Territory, neglected diseases and the action of community and endemic combat agents.

OBJECTIVE: To characterize knowledge, practices, and professional experience of community health agents (ACS) and endemic combat agents (ACE) on leprosy and Chagas disease (DC), during participation in an integrated training workshop in the IntegraDTNs-Bahia project. METHODS: Descriptive and exploratory case study, involving health agents and endemic combat agents participating in a training workshop on the shared role of these professionals in health care and surveillance processes. The project was developed in the municipalities of Anagé, Tremedal and Vitória da Conquista, in the southwestern State of Bahia, 2019-2020. A specific instrument was applied, with questions related to knowledge and practices of surveillance and care for leprosy and Chagas disease. Descriptive analysis of the data, in addition to consolidation of the lexical analysis, was performed. RESULTS: Out of a total of 135 participants (107 ACS and 28 ACE), 80.7% of them have been working for at least 12 years, without previous participation in joint training processes. Only 17.9% of endemic combat agentes reported having participated in training on leprosy and none reported developing specific actions to control the disease. For Chagas disease, 36.4% of community health agents participated in training more than a decade before, while for 60.7% of endemic combat agents the last training was carried out in the last five years. The development of educational actions for Chagas disease was more frequent for endemic combat agents (64.3%). When asked about ways of recognizing diseases, the term "skin spots" was the most reported (38 times) for leprosy and, for Chagas disease, the term "I don't know" (17 times). CONCLUSION: Processes of health agents and endemic combat agents action in realities endemic for leprosy and Chagas disease in the interior of Bahia proved to be fragmented in the territories. For these diseases, the distance between surveillance and health care actions is reinforced, including in training processes. The importance of innovative permanent and integrated education actions is reiterated to actually promote changes in practices.

Territory, neglected diseases and the action of community and endemic combat agents / Território, doenças negligenciadas e ação de agentes comunitários e de combate a endemias

ABSTRACT OBJECTIVE To characterize knowledge, practices, and professional experience of community health agents (ACS) and endemic combat agents (ACE) on leprosy and Chagas disease (DC), during participation in an integrated training workshop in the IntegraDTNs-Bahia project. METHODS Descriptive and exploratory case study, involving health agents and endemic combat agents participating in a training workshop on the shared role of these professionals in health care and surveillance processes. The project was developed in the municipalities of Anagé, Tremedal and Vitória da Conquista, in the southwestern State of Bahia, 2019-2020. A specific instrument was applied, with questions related to knowledge and practices of surveillance and care for leprosy and Chagas disease. Descriptive analysis of the data, in addition to consolidation of the lexical analysis, was performed. RESULTS Out of a total of 135 participants (107 ACS and 28 ACE), 80.7% of them have been working for at least 12 years, without previous participation in joint training processes. Only 17.9% of endemic combat agentes reported having participated in training on leprosy and none reported developing specific actions to control the disease. For Chagas disease, 36.4% of community health agents participated in training more than a decade before, while for 60.7% of endemic combat agents the last training was carried out in the last five years. The development of educational actions for Chagas disease was more frequent for endemic combat agents (64.3%). When asked about ways of recognizing diseases, the term "skin spots" was the most reported (38 times) for leprosy and, for Chagas disease, the term "I don't know" (17 times). CONCLUSION Processes of health agents and endemic combat agents action in realities endemic for leprosy and Chagas disease in the interior of Bahia proved to be fragmented in the territories. For these diseases, the distance between surveillance and health care actions is reinforced, including in training processes. The importance of innovative permanent and integrated education actions is reiterated to actually promote changes in practices.

RESUMO OBJETIVO Caracterizar conhecimentos, práticas e experiência profissional de agentes comunitários de saúde (ACS) e agentes de controle de endemias (ACE) sobre hanseníase e doença de Chagas (DC), durante participação em oficina de formação integrada no projeto IntegraDTNs-Bahia. MÉTODOS Estudo de caso descritivo e exploratório, envolvendo comunitários de saúde e agentes de controle de endemias, participantes de oficina de formação sobre o papel compartilhado desses profissionais no processo de vigilância e atenção à saúde. Projeto desenvolvido nos municípios de Anagé, Tremedal e Vitória da Conquista, no Sudoeste do Estado da Bahia, 2019-2020. Aplicou-se instrumento específico prévio com questões relativas a conhecimentos e práticas de vigilância e atenção para hanseníase e doença de Chagas. Análise descritiva dos dados, além de consolidação da análise léxica. RESULTADOS Do total de 135 participantes (107 ACS e 28 ACE), 80,7% deles atuam há pelo menos 12 anos, sem participação prévia em processos de formação conjunta. Apenas 17,9% dos agentes de controle de endemias relataram ter participado de capacitações sobre hanseníase e nenhum informou desenvolver ações específicas de controle da doença. Para a doença de Chagas, 36,4% dos agentes comunitários de saúde participaram de capacitações há mais de uma década, enquanto para 60,7% dos agentes de controle de endemias a última capacitação foi realizada nos últimos cinco anos. O desenvolvimento de ações educativas para a doença de Chagas foi mais frequente para agentes de controle de endemias (64,3%). Quando perguntados sobre formas de reconhecimento das doenças, a palavra "manchas na pele" foi a mais relatada (38 vezes) para hanseníase e, para a doença de Chagas, a palavra "não sei" (17 vezes). CONCLUSÃO Os processos de atuação de agentes comunitários de saúde e agentes de controle de endemias em realidades endêmicas para hanseníase e doença de Chagas no interior da Bahia revelaram-se desintegrados nos territórios. Para essas doenças, reforça-se o distanciamento entre ações de vigilância e de atenção à saúde, inclusive nos processos de capacitação. Reitera-se a importância de ações inovadoras de educação permanentes e integradas para promover de fato mudanças nas práticas.

IV Seminario "Salud y cooperación al desarrollo": La cooperación para el desarrollo en la prevención de las enfermedades infecciosas de naturaleza emergente y reemergentes / No disponible

No disponible

Centralización y gestión del control de las enfermedades transmisibes en América Latina / Decentralization and management of communicable disease control in Latin America

El libro recupera y sistematiza los debates planteados en la reunión, con el propósito adicional de promover la formación de una masa crítica que investigue la descentralización y los PCET. Para ello se ha organizado el material de la siguiente manera. Primero una introducción en la que se presenta en forma sintética la situación actual en lo que atañe a la gestión de los PCET, haciendo hincapié en el contraste entre programas verticales y abordajes horizontales.

Reaching maturity - 25 years of the TDR.

In its first 25 years of existence, TDR has become a key player in the development of new tools for the control of tropical diseases and the training of researchers from disease-endemic countries. In order to maintain its leading position, cope with new health challenges and profit from new avenues opened by science and technology breakthroughs, a new strategic vision is now being implemented. It aims at a closer interaction with health systems and disease control programmes, capacity strengthening based on selected research initiatives and full exploitation of scientific and technological advances in the biomedical, social and information sciences, as discussed here by Carlos Morel.

[Community participation and control of endemic diseases in Brazil: problems and possibilities]. / Problemas e possibilidades de participação comunitária no controle das grandes endemias no Brasil.

Community participation (CP) is considered one of the most important elements for the control of endemic diseases in poor countries, particularly for prevention and epidemiological surveillance. Mainly affecting the poorest segments of the population, endemic diseases are costly and require specific government action aimed at efficient, egalitarian, universal health system, where CP acts in a guardian, monitoring capacity and entails other specific tasks. Despite its rationality, CP has not been encouraged in countries like Brazil, due to the highly centralized nature of political power and activity. Several examples and situations of CP in Brazilian endemic diseases are described and discussed in the article. CP for endemic disease control should be seen as an ongoing social process, a profound social exercise, and a great challenge for the country as a whole and the new Unified Health System now being implemented in Brazil.

The flagellar fraction of Trypanosoma cruzi depleted of an immunosuppressive antigen enhances protection to infection and elicits spontaneous T cell responses.

The flagellar fraction (FF) of Trypanosoma cruzi can be separated by immunoaffinity chromatography in two fractions with balanced but opposite immunological effects. The immunoaffinity purified fraction has immunosuppressive activity mediated at least partially by TGF-beta (Hansen et al., submitted). Here we report that the fraction depleted of immunosuppresive antigens (FT) administered with iscom-matrix as adjuvant provides enhanced protection to an infection challenge in immunized mice. In vitro, the FT but not the FF stimulated resident peritoneal cells to produce IL-1 and IL-6. In immunized mice, the FT elicited higher levels of antigen-specific IgG2a than the FF as well as broader recognition of T. cruzi antigens. Splenocytes from mice immunized with FT proliferated spontaneously in vitro and secreted TH1 and TH2 cytokines. The protection provided by FT correlates with its capacity to enhance the secretion of IFN-gamma. We postulate that immunosuppressive antigens present in the FF prevent the development of memory cells secreting IFN-gamma through a TGF-beta dependent mechanism.

Preventive health care and screening of Latin American immigrants in the United States.

BACKGROUND: The Central and South American immigrant population in the United States is large and growing. A review of the preventive health care needs of this population has not previously been done but would be helpful to clinicians caring for immigrants in this country. METHODS: Using MEDLINE, the literature related to immigrants and their health status was searched, using the key words "immigrant," "refugee," "South/Central/Latin America," "health status," "screening," "nutrition," "parasites," "stomach/gastric cancer," "children," and "psychological." The American Statistics Index and Index to International Statistics were also resources. The available literature was reviewed and led to the recommendations in this article. RESULTS: Screening strategies for Latin American immigrants are discussed for intestinal parasites, tuberculosis, hepatitis B, schistosomiasis, leprosy, American trypanosomiasis (Chagas disease), malaria, human immunodeficiency virus (HIV) infection, cervical and gastric cancer, sickle cell trait, malnutrition, iron-deficiency anemia, incomplete immunizations, dental problems, psychological problems, impairment in the elderly, alcohol use, smoking, physical inactivity, and hypertension. There are not enough data to evaluate fully the screening strategies for most of these conditions, but recommendations are offered based on current knowledge. CONCLUSIONS: Screening is recommended for intestinal parasites and schistosomiasis, tuberculosis, hepatitis B in prenatal patients, leprosy in immigrants from high-risk areas, yearly Papanicolaou smears, malnutrition, iron-deficiency anemia, incomplete immunizations, dental problems, history of violence, and depression. Screening for sickle cell trait in prenatal patients from South America and universal hepatitis B screening are less clearly indicated but could be appropriate. Screening for American trypanosomiasis (Chagas disease), malaria, and gastric cancer is not recommended. Screening for HIV infection, functional impairment in the elderly, alcohol use, cigarette smoking, physical inactivity, and hypertension should be the same as for the general population.

Anais do 1§ Congresso Brasileiro de Epidemiologia. Epidemiologia e desigualdade social: os desafios do final do século / Annals of the 1st Brazilian Congress of Epidemiology. Epidemiology and social inequality: the challanges by the end of century

A descentralizaçäo possibilitada pela implantaçäo do SUS aos estados e municípios permitiu a reuniäo de poder, recursos e conhecimentos técnicos. Esta açäo viabilizou a definiçäo de prioridades com a finalidade de atender às demandas näo identificadas pelos indivíduos através de programas de controle de doenças. Uma avaliaçäo dos programas de controle da doença de Chagas, febre amarela, dengue, hanseníase e poliomielite é apresentada (AMSB)

Programación de actividades de saneamiento ambiental: año 1980

Informe de las actividades a desarrollar y llevadas a cabo en higiene y seguridad laboral, saneamiento ambiental. Estadísticas