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Resumo Objetivo identificar, dentro dos três eixos de vulnerabilidades (individuais, sociais e programáticas), os fatores associados aos desfechos desfavoráveis do tratamento de tuberculose (TB) entre os idosos no Brasil entre 2015 e 2019. Método trata-se de um estudo transversal com dados secundários provenientes do Sistema de Informação de Agravos de Notificação dos casos de TB notificados no Brasil, em pessoas com idade igual ou maior que 60 anos. As co-variáveis associadas com o desfecho de interesse (p≤0,20) foram incluídas em um modelo de regressão logística multinomial utilizando a categoria cura como referência. Resultados idosos autodeclarados pretos e pardos, em situação de rua, com transtorno de saúde mental, que vivem com o vírus da imunodeficiência humana (HIV), que utilizam drogas lícitas e ilícitas tiveram maiores chances de perda de seguimento. Enquanto idosos em situação de rua, com transtorno de saúde mental, que utilizam drogas lícitas e ilícitas, e que não realizaram baciloscopia, apresentaram maiores chances para ocorrência de óbito por TB. Para o desfecho óbito por outras causas, pessoas que vivem com diabetes mellitus e com HIV, que utilizam drogas lícitas e ilícitas, tiveram maiores chances para ocorrência desse desfecho. Conclusão os resultados destacam a influência de fatores nos desfechos do tratamento da TB em idosos, abrangendo os eixos individual, social e programático. Aspectos como idade avançada, raça, sexo feminino, comorbidades e situação de rua foram identificados como determinantes relevantes, ressaltando a necessidade de abordagens integradas para melhorar os resultados e promover um desfecho favorável no tratamento da TB em idosos.
Abstract Objective To identify, within the three axes of vulnerabilities (individual, social, and programmatic), the factors associated with unfavorable treatment outcomes of tuberculosis (TB) among older adults in Brazil between 2015 and 2019. Method This is a cross-sectional study utilizing secondary data from the Notifiable Diseases Information System (SINAN) regarding reported TB cases in Brazil, among individuals aged 60 years or older. The covariates associated with the outcome of interest (p≤0.20) were included in a multinomial logistic regression model using the cure category as the reference. Results Older adults self-identified as black or mixed-race, experiencing homelessness, with mental health disorders, living with the human immunodeficiency virus (HIV), and engaging in the use of licit and illicit drugs had higher odds of loss to follow-up. Furthermore, older adults experiencing homelessness, with mental health disorders, engaging in the use of licit and illicit drugs, and who did not undergo bacilloscopy, presented higher odds of death due to TB. For the outcome of death due to other causes, individuals living with diabetes mellitus and HIV, engaging in the use of licit and illicit drugs, also had higher odds of experiencing this outcome Conclusion The results highlighted the influence of factors on TB treatment outcomes in older adults, encompassing the individual, social, and programmatic axes. Aspects such as advanced age, race, female sex, comorbidities, and homelessness were identified as relevant determinants, emphasizing the need for integrated approaches to improve outcomes and promote a favorable treatment outcome for TB in older adults.
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Introduction: Several polymorphisms altering the NAT2 activity have already been identified. The geographical distribution of NAT2 variants has been extensively studied and has been demonstrated to vary significantly among different ethnic population. Here, we describe the genetic variability of human N-acetyltransferase 2 (NAT2) gene and the predominant genotype-deduced acetylation profiles of Brazilians. Methods: A total of 964 individuals, from five geographical different regions, were genotyped for NAT2 by sequencing the entire coding exon. Results: Twenty-three previously described NAT2 single nucleotide polymorphisms (SNPs) were identified, including the seven most common ones globally (c.191G>A, c.282C>T, c.341T>C, c.481C>T, c.590G>A, c.803A>G and c.857G>A). The main allelic groups were NAT2*5 (36%) and NAT2*6 (18.2%), followed to the reference allele NAT2*4 (20.4%). Combined into genotypes, the most prevalent allelic groups were NAT2*5/*5 (14.6%), NAT2*5/*6 (11.9%) and NAT2*6/*6 (6.2%). The genotype deduced NAT2 slow acetylation phenotype was predominant but showed significant variability between geographical regions. The prevalence of slow acetylation phenotype was higher in the Northeast, North and Midwest (51.3%, 45.5% and 41.5%, respectively) of the country. In the Southeast, the intermediate acetylation phenotype was the most prevalent (40.3%) and, in the South, the prevalence of rapid acetylation phenotype was significantly higher (36.7%), when compared to other Brazilian states (p < 0.0001). Comparison of the predicted acetylation profile among regions showed homogeneity among the North and Northeast but was significantly different when compared to the Southeast (p = 0.0396). The Southern region was significantly different from all other regions (p < 0.0001). Discussion: This study contributes not only to current knowledge of the NAT2 population genetic diversity in different geographical regions of Brazil, but also to the reconstruction of a more accurate phenotypic picture of NAT2 acetylator profiles in those regions.
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Background and objectives: to compare the clinical and sociodemographic aspects of individuals with SARS reported in the countryside of Rio Grande do Sul in 2020 and 2021. Methods: a cross-sectional study, from March 2020 to October 2021. Clinical and sociodemographic variables of individuals with SARS symptoms were analyzed, compared through descriptive, univariate analyses, according to the year of reporting. Results: a total of 4,710 cases of SARS were reported; 53.4% were SARS related to COVID-19 in 2020 and 87.5% in 2021 (p<0.001). Comparing 2020 and 2021, the sociodemographic profile changed in terms of age group, skin color and education (p<0.001). Regarding clinical aspects, there was a reduction in prevalence of pre-existing health conditions, except obesity, changes in reported signs and symptoms and reduction in hospital and Intensive Care Unit admissions. Conclusion: the changes in the profile may reflect the effect of the different variants and the start of immunization for SARS-CoV-2.(AU)
Justificativa e objetivos: comparar, entre os anos de 2020 e 2021, os aspectos clínicos e sociodemográficos dos indivíduos com Síndrome Respiratória Aguda Grave (SRAG) notificados em uma região de saúde do interior do Rio Grande do Sul. Métodos: estudo transversal descritivo, realizado de março de 2020 a outubro de 2021. Foram analisadas variáveis clínicas e sociodemográficas de indivíduos com sintomas de SRAG, comparadas através de análises descritivas, univariadas, conforme o ano de notificação. Resultados: foram notificados 4.710 casos com SRAG; 53,4% foram SRAG relacionados à COVID-19 em 2020 e, 87,5%, em 2021 (p<0,001). Comparando os anos 2020 e 2021, o perfil sociodemográfico modificou quanto faixa etária, cor da pele e escolaridade (p<0,001). Quanto aos aspectos clínicos, houve redução da prevalência de condições de saúde preexistente, exceto obesidade, alterações nos sinais e sintomas relatados e diminuição de internações hospitalares e na Unidade de Terapia Intensiva. Conclusão: as mudanças no perfil podem refletir o efeito das diferentes variantes e o início da imunização para SARS-CoV-2.(AU)
Justificación y objetivos: comparar los aspectos clínicos y sociodemográficos de individuos con SARS notificados en el interior de Rio Grande do Sul en los años 2020 y 2021. Métodos: estudio descriptivo transversal, realizado de marzo de 2020 a octubre de 2021. Se analizaron variables clínicas y sociodemográficas de individuos con síntomas de SARS, comparadas mediante análisis descriptivos univariados, según el año de notificación. Resultados: se notificaron 4.710 casos de SARS; el 53,4% fueron SARS relacionados con COVID-19 en 2020 y el 87,5% en 2021 (p<0,001). Comparando los años 2020 y 2021, el perfil sociodemográfico cambió en cuanto a grupo de edad, color de piel y escolaridad (p<0,001). En cuanto a los aspectos clínicos, hubo reducción en la prevalencia de condiciones de salud preexistentes, excepto obesidad, cambios en los signos y síntomas reportados y reducción en los ingresos hospitalarios y en la Unidad de Cuidados Intensivos. Conclusión: los cambios en el perfil pueden reflejar el efecto de las diferentes variantes y el inicio de la inmunización para el SARS-CoV-2.(AU)
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Humanos , Epidemiologia Descritiva , Estudos Transversais , Síndrome Respiratória Aguda Grave , SARS-CoV-2 , COVID-19RESUMO
Brazil currently ranks second in absolute deaths by COVID-19, even though most of its population has completed the vaccination protocol. With the introduction of Omicron in late 2021, the number of COVID-19 cases soared once again in the country. We investigated in this work how lineages BA.1 and BA.2 entered and spread in the country by sequencing 2173 new SARS-CoV-2 genomes collected between October 2021 and April 2022 and analyzing them in addition to more than 18,000 publicly available sequences with phylodynamic methods. We registered that Omicron was present in Brazil as early as 16 November 2021 and by January 2022 was already more than 99% of samples. More importantly, we detected that Omicron has been mostly imported through the state of São Paulo, which in turn dispersed the lineages to other states and regions of Brazil. This knowledge can be used to implement more efficient non-pharmaceutical interventions against the introduction of new SARS-CoV variants focused on surveillance of airports and ground transportation.
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COVID-19 , SARS-CoV-2 , Humanos , SARS-CoV-2/genética , Brasil/epidemiologia , Meios de Transporte , VacinaçãoRESUMO
Prostate cancer (PCa) is one of the most prevalent types of cancer in men worldwide; however, the main diagnostic tests available for PCa have limitations and a biopsy is required for histopathological confirmation of the disease. Prostate-specific antigen (PSA) is the main biomarker used for the early detection of PCa, but an elevated serum concentration is not cancer-specific. Therefore, there is a need for the discovery of new non-invasive biomarkers that can accurately diagnose PCa. The present study used trichloroacetic acid-induced protein precipitation and liquid chromatography-mass spectrometry to profile endogenous peptides in urine samples from patients with PCa (n=33), benign prostatic hyperplasia (n=25) and healthy individuals (n=28). Receiver operating characteristic curve analysis was performed to evaluate the diagnostic performance of urinary peptides. In addition, Proteasix tool was used for in silico prediction of protease cleavage sites. Five urinary peptides derived from uromodulin were revealed to be significantly altered between the study groups, all of which were less abundant in the PCa group. This peptide panel showed a high potential to discriminate between the study groups, resulting in area under the curve (AUC) values between 0.788 and 0.951. In addition, urinary peptides outperformed PSA in discriminating between malignant and benign prostate conditions (AUC=0.847), showing high sensitivity (81.82%) and specificity (88%). From in silico analyses, the proteases HTRA2, KLK3, KLK4, KLK14 and MMP25 were identified as potentially involved in the degradation of uromodulin peptides in the urine of patients with PCa. In conclusion, the present study allowed the identification of urinary peptides with potential for use as non-invasive biomarkers in PCa diagnosis.
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To evaluate the genetic diversity and clustering rates of M. tuberculosis strains to better understand transmission among persons deprived of liberty (PDL) in Rio Grande do Sul (RS), southern Brazil. This is a cross-sectional study, including strains of M. tuberculosis isolated from PDL, stored at the Central Laboratory of RS, in the period from 2013 to 2018. The molecular characterization was performed using the MIRU-VNTR 15 loci method. A total of 598 M. tuberculosis strains were genotyped, and 37.5% were grouped into 53 clusters. Cluster sizes ranged from 2 to 34 strains. The largest cluster of the study had strains from 34 PDL, and 58.8% of the PDL of this cluster were in P01. Among the clusters formed, in 60.3%, there was at least one strain from P01. The most common strains in RS were LAM (53.2%) and Haarlem (31.1%). The LAM strain was the most likely to form clusters, and Haarlem was associated with anti-TB drug resistance. This was translational research, and the results can collaborate with the TB control programs, leading to improved strategies that allow the reduction of the TB burden in prisons.
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Mycobacterium tuberculosis , Tuberculose , Humanos , Mycobacterium tuberculosis/genética , Epidemiologia Molecular , Brasil/epidemiologia , Estudos Transversais , Genótipo , Repetições Minissatélites , Tuberculose/microbiologia , FilogeniaRESUMO
Resumo A Educação Permanente em Saúde legitimou a educação na saúde com base na aprendizagem significativa, em vivências no cotidiano de trabalho e na solução de problemas de forma coletiva, além de estar pautada no Quadrilátero Ensino-Gestão-Atenção-Controle Social. A pandemia da Covid-19 exigiu novas formas de fazer saúde e educação, principalmente no sistema prisional, onde a superlotação é um impeditivo ao isolamento social. Este estudo teve como objetivo identificar, por meio de rodas de conversa virtuais, os desafios encontrados no cotidiano de trabalho e discutir propostas de intervenção com os atores do sistema prisional no período pandêmico, na perspectiva da Educação Permanente em Saúde. Foi utilizada abordagem qualitativa de investigação com caráter descritivo, interpretativo e compreensivo de análise do fenômeno social, por meio da análise de conteúdo temático de Minayo. Da análise temática de conteúdo emergiram quatro categorias: desafios da assistência em saúde no sistema prisional no contexto da pandemia da Covid-19; desafios para a gestão da saúde nos estabelecimentos prisionais; interlocução entre instituições de ensino e sistema prisional; e o controle social e a representação familiar. As rodas de conversa virtuais propiciaram discussões aprofundadas e construções coletivas, propondo encaminhamentos pautados no Quadrilátero da Educação Permanente em Saúde.
Abstract Permanent Education in Health legitimized health education based on meaningful learning, experiences in daily work and collective problem solving, in addition to being based on the four-way approach, based on teaching, management, attention and social control. The COVID-19 pandemic has required new ways of doing health and education, especially in the prison system, where overcrowding is an impediment to social isolation. This study aimed to identify, through virtual conversation circles, the challenges encountered in daily work and discuss proposals for intervention with the actors of the prison system in the pandemic period, from the perspective of Permanent Education in Health. It was used a qualitative research approach with descriptive, interpretative and comprehensive analysis of the social phenomenon, through Minayo's thematic analysis of content. From the thematic analysis of content, four categories emerged: challenges of health care in the prison system in the context of the COVID-19 pandemic; challenges for health management in prisons; dialogue between educational institutions and the prison system; and social control and family representation. The virtual conversation rounds provided in-depth discussions and collective constructions, proposing referrals based on the four-way approach of Permanent Education in Health.
Resumen La Educación Permanente en Salud legitimó la educación en salud basada en el aprendizaje significativo, en experiencias en el cotidiano de trabajo y en la resolución colectiva de problemas, además de basarse en el Cuadrilátero Enseñanza-Gestión-Atención-Control Social. La pandemia del Covid-19 requirió nuevas formas de hacer salud y educación, especialmente en el sistema penitenciario, donde el amontonamiento es un impedimento para el aislamiento social. Este estudio tuvo como objetivo identificar, a través de círculos de conversación virtuales, los desafíos encontrados en el trabajo diario y discutir propuestas de intervención con los actores del sistema penitenciario en el período pandémico, en la perspectiva de la Educación Permanente en Salud. Se utilizó un enfoque de investigación cualitativo con un análisis descriptivo, interpretativo y comprensivo del análisis del fenómeno social, a través del análisis de contenido temático de Minayo. Del análisis temático de contenido surgieron cuatro categorías: desafíos de la atención en salud en el sistema penitenciario en el contexto de la pandemia de la Covid-19; desafíos para la gestión de la salud en las cárceles; diálogo entre las instituciones educativas y el sistema penitenciario; y el control social y la representación familiar. Los círculos de conversación virtuales proporcionaron discusiones profundas y construcciones colectivas, proponiendo encaminamientos basados en el Quadrilátero de la Educación Permanente en Salud.
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Educação Continuada , Pandemias , COVID-19 , SARS-CoV-2RESUMO
OBJECTIVE: to describe the spatial distribution, treatment status and characteristics of cases of people infected with the human immunodeficiency virus HIV in Santa Cruz do Sul, RS, 2001 to 2020. METHODS: descriptive study with data from individuals undergoing treatment for HIV/AIDS, in Santa Cruz do Sul, diagnosed from January 2001 to October 2020. RESULTS: 708 (94.4%) cases were analyzed, of these (58.2%) were male, with a mean age of 39 years, the maximum incidence rate was in 2019 (59.4/100,000 inhabitants), there was a high frequency of cases in the south and central region of the city, 92.9% of these individuals were still in active treatment and the dropout rate was 7.1% in the period. CONCLUSION: a higher incidence of HIV was observed in adult male, from the central and southern regions of the city, with a treatment rate close to the goals of the World Health Organization and a low dropout rate.
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Síndrome da Imunodeficiência Adquirida , Adulto , Humanos , Masculino , Feminino , Incidência , Brasil/epidemiologia , Síndrome da Imunodeficiência Adquirida/epidemiologia , CidadesRESUMO
Resumo Os objetivos deste artigo são descrever o processo de implementação das Equipes de Atenção Primária Prisional no Rio Grande do Sul, a frequência de notificações de tuberculose na população privada de liberdade e a relação cronológica entre ambas. Trata-se de uma pesquisa documental aninhada a um estudo transversal descritivo de série histórica. Foram analisadas as portarias de habilitação de Equipes de Atenção Primária Prisional e os números e os anos de notificação dos casos de tuberculose oriundos do Sistema Nacional de Agravos de Notificação no período de 2014 a 2020. O estado do Rio Grande do Sul foi pioneiro na municipalização e cofinanciamento da saúde prisional, o que resultou na implantação de 45 equipes, com cobertura aproximada de 54,5% das pessoas privadas de liberdade em regime fechado. As equipes notificaram, entre 2014 e 2020, 5.175 casos de tuberculose, com incremento progressivo da notificação de casos, assim como a implantação de novas equipes. A estratégia de implantação de Equipes de Atenção Primária Prisional, impulsionada pela Política Nacional de Atenção Integral à Saúde das Pessoas Privadas de Liberdade no Sistema Prisional, mostrou-se de fundamental importância para o aumento de diagnósticos, notificações e controle da tuberculose no estado do Rio Grande do Sul.
Abstract This paper aims to describe the implementation process of the Prison Primary Care Teams in Rio Grande do Sul, the frequency of tuberculosis notifications in people deprived of liberty, and their chronological relationship. This documentary research is nested in a descriptive cross-sectional study of historical series. We analyzed the decrees on the qualification of Prison Primary Care Teams, the number, and the year of notification of tuberculosis cases from the National System of Notifiable Diseases from 2014 to 2020. The state of Rio Grande do Sul pioneered prison health municipalization and shared financing, which resulted in the implementation of 45 teams, covering approximately 54.5% of people deprived of liberty a closed regime. The teams notified 5,175 cases of tuberculosis from 2014 to 2020, with a progressive increase in the notification of cases and the implementation of new teams. The strategy of implementing Prison Primary Care Teams driven by the National Comprehensive Health Care Policy for People Deprived of Liberty in the Prison System was crucial for increasing TB diagnosis, notification, and control in Rio Grande do Sul.
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Resumo A tuberculose (TB) apresenta incidências elevadas em todo o mundo, sendo ainda mais grave em pessoas privadas de liberdade (PPL). Foi avaliada a completude das notificações de TB de PPL no SINAN realizadas por equipes de atenção primária prisional (eAPP) ou por outros estabelecimentos de saúde do RS. Estudo descritivo, transversal, utilizando dados de notificações de PPL feitas no SINAN TB pelas eAPP ou por outros estabelecimentos de saúde, de janeiro de 2014 a novembro de 2018. Foi analisado o percentual de completude das variáveis: sexo, raça/cor, escolaridade, HIV, tipo de entrada, baciloscopia de escarro, cultura do escarro, Aids, tratamento antirretroviral durante o tratamento para a TB, tratamento diretamente observado (TDO), baciloscopia de 6º mês e situação de encerramento. Praticamente 53% dos casos de TB em PPL foram notificados por eAPP, e 47,1% foram notificados por outros estabelecimentos de saúde. Oitenta por cento das variáveis foram classificadas na categoria 4 (75,1% a 100% de completude). No entanto, as variáveis TDO e baciloscopia de 6º mês foram classificadas na categoria 3 (50,1% e 75% de completude). Embora não comprometa a notificação da TB no SINAN, a ausência de dados pode prejudicar a qualidade das informações sobre a doença.
Abstract Tuberculosis (TB) has a high incidence in several countries and is even more severe in prisoners. We evaluated the completeness of prisoners TB notifications in the Notifiable Disease Information System (SINAN) carried out by prison primary care teams (eAPP) or by other health facilities in the state of Rio Grande do Sul (RS). This descriptive cross-sectional study used prisoners data notifications in the SINAN TB by the eAPP or other health facilities from January 2014 to November 2018. We analyzed the percentage of completeness of the variables: gender, ethnicity, schooling, HIV, entry type, sputum smear, sputum culture, AIDS, ART during TB treatment, directly observed treatment (DOT), sixth-month smear, and closure status. Around 52.9% of TB cases in prisoners were reported by eAPP, and other health facilities reported 47.1% of the cases. Eighty percent of the variables were classified in category 4 (75.1% to 100% completeness). However, the DOT and sixth-month smear variables were classified into category 3 (50.1% and 75% completeness). While it does not compromise the notification of TB in the SINAN, the lack of data can impair the quality of information about the disease.
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Tuberculosis (TB) has a high incidence in several countries and is even more severe in prisoners. We evaluated the completeness of prisoners TB notifications in the Notifiable Disease Information System (SINAN) carried out by prison primary care teams (eAPP) or by other health facilities in the state of Rio Grande do Sul (RS). This descriptive cross-sectional study used prisoners data notifications in the SINAN TB by the eAPP or other health facilities from January 2014 to November 2018. We analyzed the percentage of completeness of the variables: gender, ethnicity, schooling, HIV, entry type, sputum smear, sputum culture, AIDS, ART during TB treatment, directly observed treatment (DOT), sixth-month smear, and closure status. Around 52.9% of TB cases in prisoners were reported by eAPP, and other health facilities reported 47.1% of the cases. Eighty percent of the variables were classified in category 4 (75.1% to 100% completeness). However, the DOT and sixth-month smear variables were classified into category 3 (50.1% and 75% completeness). While it does not compromise the notification of TB in the SINAN, the lack of data can impair the quality of information about the disease.
A tuberculose (TB) apresenta incidências elevadas em todo o mundo, sendo ainda mais grave em pessoas privadas de liberdade (PPL). Foi avaliada a completude das notificações de TB de PPL no SINAN realizadas por equipes de atenção primária prisional (eAPP) ou por outros estabelecimentos de saúde do RS. Estudo descritivo, transversal, utilizando dados de notificações de PPL feitas no SINAN TB pelas eAPP ou por outros estabelecimentos de saúde, de janeiro de 2014 a novembro de 2018. Foi analisado o percentual de completude das variáveis: sexo, raça/cor, escolaridade, HIV, tipo de entrada, baciloscopia de escarro, cultura do escarro, Aids, tratamento antirretroviral durante o tratamento para a TB, tratamento diretamente observado (TDO), baciloscopia de 6º mês e situação de encerramento. Praticamente 53% dos casos de TB em PPL foram notificados por eAPP, e 47,1% foram notificados por outros estabelecimentos de saúde. Oitenta por cento das variáveis foram classificadas na categoria 4 (75,1% a 100% de completude). No entanto, as variáveis TDO e baciloscopia de 6º mês foram classificadas na categoria 3 (50,1% e 75% de completude). Embora não comprometa a notificação da TB no SINAN, a ausência de dados pode prejudicar a qualidade das informações sobre a doença.
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Prisioneiros , Tuberculose , Humanos , Brasil/epidemiologia , Estudos Transversais , Tuberculose/tratamento farmacológico , Tuberculose/epidemiologia , Sistemas de InformaçãoRESUMO
This paper aims to describe the implementation process of the Prison Primary Care Teams in Rio Grande do Sul, the frequency of tuberculosis notifications in people deprived of liberty, and their chronological relationship. This documentary research is nested in a descriptive cross-sectional study of historical series. We analyzed the decrees on the qualification of Prison Primary Care Teams, the number, and the year of notification of tuberculosis cases from the National System of Notifiable Diseases from 2014 to 2020. The state of Rio Grande do Sul pioneered prison health municipalization and shared financing, which resulted in the implementation of 45 teams, covering approximately 54.5% of people deprived of liberty a closed regime. The teams notified 5,175 cases of tuberculosis from 2014 to 2020, with a progressive increase in the notification of cases and the implementation of new teams. The strategy of implementing Prison Primary Care Teams driven by the National Comprehensive Health Care Policy for People Deprived of Liberty in the Prison System was crucial for increasing TB diagnosis, notification, and control in Rio Grande do Sul.
Os objetivos deste artigo são descrever o processo de implementação das Equipes de Atenção Primária Prisional no Rio Grande do Sul, a frequência de notificações de tuberculose na população privada de liberdade e a relação cronológica entre ambas. Trata-se de uma pesquisa documental aninhada a um estudo transversal descritivo de série histórica. Foram analisadas as portarias de habilitação de Equipes de Atenção Primária Prisional e os números e os anos de notificação dos casos de tuberculose oriundos do Sistema Nacional de Agravos de Notificação no período de 2014 a 2020. O estado do Rio Grande do Sul foi pioneiro na municipalização e cofinanciamento da saúde prisional, o que resultou na implantação de 45 equipes, com cobertura aproximada de 54,5% das pessoas privadas de liberdade em regime fechado. As equipes notificaram, entre 2014 e 2020, 5.175 casos de tuberculose, com incremento progressivo da notificação de casos, assim como a implantação de novas equipes. A estratégia de implantação de Equipes de Atenção Primária Prisional, impulsionada pela Política Nacional de Atenção Integral à Saúde das Pessoas Privadas de Liberdade no Sistema Prisional, mostrou-se de fundamental importância para o aumento de diagnósticos, notificações e controle da tuberculose no estado do Rio Grande do Sul.
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Prisões , Tuberculose , Humanos , Estudos Transversais , Brasil/epidemiologia , Tuberculose/epidemiologia , Equipe de Assistência ao PacienteRESUMO
Tuberculosis (TB) is a serious infectious disease, and its control is considered a challenge, especially among vulnerable populations such as prisoners. The occurrence of TB in prisons is an alarming public health problem in many countries. This integrative review aims to describe the epidemiology of TB and control strategies for this disease in countries with the largest prison populations. Studies have shown that it is essential to know the prevalence of TB in prisons of each country. This is because it can serve as an indication of the need for action in prisons to reduce TB rates, including improving the structure of prison environments, rapidly and accurately diagnosing new cases, identifying drug-resistant strains, and implementing effective and directly observed treatment for TB.
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Prisioneiros , Tuberculose , Humanos , Prisões , Tuberculose/diagnóstico , Tuberculose/epidemiologia , Tuberculose/prevenção & controle , Prevalência , Populações VulneráveisRESUMO
Caracterizar o perfil epidemiológico, clínico e genético de pacientes com Covid-19. Realizou-se um estudo observacional e transversal com voluntários que tiveram diagnóstico de Covid-19 no período de abril de 2020 a maio de 2021 no município de Santa Cruz do Sul (RS, Brasil), no qual foram coletados dados clínicos e epidemiológicos, além de amostras de sangue para a identificação de polimorfismos no gene ACE2. Foram recrutados 87 indivíduos e destes, 16,7% necessitaram de internação hospitalar, sendo a maioria do sexo masculino. A obesidade foi a comorbidade mais frequente, no entanto, doenças cardiovasculares, hipertensão e diabetes apresentaram maior significância quando associadas às internações. Em relação à características genéticas, entre os voluntários não foram encontrados polimorfismos no gene ACE2. A pesquisa sugere que o sexo masculino e presença de comorbidades são importantes fatores de risco para a severidade da Covid-19.
Current paper characterizes the epidemiological, clinical and genetic profile of patients with Covid-19. An observational and cross-sectional study was carried out with volunteers diagnosed with Covid-19 between April 2021 and May 2021 in the municipality of Santa Cruz do Sul, Brazil; a blood sample also identified polymorphism in the ACE2 gene. 87 patients were recruited; 6.7% required hospitalization, the majority being male. Although obesity was a more frequent co-morbidity, cardiovascular diseases, hypertension and diabetes were more significant when associated with hospitalizations. In the case of genetic characteristics, polymorphisms were found in the ACE2 gene among volunteers. Important research suggests male gender and co-morbidities are risk factors for the severity of Covid-19.
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Objective: to describe the spatial distribution, treatment status and characteristics of cases of people infected with the human immunodeficiency virus HIV in Santa Cruz do Sul, RS, 2001 to 2020. Methods: descriptive study with data from individuals undergoing treatment for HIV/AIDS, in Santa Cruz do Sul, diagnosed from January 2001 to October 2020. Results: 708 (94.4%) cases were analyzed, of these (58.2%) were male, with a mean age of 39 years, the maximum incidence rate was in 2019 (59.4/100,000 in habitants), there was a high frequency of cases in the south and central region of the city, 92.9% of these individuals were still in active treatment and the dropout rate was 7.1% in the period. Conclusion: a higher incidence of HIV was observed in adult male, from the central and southern regions of the city, with a treatment rate close to the goals of the World Health Organization and a low dropout rate.
Objetivo: describir la distribución espacial, estado de tratamiento y características de los casos de personas infectadas por el virus de la inmunodeficiencia humana en Santa Cruz do Sul, RS, 2001 hasta 2020. Métodos: estudio descriptivo con datos de individuos en tratamiento por VIH/SIDA, en Santa Cruz do Sul, diagnosticados de enero de 2001 a octubre de 2020. Resultados: se analizaron 708 (94,4%) casos, de estos (58,2%) eran del sexo masculino, con una edad media de 39 años, la tasa de incidencia máxima fue en 2019 (59,4/100.000 habitantes), hubo una alta frecuencia de casos en la región sur y centro del municipio, el 92,9% de estos individuos seguían en tratamiento activo y la deserción fue del 7,1% en el período. Conclusión: se observó una mayor incidencia de VIH en hombres adultos, de las regiones centro y sur de la ciudad, con una tasa de tratamiento cercana a las metas de la Organización Mundial de la Salud y una baja tasa de deserción.
Objetivo: descrever a distribuição espacial, a situação do tratamento e as características dos casos de pessoas infectadas pelo vírus da imunodeficiência humana (HIV), em Santa Cruz do Sul/RS, de 2001 a 2020. Métodos: estudo descritivo com dados de indivíduos em tratamento para HIV/aids, em Santa Cruz do Sul, diagnosticados no período de janeiro de 2001 a outubro de 2020. Resultados: foram analisados 708 (94,4%) casos, dos quais 58,2% eram do sexo masculino, com idade média de 39 anos. A taxa de incidência máxima foi registrada em 2019 (59,4/100 mil habitantes), e observou-se frequência elevada de casos nas regiões sul e central do município; 92,9% dos indivíduos continuavam em tratamento ativo, e a taxa de abandono alcançou 7,1% no período. Conclusão: observou-se uma maior incidência de HIV entre adultos do sexo masculino, das regiões central e sul da cidade, com uma taxa de tratamento próxima às metas da Organização Mundial da Saúde (OMS) e baixa taxa de abandono.
RESUMO
BACKGROUND: Tuberculosis is a worldwide public health problem and is more prevalent in specific populations, such as prisoners. The aim of this study was to analyze the epidemiological and operational indicators of tuberculosis in prisoners in a southern region of Brazil. METHODS: This was a descriptive, observational study, utilizing secondary data from the Notifiable Diseases Information System on tuberculosis cases diagnosed in prisoners in the state of Rio Grande do Sul, southern Brazil, from 2014 to 2018. Prisoner data used to calculate incidence were extracted from reports by the National Penitentiary Department. RESULTS: From 2014 to 2018, 3,557 tuberculosis cases were reported in Rio Grande do Sul prisoners. The incidence rate of tuberculosis in prisoners was 1,235/100,000 individuals in 2014 and 1,430/100,000 individuals in 2018. The proportion of new TB cases tested for HIV was high, 83.4% in this period; among those tested, 12.9% were HIV coinfected. The proportion of new cases of pulmonary tuberculosis confirmed by laboratory criteria was 52.6% in this period. In total, 18.4% of new pulmonary tuberculosis cases were initiated on directly observed treatment in this period, and 36.4% of contacts of new cases of pulmonary tuberculosis with laboratory confirmation were examined. Among retreatment pulmonary tuberculosis cases, 82.4% were laboratory-confirmed. CONCLUSIONS: Tuberculosis incidence is increasing on a per-capita and absolute basis in Rio Grande do Sul. Laboratory confirmation, HIV testing, directly observed treatment, and contact investigation rates were all low, indicating the need to improve medical and public health measures for tuberculosis control in prisons.
Assuntos
Infecções por HIV , Prisioneiros , Tuberculose Pulmonar , Tuberculose , Humanos , Brasil/epidemiologia , Prisões , Tuberculose/diagnóstico , Tuberculose/epidemiologia , Tuberculose Pulmonar/diagnóstico , Tuberculose Pulmonar/epidemiologiaRESUMO
Objetivo: identificar a prevalência da Síndrome de Burnout e as características sociodemográficas e ocupacionais associadas em enfermeiros de ESFs de municípios da 28ª Região de Saúde do Rio Grande do Sul. Método: trata-se de um estudo transversal, incluindo enfermeiros de Estratégia Saúde da Família de 13 municípios de uma região do sul do Brasil que responderam um questionário online com aspectos sociodemográficos e ocupacionais e o Maslach Burnout Inventory para mensurar o desfecho de SB no período de março a agosto de 2018. Resultados: um total de 47 enfermeiros respondeu o instrumento. A prevalência de Síndrome de Burnout foi de 57,4%. Os enfermeiros que possuem interesse em trocar de profissão, assim como aqueles que trabalhavam na zona urbana apresentaram associação com a Síndrome de Burnout (p≤0,05). Conclusão: o estudo demonstrou alta prevalência de Síndrome de Burnout entre os enfermeiros que atuam em ESFs da 28ª Região de Saúde, indicando predisposição em desenvolvê-la(AU)
Objective: To identify the prevalence of Burnout Syndrome and AS associated sociodemographic and occupational characteristics in nurses of FHTs from municipalities of the 28th Health Region of Rio Grande do Sul. Methods: This is a crosssectional study, including Family Health Strategy nurses from 13 municipalities of a region of southern Brazil that answered an online questionnaire with sociodemographic and occupational aspects and the Maslach Burnout Inventory to measure the SB outcome from March to August 2018. Results: A total of 47 nurses answered the instrument. The prevalence of SB was 57.4%. Nurses with an interest in changing jobs, as well as those working in the urban area, had an association with SB (p≤0.05). Conclusions: The study demonstrated a high prevalence of SB among nurses who work in FHSs of the 28th Health Region, indicating a predisposition to develop it.(AU)
Objetivo: Identificar la prevalencia de Sindome de Burnout y características sociodemográficas y ocupacionales asociadas en enfermeras de ESFs de municipios de la 28ª Región Sanitaria de Rio Grande do Sul. Métodos: Se trata de un estudio transversal, que incluye enfermeras de la Estrategia de Salud de la Familia de 13 municipios de una región del sur de Brasil. Quienes respondieron un cuestionario en línea con aspectos sociodemográficos y ocupacionales y el Maslach Burnout Inventory para medir el resultado de SB de marzo a agosto de 2018. Resultados: Un total de 47 enfermeras respondieron al instrumento. La prevalencia de BS fue del 57,4%. Las enfermeras que tienen interés en cambiar de profesión, así como las que trabajaban en el área urbana, se asociaron con BS (p≤0.05). Conclusiones: El estudio demostró una alta prevalencia de BS entre las enfermeras que trabajan en ESFs de la 28ª Región de Salud, lo que indica una predisposición a desarrollarla(AU)
Assuntos
Humanos , Masculino , Feminino , Esgotamento Profissional , Enfermeiras e EnfermeirosRESUMO
Descrever a experiência de implementação da planificação da atenção à saúde no sistema prisional do Rio Grande do Sul. Relato de experiência do projeto piloto de reorganização da atenção primária desenvolvido com uma equipe de saúde prisional, com conteúdo adaptado do Projeto de Planejamento da Atenção Básica desenvolvido no Estado. As atividades aconteceram em seis oficinas temáticas, de junho a setembro de 2019, nas dependências do presídio, com a participação de trabalhadores de saúde e segurança. Dez trabalhadores participaram das oficinas que levaram à problematização das práticas vivenciadas, reflexões sobre suas atribuições na instituição penal e o papel do trabalhador como protagonista da mudança. A Planificação da Atenção Básica no sistema prisional é um projeto pioneiro e pode potencializar as ações das equipes de saúde prisional na Rede de Atenção à Saúde.
To describe the experience of implementing health care planning in the prison system in the state of Rio Grande do Sul. Experience report of a pilot project for the primary care reorganization developed with a prison health team, with content adapted from the Primary Care Planning Project developed in the state. The activities took place in six thematic workshops, from June to September 2019, on the premises of the prison, with the participation of health and safety workers. Ten workers participated in the workshops that led to the problematization of the practices experienced, reflections on their attributions in the penal institution and the worker's role as a protagonist of change. Planning Primary Care in the prison system is a pioneering project and can enhance the actions of prison health teams in the Health Care Network.