RESUMO
Water is essential for the socio-economic development of a region and also for the survival of human beings. Water scarcity has direct and indirect impacts on the environment, the economy and human health. It can change the profile of morbidity and mortality of diseases, as well as having an impact on the supply of services that are essential public to the quality of life. This study aims to contextualize the occurrence of drought in Brazil, its effects on human health, as well as actions to be developed by the health sector to reduce the risk to those living in affected areas, with an emphasis on the monitoring of the quality of drinking water. This is a descriptive, qualitative study with a documental basis. The documents that were researched were related to initiatives by the Health Surveillance Secretariat of the Ministry of Health up until 2014. It is necessary to strengthen the performance capacity of the Unified Health System (SUS) in order to develop timely responses to reduce the risk to public health.
Assuntos
Secas , Qualidade de Vida , Brasil , Meio Ambiente , Humanos , Saúde PúblicaRESUMO
Abstract Low quality drinking water has been directly correlated to the occurrence of waterborne illnesses in northern Brazil. To minimize health risks related to the water supply, the Ministry of Health has proposed the implementation of the National Program for the Surveillance of Drinking Water Quality (VIGIAGUA) in Brazilian municipalities. Focusing on the Legal Amazon region, the present study demonstrates a historical account of the percentage of municipalities included in the VIGIAGUA program in place, which in 2013 reached 45.1% of the region municipalities. This study also identifies vulnerable areas in terms of the water quality in the states of Amapá, Amazonas and Maranhão. With this analysis of the current status of the drinking water supply, this study intends to support and direct the strategic efforts of environmental health monitoring in the region.
Resumo A baixa qualidade da água para consumo humano está diretamente relacionada à ocorrência de doenças de transmissão hídrica. Para minimizar riscos à saúde e vulnerabilidades relacionadas ao abastecimento de água, o Ministério da Saúde propõe a implantação do Programa Nacional de Vigilância da Qualidade da Água para Consumo Humano (Vigiagua) aos municípios brasileiros. Focando na região da Amazônia Legal, o presente estudo demonstra uma série histórica do percentual de municípios com o programa Vigiagua implantado, atingindo em 2013 a marca de 45,1% dos municípios dessa região. O estudo ainda identifica áreas muito vulneráveis nos estados do Amapá, Amazonas e Maranhão para a questão da qualidade da água. Com esta análise da situação do abastecimento de água para consumo humano pretende-se subsidiar e direcionar as ações estratégicas da vigilância em saúde ambiental na região.
RESUMO
Resumo A água é essencial para o desenvolvimento socioeconômico de um território e, também, para sobrevivência do ser humano. A escassez hídrica causa impactos diretos e indiretos sobre o ambiente, a economia e a saúde humana, podendo alterar o perfil de morbidade e mortalidade das doenças, além de impactar a oferta de serviços públicos essenciais à qualidade de vida. Este estudo visa contextualizar a ocorrência de estiagem e seca no Brasil, os efeitos à saúde humana, bem como ações a serem desenvolvidas pelo setor saúde para reduzir o risco de exposição da população das áreas atingidas, com ênfase nas ações de vigilância da qualidade da água para consumo humano. Trata-se de estudo descritivo, qualitativo, com base documental. Foram pesquisados documentos elaborados com base em iniciativas da Secretaria de Vigilância em Saúde do Ministério da Saúde até 2014. Considera-se necessário fortalecer a capacidade de atuação do Sistema Único de Saúde para o desenvolvimento de respostas oportunas para a redução do risco à saúde da população.
Abstract Water is essential for the socio-economic development of a region and also for the survival of human beings. Water scarcity has direct and indirect impacts on the environment, the economy and human health. It can change the profile of morbidity and mortality of diseases, as well as having an impact on the supply of services that are essential public to the quality of life. This study aims to contextualize the occurrence of drought in Brazil, its effects on human health, as well as actions to be developed by the health sector to reduce the risk to those living in affected areas, with an emphasis on the monitoring of the quality of drinking water. This is a descriptive, qualitative study with a documental basis. The documents that were researched were related to initiatives by the Health Surveillance Secretariat of the Ministry of Health up until 2014. It is necessary to strengthen the performance capacity of the Unified Health System (SUS) in order to develop timely responses to reduce the risk to public health.
Assuntos
Humanos , Qualidade de Vida , Secas , Brasil , Saúde Pública , Meio AmbienteRESUMO
Paracoccidioidomycosis (PCM) is an endemic mycosis in Latin America caused by the dimorphic fungus Paracoccidioides brasiliensis. The pattern of the immune responses to P. brasiliensis determines the disease progression and clinical outcome. Innate immune response is mediated by phagocytic cells, such as macrophage and neutrophils, which ingest and kill invading pathogens and then trigger the adaptive immune system through the secretion of cytokines and chemokines. The C-type like lectin receptors (CLR) and Toll-like receptors (TLRs) are the two main pattern recognition receptors in phagocytic cells that recognize fungal components. Therefore, the purpose of the present study was to evaluate the expression of TLR-1, TLR-2, TLR-4 and dectin-1 (CLR) in monocytes and neutrophils from healthy individuals after stimulation with Pb18 (high virulence) and Pb265 (low virulence) yeasts of P. brasiliensis. As positive controls we used specific ligands to TLR-4 (LPS), TLR-2 and dectin-1 (zymosan). Our results demonstrated a decreased of TLRs and dectin-1 expression mainly on monocytes as opposes on neutrophils, as soon as 30 minutes after yeast cells stimulation. This decrease was similar to the one caused by zymosan stimulation and indicates that up binding the complexes are rapidly internalized. There was a tendency towards an increased TLR2 and dectin-1 mRNA expression in response to fungal cells, mainly to Pb265. P. brasiliensis yeast cells induced the production of pro-inflammatory and anti-inflammatory cytokines, but the low ratio between TNF-alpha and IL-10 in response to zymosan and Pb265 indicates a balanced production of IL-10 and TNF-alpha, while Pb18 predominantly induced TNF-alpha secretion. Fungal cells also induced an elevated production of PGE(2) by monocytes and neutrophils showing their potential to provoke an intense inflammatory response. Altogether our results suggest the participation of TLR2, TLR-4 and dectin-1 in P. brasiliensis recognition, internalization and consequent activation of the immune response against the fungus. Moreover, the preferential recognition of zymosan and Pb265 by TLR-2 and dectin-1 would result in the production of adequate concentration of IL-10, which would be able to counterbalance the excessive inflammatory response mediated by TNF-alpha and PGE2. With these attributes the low virulence strain of P. brasiliensis would induce a controlled immune response beneficial to the host.