased from 1.5/1000 babies born alive, in 2010, to 3.3/1000 in 2017. There was a significant association between the prenatal and the variables educational level (p<0.0001), occupation (p=0.0105), gestational age (p < 0.0001), and type of delivery (p < 0.0001). The mean rate of adherence to the antiretroviral treatment in the prenatal was 68.8% (DP = ± 3.7). CONCLUSION: The high rates of HIV detection in pregnant women suggest the need to intensify the health care to women during the prenatal, guaranteeing an integral care, early diagnoses, and enhancing the strategies to improve the adherence to the antiretroviral treatment, aiming to achieve the viral suppression of the mother by the time of childbirth, thus diminishing the risk of a vertical transmission.

Suicide in indigenous and non-indigenous population: a contribution to health management.

OBJECTIVE: To analyze the sociodemographic and epidemiological profile of suicide in the indigenous and non-indigenous population and the spatiality of the event. METHOD: Epidemiological, descriptive research, carried out with data from the Mortality Information System. Suicide mortality rates were calculated for the 144 municipalities in Pará and linked to the geographic location values of the municipalities; subsequently, thematic maps were built using the QGIS 3.10.3 software. The association between variables was measured by the G test. RESULTS: 1,387 suicide records were studied, and the mortality rate among indigenous people was low in comparison to non-indigenous people, reaching 0.1/100 thousand inhabitants and 17.5/100 thousand inhabitants, respectively. CONCLUSION: Suicide is heterogeneously distributed in the territory, with greater vulnerability of the indigenous people, which demands different policies considering their cultural diversity.

Knowledge and practices of Primary Care professionals on diabetic neuropathy: study of social representations.

OBJECTIVES: to analyze the knowledge and practices of Primary Health Care professionals about diabetic neuropathy through their social representations. METHODS: a qualitative, descriptive study, anchored in the procedural aspect of the Theory of Social Representations. It was carried out in four Family Health Units in Belém-Pará, with 31 professionals from four health teams. Data were produced by individual semi-structured interviews, and the corpus was submitted to content analysis. RESULTS: two thematic categories were defined, showing the participants' understanding and imagination about neuropathy, as well as the biopsychosocial repercussions of this complication in patients' daily lives. The multidisciplinary practices developed in the context of disease treatment/prevention and the consequences of this performance were also shown. FINAL CONSIDERATIONS: professionals' representations are anchored in neuropathy occurrence due to the deficient standard of care for themselves by patients, which results in the team's surpassing care attitude as an alternative to illness' challenges.

[Abandonment of tuberculosis treatment among patients co-infected with TB/HIV]. / Abandono do tratamento de tuberculose em co-infectados TB/HIV.

This study aimed at analyzing the reasons that patients co-infected with tuberculosis and HIV leave the treatment of tuberculosis and to know the conduct of the health team toward that abandonment. The study, using a qualitative approach, performed semi-structured interviews on 45 professionals working at a referral health center in Pará state. Two units emerged based on the thematic analysis: patient-associated factors that make TB treatment adherence difficult; and service-associated factors that contribute to treatment abandonment. It was found that, in terms of the patients, that their low socioeconomic condition was the most common factor that led to abandonment. Other factors that led to this outcome included the adverse drug effects, the use of illegal drugs, and poor personal motivation. Regarding the service, issues related to the physical structure, working process organization and accessibility were also relevant to their non-adherence. Results show there is a need to change the practices performed at the health care services.

[That so-called papanicolaou: women's social representations about the screening test for cervical cancer]. / Esse tal Nicolau: representações sociais de mulheres sobre o exame preventivo do câncer cérvico-uterino.

This research aims to identify women's social representations of women regarding cervical cancer and describe the relationship of these social representations with preventive care. The study used a qualitative-exploratory approach, with the theory of social representations as the theoretical-conceptual support. Data collection was performed using two techniques: the free association of words and the semi-directed interview with open questions. The thematic analysis technique was used for data interpretation. The research resulted in two thematic units: cervical cancer: an early treatable wound and the screening test: taking because of fearing. It was observed that women have great fear of having cervical cancer and, therefore, recognize the importance of the screening test and see it as an act of self-care towards their health.

[My dependent body: social representations of diabetic patients]. / Meu corpo dependente: representações sociais de pacientes diabéticos.

This study aims at identifying social representations of diabetic clients on your body after the amputation, and analyze the relationship of these representations to the care of themselves. The research was a qualitative, exploratory, with the use of the social representations theory and case study method. The scenario was a hospital in the city of Belém, Pará, 20 subjects participated. The data collection techniques were: a free association of words and watch free. After examining three categories emerged: the healthy body - term health of living well, the body work - the perfection and beauty in daily life, The body amputated - the limitation caused by amputation; and the amputated body and its relation to the care of themselves. It is clear concern to recover the lost welfare.

[Social representations of women submitted to mastectomy and the implications for self-care]. / Representações sociais de mulheres mastectomizadas e suas implicações para o autocuidado.

The purposes of this research was to identify the social representations of women on breast mastectomy and to analyze the implications of these social representations to care for self-care. This is a qualitative study using the Theory of Social Representations as theoretical reference. For data collection it was employed two techniques: the free association of ideas and observation. For data analysis the thematic analysis was used. The research resulted in two thematic units: the breast and its representations of social change in the body and social representations of women mastectomy: implications for self care. In the study, showed that women objected care of the breasts through the realization of self-examination.

Tuberculosis: evaluation of the time between identification of symptoms and beginning of treatment.

OBJECTIVE: To analyze the time elapsed between the identification of respiratory symptoms and the beginning of tuberculosis treatment, considering the sputum smear microscopy and the RMT. METHOD: Descriptive, retrospective epidemiological study, carried out in two Health Units, which were the only units that performed diagnosis by sputum smear microscopy and Rapid Molecular Test in the city. Data on respiratory symptoms with a positive result for tuberculosis were used. Analysis of data distribution and variance was performed, with a significance level of 5%. RESULTS: The longest time interval found was "result/beginning of treatment", for both tests, with a median of 3 days. It was found that the patient takes longer to receive the result when performing the Rapid Molecular Test. CONCLUSION: Patients who had the Rapid Molecular Test waited longer for results when compared to sputum smear microscopy, leading to a reflection on the need for further studies on the operation of health services.

Knowledge of primary health care professionals on health policies for the riverside population.

OBJECTIVES: to analyze the knowledge of health professionals on the health policies for the riverside population; identify how health practices with this group are developed; and discuss facilitators and barriers for the implementation of these policies. METHODS: qualitative and descriptive study with 24 professionals from the Riverside Family Health Strategy Teams in the city of Belém-Pará. Data were collected in individual interviews and analyzed by Content Analysis. RESULTS: although professionals demonstrate knowledge about public health policies, there is a need to expand and strengthen knowledge about health policies for the riverside population. The activities directed to the communities took place in the Unit itself, and some did not occur due to insufficient material and human resources. FINAL CONSIDERATIONS: the greatest barrier for the organization of health care is the lack of material and human resources, and the most prominent facilitator was the union and cohesion of the health team.

Behaviors related to Quilombola women's health: a social representations study.

OBJECTIVE: To Identify Quilombola women's social representations about health care and to characterize practices performed by them. METHOD: a descriptive, qualitative study, applying the Social Representations Theory, conducted with 30 women from a Quilombola community in the Brazilian Amazon. Individual interviews and thematic content analysis were carried out. RESULTS: Health care practices are related to the home, people, families, and environment, indicating a Quilombola women's extended understanding about health care. In the first instance, natural resources derived from traditional knowledge and use of herbs are applied, in the second instance, the official health system, with the mother-woman being the main caregiver of the family. FINAL CONSIDERATIONS: the mother enables a health care in the family daily life, and she is the main way of access health professionals have to enter the Quilombola community and provide proper care from the official health system to the group.

Tuberculosis associated with the living conditions in an endemic municipality in the North of Brazil.

OBJECTIVE: to analyze the association between the occurrence of new tuberculosis cases and the Adapted Living Condition Index, and to describe the spatial distribution in an endemic municipality. METHOD: this is an analytical and ecological study that was developed from new cases in residents of an endemic municipality in the North Region of Brazil. The data were obtained from the Notifiable Diseases Information System and from the 2010 Demographic Census. The Adapted Living Conditions Index was obtained by factor analysis and its association with the occurrence of the disease was analyzed by means of the chi-square test. The type I error was set at 0.05. Kernel estimation was used to describe the density of tuberculosis in each census sector. RESULTS: the incidence coefficient was 97.5/100,000 inhabitants. The data showed a statistically significant association between the number of cases and socioeconomic class, with the fact that belonging to the highest economic class reduces the chance of the disease occurring. The thematic maps showed that tuberculosis was distributed in a heterogeneous way with a concentration in the Southern region of the municipality. CONCLUSION: tuberculosis, associated with precarious living conditions, reinforces the importance of discussion on social determinants in the health-disease process to subsidize equitable health actions in risk areas, upon a context of vulnerability.