Evaluation of the awareness, control and cost-effectiveness of hypertension treatment in a Brazilian city: populational study.

OBJECTIVES: Hypertension is a highly prevalent disease worldwide, constituting one of the main risk factors for cardiovascular morbidity and mortality. The aims of this study were to evaluate the level of awareness and control of hypertension comparing sex, socioeconomic and educational level, BMI and drug therapy in over 40-year-old patients. The cost-effectiveness of the main pharmacologic classes of antihypertensives, as monotherapy and combination therapy, was also assessed. METHODS: In this randomized and cross-sectional populational study, a sample of 738 hypertensive adults with ages at least 40 years were evaluated. Of these, 345 (46.7%) were men and 393 (53.3%) were women. RESULTS: A total of 72.9% of the hypertensives knew about their disease. Women in the 40-49 and 50-59 age groups and obese individuals had a higher rate of awareness of their hypertensive status. The rates of awareness were similar in different social classes and educational levels, however, blood pressure control varied. beta-Blockers were the most effective drugs to control blood pressure with no differences being observed between monotherapy and combinations. Diuretics were the most cost-effective. CONCLUSION: Approximately half of the participants received monotherapy. The best percentage of control with monotherapy was obtained with beta-blockers but the diuretics treatment was the most cost-effective. The levels of awareness and control were high compared with developed countries, most evident in the higher social classes and higher education levels.

Hepatitis B in healthcare workers: prevalence, vaccination and relation to occupational factors

The prevalence of hepatitis B virus (HBV) in healthcare workers (HCW) in Brazilian university hospitals is high. However, vaccination of these workers and relations with occupational factors are not well documented. A prospective study was made of 1,433 HCW and 872 administrative employees of the Hospital de Base (HB), São José do Rio Preto, SP, Brazil, and 2,583 blood donor candidates from the Hospital Blood Bank. HCW were observed from January 1994 to December 1999. Data were obtained from exams made when a worker entered hospital service, periodically and after work-related injuries. Serological reactions were analyzed in HCW who received HBV vaccine. Occupational and non-occupational information was obtained through a questionnaire. The prevalence of HBV among HCW (0.8 percent) was significantly higher than in blood-donor candidates (0.2 percent). Among the HCW who were vaccinated, 86.4 percent were immunized. Multivariate analysis revealed that increased age reduced the chance of immunization. Among the occupational factors, time in service contributed to a 14 percent increase in the chances of having positive serology, and work-related injuries increased the risk of HBV infection 4.29 times. The maximum risk sector presented a larger number of HCW with positive anti-HBc serology. There was a higher seroconversion in HCW who received the full set of HBV vaccines. In HCW with positive serology, the factors that presented greatest risks were time in service, work-related injuries and maximum risk sector.

Hepatitis B in healthcare workers: prevalence, vaccination and relation to occupational factors.

The prevalence of hepatitis B virus (HBV) in healthcare workers (HCW) in Brazilian university hospitals is high. However, vaccination of these workers and relations with occupational factors are not well documented. A prospective study was made of 1,433 HCW and 872 administrative employees of the Hospital de Base (HB), São José do Rio Preto, SP, Brazil, and 2,583 blood donor candidates from the Hospital Blood Bank. HCW were observed from January 1994 to December 1999. Data were obtained from exams made when a worker entered hospital service, periodically and after work-related injuries. Serological reactions were analyzed in HCW who received HBV vaccine. Occupational and non-occupational information was obtained through a questionnaire. The prevalence of HBV among HCW (0.8%) was significantly higher than in blood-donor candidates (0.2%). Among the HCW who were vaccinated, 86.4% were immunized. Multivariate analysis revealed that increased age reduced the chance of immunization. Among the occupational factors, time in service contributed to a 14% increase in the chances of having positive serology, and work-related injuries increased the risk of HBV infection 4.29 times. The maximum risk sector presented a larger number of HCW with positive anti-HBc serology. There was a higher seroconversion in HCW who received the full set of HBV vaccines. In HCW with positive serology, the factors that presented greatest risks were time in service, work-related injuries and maximum risk sector.

Acidentes de trabalho com pérfuro-cortante envolvendo a equipe de enfermagem de um hospital de ensino / Occupational accidents with sharp-edged objects occurring in the nursing team of a general school hospital

Os acidentes de trabalho com material pérfuro-cortante representam grande risco à saúde da equipe de enfermagem, em decorrência das atividades executadas e das condições de trabalho vigentes. O objetivo deste estudo foi identificar as características de acidente de trabalho com pérfuro-cortante, envolvendo a equipe de enfermagem de um hospital geral de ensino, ocorridos no período de 1996 a 1999. os dados foram coletados junto ao Centro de Atendimento à Saúde do Trabalhador (CEAT), constituindo-se a amostra de 272 trabalhadores de enfermagem, sendo 16 (5,9 por cento) enfermeiros, 208 (76,5 por cento) auxiliares de enfermagem e 48 (17,6 por cento) atendentes de enfermagem, que notificaram a ocorrência de acidentes com pérfuro-cortantes, no período de coleta dos dados. Na análise dos resultados constatou-se que os acidentes ocorreram principalmente: com os auxiliares de enfermagem (76,5 por cento), entre mulheres 980,1 por cento); na faixa etária de 20 a 39 anos (74,6 por cento); com trabalhadores que foram ou eram casados ou com união consensual (55,5 por cento); que atuavam em unidade especializada (34,6 por cento), com jornada diária de trabalho de 6 horas (59,6 por cento) e que tinham até 5 anos de trabalho neste hospital (75,3 por cento); que os materiais pérfuro-cortantes que mais causaram acidentes foram os usados no preparo e administração de medicamentos (agulhas). os dados obtidos fornecem subsídios para implementar medidas de prevenção e proteção da saúde dos trabalhadores da equipe de enfermagem, no contexto estudado