Spatial distribution of malaria and primary healthcare in Cametá and Tucuruí, Pará state, Brazil.

INTRODUCTION: Malaria cases in Brazil are concentrated in the Amazon region. In the state of Pará, malaria is considered an endemic disease, and the population has different levels of exposure, which contributes to different types of occurrence in the municipalities. METHODOLOGY: A descriptive, cross-sectional, and ecological study was conducted using data from the Malaria Epidemiological Surveillance System of the municipalities of Cametá and Tucuruí, PA, Brazil, from 2014 to 2018; the Brazilian Institute of Geography and Statistics; and the National Registry of Health Institutions of the Ministry of Health. Statistical and spatial analyses of epidemiological, laboratory and public health service coverage variables were performed using the Bioestat 5.0 and ArcGis 10.5 software. RESULTS: 11,381 Malaria cases were reported in the two municipalities. The highest percentage of case notifications was reported in brown-skinned men aged from 19 and 59 years, and who had primary education levels. The predominant occupations were farming and livestock in Cametá and domestic activity in Tucuruí. The most common diagnostic examination used was a thick blood smear, and Plasmodium vivax was the species most often encountered. The percentage of primary care coverage increased during the study period. The spatial distribution of the disease was not homogeneous, and there were clusters of cases with different densities in Cametá and Tucuruí. CONCLUSIONS: Malaria is a public health problem in the municipalities of Cametá and Tucuruí, because of its transmission dynamics and variable spatial distribution as well as the coexistence of factors that favor the exposure of resident populations to epidemiological situations, thus reflecting health inequities.

Percepção e conhecimento dos estudantes de medicina acerca do HIV e da AIDS / Perceptions and knowledge of medical students about HIV and AIDS / Percepción y conocimiento de los estudiantes de medicina sobre el VIH y el SIDA

Justificativa e Objetivos: O grau de informação não se restringe às questões informativas e de oportunidade de conhecimento, mas também ao desenvolvimento de uma percepção individual consciente para a adoção de práticas de prevenção da transmissão do vírus. Assim, objetivou-se avaliar a percepção e o conhecimento dos graduandos de medicina, acerca do HIV e da AIDS. Métodos: Caracteriza-se como um estudo transversal, observacional e unicêntrico, por meio da aplicação de um questionário estruturado e dois referentes à atitude frente à AIDS e ao indivíduo/percepção de risco e sobre o conhecimento dos meios de transmissão. Aplicaram-se os testes T-Student e Qui-quadrado de Pearson, com p<0,05. Participaram 223 estudantes de medicina do 1º ao 8º semestres. Resultados: A maioria dos universitários referiu ter compaixão (90,58%) e não culpabilização (97,31%) frente ao HIV e a AIDS. Todavia, 69,06% não se sentem preparados para atender esses pacientes. Ademais, 76,68% referiram não possuir risco de contrair o HIV, fato preocupante pelo risco inerente à profissão. Das 20 questões sobre o conhecimento dos meios de transmissão, o grau de acerto variou de 18,2 e 19,4 pontos. Prevenção (85,2%), preconceito (75,78%) e preservativo (72,65%) foram os principais valores simbólicos associados à AIDS. Conclusão: Os estudantes apresentaram atitudes éticas e humanísticas frente ao paciente com HIV ou com AIDS e um elevado grau de conhecimento acerca dos meios de transmissão do HIV. Sobre a percepção de risco, ressalta-se a necessidade de uma abordagem mais direcionada nas disciplinas de Saúde Pública, de Infectologia e de Imunologia.(AU)

Background and Objectives: The degree of information is not restricted to informative and opportunity questions of knowledge, but also to the development of a conscious individual perception for the adoption of practices of prevention of virus transmission. Thus, the objective was to evaluate the perception and knowledge of medical students about HIV and AIDS. Methods: It is characterized as a transversal, observational and unicentric study, through the application of a structured questionnaire and two referring to the attitude towards AIDS and the individual / perception of risk and about the knowledge of the means of transmission. Student's T-test and Pearson's Chi-square test were applied, with p <0.05. 223 medical students participated in the 1st to 8th semesters. Results: Most university students reported having compassion (90.58%) and no blame (97.31%) for HIV and AIDS. However, 69.06% do not feel prepared to treat these patients. In addition, 76.68% reported not having a risk of contracting HIV, a fact of concern for the inherent risk of the profession. Of the 20 questions on the knowledge of the means of transmission, the degree of accuracy ranged from 18.2 and 19.4 points. Prevalence (85.2%), prejudice (75.78%) and condom (72.65%) were the main symbolic values associated with AIDS. Conclusion: Students presented ethical and humanistic attitudes towards patients with HIV or AIDS and a high degree of knowledge about the means of HIV transmission. Regarding the perception of risk, the need for a more focused approach in the disciplines of Public Health, Infectology and Immunology is emphasized.(AU)

Justificación y Objetivos: El grado de información no se restringe a las cuestiones informativas y de oportunidad de conocimiento, sino también al desarrollo de una percepción individual consciente para la adopción de prácticas de prevención de la transmisión del virus. Así, se objetivó evaluar la percepción y el conocimiento de los graduandos de medicina, acerca del VIH y del SIDA. Métodos: Se caracteriza como un estudio transversal, observacional y unicéntrico, por medio de la aplicación de un cuestionario estructurado y dos referentes a la actitud frente al SIDA y al individuo / percepción de riesgo y sobre el conocimiento de los medios de transmisión. Se aplicaron las pruebas T-Student y Qui-cuadrado de Pearson, con p <0,05. Participaron 223 estudiantes de medicina del 1º al 8º semestres. Resultados: La mayoría de los universitarios refirió tener compasión (90,58%) y no culpabilización (97,31%) frente al VIH y el SIDA. Sin embargo, el 69,06% no se siente preparado para atender a estos pacientes. Además, el 76,68% mencionó no tener riesgo de contraer el VIH, hecho preocupante por el riesgo inherente a la profesión. De las 20 preguntas sobre el conocimiento de los medios de transmisión, el grado de acierto varió de 18,2 y 19,4 puntos. Prevención (85,2%), preconcepto (75,78%) y preservativo (72,65%) fueron los principales valores simbólicos asociados al SIDA. Conclusión: Los estudiantes presentaron actitudes éticas y humanísticas frente al paciente con VIH o con SIDA y un alto grado de conocimiento acerca de los medios de transmisión del VIH. Sobre la percepción de riesgo, se resalta la necesidad de un enfoque más direccionado en las disciplinas de Salud Pública, de Infectología e Inmunología.(AU)