Demographic, social, and clinical aspects associated with access to COVID-19 health care in Pará province, Brazilian Amazon.

Internal social disparities in the Brazilian Amazon became more evident during the COVID-19 pandemic. The aim of this work was to examine the demographic, social and clinical factors associated with access to COVID-19 health care in Pará Province in the Brazilian Amazon. This was an observational, cross-sectional, analytical study using a quantitative method through an online survey conducted from May to August 2023. People were eligible to participate if they were current residents of Pará, 18-years-old or older, with self-reported diagnoses of COVID-19 through rapid or laboratory tests. Participants completed an electronic survey was developed using Research Electronic Data Capture (REDCap) software-The adapted questionnaire "COVID-19 Global Clinical Platform: Case Report Form for Post-COVID Condition". Questions focused on access to COVID-19 treatment, demographic characteristics, COVID-19 vaccine and clinical characteristics. Respondent-driven sampling was applied to recruit participants. Multiple logistic regression was utilized to identify the associated factors. Overall, a total of 638 participants were included. The average age was 31.1 years. Access to COVID-19 health care was 68.65% (438/638). The participants most likely to access health care were those with moderate or severe COVID-19 (p = 0.000; OR: 19.8) and females (p = 0.001; OR: 1.99). Moreover, participants who used homemade tea or herbal medicines were less likely to receive health care for COVID-19 in health services (p = 0.002; OR: 0.54). Ensuring access to healthcare is important in a pandemic scenario.

Continuing work in times of COVID-19: Protection measures in the workplace for health professionals.

BACKGROUND: The arrival of COVID-19 in Brazil and the accelerated process of dissemination/contamination added to the evolution of the clinical picture of the disease, and the saturation of the capacity of health services, creating new challenges for researchers, governments, and professionals involved in the occupational health area. OBJECTIVE: This article aims to systematize and synthesize the proposals adopted by the legislation and by the Brazilian State, with a focus on worker protection and guaranteeing a safe work environment for the performance of their professional activities. METHODS: This is qualitative bibliographical research of the narrative literature review type, developed from October 2020 to June 2021 in legislation databases using the strategy: "COVID-19" AND "coronavirus/coronavirus" AND "worker health" on official Brazilian government websites. RESULTS: The lack of an emergency plan for efficient actions to respond to the epidemic caused and is still causing the daily deaths of workers. CONCLUSION: There is a need to guarantee the effectiveness of national and international policies and norms that have been neglected by the Brazilian government.

Fatores sociodemográficos associados ao uso do preservativo na população ribeirinha / Factores sociodemográficos asociados al uso del preservativo en una población ribereña / Sociodemographic factors associated with condom use in a riverside population

Objetivo: estimar a prevalência e fatores associados ao uso do preservativo em população ribeirinha. Materiais e método: estudo transversal, analítico, realizado com 209 ribeirinhos do estado da Paraíba, Brasil, de junho a outubro de 2019. Os dados foram coletados por meio de entrevista individual e privativa com a utilização de um questionário estruturado com variáveis sociodemográficas e de comportamento sexual. As análises foram realizadas pela regressão de Poisson e estimadas as razões de prevalência. Análises bivariadas e múltiplas foram utilizadas para identificar associação entre as variáveis sociodemográficas e comportamentais com o uso do preservativo. Resultados: a prevalência estimada de uso do preservativo foi de 18,2% (IC: 95% 13,0-23,4). Ribeirinhos com idade maior que 40 anos apresentaram menor probabilidade de uso do preservativo (RP = 0,53; IC: 95% 0,34-0,83). Por sua vez, ribeirinhos com mais de oito anos de estudo apresentaram maior probabilidade de uso do preservativo (RP = 3,94; IC 95% 2,65-5,88).Conclusões: a prevalência do uso do preservativo entre os ribeirinhos foi baixa. Entretanto, indivíduos com maior escolaridade apresentaram maiores chances de uso. A prevenção combinada é uma alternativa para o controle das infecções transmissíveis, sendo o preservativo a principal medida de prevenção; portanto, compreender as singu-laridades da população ribeirinha e os fatores de risco para a boa adesão é imprescindível

Objetivo: estimar la prevalencia y los factores asociados al uso del preservativo en una población ribereña. Materiales y método: estudio transversal analítico, realizado con 209 habitantes ribereños del estado de Paraíba, Brasil, entre junio y octubre de 2019. Los datos fueron recolectados a través de entrevistas individuales y privadas mediante un cuestionario estructurado con variables socio-demográficas y de comportamiento sexual. Los análisis se realizaron utilizando la regresión de Poisson, estimando las razones de prevalencia. Se utilizaron análisis bivariados y múltiples para identificar la asociación entre las variables sociodemográficas y conductuales relacionadas con el uso del preservativo. Resultados: la prevalencia estimada del uso de preservativo fue de 18,2 % (IC = 95 % 13,0-23,4). Los habitantes ribereños mayores de 40 años reportaron una menor probabilidad de uso del condón (RP = 0,53; IC del 95 %: 0,34-0,83). Por otro lado, los individuos con más de 8 años de escolaridad fueron más propensos a utilizar preservativo (RP = 3,94; IC 95 %: 2,65-5,88). Conclusiones: la prevalencia del uso del preservativo entre la población estudiada fue baja. Sin embargo, aquellos individuos con mayor grado de escolaridad fueron más propensos a emplearlo. La prevención combinada es una alternativa para el control de las infecciones transmisibles, siendo el preservativo la principal medida preventiva. Por lo tanto, resulta fundamental conocer las singularidades de la población ribereña y los factores de riesgo para una buena adherencia.

Objective: To estimate the prevalence and factors associated with condom use in a riverside population. Materials and method: Cross-sectional and analytical study with 209 riverside inhabitants in the state of Paraíba, Brazil, from June to October 2019. Data were collected through individual and private interviews using a structured questionnaire with sociodemographic and sexual behavior-related variables. Analysis was conducted using Poisson regression. Prevalence ratios were estimated. Bivariate and multiple analyzes were used to identify the association between sociodemographic and behavioral variables with condom use. Results: The estimated prevalence of condom use was 18.2% (95% CI: 13.0-23.4). Riverside people over 40 years were less likely to use condoms (PR = 0.53; 95% ci: 0.34-0.83). On the other hand, individuals with more than 8 years of schooling were more likely to use condoms (PR = 3.94; 95% CI: 2.65-5.88). Conclusions: The prevalence of condom use among participants was low. However, individuals with higher education attainment were more likely to use it. Combined prevention is an alternative to control communicable infections, with condoms being the main prevention measure. Consequently, understanding the singularities of similar populations and the risk factors for good adherence to condom use is essential.

Increased use of psychoactive substances among Brazilian health care professionals during the COVID-19 pandemic.

This study aimed to estimate the prevalence of increased psychoactive substance use (PSU) and associated factors among health care professionals. A cross-sectional and analytical study with 12,086 Brazilian health professionals was undertaken. An online questionnaire was used to gather data concerning sociodemographic factors, increased consumption of alcoholic beverages, tobacco, and hypnotics or sedatives during the COVID-19 pandemic. The prevalence of tobacco, alcoholic beverages, and hypnotic or sedative consumption were 17.8 %, 69.0 % and 17.1 %, respectively. Regression analyses indicated that having no religion and social isolation were associated with increased PASU during the pandemic. COVID-19 pandemic stressors may increase PASU, and increased PASU may increase the risk of substance use disorders and substance use-related chronic diseases, such as cancer.

Health-related quality of life predictors in people with chronic wounds.

OBJECTIVE: To assess health-related quality of life and its predictors among people with chronic wounds. MATERIAL AND METHODS: A cross-sectional, analytical study was conducted with 85 people with chronic wounds, from July to September 2019, at a university hospital in the state of Paraíba, Brazil. Data were collected using forms and the Cardiff Wound Impact Schedule (CWIS). For data analysis, multiple linear regression was performed. RESULTS: The mean quality of life score according to the CWIS was 45.57. The variables gender, marital status, comorbidities, duration of injury and appearance of exudate were negatively associated with the well-being domain. Injury duration, tissue depth, tissue type, and exudate volume were variables negatively associated with physical symptoms and mastery of daily living. Religion, wound origin, duration, lesion size, and tissue depth were negatively associated with the social life domain. CONCLUSION: Sociodemographic characteristics and wound-related aspects need to be considered when assessing and caring for patients with chronic wounds to ensure a better quality of life.

Factors associated with the use of personal protective equipment among Brazilian physicians during the COVID-19 pandemic.

INTRODUCTION: The objective was to analyze the factors associated with use of Personal Protective Equipment (PPE) among Brazilian physicians during the COVID-19 pandemic. METHODOLOGY: An analytical cross-sectional study was conducted from October to December 2020 with 1298 Brazilian physicians. The respondent driven sampling technique was used by sharing the survey through social media. RESULTS: Factors associated with the use of PPE while caring for COVID-19 patients were: being female (AOR = 1.57; 95% CI: 1.24-1.98; p ≤ 0.001); working in Intensive Care Unit (ICU) (AOR = 2.78; 95% CI: 2.06-3.75; p ≤ 0.001); training (AOR = 1.62; 95% CI: 1.25-2.09; p ≤ 0.001); access to sufficient PPE (AOR = 2.22; 95% CI: 1.27-3.90; p = 0.0050), and PPE of good quality (AOR = 1.84; 95% CI: 1.16-2.92; p = 0.009). The following factors were associated with the use of recommended PPE during procedures that generate aerosols in the context of COVID-19: working in the ICU (ORA=2.73; 95% CI: 2.06-3.62; p < 0.01); working in a field hospital (AOR = 1.37; 95% CI: 1.06-1.79; p = 0.018;) training (AOR = 1.72 95% CI: 1.32-2.24; p < 0.01); access to sufficient PPE (AOR = 1.63; 95% CI: 0.91-2.92; p < 0.01), PPE of good quality (AOR = 2.07; 95% CI: 1.28-3.35; p = 0.003). CONCLUSIONS: The factors associated with the use of necessary PPE with COVID-19 patients and for procedures that generate aerosols were identified. Educational interventions for professionals and managers must be implemented to direct them towards protecting themselves and others.

Factors associated with the diagnosis of COVID-19 among Brazilian health professionals COVID-19 and health professionals.

INTRODUCTION: Health professionals are on the front lines against the Coronavirus 2019 (COVID-19) pandemic and are at high risk for acquiring the infection. Failures in precautionary measures, inadequacy/scarcity of Personal Protective Equipment (PPE), and lack of social and family distancing may be associated with increased exposure and contamination by the new coronavirus. This study investigated the prevalence of COVID-19 among Brazilian health professionals and associated factors according to demographic and occupational characteristics. METHODS: A cross-sectional, analytical study was conducted using an online survey with 12,086 health professionals from all regions of Brazil. Data were collected using an adaptation of the respondent-driven sampling method for the virtual environment. The outcome variable was the diagnosis of COVID-19. Bivariate and multiple logistic regression analyzes were used to identify an association between the diagnosis of COVID-19 and demographic and occupational variables. Variables were considered statistically significant based on p<0.05. RESULTS: Most participants were female, from the northeast region, and nursing professionals. A prevalence of 31.95% (95%CI: 31.0%, 32.9%) of COVID-19 was estimated. Following multiple regression analysis, the variables associated with the diagnosis of COVID-19 among health professionals were: male gender, married individuals, professionals who provide care to patients with COVID-19, who work in a field hospital, and those who work in institutions that did not offer enough quality PPE. CONCLUSIONS: The study found a high prevalence of COVID-19 infection, with male professionals being those with greater chances. Inadequate supply or poor quality of PPE offered by health institutions compromises the health of professionals with an increase in positive diagnosis for COVID-19.

Quality of sexual life of riparian women: Analysis of sexual practices and attitudes.

OBJECTIVE: To analyse the sexual practices, attitudes, and sexual quality of life of Riparian woman and associated factors. METHOD: A cross-sectional analytical study conducted among Riparian women using the Study of Sexual Behaviour (SSB) questionnaire. A bivariate analysis and binary logistic regressions were performed to identify factors associated with sexual quality of life. RESULTS: A total of 138 women participated in the study (n = 138). Of the women, 34.1% and 33.3% reported pain and loss of interest during or after sex, respectively. In terms of practices during sex, women reported kissing (85.5%), cuddling (89.1%), mutual masturbation (37.2%), oral sex (34.8%), and anal sex (23.9%). However, the majority reported not using condoms during sex (63.0%). In terms of sexual quality of life, 39.9% of the women rated it as good. Higher education and early sexual initiation increase the chances of a "good" sexual quality of life. CONCLUSION: Because Riparian women engage in some risky sexual behaviours, such as not using condoms, educational strategies on the prevention of sexually transmitted infections should be reinforced and incorporated in this population. This may help improve these women's sexual quality of life.

Incidência da COVID-19 e fatores associados: uma analise segundo diagnóstico laboratorial / Incidence of COVID-19 and Associated Factors: An Analysis According to Laboratory Diagnosis / Incidencia del COVID-19 y factores asociados: un análisis según diagnóstico de laboratorio

Introdução: o rastreamento de casos através dos testes para detecção da COVID-19 é indispensável para controlar/retardar a propagação da doença. Objetivo: identificar a incidência da COVID-19 segundo positividade dos testes rápidos e os fatores associados na população do estado do Rio Grande do Sul, Brasil. Método: estudo transversal, desenvolvido com 121.622 indivíduos notificados e residentes no estado do Rio Grande do Sul, de março a junho de 2020, a partir de dados de domínio público. Para a análise considerou-se como desfecho a positividade para os testes rápidos da COVID-19. Análises bivariadas foram realizadas para identificar associação entre a positividade dos testes rápidos com variáveis demográficas, clínicas e tempo transcorrido entre início dos sintomas e realização dos testes. Além disso, foram também calculadas odds ratio, e seus respectivos intervalos de confiança ao nível de 95 %, e p-valor apresentado a partir do método de Wald. Resultados: predomínio de indivíduos do sexo masculino, 51 %, na faixa etária de 20 a 39 anos, 46,4 % e profissionais de saúde, 99,9 %. No que se refere ao tempo transcorrido entre o início dos sinais e sintomas clínicos e o diagnóstico, observa-se que 61,7 % indivíduos que fizeram os testes com até 9 dias de início de sintomas apresentaram um resultado positivo. Sexo, faixa etária e tempo para a realização do teste foram associadas a positividade para o teste rápido da COVID-19. Conclusão: é importante minimizar os resultados de teste falso-positivos escolhendo um ensaio com alta especificidade e testando populações e indivíduos no período oportuno.

Introduction: case tracking through COVID-19 screening tests is indispensable to control/delay the spread of the disease. Objective: to identify the incidence of COVID-19 through the positivity of rapid tests and associated factors in the population of the state of Rio Grande do Sul, Brazil. Methods: cross-sectional study, developed with 121,622 individuals notified and residing in the state of Rio Grande do Sul, from March to June 2020, from public domain data. For the analysis, positive results in COVID-19 rapid tests were considered. Bivariate analyses were performed to identify the association between the positive result in the rapid tests and demographic and clinical variables and the time elapsed between the onset of symptoms and the performance of the test. Likewise, odds ratios and their respective confidence intervals were calculated at the 95% level, and the p-value presented through the Wald method. Results: predominance of male individuals, 51%; in the age range of 20 to 39 years, 46,4%; and health professionals, 99,9%. Regarding the time elapsed between the onset of clinical signs and symptoms and diagnosis, 61,7% of the individuals who were tested up to 9 days after the onset of symptoms had a positive result. Sex, age group and time to test were associated with a positive result for the COVID-19 rapid test. Conclusion: it is important to minimize false-positive test results by choosing an assay with high specificity and testing populations and individuals in a timely manner.

Introducción: el rastreo de casos a través de pruebas de detección de COVID-19 es indispensable para controlar/retardar la propagación de la enfermedad. Objetivo: identificar la incidencia del COVID-19 por medio de la positividad de las pruebas rápidas y factores asociados en la población del estado de Rio Grande del Sur, Brasil. Método: estudio transversal, desarrollado con 121.622 individuos notificados y residentes en el estado de Rio Grande del Sur, de marzo a junio de 2020, a partir de datos de dominio público. Para el análisis se consideraron los resultados positivos en las pruebas rápidas de COVID-19. Se realizaron análisis bivariados para identificar la asociación entre el resultado positivo en las pruebas rápidas y variables demográficas, clínicas y tiempo transcurrido entre el inicio de los síntomas y la realización de la prueba. Igualmente, se calcularon razones de probabilidad y sus respectivos intervalos de confianza a nivel de 95%, y el p-valor presentado a través del método de Wald. Resultados: predominio de individuos de sexo masculino, 51%; en la franja etaria de 20 a 39 años, 46,4%; y profesionales de la salud, 99,9 %. En lo que se refiere al tiempo transcurrido entre el comienzo de señales y síntomas clínicos y el diagnóstico, se observa que 61,7 % de los individuos que se practicaron la prueba con hasta 9 días del inicio de los síntomas presentaron un resultado positivo. Sexo, grupo etario y tiempo para la realización de la prueba se asociaron al resultado positivo para la prueba rápida de COVID-19. Conclusión: es importante minimizar los resultados de la prueba falso-positivos eligiendo un ensayo con alta especificidad y analizando poblaciones e individuos en el período oportuno.

Limiting factors of face shield use for health professionals during the COVID-19 pandemic.

BACKGROUND: Coronavirus disease (COVID-19) is caused by SARS-COV2, a highly transmissible and pathogenic viral infection, and was identified in December 2019 in Wuhan, China. Three months later, it became a severe pandemic. OBJECTIVE: To identify scientific evidence on the use of face shields by health professionals during the COVID-19 pandemic period. METHOD: An integrative literature review of articles obtained from PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science databases was undertaken. For the search, controlled, non-controlled descriptors and specific keywords: "face shield," "fluid resistance procedure," "respiratory infections," "healthcare workers," "COVID-19," "aerosols," and "personal protection infection" were used. RESULTS: The sample comprised seven studies. The available evidence has shown that face shields do not have a defined standard for their production-their effectiveness depends on the quality of the visor, structure, and fixation system. They must be used as adjuvants to other personal protective equipment (PPE), and their isolated use is not recommended due to the fragilities of peripheral face sealing, especially during the COVID-19 pandemic period. CONCLUSION: Due to the shortage of this equipment, domestic face shields can be indicated if they meet production requirements, based on scientific evidence for their efficient use.

Knowledge, Behaviors, and Perceptions of Risk of COVID-19 Among Brazilian Nursing Students: A Cross-sectional Study.

BACKGROUND: The COVID-19 pandemic presented important challenges for the education of nursing students to provide health care with competence, quality, and safety. OBJECTIVES: The purpose was to analyze knowledge, behavior, and perception of risk regarding COVID-19 and associated factors. METHODS: A cross-sectional study was conducted among 2637 Brazilian undergraduate nursing students using a self-reported online survey. RESULTS: Students' knowledge about COVID-19 in general was considered inadequate. Students had limited knowledge about preventive measures in the hospital environment and recommendations for aerosol precautions. More than 90% of graduates adopted recommended prevention measures, and 86.1% perceived themselves to be at a greater risk of acquired SARS-CoV-2 during clinical practice. CONCLUSIONS: The results show the need to rethink undergraduate nursing education regarding the prevention and control of infectious diseases, including the most appropriate strategies for COVID-19 prevention measures.

Epidemiology of HIV, syphilis, and hepatitis B and C among manual cane cutters in low-income regions of Brazil.

BACKGROUND: In recent decades the epidemic of asymptomatic sexually transmitted infections has extended deep into Brazil, including small towns and rural areas. The purpose of this study was to investigate the epidemiology of HIV, syphilis, and hepatitis B (HBV) and hepatitis C viruses (HCV), and to evaluate immunization coverage against hepatitis B in a group of rural workers in Brazil. METHODS: In 2016, a cross-sectional study was conducted with 937 manual sugarcane cutters of the Midwest and Northeast Regions of Brazil. All individuals were interviewed and screened for HIV, syphilis, HBV and HCV. Correlating factors with lifetime HBV infection were investigated using logistic regression. Positive Predictive Values, Negative Predictive Values, sensitivity and specificity were also calculated relative to vaccination against Hepatitis B, comparing anti-HBs titers to vaccination reports. RESULTS: Most reported previous hospitalization (55%), occupational injuries (54%), sharing of personal items (45.8%), alcohol consumption (77.2%), multiple sexual partners in previous 12 months (39.8%), and no condom use during sexual intercourse in last 12 months (46.5%). Only 0.2% reported using injection drugs. Anti-HIV-1 was detected in three individuals (0.3%). Serological markers of lifetime syphilis (treponemal test) were detected in 2.5% (95% CI: 1.6-3.6) of participants, and active syphilis (treponemal test and VDRL) present in 1.2%. No samples were positive for anti-HCV. The prevalence of lifetime HBV infection (current or past infection) was 15.9%, and 0.7% (95% CI 0.4 to 1.5) were HBsAg-positive. Previous hospitalization (OR 1.53, CI 1.05-2.24, p < 0.01) and multiple sexual partners in the last 12 months (OR 1.80, CI 1.25-2.60, p < 0.01) were predictors for lifetime HBV infection. Although 46.7% (95% CI 43.4-49.9) of individuals reported having been vaccinated against hepatitis B, only 20.6% (95% CI 18.1-23.3) showed serological evidence of previous hepatitis B vaccination (positive for anti-HBs alone). CONCLUSIONS: The high prevalence of syphilis and HBV compared to the general population and the high frequency of risk behaviors show the potential for sexual and parenteral dissemination of these agents in this rural population. In addition, the low frequency of hepatitis B vaccinated individuals suggests a need for improved vaccination services.