Spatial analysis of congenital syphilis in a federative unit in northeastern Brazil.

BACKGROUND: Congenital syphilis is an infectious disease that affects 1 million children a year worldwide. METHODS: The objective of this study was to describe a spatial analysis of the epidemiological characteristics of congenital syphilis in the state of Maranhão, Brazil from 2007 to 2018. This was an ecological study using data obtained in May 2020 from three Brazilian information systems. The spatial correlation was analyzed according to local and global Moran indexes. RESULTS: During the 12-y period, 1 426 177 children were born. Of these children, 3684 acquired congenital syphilis (0.26%; mean annual rate of 2.62/1000 live births) and 70 died (1.90%; mean annual rate 0.05). The clusters were statistically significant according to the global Moran index of 0.40 (p=0.01). Spearman's correlation coefficient between the rate of detection of syphilis in pregnant women and family health strategy teams was strong, positive and significant (ρ=0.73; p<0.00). Most of the variables studied showed a trend of annual increase (p<0.05). CONCLUSIONS: The use of spatial analysis tools have made it possible to detect areas with both a greater and a lesser need for intervention, and to more effectively improve and monitor those areas to change the epidemiological profile of the disease.

Access to Health Services and Assistance Offered to the Afro-Descendant Communities in Northern Brazil: A Qualitative Study.

The remnants of quilombos, individuals of African descent, have faced several barriers throughout its history, either due to prejudice imposed by society, or the non-fulfillment of their rights guaranteed in the 1988 Constitution, such as access to health services. Thus, this study aims to evaluate the health care offered to quilombo communities in the northern region of Tocantins. This is an exploratory, descriptive study with a qualitative approach, including field research and focus group, carried out with 58 quilombo remnants people from communities in the northern region of Tocantins. Data collection was carried out between from October 2017 to July 2018, through semi-structured interviews. We found that these communities have limited access to health services, in addition to a negative perception of the assistance offered to the health of their population and the commitment of managers. Therefore, access to health and assistance received by the studied communities required to be prioritized since the care provided is not unique and has not met the health demands and needs of the remaining quilombos in northern Tocantins, Brazil.

El juguete terapéuticoinstruccional según los cuidadores de niños hospitalizados / The instructional therapeutic toy according to caregivers of hospitalized children

OBJETIVO: Describir la eficacia del juguete terapéutico instructivo de acuerdo con el criterio de cuidadores de niños hospitalizados. MÉTODO: Estudio descriptivo, cualitativo y fenomenológico, llevado a cabo entre enero y febrero de 2017, en hospital público. Muestra compuesta por siete sujetos. Datos recolectados mediante entrevista grabada y transcrita, iniciada con la pregunta orientadora: «¿Qué opinas de la utilización del juguete terapéutico instruccional con tu hijo?». RESULTADOS: Por medio del análisis de las conversaciones, fue posible identificar cinco categorías: Juguete como instrumento de aprendizaje, Juguete en el afrontamiento del procedimiento, Juguete como instrumento esclarecedor, Juguete como ayuda a la mejora del humor y Utilización del juguete como intervención de enfermería. CONCLUSIÓN: Los cuidadores de los niños consideraron positiva la utilización de la técnica del juguete terapéutico instruccional, como forma de humanizar la hospitalización del niño, oportunidad de expresar emociones y participar de forma activa en la implementación del juguete en la atención infantil

OBJECTIVE: To describe the effectiveness of using an instructional therapeutic toy, according to caregivers of hospitalized children. METHOD: A descriptive, qualitative and phenomenological study, conducted from January to February 2017, in a public hospital. The sample was made of seven subjects. Data was collected through recorded and transcribed interviews, initiated by the guiding question: «What do you think of using the instructional therapeutic toy with your son?». RESULTS: While analyzing the content of the interviews, it was possible to identify five categories: the toy as a learning tool, the toy as a tool to demonstrate the medical procedure, the toy as an enlightening instrument, the toy as an aid to improve humor, and the toy as a nursing intervention. CONCLUSION: Children caregivers have considered positive the use of the instructional therapeutic toy as a way of humanizing children hospitalization, giving them an opportunity to express emotions, and to participate actively in the implementation of the toy child care

Socio-environmental factors and diarrheal diseases in under five-year old children in the state of Tocantins, Brazil.

BACKGROUND: Diarrhea is a waterborne disease that affects children, especially those under 5 years of age. The objective of this study was to identify the spatial patterns of distribution of diarrheal disease in under 5-year-old children in the State of Tocantins, Brazil, from 2008 to 2013. METHODS: Geoprocessing tools were used to carry out an epidemiological study, to prepare thematic maps in the TerraView 4.2.2 software based on secondary data. General indicators of the disease, presence of spatial dependence through the Global Moran's Index (I) and the Spatial Association Index (LISA) were described. RESULTS: There were 3,015 cases of under 5-year-old children hospitalized for diarrhea, with an average annual rate (AAR) of 4.10/1,000 inhabitants (inhab.). Among the main characteristics were: increasing rates in under 1-year-old children (6.16 to 9.66/1,000 inhabitants); children aged 1 to 4 full years (63%); males (55%); 8 deaths of under one-year-old children (75%); county of Araguaína (67%); incidence in the county of Nazaré (63.97/1,000 inhab.); prevalence and incidence in the Araguaína microregion (45%, AAR 9.38/1,000 inhab.). The presence of a cluster with spatial autocorrelation was found in the Araguaína microregion, which was statistically significant (I = 0.11, p-value < 0.03), with priority of intervention (Moran Map). CONCLUSIONS: There was an increase in the number of hospitalizations for diarrhea in under 5-year-old children in the state of Tocantins. The spatial analysis identified clusters of priority areas for measures of maintenance and control of diarrheal diseases.