Spatiotemporal dynamics and risk estimates of COVID-19 epidemic in Minas Gerais State: analysis of an expanding process.

COVID-19 is an infectious disease caused by the recently discovered coronavirus SARS-Cov-2. The disease became pandemic affecting many countries globally, including Brazil. Considering the expansion process and particularities during the initial stages of the epidemic, we aimed to analyze the spatial and spatiotemporal patterns of COVID-19 occurrence and to identify priority risk areas in Minas Gerais State, Southeast Brazil. An ecological study was performed considering all data from human cases of COVID-19 confirmed from the epidemiological week (EW) 11 (March 08, 2020) to EW 26 (June 27, 2020). Crude and smoothed incidence rates were used to analyze the distribution of disease patterns based on global and local indicators of spatial association and space-time risk assessment. Positive spatial autocorrelation and spatial dependence were found. Our results suggest that the metropolitan region of the State capital Belo Horizonte (MRBH) and Vale do Rio Doce mesoregions, as major epidemic foci in the beginning of the expansion process, have had important influence on the dispersion of SARS-CoV-2 in Minas Gerais State. Triangulo Mineiro/Alto Paranaiba region presented the highest risk of infection. In addition, six statistically significant spatiotemporal clusters were identified in the State, three at high risk and three at low risk. Our findings contribute to a greater understanding of the space-time disease dynamic and discuss strategies for identification of priority areas for COVID-19 surveillance and control.

Association of outcomes with comprehension, adherence and behavioral characteristics of tuberculosis patients using fixed-dose combination therapy in Contagem, Minas Gerais, Brazil.

The present study aimed to assess the association of outcomes with comprehension, adherence and behavioral characteristics of tuberculosis (TB) patients using fixed-dose combination (FDC) therapy in the city of Contagem, MG, Brazil. This study used standardized questionnaires to collect data. Outcomes included cure in 77.2% (64/ 83), noncompliance with treatment in 20.4% (17/ 83), and absence of organ failure or death cases. The rate of adherence to treatment was high (71.1% - 59/ 83), while the level of comprehension of the treatment was insufficient for the majority of patients (72.3% - 60/ 83). When a greater number of medicines was used, the chance of noncompliance with treatment increased exponentially (p = 0.00 - OR 1.72). Light-skinned black patients, alcoholics and those who live with HIV/ AIDS showed a significant association with noncompliance with treatment (p=0.039 - OR 3.38, p=0.002 - OR 4.68, and p=0.001 - OR 9.68, respectively). Comprehension also presented a significant association with noncompliance with treatment (p=0.01 and OR 5.76 and CI 1.49-22.29). The probability of noncompliance with treatment in the first few months was greater than in the subsequent months. This study demonstrates that if the TB patients had a better understanding of the treatment, the outcome would have been more favorable as regards a proper cure.

Association of outcomes with comprehension, adherence and behavioral characteristics of tuberculosis patients using fixed-dose combination therapy in Contagem, Minas Gerais, Brazil

ABSTRACT The present study aimed to assess the association of outcomes with comprehension, adherence and behavioral characteristics of tuberculosis (TB) patients using fixed-dose combination (FDC) therapy in the city of Contagem, MG, Brazil. This study used standardized questionnaires to collect data. Outcomes included cure in 77.2% (64/ 83), noncompliance with treatment in 20.4% (17/ 83), and absence of organ failure or death cases. The rate of adherence to treatment was high (71.1% - 59/ 83), while the level of comprehension of the treatment was insufficient for the majority of patients (72.3% - 60/ 83). When a greater number of medicines was used, the chance of noncompliance with treatment increased exponentially (p = 0.00 - OR 1.72). Light-skinned black patients, alcoholics and those who live with HIV/ AIDS showed a significant association with noncompliance with treatment (p=0.039 - OR 3.38, p=0.002 - OR 4.68, and p=0.001 - OR 9.68, respectively). Comprehension also presented a significant association with noncompliance with treatment (p=0.01 and OR 5.76 and CI 1.49-22.29). The probability of noncompliance with treatment in the first few months was greater than in the subsequent months. This study demonstrates that if the TB patients had a better understanding of the treatment, the outcome would have been more favorable as regards a proper cure.

Vulnerabilidades e acesso em saúde na adolescência na perspectiva dos pais / Vulnerabilidad y acceso en salud de los adolescentes en la vista de los padres / Vulnerability and access in adolescent health in view of the parents

Objetivo: Analisar a percepção de pais sobre vulnerabilidades e necessidades de acesso em saúde na adolescência no município de Contagem/Minas Gerais. Método: trata-se de estudo descritivo desenvolvido com 94 pais de adolescentes de 12 escolas públicas municipais que responderam a um questionário semiestruturado e autoaplicável. As informações foram analisadas a partir do modelo de análise de conteúdo proposto por Bardin. Resultados: a exposição/utilização de drogas, hábitos alimentares inadequados, barreiras no acesso em saúde e comportamentos de risco/agravos associados à sexualidade foram as principais vulnerabilidades à saúde na adolescência apontadas pelos participantes. Apesar de priorizarem a consulta médica e odontológica, mencionaram a importância da enfermagem no acesso às ações de saúde na adolescência, como à vacinação, grupos educativos e avaliação do crescimento/desenvolvimento dos adolescentes. Conclusão: a promoção da saúde dos adolescentes demanda por constante avaliação das situações e níveis de vulnerabilidades à saúde desse grupo através do Programa Saúde na Escola.

Objetivo: Analizar la percepción de los padres acerca de las vulnerabilidades y las necesidades de acceso de salud de los adolescentes en el municipio de Contagem /Minas Gerais. Método: se realizó un estudio descriptivo con 94 padres de adolescentes de 12 escuelas públicas municipales que respondieron a una encuesta auto aplicable ysemi-estructurada. Los datos fueron analizados a partir del análisis propuesto por el modelo de contenido de Bardin. Resultados: El uso de la exposición/uso de drogas, malos hábitos alimenticios, las barreras para acceder a los comportamientos de riesgo/agravamientos asociados con la sexualidad fueron las principales vulnerabilidades para la salud en la adolescencia indicados por los participantes. Aunque priorizar la consulta médica y dental, mencionó se la importancia de la enfermería en el acceso a las acciones de salud en la adolescencia, como la vacunación, grupos educacionales y evaluación del crecimiento y desarrollo de los adolescentes. Conclusión: la promoción de la salud de los adolescentes demanda para la evaluación constante de las situaciones y los niveles de vulnerabilidad de la salud de este grupo a través del Programa de Salud Escolar.

Method: this is a descriptive study conducted with 94 parents of adolescents from 12 municipal public schools who answered a semi-structured and self-administered questionnaire. The data were analyzed from the analysis of content model proposed by Bardin. Results: exposure/drug use, poor dietary habits, barriers to accessing health and risk behaviors/conditions associated with sexuality were the main vulnerabilities to health in adolescence indicated by the participants. Although prioritize medical and dental appointments, it was mentioned the importance of nursing in access to health actions in adolescence, such as vaccination, educational groups and assessing of growth/development of adolescents. Conclusion: the promotion of adolescent health demand for constant evaluation of situations and levels of health vulnerabilities of this group through the School Health Program.