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1.
Rev. enferm. UERJ ; 28: e44773, jan.-dez. 2020.
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1119608

RESUMEN

Objetivo:descrever a frequência dos fatores de risco cardiovascular em idosos de uma comunidade quilombola. Método: estudo transversal desenvolvido com idosos quilombolas cadastrados na Estratégia Saúde da Família. A coleta foi realizada com uma amostra de 62 idosos, utilizando-se o teste do qui-quadrado para análise dos dados. Resultados: as frequências dos fatores de risco foram: 67,7% de hipertensão arterial, 54,8% de adiposidade abdominal, 22,6% de glicemia capilar elevada, 19,4% de excesso de peso, 3,2% de sedentarismo e 3,2% de tabagismo, com diferença estatística apenas para adiposidade abdominal em idosas de cor branca (p<0,05). Conclusão: o estudo identificou elevada frequência de fatores de risco cardiovasculares nos idosos quilombolas atendidos na atenção primária à saúde, com destaque para hipertensão arterial, adiposidade abdominal e glicemia capilar elevada. Os resultados apontam a necessidade de melhoria de acesso da comunidade quilombola aos serviços de saúde.


Objective: to describe the frequency of cardiovascular risk factors in the older adults of a quilombola community. Method: in this cross-sectional study of 62 older adults of a quilombo registered with Brazil's Family Health Strategy, the data collected were analyzed using the Chi-square test. Results: risk factor frequencies were: 67.7% for arterial hypertension; 54.8%, abdominal adiposity; 22.6%, high capillary blood glucose; 19.4%, overweight; 3.2%, sedentary lifestyle; and 3.2%, smoking. Statistical difference was observed only for abdominal adiposity in older, white women (p<0.05). Conclusion: this study identified a high frequency of cardiovascular risk factors in quilombola older adults treated in primary health care, particularly arterial hypertension, abdominal adiposity, and high capillary blood glucose. These results indicate the need to improve quilombola communities' access to health services.


Objetivo: describir la frecuencia de factores de riesgo cardiovascular en los adultos mayores de una comunidad quilombola. Método: en este estudio transversal de 62 adultos mayores de un quilombo inscrito en la Estrategia de Salud de la Familia de Brasil, los datos recolectados se analizaron mediante la prueba de Chi-cuadrado. Resultados: las frecuencias de los factores de riesgo fueron: 67,7% para la hipertensión arterial; 54,8%, adiposidad abdominal; 22,6%, glucemia capilar elevada; 19,4%, sobrepeso; 3,2%, sedentarismo; y 3,2%, tabaquismo. Se observó diferencia estadística solo para la adiposidad abdominal en mujeres blancas mayores (p<0,05). Conclusión: este estudio identificó una alta frecuencia de factores de riesgo cardiovascular en adultos mayores quilombolas tratados en atención primaria de salud, particularmente hipertensión arterial, adiposidad abdominal y glucemia capilar alta. Estos resultados indican la necesidad de mejorar el acceso de las comunidades quilombolas a los servicios de salud.


Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Enfermedades Cardiovasculares , Grupos Étnicos , Factores de Riesgo , Accesibilidad a los Servicios de Salud , Tabaquismo , Glucemia , Brasil , Epidemiología Descriptiva , Estrategia de Salud Familiar , Circunferencia Abdominal , Conducta Sedentaria , Hipertensión , Obesidad
2.
Rev. enferm. UERJ ; 28: e49514, jan.-dez. 2020.
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1118069

RESUMEN

Objetivo: desvelar a percepção das mulheres sobre o acesso aos serviços de saúde como ferramenta do processo de ressocialização. Método: trata-se de um estudo fenomenológico-sociológico, qualitativo, realizado entre novembro de 2018 e novembro de 2019, com 10 mulheres de um estabelecimento prisional feminino de Maceió, Alagoas. Resultados: as participantes possuíam de 22 a 54 anos, ensino fundamental incompleto, pardas, solteiras, já haviam vivenciado a maternidade. Emergiram duas categorias temáticas: percepções do acesso aos serviços de saúde: a invisibilidade das mulheres e acesso aos serviços de saúde como uma ferramenta de ressocialização: elos dilacerados e Trabalho e Educação como alternativa de Fuga do esquecimento, ociosidade e solidão. Conclusão: evidenciou-se a percepção de invisibilidade das mulheres privadas de liberdade e desvinculação do acesso aos serviços de saúde como ferramenta do processo de ressocialização.


Objective: to unveil women's perceptions of access to health services as a tool in the re-socialization process. Method: this qualitative, phenomenological-sociological study was conducted between November 2018 and November 2019 with 10 women at a women's prison in Maceió, Alagoas, Brazil. Results: the participants were 22 to 54 years old, of mixed race, single, had not completed lower secondary school, and had already experienced motherhood. Two thematic categories emerged: "Perceptions of access to health services: women's invisibility" and "Access to health services as a resocialization tool: ties in shreds and Work and Education as an alternative escape route from oblivion, idleness and loneliness. Conclusion: the women deprived of their freedom were found to perceive themselves to be invisible and disconnected from access to health services as a tool in the resocialization process.


Objetivo: revelar las percepciones de las mujeres sobre el acceso a los servicios de salud como herramienta en el proceso de resocialización. Método: este estudio cualitativo, fenomenológico-sociológico se realizó entre noviembre de 2018 y noviembre de 2019 con 10 mujeres en una cárcel de mujeres en Maceió, Alagoas, Brasil. Resultados: las participantes tenían entre 22 y 54 años, mestizas, solteras, no habían completado el primer ciclo de secundaria y ya habían experimentado la maternidad. Surgieron dos categorías temáticas: "Percepciones del acceso a los servicios de salud: invisibilidad de las mujeres" y "Acceso a los servicios de salud como herramienta de resocialización: lazos en jirones y Trabajo y Educación como vía alternativa de escape al olvido, la ociosidad y la soledad. Conclusión: las mujeres privadas de libertad se percibieron a sí mismas invisibles y desconectadas del acceso a los servicios de salud como herramienta en el proceso de resocialización.


Asunto(s)
Humanos , Femenino , Adulto , Persona de Mediana Edad , Adulto Joven , Prisiones , Socialización , Salud de la Mujer , Accesibilidad a los Servicios de Salud , Brasil , Investigación Cualitativa , Inequidad de Género , Libertad , Soledad
3.
Pan Afr Med J ; 35(Suppl 2): 130, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33193945

RESUMEN

The COVID-19 pandemic has strained health care systems beyond capacity resulting in many people not having access to life-sustaining measures even in well-resourced countries. Palliative and end-of-life care are therefore essential to alleviate suffering and ensure a continuum of care for patients unlikely to survive. This is challenging in sub-Saharan Africa where lack of trained teams on basic palliative care and reduced access to opioids limit implementation of palliative and end-of-life care. At the same time, health care providers have to cope with local cultural conceptions of death and absence of advance care directives.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/terapia , Cuidados Paliativos/organización & administración , Pandemias , Neumonía Viral/terapia , Cuidado Terminal/organización & administración , Directivas Anticipadas , África del Sur del Sahara/epidemiología , Analgésicos Opioides/provisión & distribución , Analgésicos Opioides/uso terapéutico , Actitud Frente a la Muerte , Barreras de Comunicación , Continuidad de la Atención al Paciente , Infecciones por Coronavirus/tratamiento farmacológico , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/psicología , Cultura , Accesibilidad a los Servicios de Salud , Humanos , Cuidados Paliativos/psicología , Neumonía Viral/epidemiología , Neumonía Viral/psicología , Relaciones Profesional-Paciente , Insuficiencia Respiratoria/tratamiento farmacológico , Insuficiencia Respiratoria/etiología , Insuficiencia Respiratoria/mortalidad , Estigma Social , Cuidado Terminal/psicología
4.
Pan Afr Med J ; 35(Suppl 2): 135, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33193950

RESUMEN

Tuberculous neuroretinis, a relatively rare manifestation of extra-pulmonary tuberculosis, is characterized by optic disc edema, peripapillary and macula swelling, with hard exudates forming a partial or complete 'macular star' While the disease may present a diagnostic challenge for Ophthalmologists, prognosis is usually good, with proper management. The Coronavirus Disease 2019 (COVID-19) pandemic has presented a healthcare delivery dilemma in many parts of the world, with poor accessibility to, and under-utilization of, important healthcare services by non-COVID-19-related cases. Herein is a report of a case of tuberculous neuroretinitis in Lagos, Nigeria, whose care was negatively impacted by the ongoing pandemic through the combined factors of the interruption of clinical services during the lockdown, patient avoidance of healthcare facilities and the absence of robust telehealth services. These all culminated in the delayed institution of therapy which may be responsible for the poor visual outcome of no-light-perception.


Asunto(s)
Continuidad de la Atención al Paciente , Infecciones por Coronavirus/epidemiología , Accesibilidad a los Servicios de Salud , Pandemias , Neumonía Viral/epidemiología , Retinitis/tratamiento farmacológico , Tuberculosis Ocular/tratamiento farmacológico , Antituberculosos/uso terapéutico , Teléfono Celular , Diagnóstico Tardío , Técnicas de Diagnóstico Oftalmológico , Quimioterapia Combinada , Femenino , Clausura de las Instituciones de Salud , Humanos , Mácula Lútea/patología , Nigeria/epidemiología , Fotograbar , Cuarentena , Retinitis/diagnóstico , Telemedicina , Tomografía de Coherencia Óptica , Resultado del Tratamiento , Negativa del Paciente al Tratamiento , Tuberculosis Ocular/diagnóstico , Adulto Joven
5.
Pan Afr Med J ; 35(Suppl 2): 139, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33193954

RESUMEN

Thiamine-responsive megaloblastic anaemia (TRMA) is a syndrome associated with megaloblastic anaemia, diabetes mellitus and sensorineural deafness, due to mutations in the SLC19A2gene, which codes for a thiamine carrier protein. Oral thiamine supplementation is the main treatment. We report the case of a 19-year-old man known for TRMA, who presented in the emergency department with bicytopenia (haemoglobin 5,4 g/dL, thrombocytes 38×109/L) revealed by dyspnea and chest pain. Investigations excluded bleeding, hemolysis, coagulopathy and iron deficiencies. A recent infection and an acute coronary syndrome have also been eliminated. We later found out that thiamine treatment had been discontinued three months before, due to general confinement in Tunisia during the COVID-19 pandemic. Parenteral administration of 100 mg of thiamine daily resulted in the recovery of haematopoiesis within three weeks.


Asunto(s)
Anemia Megaloblástica/sangre , Betacoronavirus , Infecciones por Coronavirus/epidemiología , Diabetes Mellitus/sangre , Pérdida Auditiva Sensorineural/sangre , Pandemias , Neumonía Viral/epidemiología , Deficiencia de Tiamina/congénito , Trombocitopenia/etiología , Síndrome Coronario Agudo/diagnóstico , Anemia Megaloblástica/tratamiento farmacológico , Anemia Megaloblástica/fisiopatología , Dolor en el Pecho/etiología , Diabetes Mellitus/tratamiento farmacológico , Diabetes Mellitus/fisiopatología , Diagnóstico Diferencial , Hemoglobina A Glucada/análisis , Accesibilidad a los Servicios de Salud , Pérdida Auditiva Sensorineural/tratamiento farmacológico , Pérdida Auditiva Sensorineural/fisiopatología , Hemoglobinas/análisis , Humanos , Masculino , Derrame Pericárdico/diagnóstico por imagen , Derrame Pericárdico/etiología , Recurrencia , Tiamina/provisión & distribución , Tiamina/uso terapéutico , Deficiencia de Tiamina/sangre , Deficiencia de Tiamina/tratamiento farmacológico , Deficiencia de Tiamina/fisiopatología , Túnez , Adulto Joven
6.
Pan Afr Med J ; 35(Suppl 2): 140, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33193955

RESUMEN

The COVID-19 pandemic and its public health control measures have led to worldwide interruptions in healthcare service delivery, and cancer services are no exception. These interruptions have exacerbated the effects of previously reported barriers to accessing cancer care which was reportedly low even before the pandemic. If these effects are not mitigated, the achievements in cancer control that had already been made could be watered down. Measuring the impact of COVID-19 pandemic control measures on delivery of and access to cancer services in Uganda as well as other countries worldwide can inform the design of current and future responses to epidemics while putting into context other diseases like cancer that have a high burden.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Accesibilidad a los Servicios de Salud , Neoplasias/terapia , Pandemias , Neumonía Viral/epidemiología , Continuidad de la Atención al Paciente , Prestación de Atención de Salud , Países en Desarrollo , Promoción de la Salud , Necesidades y Demandas de Servicios de Salud , Humanos , Tamizaje Masivo , Neoplasias/diagnóstico , Neoplasias/epidemiología , Cuarentena , Sistema de Registros , Uganda/epidemiología
7.
Pan Afr Med J ; 35(Suppl 2): 143, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33193958

RESUMEN

Zimbabwe reported its first case of COVID-19 on 20 March 2020, and since then the number has increased to over 4000. To contain the spread of the causative SARS-CoV-2 and prepare the healthcare system, public health interventions, including lockdowns, were imposed on 30 March 2020. These resulted in disruptions in healthcare provision, and movement of people and supply chains. There have been resultant delays in seeking and accessing healthcare by the patients. Additionally, disruption of essential health services in the areas of maternal and child health, sexual and reproductive health services, care for chronic conditions and access to oncological and other specialist services has occurred. Thus, there may be avoidable excess morbidity and mortality from non-COVID-19 causes that is not justifiable by the current local COVID-19 burden. Measures to restore normalcy to essential health services provision as guided by the World Health Organisation and other bodies needs to be considered and implemented urgently, to avoid preventable loss of life and excess morbidity. Adequate infection prevention and control measures must be put in place to ensure continuity of essential services whilst protecting healthcare workers and patients from contracting COVID-19.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Prestación de Atención de Salud , Pandemias , Neumonía Viral/epidemiología , Enfermedad Crónica/epidemiología , Control de Enfermedades Transmisibles/organización & administración , Continuidad de la Atención al Paciente , Infecciones por Coronavirus/prevención & control , Guías como Asunto , Recursos en Salud/provisión & distribución , Accesibilidad a los Servicios de Salud , Humanos , Pacientes no Asegurados , Medicina , Modelos Teóricos , Mortalidad , Neoplasias/terapia , Pandemias/prevención & control , Aceptación de la Atención de Salud , Equipo de Protección Personal/provisión & distribución , Neumonía Viral/prevención & control , Servicios de Salud Reproductiva/provisión & distribución , Organización Mundial de la Salud , Zimbabwe/epidemiología
8.
Pan Afr Med J ; 35(Suppl 2): 144, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33193959

RESUMEN

Introduction: since the first spread of the novel coronavirus (COVID-19) in Morocco in March 2020, the Moroccan Health System underwent an important pressure and remarkable efforts were spent to provide efficient reactions to this emergency. Public hospitals have set adapted strategies dedicated to overcoming the overload of COVID-19 patients, and our Oncology and Hematology Center (OHC) has implemented a flexible adapted strategy aiming to reduce the burden of COVID-19. We report our single-center experience on the detailed infection control measures undertaken to minimize virus transmission. Methods: we reviewed all patients treated at the OHC from March 2nd to April 20th, 2020 as measures were taken since the detection of the first COVID-19 case to ensure the protection of patients and healthcare providers, especially a screening zone for any patient entering the center. The patient's data were retrospectively collected and anonymized. Results: we notified a significant decrease in patients' admissions during the lockdown period at the different units of our center. The screening area received a total of 5267 patients during our study period, with an average of 105 patients per day. Interestingly, no healthcare professional was infected and only 8 patients showed symptoms of fever and cough, and all of them had a negative test for COVID-19 (RT-PCR). Thus, the OHC is considered as a COVID-19 free center with zero cases among patients and healthcare providers. Conclusion: by having a 0% rate of infection, the efficiency of our measures is proven, but efforts are still needed as we have to measure the impact of this pandemic in our cancer management.


Asunto(s)
Betacoronavirus , Instituciones Oncológicas/organización & administración , Infecciones por Coronavirus/epidemiología , Neoplasias/terapia , Pandemias , Neumonía Viral/epidemiología , Técnicas de Laboratorio Clínico , Continuidad de la Atención al Paciente , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/prevención & control , Manejo de la Enfermedad , Femenino , Accesibilidad a los Servicios de Salud , Departamentos de Hospitales/estadística & datos numéricos , Unidades Hospitalarias/estadística & datos numéricos , Humanos , Control de Infecciones/organización & administración , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Transmisión de Enfermedad Infecciosa de Profesional a Paciente/prevención & control , Masculino , Tamizaje Masivo/organización & administración , Persona de Mediana Edad , Marruecos , Pandemias/prevención & control , Neumonía Viral/diagnóstico , Neumonía Viral/prevención & control , Estudios Retrospectivos
9.
Pan Afr Med J ; 35(Suppl 2): 149, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33193964

RESUMEN

HIV/AIDS is an infectious disease that has claimed the lives of millions of people worldwide. Currently, there is no vaccine that has been developed in a bid to fight this deadly infection, however, antiretrovirals (ARVs), which are drugs used in the treatment of HIV infection are routinely prescribed to infected persons. They act via several mechanisms of action to reduce the severity of infection and rate of infectivity of the virus by decreasing the viral load while increasing CD4 counts. COVID-19 pandemic has resulted in unprecedented events affecting almost all areas of humans' life including availability of medicines and other consumables. This paper analyses the availability of ARVs during COVID-19 era and offered recommendations to be adopted in order to prevent shortages.


Asunto(s)
Antirretrovirales/uso terapéutico , Infecciones por Coronavirus/tratamiento farmacológico , Reposicionamiento de Medicamentos , Infecciones por VIH/tratamiento farmacológico , Pandemias , Neumonía Viral/tratamiento farmacológico , Fármacos Anti-VIH/economía , Fármacos Anti-VIH/provisión & distribución , Fármacos Anti-VIH/uso terapéutico , Antirretrovirales/economía , Antirretrovirales/provisión & distribución , Terapia Antirretroviral Altamente Activa/economía , Betacoronavirus , Infecciones por Coronavirus/economía , Infecciones por Coronavirus/epidemiología , Países en Desarrollo , Costos de los Medicamentos/tendencias , Industria Farmacéutica , Infecciones por VIH/economía , Infecciones por VIH/epidemiología , Accesibilidad a los Servicios de Salud , Humanos , Seguro de Servicios Farmacéuticos , Cumplimiento de la Medicación , Nigeria/epidemiología , Pandemias/economía , Neumonía Viral/economía , Neumonía Viral/epidemiología , Carga Viral/efectos de los fármacos
10.
J Subst Abuse Treat ; 119: 108128, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-33138923

RESUMEN

The COVID-19 pandemic and its containment strategies have presented unique challenges to India's healthcare infrastructure. While a national lockdown initially resulted in the closure of all licensed liquor shops, it also made healthcare facilities dedicated to the treatment of substance use disorders challenging to access. Addiction treatment services have been functioning at limited capacity with a lack of consensus on operating procedures. In this article, we present actual case scenarios where lockdown affected substance use and the treatment process, and discuss the policy implications and considerations for both.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Prestación de Atención de Salud/organización & administración , Trastornos Relacionados con Opioides/rehabilitación , Neumonía Viral/epidemiología , Centros de Tratamiento de Abuso de Sustancias/organización & administración , Adulto , Accesibilidad a los Servicios de Salud , Humanos , India/epidemiología , Masculino , Persona de Mediana Edad , Pandemias
11.
J Subst Abuse Treat ; 119: 108147, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-33138930

RESUMEN

Many states have responded to the spread of COVID-19 by implementing policies which have led to a dramatic reduction in jail populations. We consider the benefits associated with providing the population of individuals who would, but for these policies, be incarcerated with substance use disorder (SUD) treatment. We discuss problems that may prevent this population from receiving SUD treatment as well as policies which may mitigate these problems.


Asunto(s)
Infecciones por Coronavirus , Accesibilidad a los Servicios de Salud , Pandemias , Neumonía Viral , Prisiones/estadística & datos numéricos , Trastornos Relacionados con Sustancias/rehabilitación , Humanos , Políticas , Prisioneros , Gobierno Estatal
12.
Med Sci (Paris) ; 36(11): 1034-1037, 2020 Nov.
Artículo en Francés | MEDLINE | ID: mdl-33151866

RESUMEN

Coronavirus disease (COVID)-19 is an emerging pandemic infection whose significant ability to spread in a naïve population is well established. The first response of states to the COVID-19 outbreak was to impose lock-down and social barrier measures, such as wearing a surgical mask or social distancing. One of the consequences of this pandemic in terms of public health was the suspension or slowdown of infant vaccination campaigns, in almost all countries. The indirect effects of COVID-19 may therefore weigh on mortality from measles and polio in developing countries. In this pandemic chaos, the only hope lies in the rapid development of an effective vaccine against severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). However, acceptance of this vaccine has not yet been won, as beyond the many unknowns that will inevitably weigh around such rapid development, skepticism among vaccine hesitants is growing.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Programas de Inmunización/estadística & datos numéricos , Pandemias , Neumonía Viral/epidemiología , Salud Pública/estadística & datos numéricos , Vacunación/estadística & datos numéricos , Betacoronavirus/fisiología , Infecciones por Coronavirus/inmunología , Infecciones por Coronavirus/prevención & control , Brotes de Enfermedades/prevención & control , Accesibilidad a los Servicios de Salud/organización & administración , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Humanos , Programas de Inmunización/organización & administración , Programas de Inmunización/normas , Programas de Inmunización/tendencias , Sarampión/epidemiología , Sarampión/prevención & control , Pandemias/prevención & control , Participación del Paciente/estadística & datos numéricos , Participación del Paciente/tendencias , Neumonía Viral/inmunología , Neumonía Viral/prevención & control , Poliomielitis/epidemiología , Poliomielitis/prevención & control , Salud Pública/normas , Salud Pública/tendencias , Cobertura de Vacunación/organización & administración , Cobertura de Vacunación/estadística & datos numéricos , Vacunas Virales/uso terapéutico
13.
Afr J Prim Health Care Fam Med ; 12(1): e1-e4, 2020 Nov 05.
Artículo en Inglés | MEDLINE | ID: mdl-33181873

RESUMEN

Cape Town is currently one of the hotspots for COVID-19 on the African continent. The Metropolitan Health Services have re-organised their primary health care (PHC) services to tackle the epidemic with a community-orientated primary care perspective. Two key goals have guided the re-organisation, the need to maintain social distancing and reduce risk to people using the services and the need to prepare for an influx of people with COVID-19. Facilities were re-organised to have 'screening and streaming' at the entrance and patients were separated into hot and cold streams. Both streams had 'see and treat' stations for the rapid treatment of minor ailments. Patients in separate streams were then managed further. If patients with chronic conditions were stable, they were provided with home delivery of medication by community health workers. Community health workers also engaged in community-based screening and testing. Initial evaluation of PHC preparedness was generally good. However, a number of key issues were identified. Additional infrastructure was required in some facilities to keep the streams separate with the onset of winter. Managers had to actively address the anxiety and fears of the primary care workforce. Attention also needed to be given to the prevention and treatment of non-COVID conditions as utilisation of these services decreased. The epidemic exposed intersectoral and intrasectoral fault lines, particularly access to social services at a time when they were most needed. Community screening and testing had to be refocused due to limited laboratory capacity and a lengthening turnaround time.


Asunto(s)
Servicios de Salud Comunitaria/métodos , Infecciones por Coronavirus/terapia , Prestación de Atención de Salud/métodos , Instituciones de Salud , Planificación en Salud , Pandemias , Neumonía Viral/terapia , Atención Primaria de Salud/métodos , Betacoronavirus , Enfermedad Crónica , Ciudades , Agentes Comunitarios de Salud , Coronavirus , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/virología , Epidemias , Personal de Salud , Accesibilidad a los Servicios de Salud , Humanos , Tamizaje Masivo , Organizaciones , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología , Neumonía Viral/virología , Estaciones del Año , Sudáfrica/epidemiología , Triaje
14.
J Acquir Immune Defic Syndr ; 85(4): e67-e69, 2020 12 01.
Artículo en Inglés | MEDLINE | ID: mdl-33136755

RESUMEN

BACKGROUND: COVID-19 is a new pandemic, and its impact by HIV status is unknown. National reporting does not include gender identity; therefore, data are absent on the impact of COVID-19 on transgender people, including those with HIV. Baseline data from the American Cohort to Study HIV Acquisition Among Transgender Women in High Risk Areas (LITE) Study provide an opportunity to examine pre-COVID factors that may increase vulnerability to COVID-19-related harms among transgender women. SETTING: Atlanta, Baltimore, Boston, Miami, New York City, Washington, DC. METHODS: Baseline data from LITE were analyzed for demographic, psychosocial, and material factors that may affect vulnerability to COVID-related harms. RESULTS: The 1020 participants had high rates of poverty, unemployment, food insecurity, homelessness, and sex work. Transgender women with HIV (n = 273) were older, more likely to be Black, had lower educational attainment, and were more likely to experience material hardship. Mental and behavioral health symptoms were common and did not differ by HIV status. Barriers to health care included being mistreated, provider discomfort serving transgender women, and past negative experiences; as well as material hardships, such as cost and transportation. However, most reported access to material and social support-demonstrating resilience. CONCLUSIONS: Transgender women with HIV may be particularly vulnerable to pandemic harms. Mitigating this harm would benefit everyone, given the highly infectious nature of this coronavirus. Collecting gender identity in COVID-19 data is crucial to inform an effective public health response. Transgender-led organizations' response to this crisis serve as an important model for effective community-led interventions.


Asunto(s)
Infecciones por Coronavirus/psicología , Infecciones por VIH/complicaciones , Neumonía Viral/psicología , Personas Transgénero/psicología , Poblaciones Vulnerables/psicología , Boston , Infecciones por Coronavirus/complicaciones , Femenino , Accesibilidad a los Servicios de Salud/tendencias , Humanos , Estudios Longitudinales , Masculino , Mid-Atlantic Region , Pandemias , Neumonía Viral/complicaciones , Carencia Psicosocial , Apoyo Social , Factores Socioeconómicos , Sudeste de Estados Unidos
15.
N C Med J ; 81(6): 348-354, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33139462

RESUMEN

BACKGROUND Resettled refugees are at increased risk of poor health outcomes due to acculturation challenges, logistical barriers, experiences of trauma, and other barriers to care that are poorly understood. Refugee children may be particularly vulnerable due to disruptions in health, well-being, education, and nutrition during the resettlement process.METHOD To describe the health care barriers facing refugees in the North Carolina Triangle area (comprised of Durham, Chapel Hill, Raleigh, and their surrounding areas), we conducted three focus group interviews (in Arabic, French, and Swahili) with 25 refugee parents from Syria, Iraq, Central African Republic, the Democratic Republic of the Congo, and Chad. We also administered a survey to nine organizations that provide services for refugees.RESULTS Focus group responses highlighted the multidimensional nature of health care barriers for refugee families and children, encompassing challenges with acculturation, communication, transportation, finances, and health literacy. Organizations emphasized similar challenges and described their efforts to improve access to services through increased communication, coordination, and seeking new financial support for programs.LIMITATIONS Given the geographic focus of the study, results may not be generalizable to other populations and settings. Men spoke more than women in some focus groups, and participants may have been influenced by more vocal contributors. Furthermore, this study is limited by a lack of health outcomes data.CONCLUSIONS This study suggests that the health care needs of refugees living in the North Carolina Triangle area can be better met by providing comprehensive, coordinated, and culturally relevant care. This could include minimizing the number of visits by integrating multiple services under one roof, providing trauma-informed interpreters, and offering accessible transportation services.


Asunto(s)
Accesibilidad a los Servicios de Salud , Refugiados , Niño , Familia , Femenino , Grupos Focales , Humanos , Masculino , North Carolina
17.
Epilepsy Behav ; 112: 107476, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-33181895

RESUMEN

The current pandemic of coronavirus disease 2019 (COVID-19) that led to an unprecedented crisis with significant health, social, and economic repercussions presented more serious concerns for those living with some chronic conditions such as epilepsy. This study was aimed to find out impact of the COVID-19 pandemic on management of epilepsy. A cross-sectional study was conducted through telephone interviews, targeting 213 caregivers of pediatric patients with epilepsy, belonging to underserved areas of Faisalabad, Punjab, Pakistan. A simple questionnaire was designed to record the responses of participants relevant to the direct and indirect effects of COVID-19 pandemic and their knowledge about possible ways that can be accessed for the management of epilepsy during an ongoing pandemic. The current study, which holds 77% of the respondents from rural areas and 23% from urban settings, showed that partial measures of lockdown taken to stop or slow the spread of COVID-19 resulted in adverse economic and health outcomes in the said population including cancelation of follow-up visits, worsening of seizures, job loss, burden of antiepileptic drugs (AEDs) costs, and discontinuation of medicines. Furthermore, knowledge about alternative ways to access health facilities was found very poor among caregivers. Income sources of poor people disrupted by lockdown can lead to unintentional nonadherence to medication, which is a clear picture of inequitable distribution of resources. This study highlights the major issues faced by the caregivers during this ongoing pandemic of COVID-19.


Asunto(s)
Anticonvulsivantes , Infecciones por Coronavirus/prevención & control , Coronavirus , Epilepsia/tratamiento farmacológico , Accesibilidad a los Servicios de Salud , Neumonía Viral/prevención & control , Cuarentena/psicología , Aislamiento Social , Anticonvulsivantes/economía , Anticonvulsivantes/provisión & distribución , Anticonvulsivantes/uso terapéutico , Betacoronavirus , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/psicología , Estudios Transversales , Epilepsia/epidemiología , Femenino , Recursos en Salud , Humanos , Estudios Longitudinales , Masculino , Cumplimiento de la Medicación , Pakistán , Pandemias , Neumonía Viral/epidemiología , Neumonía Viral/psicología , Convulsiones/epidemiología , Encuestas y Cuestionarios , Telemedicina , Poblaciones Vulnerables
18.
BMJ Glob Health ; 5(11)2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-33184065

RESUMEN

INTRODUCTION: The COVID-19 pandemic caused a healthcare crisis in China and continues to wreak havoc across the world. This paper evaluated COVID-19's impact on national and regional healthcare service utilisation and expenditure in China. METHODS: Using a big data approach, we collected data from 300 million bank card transactions to measure individual healthcare expenditure and utilisation in mainland China. Since the outbreak coincided with the 2020 Chinese Spring Festival holiday, a difference-in-difference (DID) method was employed to compare changes in healthcare utilisation before, during and after the Spring Festival in 2020 and 2019. We also tracked healthcare utilisation before, during and after the outbreak. RESULTS: Healthcare utilisation declined overall, especially during the post-festival period in 2020. Total healthcare expenditure and utilisation declined by 37.8% and 40.8%, respectively, while per capita expenditure increased by 3.3%. In a subgroup analysis, we found that the outbreak had a greater impact on healthcare utilisation in cities at higher risk of COVID-19, with stricter lockdown measures and those located in the western region. The DID results suggest that, compared with low-risk cities, the pandemic induced a 14.8%, 26.4% and 27.5% reduction in total healthcare expenditure in medium-risk and high-risk cities, and in cities located in Hubei province during the post-festival period in 2020 relative to 2019, an 8.6%, 15.9% and 24.4% reduction in utilisation services; and a 7.3% and 18.4% reduction in per capita expenditure in medium-risk and high-risk cities, respectively. By the last week of April 2020, as the outbreak came under control, healthcare utilisation gradually recovered, but only to 79.9%-89.3% of its pre-outbreak levels. CONCLUSION: The COVID-19 pandemic had a significantly negative effect on healthcare utilisation in China, evident by a dramatic decline in healthcare expenditure. While the utilisation level has gradually increased post-outbreak, it has yet to return to normal levels.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Gastos en Salud/estadística & datos numéricos , Accesibilidad a los Servicios de Salud , Aceptación de la Atención de Salud/estadística & datos numéricos , Neumonía Viral/epidemiología , Betacoronavirus , China/epidemiología , Humanos , Pandemias
19.
Rev Saude Publica ; 54: 102, 2020.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-33146296

RESUMEN

OBJECTIVE: To present the methodological approach used in a research that analyzed the use and performance of specialized health care, from primary care access, in four major Brazilian cities: Fortaleza (CE), Campinas (SP), São Paulo (SP) and Porto Alegre (RS). METHODS: Presentation and discussion of the quantitative-qualitative components of the proposed research strategy. RESULTS: Four tracing conditions were studied: systemic arterial hypertension, high-risk pregnancy, breast cancer and severe mental disorder. For each health condition, indicators were constructed based on health information systems data, pointing out frequencies, temporal trends and local differences. This initial contextualization was enriched with a descriptive-qualitative study of the performance of each municipal health service network. Next, a cross-sectional study was conducted through a survey of 7,053 users of specialized services for each health condition. Finally, in-depth interviews were conducted with key actors to complement selected operational aspects of each municipality's network. The results of all these data sources were triangulated, allowing us to explore the variability of SUS implementations in different regional scenarios. CONCLUSIONS: The multifaceted analytical model presented allows us to understand relevant aspects of the Unified Health System performance, paying attention to the singularities, heterogeneities and inequalities that characterize its implementation in Brazil and emphasizing the performance of local networks for the addressed health conditions.


Asunto(s)
Prestación de Atención de Salud/organización & administración , Atención Primaria de Salud/organización & administración , Brasil , Ciudades , Estudios Transversales , Accesibilidad a los Servicios de Salud , Humanos , Factores Socioeconómicos
20.
Rev Saude Publica ; 54: 109, 2020.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-33146299

RESUMEN

OBJECTIVE: To analyze the shortage of benzathine penicillin G (BPG), characterizing its temporal evolution and spatial distribution in the city of Rio de Janeiro from 2013 to 2017. METHODS: This ecological study used gestational and congenital syphilis notifications, BPG distribution records, and sociodemographic data from the population of Rio de Janeiro. To quantify the shortage, a BPG supply indicator was estimated per quarter for each neighborhood between 2013 and 2017. Thematic maps were created to identify areas and periods with greater BPG shortage, described according to sociodemographic factors, health services network, and epidemiological features in the incidence of syphilis. RESULTS: BPG shortage in Rio de Janeiro from 2013 to 2017 was not homogeneous in space nor in time. The temporal evolution and spatial distribution of BPG scarcity shows that the shortage affected the inhabitants of the municipality in different ways. Shortage was lower in 2013 and 2016 and more severe in 2014, 2015, and 2017, particularly in neighborhoods within the programmatic areas PA3 and PA5, poorer and with higher prevalence rates of gestational and congenital syphilis. CONCLUSIONS: Analyzing BPG shortage and its temporal evolution and spatial distribution in Rio de Janeiro allowed us to realize that the inhabitants are affected in different ways. Understanding this process contributes to the planning of actions to face shortage crises, minimizing possible impacts on the management of syphilis and reducing inequality in access to treatment.


Asunto(s)
Accesibilidad a los Servicios de Salud , Disparidades en el Estado de Salud , Penicilina G Benzatina/provisión & distribución , Sífilis Congénita/epidemiología , Sífilis/epidemiología , Brasil/epidemiología , Femenino , Humanos , Masculino , Penicilina G Benzatina/uso terapéutico , Embarazo , Análisis Espacio-Temporal , Sífilis/tratamiento farmacológico , Sífilis Congénita/tratamiento farmacológico
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