Demandas e utilização de serviços de saúde entre imigrantes de uma região metropolitana do nordeste do Brasil / Demandas y uso de servicios de salud entre inmigrantes de uma región metropolitana del noreste de Brasil / Demands and use of health services among immigrants from a metropolitan region in northeastern Brazil

Resumo Objetivo analisar as demandas e a utilização dos serviços de saúde por imigrantes na Região Metropolitana de Aracaju, Sergipe. Método recrutaram-se, pelo método bola de neve, 186 imigrantes, alocados em clusters relacionados à renda per capita do país de origem e países da América Latina ou não. Utilizou-se questionário auto aplicado sobre as condições e práticas de saúde. Resultados imigrantes de países com renda baixa e média baixa (IMB) são mais jovens, com menor tempo de permanência no Brasil, possuem ensino fundamental/médio, exercem atividade laboral sem carteira de trabalho assinada e renda de até um salário mínimo (p<0,05). Imigrantes da América Latina (IAL) possuem aproximadamente duas vezes mais chances de ter alguma doença crônica não transmissível (DCNT), comparados aos imigrantes de outros países (IOP). A idade e o tempo de permanência no Brasil influenciam na autoavaliação da saúde, na busca por serviços de saúde e ter alguma DCNT (p<0,05). O Sistema Único de Saúde foi o mais buscado tanto na chegada ao Brasil quanto nos últimos 12 meses, principalmente pelos IMB e IAL (p<0,05). Conclusão e implicações para a prática observaram-se diferenças dentro dos subgrupos de imigrantes, principalmente em termos de padrões de utilização, ressaltando a importância da competência transcultural na assistência.

Resumen Objetivo fueron analizadas las demandas y el uso de los servicios de salud por los inmigrantes en la Región Metropolitana de Aracaju, Sergipe. Método fueron reclutados, mediante el método bola de nieve, 186 inmigrantes y se dividieron en agrupación es según la renta per cápita del país de origen y continente. Se utilizó un cuestionario auto aplicado sobre condiciones y prácticas de salud. Resultados los inmigrantes de países de renta baja y media baja (IMB) son más jóvenes, han pasado menos tiempo en Brasil, tien en educación primaria/secundaria, trabajan sin contrato formal y tienen una renta de hasta 1 mínimo salario (p<0,05). Los inmigrantes de Latinoamérica (LAI) tienen aproximadamente el doble de probabilidades de tener una enfermedad crónica no transmisible (ENT) em comparación con inmigrantes de otros países (IOP). La edad y el tiempo de permanencia en Brasil influyen en la autoevaluación de la salud, la búsqueda de servicios de salud y el tener algunas ENT (p<0,05). El Sistema Único de Salud (Sistema Único de Saúde) fue el más buscado tanto a su llegada a Brasil como en los últimos 12 meses, principalmente por el IMB y la IAL (p<0,05). Conclusión e implicaciones para la práctica se observaron diferencias dentro de los subgrupos de inmigrantes, principalmente en términos de sus patrones de uso, resaltando la importancia de la competencia intercultural em la asistencia.

Abstract Objective This study aimed to analyze the demands and use of health services by international migratory clusters in the metropolitan region of Aracaju, Sergipe. Method A total of 186 immigrants were recruited, and divided into clusters according to the country of origin and continent. An epidemiological questionnaire on health conditions and care-related. Results Low and low middle income country immigrants (LMI) are younger, with lower length of stay in Brazil, elementary education, working without a formal contract, with an income of up to 1 minimum wage (p<0.05). Latin America immigrants (LAI) are approximately twice as likely to have some Chronic noncommunicable disease (NCDs), compared to other country immigrants (OCI). Age and length of stay in Brazil influence self-rated health, search for health services and having some NCDs (p<0.05). The Unified Health System (Sistema Único de Saúde) was the most sought after both on arrival in Brazil and in the last 12 months, mainly by LMI and LAI (p<0.05). Conclusion and implications for practice Differences were observed within immigrant subgroups, mainly in terms of their use patterns and the importance for cross-cultural competence in health care.

Socioenvironmental factors associated with Schistosoma mansoni infection and intermediate hosts in an urban area of northeastern Brazil.

Schistosomiasis, which is caused by trematodes of the genus Schistosoma and by the species Schistosoma mansoni in Brazil, is transmitted primarily by Biomphalaria glabrata mollusks. Infections occur in humans and mollusks in freshwater environments contaminated with feces from infected humans. This study aimed to evaluate potential foci of schistosomiasis based on the identification of infection sites for the snails, factors that increased the human infection probability of S. mansoni infection, and the relationship of the disease with abiotic, biotic, and sociocultural factors. The study was conducted in an urban area on the northeast coast of Brazil; this location was chosen based on the following factors: the presence of B. glabrata, nearby freshwater, and the absence of sewer treatment. A parasitological analysis was performed to evaluate infections of the mollusks and residents inside the perimeter defined by the collection points. Questionnaires were applied to obtain demographic data and to identify behaviors that led to human infection. To verify the contamination of freshwater by human feces, a microbiological analysis of the water was performed at the mollusk collection points to determine the rate of contamination with fecal coliforms. A total of 10,270 B. glabrata mollusks were collected between August 2013 and August 2014, of which 8.8% were positive for S. mansoni; the prevalence ranged from 0 to 34.5% over the study period. A total of 232 coprological samples from the residents were analyzed. The S. mansoni infection prevalence rate was 16.4%, and the S. mansoni parasitic load in the infected residents was 54.9 eggs per gram of feces on average. Males were more affected by the parasite, especially in the 8-17-year-old age range. Thermotolerant coliforms were observed at the mollusk collection sites, which indicated that freshwater and sewage were in continuous contact. This contamination indicated poor sanitary conditions, as was previously observed, which could be combined with detrimental behavior due to the residents' habits. These conditions cause a predisposition for both intermediate and definitive infections of the hosts by creating a socioenvironmental scenario that is conducive to the formation and maintenance of potential schistosomiasis foci. This and similar areas deserve special attention from the government with an aim of improving sanitation services and local resident knowledge to prevent future contamination.

Determinantes sociocomportamentais e vulnerabilidade de crianças da educação infantil à pediculose / Socio-behavioral determinants and the vulnerability of children during early childhood education to pediculosis / Determinantes sociocomportamentales y vulnerabilidad de niños de la educación inicial a la pediculosis

O espaço escolar é associado à alta infestação pelo piolho de cabeça. Este trabalho objetivou caracterizar os determinantes sociocomportamentais e a vulnerabilidade de pré-escolares à infestação por Pediculus humanus capitis no município de Aracaju, estado de Sergipe. A pesquisa de campo exploratória foi realizada de junho a agosto de 2014, na microrregião do bairro Augusto Franco, no domínio familiar (unidades domésticas) e escolar (Escola Municipal de Ensino Infantil). A análise dos dados utilizou a estatística descritiva, teste Qui-quadrado de Pearson e Odds Ratio. Aproximadamente de 64% (30/47) dos entrevistados recebem até 1 salário mínimo e possuem residência própria, a quantidade de filhos foi entre 2 e 3 crianças. 30% tiveram piolho, destas, 40% realizaram tratamento medicamentoso e 13,3% catação manual. Questões como a pediculose devem ser consideradas no contexto da situação, com metodologia participativa e dialógica no contexto familiar e escolar (AU).

Schools have a high rate of head lice infestations. The aim of this study was to characterize the socio-behavioral determinants and the vulnerability of early childhood education students to infestations by Pediculus humanus capitis in the city of Aracaju, Sergipe state. The exploratory field study was conducted from June to August 2014, in the micro region of the Augusto Fanco neighborhood, in the family domain (households) and school (Municipal Early Childhood Education Center). Data analysis used descriptive statistics, Pearson's Chi-square test and Odds Ratio. Approximately 64% (30/47) of respondents receive up to 1 minimum wage and have their own residence, the number of children was between 2 and 3 per interviewee. 30% had lice, of these, 40% were treated with medication and 13.3% used manual removal. Issues such as lice infestation should be considered in the context of the situation with dialogue and a participatory methodology in the family and school context (AU).

El espacio escolar está asociado a alta infestación por el piojo de cabeza. Este trabajo tuvo la finalidad de caracterizar los determinantes ociocomportamentales y la vulnerabilidad de preescolares a la infestación por Pediculus humanus capitis en el municipio de Aracaju, estado de Sergipe. La investigación de campo exploratoria fue realizada de junio a agosto de 2014, en la microrregión del barrio Augusto Franco, en el dominio familiar (unidades domésticas) escolar (Escuela Municipal de Enseñanza Inicial). El análisis de los datos utilizó la estadística descriptiva, test Chi- cuadrado de Pearson y OddsRatio. Aproximadamente 64% (30/47) de los entrevistados ganan hasta 1 salario mínimo y poseen vivienda propia; la cuantidad de hijos está entre 2 y 3 niños. Aproximadamente 30% tuvieron piojo, de estas, 40% realizaron tratamiento medicamentoso y 13,3% quitaron manualmente. Cuestiones como la pediculosis deben ser consideradas en el contexto de la situación, con metodología participativa y dialógica en el contexto familiar y escolar (AU).