Epidemiologia descritiva da raiva dos herbívoros notificados no estado do Paraná entre 1977 e 2012 / Epidemiology of rabies in large animals of Parana, Brazil, from 1977 to 2012

A descriptive epidemiological survey of rabies in herbivorous reared in the state of Parana, Brazil, was carried out from 1977 to 2012. The positive cases and the total number of brain samples processed for diagnostic purposes were distributed according to species, year, month, geographical region and municipality. Chi-square test was used to verify if rabies was associated to these factors. Probabilistic model was applied to historical series in order to verify cyclic and seasonal patterns. In Parana, rabies is an endemic disease with variable yearly occurrence, without seasonal pattern and with a possible cyclic pattern every 18 years. Cattle (86.9%) and equides (11.3%) were mainly affected. Rabies was registered in 47.6% of all municipalities, indicating a great spread of this disease in Parana, mainly during the last decade. Middlewest and Curitiba regions, followed by Pioneer North and West regions, were the areas of most occurrence. The number of cases per municipality was weakly correlated with the number of shelters for Desmodus rotundus (r=0.469; p < 0.0001). Therefore, we suggest that annual immunization of cattle and equides should be applied in the high occurrence areas (Middlewest and Curitiba regions) and encouraged in intermediate occurrence areas (Pioneer North and West regions).(AU)

Realizou-se estudo epidemiológico descritivo da raiva dos herbívoros no estado do Paraná entre os anos de 1977 e 2012. Os casos confirmados de raiva e o total de amostras de encéfalo encaminhadas para o diagnóstico foram distribuídos por espécie, por ano, por meses, por mesorregião geográfica e por municípios, aplicando-se o teste de Qui-quadrado para verificar se havia associação com esses fatores. Modelo probabilístico foi ajustado à série histórica para verificação de padrões cíclico ou sazonal. Comprovou-se que a raiva é uma doença endêmica no PR, com ocorrência variável entre os anos, sem padrão sazonal e com ciclicidade aparente a cada 18 anos, acometendo, sobretudo, bovinos (86,9%) e equídeos (11,3%). Verificou-se grande difusão no estado (47,6% dos municípios), e a maior expansão geográfica aconteceu na última década. As áreas de ocorrência maior foram as mesorregiões Centro Oriental e de Curitiba, seguidas por Norte Pioneiro e Oeste. O número de casos de raiva por município se correlacionou, ainda que fracamente, com o número de abrigos de Desmodus rotundus (r=0,469; p < 0,0001). Sugere-se que a imunização anual de bovinos e equídeos passe a ser adotada nas áreas de maior ocorrência (mesorregiões Centro Oriental e de Curitiba) e encorajada nas de ocorrência intermediária (mesorregiões Norte Pioneiro e Oeste).(AU)

Epidemiologia descritiva da raiva dos herbívoros notificados no estado do Paraná entre 1977 e 2012 / Epidemiology of rabies in large animals of Parana, Brazil, from 1977 to 2012

Realizou-se estudo epidemiológico descritivo da raiva dos herbívoros no estado do Paraná entre os anos de 1977 e 2012. Os casos confirmados de raiva e o total de amostras de encéfalo encaminhadas para o diagnóstico foram distribuídos por espécie, por ano, por meses, por mesorregião geográfica e por municípios, aplicando-se o teste de Qui-quadrado para verificar se havia associação com esses fatores. Modelo probabilístico foi ajustado à série histórica para verificação de padrões cíclico ou sazonal. Comprovou-se que a raiva é uma doença endêmica no PR, com ocorrência variável entre os anos, sem padrão sazonal e com ciclicidade aparente a cada 18 anos, acometendo, sobretudo, bovinos (86,9%) e equídeos (11,3%). Verificou-se grande difusão no estado (47,6% dos municípios), e a maior expansão geográfica aconteceu na última década. As áreas de ocorrência maior foram as mesorregiões Centro Oriental e de Curitiba, seguidas por Norte Pioneiro e Oeste. O número de casos de raiva por município se correlacionou, ainda que fracamente, com o número de abrigos de Desmodus rotundus (r=0,469; p<0,0001). Sugere-se que a imunização anual de bovinos e equídeos passe a ser adotada nas áreas de maior ocorrência (mesorregiões Centro Oriental e de Curitiba) e encorajada nas de ocorrência intermediária (mesorregiões Norte Pioneiro e Oeste).(AU)

A descriptive epidemiological survey of rabies in herbivorous reared in the state of Parana, Brazil, was carried out from 1977 to 2012. The positive cases and the total number of brain samples processed for diagnostic purposes were distributed according to species, year, month, geographical region and municipality. Chi-square test was used to verify if rabies was associated to these factors. Probabilistic model was applied to historical series in order to verify cyclic and seasonal patterns. In Parana, rabies is an endemic disease with variable yearly occurrence, without seasonal pattern and with a possible cyclic pattern every 18 years. Cattle (86.9%) and equides (11.3%) were mainly affected. Rabies was registered in 47.6% of all municipalities, indicating a great spread of this disease in Parana, mainly during the last decade. Middlewest and Curitiba regions, followed by Pioneer North and West regions, were the areas of most occurrence. The number of cases per municipality was weakly correlated with the number of shelters for Desmodus rotundus (r=0.469; p<0.0001). Therefore, we suggest that annual immunization of cattle and equides should be applied in the high occurrence areas (Middlewest and Curitiba regions) and encouraged in intermediate occurrence areas (Pioneer North and West regions).(AU)

Dental Environment Stress: Findings among Lusophone Dental Students

Objective: To perform cross-cultural adaptation of the Dental Environment Stress (DES), to test its construct validity and reliability, and to identify the sources of stress among Brazilian dental students. Material and Methods: The DES was transculturally adapted to Portuguese using translation/back-translation, review by an expert bilingual committee and consensus building. The first version was tested in a sample of 42 dental students to check the understanding level of the alternatives. The final version was applied to all the students enrolled in a Brazilian Public Dental School. Construct validity was assessed through factor analysis, performed by principal components analysis and Varimax rotation and reliability by internal Cronbach's alpha coefficient (95% CI). Wilcoxon rank sum was conducted to test for gender and Kruskall-Wallis for year comparison. Multivariate analysis relied on ordinal logistic regression modeling. Results: Factor analysis revealed five factors that possessed eigenvalues greater than 1.5 and together explained 46.88% of the total variance. Internal consistency of each factor was adequate, with Cronbach's alpha ranging from 0.65 to 0.84. 'Examinations and grades' (82.80%) was the highest scored item. Females presented higher rates, as well as second's and fifth's years students. The entering students were generally concerned with factors related to "Academic Performance", whereas clinical year students with "Insecurity Concerning their Professional Future". Conclusion: The Portuguese version of the DES presented good results, thus it could be a valid instrument to assess the factors of perceived stress in Lusophone countries, subsidizing the development of strategies to minimize the stress and optimize school performance.

Influence of different water types on the physical and mechanical properties of gypsum

Abstract Aim: To evaluate if gypsum mixed with different water types, with their different compositions influence the dimensional change, surface roughness and compressive strength of type IV and V gypsum specimens. Methods: Sixty specimens were fabricated from metal matrices and divided into six groups (n=10) according to the used type of gypsum and water: G1, G2 and G3 - type IV gypsum and tap, mineral and distilled water, respectively; G4, G5 and G6 - type V gypsum and tap, mineral and distilled water, respectively. Water/powder ratio followed the manufacturer's recommendations (19 mL/100 g) in all groups. The same specimens were used for all tests. A micrometer dial evaluated the dimensional change. The surface roughness of three random points was determined with a rugosimeter; a universal testing machine performed the compressive strength test. The data were subjected to analysis of variance (ANOVA). Results: There was no statistically significant difference (p>0.05) between the three types of water in the studied variables. There was statistically significant difference (p<0.05) between the gypsum mixes for the dimensional change variable. Conclusions: The different water types, with their different compositions, did not influence the analyzed physical and mechanical properties.

Induction of ankylosis in the incisor for orthodontic tooth movement in rats.

BACKGROUND/AIM: The present research evaluated the induction of ankylosis and the eruption rate in rat incisors, with the aim of achieving stable anchorage for orthodontic tooth movement (OTM) of the molars. MATERIAL AND METHODS: Fifteen male Wistar rats were used. In the Experimental group, the right superior incisor of each animal was extracted, denuded of the PDL and the dental papilla, and reimplanted. The Control group was the left superior incisors. The eruption rate was measured at 7, 10, 12, 14, and 16 days after replantation. NiTi closed springs with a 50cN release force were installed for additional 9 days, and the eruption rate was determined. Then, the rats were sacrificed, and ankylosis was examined by microscopic analysis. Differences with P < 0.01 were defined as statistically significant. RESULTS: The eruption rates were 0 and 0.39 mm day(-1) in the Experimental group and Control group, respectively. All incisors of the Experimental group showed ankylosis according to histological analysis. CONCLUSIONS: The methodology used to induce ankylosis in this study was effective for anchoring the incisors during the OTM of rat molars, eliminating the undesirable effects consequent to continuous eruption.

Importance of periodontal ligament thickness

This study evaluated whether periodontal ligament (PL) thickness varied with root size and examined the possible influence of this variation on orthodontic mechanics. Measurements were taken of the maxillary left first molar in 54 male Wistar rats. Mean mesial and distal PL thicknesses were compared between the intermediate buccal and mesiobuccal roots using paired Student's t-tests with a 5% significance level. Mean values differed significantly between roots (p < 2.2 × 10-16). PL thickness in rats is directly proportional to root dimensions.

Importance of periodontal ligament thickness.

This study evaluated whether periodontal ligament (PL) thickness varied with root size and examined the possible influence of this variation on orthodontic mechanics. Measurements were taken of the maxillary left first molar in 54 male Wistar rats. Mean mesial and distal PL thicknesses were compared between the intermediate buccal and mesiobuccal roots using paired Student's t-tests with a 5% significance level. Mean values differed significantly between roots (p < 2.2 × 10(-16)). PL thickness in rats is directly proportional to root dimensions.

Longitudinal data analysis in animal experiments / Análise de dados longitudinais em experimentação animal

Longitudinal data analysis with repeated measures over time can be done in different ways: in experiments using the split plot design, with the animal as plots and time as subplots; through the analysis of multivariate models; and also by adjusting mixed models, which enables the use of different structures for the covariance matrix. The main problem involved in the analysis of repeated measures over time is related to the lack of randomization, because pairs of measurements taken along the time are correlated, which can invalidate the tests involving the time factor. To discuss the different forms of analysis, data were used from an experiment in which Santa Ines lambs were infected with 6,000 L3 Haemochus contortus and treated with condensed tannin. The source of tannin was the acacia extract obtained from Acacia mearnsii (commercially available). The data were analyzed using the software R 2.11.1 (2010). No significant effect was found (p > 0.05) of supplementation with tannin, acting on the body weight of animals. The methods used for data analysis showed similar results, which does not always occur. And considering the dependence of observations taken over time, recommended the setting of mixed models, which may involve growth curves or polynomial models that include the covariance matrix that best explains the data.

A análise de dados longitunais com medidas repetidas ao longo do tempo pode ser feita de diferentes maneiras: em experimentos usando o delineamento em parcelas subdivididas, tendo o animal como parcela e o tempo como subparcela; através da análise de modelos multivariados; e ainda através do ajuste de modelos mistos, que possibilita a utilização de diferentes estruturas para a matriz de covariâncias. O principal problema envolvido na análise de medidas repetidas ao longo do tempo está relacionado à ausência de aleatorização, pois pares de mensurações feitas no tempo estão correlacionadas, o que pode invalidar os testes envolvendo o fator tempo. Para discutir as diferentes formas de análise, foram utilizados dados provenientes de um experimento em que cordeiros Santa Inês foram infectados com 6.000 L3 de Haemochus contortus e tratados com tanino condensado. A fonte do tanino foi o extrato de acácia proveniente da Acacia mearnsii (produto comercial). Os dados foram analisados através do software livre R 2.11.1 (2010). Não foi encontrado efeito significativo (p > 0,05) da suplementação com extrato de acácia sobre o peso vivo dos animais. As metodologias utilizadas para a análise dos dados apresentaram resultados semelhantes, o que nem sempre ocorre. E, considerando a dependência das observações obtidas ao longo do tempo, recomenda-se o ajuste de modelos mistos, que podem envolv

Longitudinal data analysis in animal experiments / Análise de dados longitudinais em experimentação animal

Longitudinal data analysis with repeated measures over time can be done in different ways: in experiments using the split plot design, with the animal as plots and time as subplots; through the analysis of multivariate models; and also by adjusting mixed models, which enables the use of different structures for the covariance matrix. The main problem involved in the analysis of repeated measures over time is related to the lack of randomization, because pairs of measurements taken along the time are correlated, which can invalidate the tests involving the time factor. To discuss the different forms of analysis, data were used from an experiment in which Santa Ines lambs were infected with 6,000 L3 Haemochus contortus and treated with condensed tannin. The source of tannin was the acacia extract obtained from Acacia mearnsii (commercially available). The data were analyzed using the software R 2.11.1 (2010). No significant effect was found (p > 0.05) of supplementation with tannin, acting on the body weight of animals. The methods used for data analysis showed similar results, which does not always occur. And considering the dependence of observations taken over time, recommended the setting of mixed models, which may involve growth curves or polynomial models that include the covariance matrix that best explains the data. 

A análise de dados longitunais com medidas repetidas ao longo do tempo pode ser feita de diferentes maneiras: em experimentos usando o delineamento em parcelas subdivididas, tendo o animal como parcela e o tempo como subparcela; através da análise de modelos multivariados; e ainda através do ajuste de modelos mistos, que possibilita a utilização de diferentes estruturas para a matriz de covariâncias. O principal problema envolvido na análise de medidas repetidas ao longo do tempo está relacionado à ausência de aleatorização, pois pares de mensurações feitas no tempo estão correlacionadas, o que pode invalidar os testes envolvendo o fator tempo. Para discutir as diferentes formas de análise, foram utilizados dados provenientes de um experimento em que cordeiros Santa Inês foram infectados com 6.000 L3 de Haemochus contortus e tratados com tanino condensado. A fonte do tanino foi o extrato de acácia proveniente da Acacia mearnsii (produto comercial). Os dados foram analisados através do software livre R 2.11.1 (2010). Não foi encontrado efeito significativo (p > 0,05) da suplementação com extrato de acácia sobre o peso vivo dos animais. As metodologias utilizadas para a análise dos dados apresentaram resultados semelhantes, o que nem sempre ocorre. E, considerando a dependência das observações obtidas ao longo do tempo, recomenda-se o ajuste de modelos mistos, que podem envolv

Hormonal contraceptives and the length of their use are not independent risk factors for high-risk HPV infections or high-grade CIN.

AIMS: To evaluate the role of hormonal contraceptives as a risk factor of high-risk human papillomavirus (HR-HPV), cervical intraepithelial lesions (CIN) and cervical cancer in our multi-center population-based LAMS (Latin American Screening) study. METHODS: A cohort study with >12,000 women from Brazil and Argentina using logistic regression to analyze the covariates of hormonal contraception (HOC - oral, injections, patches, implants, vaginal ring and progesterone intrauterine system) use followed by multivariate modeling for predictors of HR-HPV and CIN2+. RESULTS: HR-HPV infection was a consistent risk factor of high-grade CIN in all three groups of women. The length of HOC use was not significantly related to high-grade squamous intraepithelial lesions (HSIL)+ Pap (p = 0.069), LSIL+ Pap (p = 0.781) or ASCUS+ (p = 0.231). The same was true with the length of HOC use and histology CIN3+ (p = 0.115) and CIN2+ (p = 0.515). Frequently, HOC users have previously shown more HPV-related lesions, as well as lower HPV prevalence if they were current smokers. But HOC use and time of usage were not independent risk factors of either HR-HPV infection or high-grade CIN using multiple logistic regressions. CONCLUSIONS: No evidence was found for an association between the use of HOC with an increased risk for HR-HPV infection or high-grade CIN in this cohort.

Smoking worsens the prognosis of mild abnormalities in cervical cytology.

OBJECTIVE: To examine the effect of smoking on the incidence of low- and high-grade cervical intraepithelial neoplasia (CIN) in women with a baseline Pap smear of atypical squamous cells (ASC) or a low-grade squamous intraepithelial lesion (LSIL). DESIGN: Prospective study in which a cohort of women with normal colposcopy and ASC/LSIL at baseline were followed at 6-month intervals of up to 36 months. Women were grouped in post-hoc analysis according to their smoking behavior: never (or past) smokers and current smokers. SETTING: This report was based on data from the Latin American Screening Study, conducted in Sao Paulo, Campinas, Porto Alegre (Brazil) and Buenos Aires (Argentina). POPULATION: A subset of 150 women derived from a cohort of 1,011 women. METHODS: Multivariate Cox analysis and Kaplan-Meier curves were used. MAIN OUTCOME MEASURES: Low- and high-grade CIN during follow-up. RESULTS: The only factor related to an increased risk of developing CIN was the positive high-risk (hr) HPV status (hazard ratio (HR) = 3.42; 95% CI: 1.11-9.43). A total of 21 cases of incident CIN were detected during follow-up. Of these, 11 appeared in the group of 67 smokers and 10 among the 83 non-smoker women (log-rank, p=0.33). Smoking status was not associated with the risk of developing CIN (HR = 0.73; 95% CI: 0.40-1.33). However, when restricting the analysis to high-grade CIN only (11 cases), the probability of developing the disease was significantly higher among smokers (p=0.04). CONCLUSIONS: Smoking contributes additional risk for developing high-grade CIN in women with ASC or LSIL cytology but normal colposcopy.

Increased risk of oncogenic human papillomavirus infections and incident high-grade cervical intraepithelial neoplasia among smokers: experience from the Latin American screening study.

BACKGROUND: The purpose of this study was to assess the effect of smoking on the prevalence and incidence of high-risk human papillomavirus (hr-HPV) infection and cervical intraepithelial neoplasia (CIN) in a large sample of Latin American women. METHODS: The study examines baseline data on over 12,000 women included in the Latin American Screening Study (Brazil and Argentina), and over 1000 women followed-up for a period of 36 months. Three groups were formed: never smokers, current, and past smokers. The prevalence of hr-HPV infection and CIN were compared between the study groups. In the prospective analysis, women were controlled at 6-month intervals to assess the cumulative risk of incident hr-HPV infection, smear abnormalities, and CIN. RESULTS: A higher prevalence (21.7%) of hr-HPV infection was found among current smokers as compared to never smokers (16.5%) or past smokers (13.5%). Being current smoker was significantly (P <0.01) associated with hr-HPV detection (OR = 1.6; 95% CI = 1.2-2.1). Being a current smoker was a significant predictor of incident hr-HPV during the follow-up [Hazards ratio (HR) = 1.4; 95% CI 1.0-1.9]. For incident CIN2+, being a past smoker (HR = 3.6; 95% CI 1.6-9.8) or current smoker (HR = 3.6; 95% CI 1.5-8.6) were the significant independent predictors. Current and past smokers had a significantly increased risk of incident CIN2+ (P <0.01). CONCLUSIONS: Smoking increases the risk of contracting hr-HPV infection and modifies the effect of a persistent hr-HPV infection by further increasing the risk of developing CIN2+. It seems that this effect modification persists over several years after smoking cessation.

Adaptations on jump capacity in Brazilian volleyball players prior to the under-19 World Championship.

The under-19 Brazilian volleyball national team has achieved great performances at international competitions. Because the vertical jump capacity is critical for success in volleyball, the purpose of this study was to identify the training-induced adaptations on jump capacity assessed by general and specific tests during 3 different moments (i.e., T1, T2, and T3) of a macrocycle of preparation for the world championship. The sample was composed of 11 athletes from the Brazilian national team-World Champion (age, 18.0 +/- 0.5 years; height: 198.7 +/- 5.4 cm; and body mass, 87.3 +/- 5.9 kg). They were evaluated for jumping capacity by the following tests: squat jump (SJ), countermovement jump (CMJ), and jump anaerobic resistance (15 seconds) (JAR) and standing reach, height, and vertical jump tests for attack and block. Descriptive statistics were computed, and a repeated-measures analysis of variance was used. The Tukey-Kramer post hoc test was used when appropriate. Significance was set at P < or = 0.05. The results showed that the training-induced adaptations on the SJ (3.9%) and CMJ (2.3%) were not statistically significant. The JAR showed statistical significance between T2 and T3 (9.6%), while the attack height and block height presented significant differences between T1 and T2 (2.5% and 3.3%, respectively) and T1 and T3 (3.0% and 3.5%, respectively). The volume of training was quantified between weeks 1 and 9 (10,750 minutes, 1,194 +/- 322 min x wk(-1)) and between weeks 10 and 18 (8,722 minutes, 969 +/- 329 min x wk(-1)). In conclusion, this study showed that there were progressive and significant training-induced adaptations, mainly on the tests that simulated the specific skills, such as spike and block, with the best results being reached after the first 9 weeks of training. This probably reflected not only the individual's capacity to adapt, but also the characteristics of the training loads prescribed during the entire macrocycle.

Afecções neurológicas associadas ao retardo mental em alunos de uma instituição especializada de Londrina, Estado do Paraná / Neural affections associated with mental retardation in students from Londrina, Paraná State, Brazil

Retardo mental (RM) é um estado de desenvolvimento intelectual alterado que dificulta a integração social do indivíduo. Nosso objetivo foi estudar 147 portadores de RM, alunos da APAE de Londrina, Estado do Paraná, matriculados de 1989 a 2003. Através de um estudo descritivo, avaliamos a prevalência de neuropatologias em relação ao sexo, ao tipo de parto a que o afetado foi submetido, à idade materna ao nascimento e ao histórico de RM nas famílias. As patologias encontradas foram: RM ? casos isolados, 34,8%; síndrome de Down (SD), 19,7%; paralisia cerebral (PC), 19,7%; outras síndromes, 15,6%; dislexia, 6,8%, e distúrbio comportamental, 3,4%. Dentre as variáveis que apresentaram maior diferença destacam-se: sexo, na diplegia-PC, 3 homens:1 mulher; tipo de parto, na hemiplegia-PC, 10 normais: 1 cesariana; e história familiar de RM entre os portadores de SD, 24,1%. Entre os portadores de RM filhos de mãe com idade avançada (>41 anos), a SD apresentou maior prevalência (50%).

Mental Retardation (MR) is an altered state of intellectual development that makes the social integration of individuals difficult. The objective was to study 147 MR individuals, registered students of APAE, from the city of Londrina, Paraná State, Brazil, from 1989 to 2003. Through a descriptive approach, we were able to assess the prevalence of neural pathologies in relation to gender, the kind of birth delivery the individuals have undergone, the age of their mothers at their birth, and the MR family history. The following diseases were found: MR ? isolated cases, 34.8%; Down Syndrome (DS), 19.7%; cerebral palsy (CP), 19.7%; other syndromes, 15.6%; dyslexia, 6.8%; and behavior disturbance, 3.4%. Among the variables that showed large differences were: the gender, in diplegia-CP, 3male:1female; kind of birth delivery, in hemiplegia-CP, 10normal:1cesarean; family history of MR among DS individuals, 24.1%. Among the MR individuals from elder mothers (>41 years old), DS was more frequent (50%).

Indicadores epidemiológicos aplicáveis a estudos sobre a associação entre saneamento e saúde de base municipal / Epidemiological indicators applied to studies about association between water supply and sanitation and health based on data at municipal level

É relativamente recente no país a prática da vigilância ambiental em saúde, sendo que a vigilância da qualidade da água para consumo humano, parte integrante da vigilância ambiental em saúde, ressente-se de estudos e pesquisas que forneçam suporte científico à formulação de instrumentos para a prática de tal vigilância. Nesse campo, a formulação e seleção de indicadores epidemiológicos constituem atividade essencial para representar os efeitos da insuficiência das ações de saneamento sobre a saúde humana e, portanto, como ferramenta para a vigilância e orientação de programas e planos de alocação de recursos em saneamento. O presente artigo é parte de um trabalho mais abrangente, elaborado para selecionar indicadores sanitários como sentinelas na prevenção e controle de doenças e agravos relacionados ao saneamento. Neste artigo são enfocados os indicadores epidemiológicos utilizados naquele estudo, apresentando a revisão bibliográfica, resultados da estatística descritiva desses indicadores, a discussão e conclusões sobre os indicadores epidemiológicos mais apropriados para serem utilizados emestudos dessa natureza. Destacam-se, como indicadores convenientes, a mortalidade infantil, a mortalidade até cinco anos por doenças diarréicas e a morbidade até cinco anos por doenças diarréicas com base na MDDA - monitorização de doenças diarréicas agudas.

Indicadores sanitários sentinelas da mortalidade infantil: um estudo ecológico de base municipal em quatro estados brasileiros / Sentinel sanitary indicators for infant mortality: a municipality-based ecological study in four brazilian states

É relativamente recente no país a prática da vigilância ambiental em saúde, área que se ocupa do monitoramento e controle dos fatores ambientais de risco à saúde humana. A vigilância da qualidade da água para consumo humano, parte integrante da vigilância ambiental em saúde, ressente de estudos e pesquisas que forneçam suporte científico à formulação de instrumentos para a prática de tal vigilância. Nesse campo, a formulação e seleção de indicadores epidemiológicos e sanitários constituem atividade essencial para representar os efeitos da insuficiência das ações de saneamento sobre a saúde humana e, portanto, como ferramenta para a vigilância e a orientação de programas e planos de alocação de recursos em saneamento. O presente artigo é parte de um trabalho mais abrangente, elaborado para selecionar indicadores sanitários como sentinelas na prevenção e controle de doenças e agravos relacionados ao saneamento, a partir da análise estatística entre um banco de dados, de base municipal, de indicadores sanitários sociais e epidemiológicos. Neste artigo são enfocados os indicadores sanitários que melhor relação apresentaram com a mortalidade infantil e que possam ser considerados sentinelas na detecção precoce daquele indicador. Destacam-se, dentre os indicadores sanitários avaliados, a proporção de turbidez fora do padrão e o percentual da população coberta por coleta de lixo.

Sistema de informação de vigilância da qualidade da água para consumo humano no Brasil / Information system on drinking water quality surveillance in Brazil

Este trabalho apresenta o Sistema de Informação em Vigilância da Qualidade da Água para Consumo Humano – SISAGUA - desenvolvido pelo Ministério da Saúde (Brasil, 2003), com objetivo de produzir, analisar e disseminar dados sobre a qualidade da água para consumo humano. O SISAGUA é um instrumento importante para a tomada de decisão no processo de promoção e prevenção de doenças de transmissão hídrica, sendo gerenciado pela Coordenação de Vigilância Ambiental em Saúde e aplicado pelas Secretarias Municipais e Estaduais de Saúde, em cumprimento à Portaria MS no. 518/2004, (Brasil, 2004a) que estabelece os padrões de potabilidade de água para consumo humano. Sua estruturação visa fornecer informações sobre a qualidade e a quantidade da água proveniente dos sistemas e fornecer soluções alternativas coletivas e individuais de abastecimento de água. A utilização do SISAGUA ocorre mediante cadastramento dos usuários e liberação de senha, com acesso restrito, em função dos níveis municipal, estadual e federal. A implantação do sistema foi concebida, inicialmente, como projeto piloto em cinco estados da federação, o qual foi avaliado e validado. Esse sistema, quando bem operado, permite aos gestores do setor saúde desencadear as ações de vigilância, com vistas a contribuir na redução dos índices da morbi-mortalidade das doenças de transmissão hídrica.

Indicadores de vigilância ambiental em saúde / Health environmenteal surveillance indicators

Este documento apresenta o processo de formulação de indicadores de vigilância ambiental em saúde discutidos em congressos, seminários e oficinas de trabalho, com o objetivo de definir os indicadores básicos que deverão orientar a prática da vigilância, auxiliando na formulação de diagnósticos e instrumentalizando o Sistema de Informação em Vigilância Ambiental em Saúde, nos diferentes níveis de gestão. Este artigo apresenta o modelo proposto pela Organização Mundial da Saúde - OMS para formulação de indicadores, onde é utilizada uma matriz de causa-efeito. Também é apresentado um elenco das principais características inerentes a eles

This document presents the formulation process of the health environmental surveillance indicators which were discussed in congresses, seminars and workshops, with the objective of defining the basic indicators which will orient the surveillance practice, helping in the diagnosis formulation and implementing the Health Environmental Surveillance Information System, at the different levels of management. This article presents the proposed model by the World Health Organization - WHO for the formulation of indicators, where a matrix of cause-effect is used. In addition, a list of the main characteristics which are inherent to them is presented