ABSTRACT
Hand-foot-and-mouth disease (HFMD) is a highly contagious viral disease commonly associated to Enteroviruses (EV). During 2018, Brazil faced massive HFMD outbreaks spread across the country. This study aimed to characterize the EV responsible for the HFMD outbreak that occurred in Paraiba State, Brazilian Northeastern region, in 2018, followed by a phylogenetic analysis to detail information on its genetic diversity. A total of 49 serum samples (one from each patient) collected from children ≤ 15 years old, clinically diagnosed with HFMD were tested for EV using conventional RT-PCR and RT-qPCR. EV infection was confirmed in 71.4% (35/49) of samples. The mean and median ages were 1.83 years and one year old, respectively. Twenty-two EV-positive samples were successfully sequenced and classified as EV-A species; 13 samples were also identified with the CV-A6 genotype. The phylogenetic analysis (VP1 region) of three samples revealed that the detected CV-A6 strains belonged to sub-lineage D3. The CV-A6 strains detected here clustered with strains from South America, Europe and West Asia strains that were also involved in HFMD cases during the 2017-2018 seasons, in addition to the previously detected Brazilian CV-A6 strains from 2012 to 2017, suggesting a global co-circulation of a set of different CV-A6 strains introduced in the country at different times. The growing circulation of the emerging CV-A6 associated with HFMD, together with the detection of more severe cases worldwide, suggests the need for a more intense surveillance system of HFMD in Brazil. In addition, this investigation was performed exclusively on serum samples, and the analysis of whole blood samples should be considered and could have shown advantages when employed in the diagnosis of enteroviral HFMD outbreaks.
Subject(s)
Foot-and-Mouth Disease , Hand, Foot and Mouth Disease , Adolescent , Animals , Brazil/epidemiology , Child , China/epidemiology , Disease Outbreaks , Foot-and-Mouth Disease/epidemiology , Genotype , Hand, Foot and Mouth Disease/diagnosis , Hand, Foot and Mouth Disease/epidemiology , Humans , Infant , PhylogenyABSTRACT
ABSTRACT Hand-foot-and-mouth disease (HFMD) is a highly contagious viral disease commonly associated to Enteroviruses (EV). During 2018, Brazil faced massive HFMD outbreaks spread across the country. This study aimed to characterize the EV responsible for the HFMD outbreak that occurred in Paraiba State, Brazilian Northeastern region, in 2018, followed by a phylogenetic analysis to detail information on its genetic diversity. A total of 49 serum samples (one from each patient) collected from children ≤ 15 years old, clinically diagnosed with HFMD were tested for EV using conventional RT-PCR and RT-qPCR. EV infection was confirmed in 71.4% (35/49) of samples. The mean and median ages were 1.83 years and one year old, respectively. Twenty-two EV-positive samples were successfully sequenced and classified as EV-A species; 13 samples were also identified with the CV-A6 genotype. The phylogenetic analysis (VP1 region) of three samples revealed that the detected CV-A6 strains belonged to sub-lineage D3. The CV-A6 strains detected here clustered with strains from South America, Europe and West Asia strains that were also involved in HFMD cases during the 2017-2018 seasons, in addition to the previously detected Brazilian CV-A6 strains from 2012 to 2017, suggesting a global co-circulation of a set of different CV-A6 strains introduced in the country at different times. The growing circulation of the emerging CV-A6 associated with HFMD, together with the detection of more severe cases worldwide, suggests the need for a more intense surveillance system of HFMD in Brazil. In addition, this investigation was performed exclusively on serum samples, and the analysis of whole blood samples should be considered and could have shown advantages when employed in the diagnosis of enteroviral HFMD outbreaks.
ABSTRACT
A Terapia Comunitária insere-se no contexto de um projeto político de transformação dos serviços e das práticas dos profissionais de saúde. Considerada como ação de saúde mental na Atenção Básica, proporciona alívio ao sofrimento emocional através da partilha de experiências de vida, contribui para a (re)significação das histórias de vida e promove mudanças em seus participantes. Através desse estudo, objetivou-se compreender as mudanças ocorridas na dimensão pessoal e profissional dos trabalhadores da Estratégia Saúde da Família com a vivência nas rodas de Terapia Comunitária. Trata-se de um estudo qualitativo que recorreu ao referencial metodológico da História Oral Temática. A pesquisa foi realizada no Distrito Sanitário II, no Município de João Pessoa-PB, com oito profissionais de saúde da Estratégia Saúde da Família (ESF) que participaram das rodas de Terapia Comunitária. Neste estudo, a rede foi composta por oito profissionais da Estratégia Saúde da Família que participaram, no mínimo, de quatro rodas de Terapia Comunitária. O material empírico foi produzido por meio de entrevista semi-estruturada e analisado a partir do tom vital da narrativa dos colaboradores realizando interface com a literatura pertinente. A análise permitiu a construção de dois eixos temáticos: Terapia Comunitária como espaço revelador de aprendizados; As rodas de Terapia Comunitária e a (re)significação das práticas profissionais. O material analisado permitiu identificar mudanças ocorridas com os profissionais da ESF em seu processo de trabalho a partir dos aprendizados proporcionados pelas vivências nas rodas. Pode-se considerar a Terapia Comunitária uma estratégia potente enquanto tecnologia de cuidado inserida na Atenção Básica na perspectiva da construção de redes de bases comunitárias para resolução de conflitos, quer para os usuários da ESF, quer para os profissionais.
The Community Therapy inserts in a political project context of services transformations and the health professionals practices. Considered a mental health action in the Basic Attention, the Community Therapy provides relief to emotional suffering through the share of life experiences, it contributes to the (re)meaning of life histories and promotes changes in its participants. Through this study, it was aimed to understand the changes happened in the personal and professional dimension in workers from Health Family Strategy with the involvement in the Community Therapy meetings. It is a qualitative study that resort to the methodological referential of Thematic Oral History. The research was accomplished at Sanitary District II, in the Municipal district of João Pessoa-PB, with eight health professionals from Health Family Strategies (ESF) that took part of Community Therapy meetings. In this study, the net was composed by eight Health Family Strategies professionals that took part, at least, of four Community Therapy meetings. The empiric material was produced through interview guided by questions and analyzed starting from the vital tone of collaborators' narrative accomplishing interface with the pertinent literature. The analysis allowed the construction of two thematic axes: Community therapy as developing space of learning, and, The Community Therapy meetings and the (re)meaning of professional practices. The analyzed material allowed to identify changes happened with the ESF professionals in their work process starting from the proportionate learning for the existences in the meetings. It can be considered the Community Therapy a potent strategy while care technology inserted in the Basic Attention in the construction perspective of community bases nets to solve ESF users or professionals conflicts.
