Reports of occupational dermatosis in the state of Espírito Santo from 2007 to 2016.

INTRODUCTION: Occupational dermatoses account for a large fraction of work-related illnesses, and have significant economic and social repercussions. Though these conditions are subject to mandatory reporting, they are often underdiagnosed, and have only been scarcely studied in Brazil. OBJECTIVES: To describe the profile of workers affected by occupational dermatosis based on reports sent to the Information System on Notifiable Diseases [Sistema de Informação de Agravos e de Notificação (SINAN)], and provide evidence to support disease prevention initiatives. METHODS: The following data were collected from incident reports sent in the state of Espírito Santo, from 2007 to 2016: city, year, age of worker, education level, gender, causal agent, race, occupation, lesion site, and need for medical leave. Data were analyzed using Microsoft Excel, using frequency and percentage statistics. RESULTS: A total of 340 incidents were reported in the state of Espírito Santo, which most cases (79%) occurring in the city of Atílio Vivácqua. The highest number of cases involved female workers aged 20 to 29 years, with complete primary and incomplete secondary education, in unskilled occupations such as domestic work, and were associated with exposure to chemical agents such as chlorine, detergents, and latex. The lesion site was reported in fewer than 2% of cases. At least 25% of affected workers required medical leave. CONCLUSIONS: The individuals most frequently affected by occupational dermatosis were women, aged 20 to 29 years, with complete primary education, in unskilled occupations. There is a need for greater investment in the education of unskilled workers, especially those who perform cleaning services.

Panorama da dengue na região sul do brasil de 2001 a 2017 / Panorama de la dengue en la región sur de brasil de 2001 a 2017 / An overview of dengue in the southern region of brazil from 2001 to 2017

Objetivo: inventariar casos notificados por dengue clássica e óbitos na região Sul do Brasil entre 2001 e 2017. Método: estudo descritivo-retrospectivo a partir de dados secundários do DATASUS/SINAN e das Secretarias de Saúde, analisados através de estatística descritiva. Resultados: observou-se aumento dos casos nos três estados: Paraná (PR) elevou casos autóctones para 94% nos últimos quatro anos, Santa Catarina (SC) para 95%, e Rio Grande do Sul (RS) para 83%, respectivamente, em 2015 e 2016. Observou-se crescente aumento de óbitos por dengue hemorrágica, principalmente no PR; em 2016, o primeiro óbito em SC; e aumento nos últimos dois anos no RS, mais de 90% em adultos. Conclusão: a região requer atenção dos órgãos de saúde, devido ao aumento de casos e óbitos por dengue, embora apresente a menor incidência da doença do país. Este estudo contribuiu para o conhecimento do cenário atual e da evolução da dengue na região Sul do Brasil.

ABSTRACT Objetivo: inventariar casos notificados por dengue clásica y óbitos en la región Sur de Brasil entre 2001 y 2017. Método: estudio descriptivo retrospectivo con base en datos secundarios del DATASUS/SINAN y de las Secretarías de Salud, analizados por medio de estadística descriptiva. Resultados: se observó crecimiento de los casos en los tres estados: Paraná (PR) tuvo elevación de casos autóctonos para 94% en los últimos cuatro años, Santa Catarina (SC) para 95%, y Rio Grande do Sul (RS) para 83%, respectivamente, en 2015 y 2016. Se observó todavía creciente aumento de óbitos por dengue hemorrágico, principalmente en PR; en 2016; el primero óbito en SC; y crecimiento en los últimos dos años en RS, más de 90% en adultos. Conclusión: la región necesita atención de los organismos de salud, a causa del crecimiento de casos y óbitos por dengue, a pesar de presentar la menor incidencia de la enfermedad del país. Este estudio contribuyó para el conocimiento del escenario actual y de la evolución de la dengue en la región Sur de Brasil.

Objective: To record cases reported as classical dengue fever and deaths in the southern region of Brazil between 2001 and 2017. Method: Descriptive-retrospective study using secondary data from DATASUS/ SINAN and State Departments, analyzed through descriptive statistics. Results: An increase in the percentage of cases of the disease in the three states was observed in the three Brazilian southern states: in Paraná (PR) the percentage of autochthonous cases reached 94% in the last four years; in Santa Catarina (SC), the percentage was 95%, and in Rio Grande do Sul (RS), 83%, respectively, in 2015 and 2016. There was an increase in the number of deaths by severe dengue (dengue hemorrhagic fever), mainly in PR; in 2016, the first death caused by dengue was observed in SC; and an increase of more than 90% in the cases of dengue among adults in the last two years in Rio Grande do Sul. Conclusion: Despite the fact the Southern region of Brazil has the lowest incidence of dengue, special attention should be paid by health agencies to the situation in the southern states due to the increase in the number of cases and deaths caused by dengue.

Using mixed methods to investigate factors influencing reporting of livestock diseases: a case study among smallholders in Bolivia.

Livestock disease surveillance is particularly challenging in resource-scarce settings, where disease events are often unreported. Surveillance performance is determined as much by the quantifiable biological attributes of the disease, as it is by motivations and barriers perceived by livestock keepers for disease reporting. Mixed methods designs, which integrate the collection, analysis and interpretation of qualitative and quantitative data in a single study, are increasingly used across different disciplines. These designs allow for a deeper exploration of the topic under investigation, than can be achieved by either approach alone. In this study a mixed methods design was used in order to gain a greater understanding of the factors that influence reporting of livestock diseases in Bolivia. There is a need to strengthen passive surveillance in this country, among other reasons as part of an eradication programme for Foot and Mouth Disease (FMD). Findings revealed livestock keepers in the study area were extremely unlikely to report the occurrence of livestock health events to the Official Veterinary Services (OVS). Communication outside the local community occurs more often through alternative routes and this is positively correlated with disease awareness. The main barriers to disease reporting identified were a lack of institutional credibility and the conflicting priorities of the OVS and livestock keepers. As for other animal and human diseases across the developing world, passive surveillance of livestock diseases in Bolivia should be enhanced; this is urgent in view of the current FMD eradication programme. Increasing timeliness and smallholders' participation requires a detailed understanding of their likely actions and perceived barriers towards disease reporting. These insights are most likely to be developed through a holistic mixed methods approach of quantitative and qualitative analyses.

Características clínico-laboratoriais no retratamento por recidiva em hanseníase / Clinical and laboratory characteristics in the retreatment of leprosy relapse

OBJETIVO: Comparar as características clínico-laboratoriais dos doentes de hanseníase durante o tratamento inicial e no retratamento por recidiva diagnosticada em unidades de saúde de referência no Estado de Mato Grosso MÉTODO: Estudo transversal de casos diagnosticados de recidiva em hanseníase em unidades de referência de 2005 a 2007 em cinco municípios do Estado. O tratamento inicial foi considerado t1 e a recidiva t2. Fontes de dados: Sistema de Informação de Agravos de Notificação, prontuários, exames laboratoriais, ficha de notificação individual e de avaliação de incapacidade física. Utilizou-se para a comparação e cálculo de proporções o teste do Qui-quadrado (c²) ao nível de significância de 5%. RESULTADOS: Verificou-se predomínio da forma clínica dimorfa em t2 quando comparada a t1 (39,6% versus 11,3%; p = 0,003); 20,8%, dos casos em recidivas apresentaram índice baciloscópico ≥ 4+ se comparados aqueles em t1 (p = 0,034); aumento (17%) dos casos de recidiva com grau zero de incapacidade quando comparados aos pacientes avaliados no momento do diagnóstico (58,5% versus 41,5%); aumento (7,5%) de recidivas com incapacidades grau 2 quando comparadas a t1 (9,4% versus 1, 9%); predomínio de casos não avaliados quanto a incapacidade física entre t1 (45,3%) e t2 (22,6%); (p = 0,040). CONCLUSÃO: Os casos de recidiva caracterizam o agravamento da doença indicadas pelo aumento do índice baciloscópico e do grau de incapacidade física. Recomenda-se maior atenção à confirmação diagnóstica de recidiva por meio de exames baciloscópicos, em especial nos multibacilares, e da avaliação neurológica sistemática de todos os pacientes de hanseníase.

OBJECTIVE: To compare clinical and laboratory data of leprosy patients diagnosed in specialized services in the State of Mato Grosso, Brazil, during the initial treatment and the retreatment of relapse. METHODS: A cross-sectional study of patients with diagnosis of leprosy relapse was conducted in specialized health services of five cities, between 2005 and 2007. Initial treatment was described as t1 and relapse treatment as t2. DATA SOURCE: Sistema de Informação de Agravos de Notificação (Sinan - Reportable Diseases Information System), medical records, laboratory tests, and files of individual reports and of physical disability assessments. The chi-square test (c2) was applied at a significance level of 5%. RESULTS: The clinical dimorphic form prevailed in t2 when compared with t1 (39.6% versus 11.3%; p = 0.003); 20.8% of relapse cases showed a bacilloscopy index ≥ 4+ in relation to those in t1 (p = 0.034)]; an increase in the number of (17%) cases of relapse with physical disability at level 0 was found, compared to patients evaluated during the diagnosis (58.5% versus 41.5%); an increase (7.5%) in the recurrence of disabilities at level 2 was observed, when compared to t1 (9.4% versus a 9%); and there was a higher prevalence of cases not evaluated for disability between t1 (45.3%) and t2 (22.6%) (p = 0.040). CONCLUSION: Cases of relapse characterized the aggravation of the disease, indicated by the increase in the bacilloscopy index and level of physical disability. Attention should be paid to the diagnostic confirmation of relapse using bacilloscopy tests, especially in multibacillary cases, and systematic neurological assessment of all leprosy patients.

Estimativa de subnotificação de casos de AIDS em uma capital do Nordeste / Estimation of underreporting of AIDS cases in a Brazilian Northeast metropolis

A subnotificação de casos de Aids representa um dos principais problemas da vigilância epidemiológica da Aids. Este trabalho teve como objetivo conhecer a subnotificação dos casos de Aids em adultos, no município de Fortaleza, nos anos de 2002 e 2003. Estimou-se ainda a subnotificação em dois hospitais de referência, Hospital São José - HSJ e Hospital Geral de Fortaleza - HGF. Utilizou-se o método de captura e recaptura com base nos dados secundários do Sistema de Informação de Agravos de Notificação - Sinan, Sistema de Controle de Exames Laboratoriais - Siscel e Sistema de Informações sobre Mortalidade-SIM. Os três sistemas foram comparados dois a dois e considerados como notificados os casos confirmados no Sinan. Os casos foram emparelhados no Programa RecLink II. Após este processo, foram selecionados os casos elegíveis para aplicação do método de captura e recaptura, com a utilização dos estimadores de Lincoln-Petersen e o de Chapman. A subnotificação estimada para Fortaleza foi de 33,1 por cento e 14,1 por cento, ao se comparar o Sinan com Siscel e SIM, respectivamente. No HSJ e HGF, a subnotificação foi de 5,4 por cento e 90,5 por cento na mesma ordem, comparando o Sinan com o Siscel. Este trabalho demonstrou elevada subnotificação de casos de Aids em Fortaleza. A subnotificação, quando avaliada por fonte, isto é, comparando-se o Siscel com o Sinan, é mais de duas vezes superior àquela estimada quando se compara as fontes SIM com Sinan, o que demonstra ser o Siscel uma importante fonte de notificação de casos de Aids. Portanto, recomenda-se que o Sinan-Aids seja comparado, periodicamente, com todas as fontes de informações disponíveis que possam contribuir para a redução da subnotificação de Aids.