Sifílide opalina como única manifestación de la sífilis secundaria / Opaline syphilid as the only manifestation of secondary syphilis i: en

Se describe el caso clínico de un paciente de 62 años de edad, quien fue atendido en la consulta de dermatología del Policlínico Aquiles Espinosa Salgado de Las Tunas, por presentar una lesión blanca, de aspecto perlado, de 0,5 cm, en la punta de la lengua. Teniendo en cuenta las características de dicha lesión, se estableció el diagnóstico de sospecha de sífilis secundaria. Se le indicó la prueba serológica para la detección de sífilis, cuyo resultado fue de 128 diluciones, por lo que se confirmó que se trataba de una sifílide opalina, como manifestación de la sífilis en estadio secundario. Se efectuó el control de foco y la fuente de contagio estaba aún sin precisar. Con el tratamiento indicado evolucionó favorablemente, pero se mantuvo el seguimiento clínico y serológico según lo establecido.

The case report of a 62 years patient who was assisted in the Dermatology Service of Aquiles Espinosa Salgado Polyclinic in Las Tunas is described, who presented a 0.5 cm white lesion, of pearly aspect, in the tip of the tongue. Taking into account the characteristics of this lesion the suspected diagnosis of secondary syphilis was established. The venereal disease research laboratory test was ordered and its result was 128 dilutions, reason why an opaline syphilid was confirmed, as a manifestation of syphilis in secondary stage. The focus control was carried out and the source of infection was still without specifying. With the suitable treatment, he had a favorable clinical course, but clinical and serologic follow up was maintained as established.

Uso de precauciones estándar durante la atención de pacientes en un programa de especialización / Application of standard precautions during patient care in a specialization program

Introducción: Con el aumento de las enfermedades infectocontagiosas durante la atención en salud, la aplicación de normas de bioseguridad es fundamental para evitar contaminación cruzada. Los estudiantes de programas de Especialización Profesional durante la atención de pacientes deben cumplir una serie de normas denominadas precauciones estándar. Objetivo: Determinar el grado de uso de las precauciones estándar por estudiantes de un programa de especialización durante la atención de pacientes. Materiales y métodos: Se realizó un estudio observacional descriptivo. El tamaño de la muestra fue de 15 estudiantes del Programa de Especialización Profesional en Endodoncia de la Facultad de Odontología de la Universidad de Chile, divididos en dos grupos, diurno (8-17 h) y vespertino (18-22 h), que firmaron un consentimiento informado para participar. Fueron evaluados en 4 dimensiones: "lavado de manos", "barreras de protección" (guantes, mascarilla, gorro, lentes protectores, pechera), "control de riesgos de accidentes cortopunzantes y salpicaduras", y "manejo de materiales y superficies". Se estableció un 60 por ciento para determinar cumplimiento mínimo de la norma comparando ambos grupos. Resultados: En el lavado de manos ambos grupos no alcanzaron el cumplimiento mínimo de la norma, con un promedio de 12 por ciento. Para "barreras de protección" ambos grupos lograron el cumplimiento mínimo, con un promedio de 63 por ciento. En "control de riesgos de accidentes cortopunzantes y salpicaduras" y "manejo de superficies", ninguno de los grupos alcanzó el cumplimiento mínimo en estas dimensiones, con un porcentaje de cumplimiento de 50 % y 43 por ciento respectivamente. Conclusiones: La mayoría de los estudiantes del Programa de Especialización Profesional en Endodoncia no aplican correctamente todas las precauciones estándar durante la atención. Es necesario reforzar en los estudiantes los contenidos relacionados con la bioseguridad y aumentar la supervisión y exigencia en su cumplimiento por parte de los docentes(AU)

Introduction: With the increase in infectious diseases during health care, the application of biosecurity standards is essential to avoid cross-contamination. Students in Professional Specialization programs must adhere to a set of standards called standard precautions during patient care. Objective: Determine the degree of application of standard precautions by students of a specialization program during patient care. Materials and methods: A descriptive observational study was conducted. The sample size was 15 students from the Professional Specialization Program in Endodontics of the Faculty of Dentistry of the University of Chile, divided into two groups, day (8-17 h) and evening (18-22 h), who signed an informed consent to participate. They were evaluated in 4 dimensions: "hand washing", "protective barriers" (gloves, mask, hat, protective lenses, breastplate), "risks control of sharp accidents and splashes", and "handling of materials and surfaces". A 60 percent was established to determine minimum compliance with the standard by comparing both groups. Results: In handwashing, both groups did not reach the minimum compliance with the standard, with an average of 12 percent. For "protective barriers" both groups achieved minimum compliance, with an average of 63 percent. In "risk control of sharp accidents and splashes" and "surface handling", none of the groups reached the minimum compliance in these dimensions, with a compliance percentage of 50 percent and 43 percent respectively. Conclusions: Most students in the Professional Specialization Program in Endodontics do not correctly apply all standard precautions during care. It is necessary to reinforce in the students the contents related to biosecurity and to increase the supervision and demand in its fulfillment by the teachers(AU)

Actualización sobre fiebre amarilla en el contexto de la reemergencia de la enfermedad / Update on Yellow Fever in the Context of the Re-emergence of the Disease

Introducción: La fiebre amarilla se ha convertido en una enfermedad reemergente y un problema para la salud pública. Se estima que afecta a más de 200 000 personas anualmente en las regiones tropicales de África, América del Sur y Centroamérica, con al menos 30 000 defunciones. Existen 47 países endémicos, de ellos 34 en el continente africano, que contribuyen con más del 90 por ciento de la morbilidad y mortalidad por fiebre amarilla en el planeta. Quienes viajan a lugares donde la enfermedad es endémica pueden importarla a otros países. Objetivo: Recopilar información científica actualizada sobre la fiebre amarilla en el contexto de su reemergencia. Métodos: Se realizó una síntesis de la información científica disponible en la literatura médica sobre la enfermedad. Se consultaron diferentes buscadores y bases de datos, como PubMed, Ebsco, Scielo, ClinicalKey y Google Académico. El periodo de búsqueda estuvo comprendido entre enero y mayo de 2019. Conclusiones: La circulación del virus de la fiebre amarilla continúa aumentando de una manera desconcertante en poblaciones humanas, tanto en África como en América del Sur y Centroamérica. En el ámbito de su reemergencia, no resulta suficiente la sostenibilidad de sistemas de vigilancia confiables, combinados con programas de control de la enfermedad. La divulgación de los conocimientos científicos alcanzados, puede contribuir a la actualización permanente del personal de salud en aras de lograr un accionar eficaz que conduzca a la disminución de la morbilidad y mortalidad por esta enfermedad en la población mundial(AU)

Introduction: Yellow fever has become a reemerging disease and a public health problem. It is estimated that it affects more than 200,000 people annually in the tropical regions of Africa, South America and Central America, with at least 30,000 deaths. There are 47 endemic countries, 34 of them on the African continent, which contribute more than 90percent of morbidity and mortality from yellow fever on the planet. Those who travel to places where the disease is endemic can import it to other countries. Objective: To collect up-to-date scientific information on yellow fever in the context of its re-emergence. Methods: A synthesis of the scientific information available in the medical literature on the disease was carried out. Different search engines and databases were consulted, such as PubMed, Ebsco, Scielo, ClinicalKey and Google Scholar. The search period was from January to May 2019. Conclusions: The circulation of the yellow fever virus continues to increase in a disconcerting way in human populations, both in Africa and in South and Central America. In the field of its re-emergence, the sustainability of reliable surveillance systems, combined with disease control programs, is not enough. The dissemination of the scientific knowledge achieved can contribute to the permanent updating of health personnel in order to achieve an effective action that leads to the reduction of morbidity and mortality from this disease in the world population(AU)

Compliance to empirical contact precautions for multidrug-resistant microorganisms.

Health care-associated infections impact patient morbidity and mortality, and institutions adopt evidence-based measures to prevent and control such infections. In this study, professionals were observed during patient care under empirical contact precautions. A total of 243 observations were performed in which 39.5% complied with all measures. The positivity rate of surveillance cultures was 38.36%, and adherence to the measures in patients with colonization was 43.1%.

Estrategia de participación comunitaria e intersectorial en la prevención del dengue / Strategy of community and intersector participation in the prevention of dengue

Introducción: El dengue constituye la enfermedad viral de transmisión por vectores con mayor importancia en la salud pública a nivel mundial. Objetivo: Diseñar una estrategia de participación comunitaria para la integración de los componentes involucrados en la lucha antivectorial y la consiguiente prevención de la propagación del dengue. Métodos: Se realizó una investigación en sistemas y servicios de salud de acción participativa en 2 sectores del área de salud del Policlínico Docente Frank País García en Santiago de Cuba, durante el bienio 2014-2015, para lo cual se establecieron 2 etapas que incluyeron diferentes acciones. La población de estudio estuvo conformada por las 8 manzanas reiterativas en criaderos de mosquitos, y las técnicas utilizadas para obtener la información fueron las encuestas y las entrevistas en profundidad. Resultados: Al inicio del estudio, 69,4 % del grupo gestor desconocía los factores de riesgo asociados a la infección por dengue y en qué consistía la cooperación con los trabajadores de la campaña, mientras que 61,8 % conocía la técnica adecuada y la frecuencia de realización del autofocal familiar. En cuanto a los conocimientos acerca del dengue, en 73,8 % eran adecuados; sin embargo, solo 63,3 % conocía cómo evitar los criaderos del vector y 60,8 % poseía conocimientos acerca del mosquito Aedes aegypti y su ciclo de vida. A medida que fue avanzando la estrategia todos los conocimientos se elevaron en más de 90,0 %. Conclusiones: La estrategia garantizó la participación activa de la comunidad, donde se desarrollaron acciones de prevención y control oportunas e integradas, que disminuyeron los riesgos para la proliferación del vector y la transmisión local de la enfermedad.

Introduction: Dengue constitutes the transmission viral disease by vectors of more importance in the public health worldwide. Objective: To design a strategy of community participation for the integration of the components involved in the vector control and the consequent prevention of dengue transmission. Methods: An investigation in systems and health services of participative action in 2 sectors of the health area of Frank País García Teaching Polyclinic was carried out in Santiago de Cuba, during the biennium 2014-2015, for which 2 stages that included different actions were established. The study population was conformed by the 8 iterative blocks in mosquito breeding sites, and the techniques used to obtain the information were surveys and interviews in depth. Results: At the beginning of the study, 69.4 % of the agent group ignored the risk factors associated to the infection of dengue and how was the cooperation with the campaign workers, while 61.8 % knew the appropriate technique and the frequency of the focus family detection. As for the knowledge about dengue, in 73.8 % were appropriate; however, just 63.3 % knew how to avoid the mosquito breeding sites and 60.8 % possessed knowledge about the vector and its cycle of life. As the strategy was advancing there was more than 90.0 % increase of all the knowledge. Conclusions: Strategy guaranteed the active participation of the community, where opportune and integrated actions of prevention and control were developed that diminished the risks for vector proliferation and local transmission of the disease.

Perfil epidemiológico dos indivíduos com grau dois de incapacidade física nos casos novos de hanseníase, durante 10 anos, em Guarapuava-PR / Epidemiological profile of grade 2 physical disability individuals in new cases of leprosy, during 10 years, in Guarapuava-PR

A Hanseníase é uma patologia infectocontagiosa e crônica, possui alto poder incapacitante e representa um grave problema para a saúde pública no Brasil. OBJETIVO: Traçar o perfil dos casos novos de hanseníase, classificados com o grau 2 de incapacidade física (GIF2) no momento do diagnóstico e descrever as principais incapacidades causadas pela doença. MÉTODOS: Estudo epidemiológico transversal, cujo levantamento de dados foi baseado nos prontuários, registros em Livros Ata nos arquivos do Ambulatório Municipal de Pneumologia e Dermatologia Sanitária de Guarapuava-PR e no Sistema de Informação de Agravos de Notificação do Ministério da Saúde. RESULTADOS: A presença do GIF2 foi mais frequente no sexo masculino, com cor de pele branca, baixa escolaridade, classificação operacional multibacilar, forma clínica virchowiana. As principais incapacidades encontradas foram lesões tróficas ou traumáticas em pés e garra em mãos. CONCLUSÃO: Há necessidade de intensificar as ações educativas para prevenção, contribuindo para o diagnóstico precoce da doença e evitando as incapacidades. (AU)

Leprosy was an infectious and chronic pathology, with high incapacitating power, and represents a serious problem for public health in Brazil. OBJECTIVE: To describe the profile of new cases of leprosy classified as grade 2 physical disability (G2D) at the time of diagnosis, and to describe the main disabilities caused by the disease. METHODS: Cross-sectional epidemiological study, whose data collection was based on medical records, records in books in the archives of the Municipal Ambulatory of Pneumology and Sanitary Dermatology of Guarapuava-PR, and in the Information System of Notifiable Ministry of Health Diseases. RESULTS: The presence of GIF2 is more frequent in maleswith white skin color, low level of education, multibacillary operational classification, virchowian clinical form. The main disabilities were trophic or traumatic lesions in the foot, and claw hands. CONCLUSION: It is necessary to enhance educational actions for prevention, contributing to the early diagnosis of the disease, and avoiding disabilities. (AU)

Conocimientos sobre malaria y prácticas de uso de mosquiteros insecticidas de larga duración en dos departamentos de Colombia / Knowledge of malaria and long-lasting insecticidal net use practices in two departments of colombia

RESUMEN Objetivos. Determinar los conocimientos sobre malaria y prácticas del uso de mosquiteros tratados con insecticidas en los departamentos de Antioquia y Chocó en Colombia, 2013. Materiales y métodos. Estudio transversal y descriptivo con muestreo probabilístico de conglomerados, estratificado y bietápico. La encuesta dirigida a jefes de hogar se elaboró usando diez preguntas sobre conocimientos, transmisión, síntomas y medidas preventivas contra la malaria, utilizado en los cuestionarios de la Encuesta Nacional de Salud en Colombia 2007, e involucrando 13 preguntas sobre los mosquiteros insecticidas de larga duración (MILD), tenencia, uso, motivos de no uso, efectos secundarios sobre la salud a corto plazo, lavado y secado. Resultados. 2078 residentes respondieron la encuesta. El 89% (IC 95%: 87,5-89,9) en Antioquia y el 94% (IC 95%: 93,0-94,0) en Chocó reconoce las causas, síntomas, tratamiento y métodos de prevención. En Antioquia el 86% (IC 95%: 84,9-87,3) tuvo al menos un mosquitero y 72% (IC 95%: 70,0-73,4) lo usó diariamente, y para el departamento de Chocó fue de 93% (IC 95%: 92,2-94,4) y 73% (IC 95%: 72,0-74,4) respectivamente. Conclusiones. Hay altos niveles de conocimiento sobre malaria; sin embargo, el cuidado de los mosquiteros no está de acuerdo a lo recomendado para aumentar su vida útil, por lo tanto, se requieren estrategias sociales propias para cada departamento.

ABSTRACT Objectives. To determine the knowledge about malaria and use practice of insecticide-treated mosquito nets in the departments of Antioquia and Chocó in Colombia, 2013. Materials and Methods. Cross-sectional and descriptive study with probability sampling of clusters, stratified and two-staged. The head of household survey was developed using ten questions on knowledge, transmission, symptoms and preventive measures against malaria, used in the questionnaires of the 2007 National Health Survey in Colombia, as well as 13 questions on long-lasting insecticidal nets, tenure, use, reasons for non-use, short-term health side effects, washing and drying. Results. 2078 residents responded to the survey. 89% (95% CI: 87.5-89.9) in Antioquia and 94% (95% CI: 93.0-94.0) in Chocó recognized the causes, symptoms, treatment and prevention methods. In Antioquia, 86% (95% CI: 84.9-87.3) had at least one mosquito net and 72% (95% CI: 70.0-73.4) used it daily; and for the department of Chocó, it was 93% (95% CI: 92.2-94.4) and 73% (95% CI: 72.0-74.4), respectively. Conclusions. There are high levels of knowledge about malaria; however, the care of the mosquito nets does not follow the recommendations to increase their useful life, therefore, specific social strategies are required for each department.

Fatores sociodemográficos, clínicos, comportamentais e afetivos-sexuais associados com parceria sexual sorodiscordante de pessoas vivendo com HIV/aids / Socio-demographic, clinical, behavioral and affective-sexual factors associated with serodiscordant sexual partners of people living with HIV / AIDS

Trata-se de um estudo transversal, analítico, com objetivo de descrever e caracterizar as variáveis sociodemográficas, clínicas, afetivo-sexuais, de gerenciamento de risco de pessoas vivendo com HIV/aids, caracterizar as ações educativas oferecidas no serviço de saúde dessas pessoas, analisar os fatores sociodemográficos, clínicos, afetivo-sexuais e a utilização das estratégias de gerenciamento de risco de pessoas vivendo com HIV/aids e sua associação com sorologia do parceiro sexual em pessoas vivendo com HIV/aids. A coleta de dados foi realizada em um Serviços de Atendimento Especializado (SAE) do município de Teresina, de novembro de 2016 a março de 2017. Foram incluídos indivíduo com idade >= a 18 anos; que estivesse em um relacionamento fixo ou casual mantendo relação sexual e com resultado de exame sorológico reagente para HIV e excluídos gestantes e pacientes em situação de privação de liberdade e aqueles que obtinham acesso aos medicamentos antirretrovirais pelo programa, mas com acompanhamento em serviço privado. Uma amostra não probabilística foi formada por 173 indivíduos. Os dados foram coletados por meio de entrevistas individuais, em sala privativa. Utilizou-se instrumento de caracterização para avaliação socioeconômica, demográfica, clínica, afetivo-sexuais, de gerenciamento de risco e as ações educativas oferecidas pelos serviços de atendimento especializado construído para estudo. O projeto foi aprovado pelo comitê de ética sob protocolo nº CAAE 59293316.6.0000.5393/2016. Entre as parcerias sexuais identificou-se um perfil de pacientes sorodiscordantes em sua maioria do sexo masculino, adultos, jovens, procedentes de Teresina, com ensino médio completo, pardos, com renda de até três salários mínimos, residindo com 1 a 2 pessoas no domicílio, entre as variáveis clinicas as parcerias sexuais sorodiscordantes tinham um predomínio de contagens de células CD4 acima de 500 com carga viral indetectável. Verificou-se associação estatística entre a sorologia do parceiro e o sexo, estado civil, filho, número de filhos. Quanto as variáveis afetivo-sexuais entre casais sorodiscordantes houve um predomínio de heterossexuais com parceria sexual fixa, o uso consistente do preservativo se fez presente na maioria dos casais, a coinfecção mais prevalente foi a sífilis, em relação as práticas sexuais o sexo oral e anal foram os mais prevalentes, a maioria utilizou álcool nas relações sexuais e a revelação da condição sorológica para o parceiro foi realizada entre mais da metade das parcerias sexuais, entretanto um minoria consideram importante realizar essa revelação. A sorologia do parceiro sexual foi associada com tipo de parceria, uso do preservativo masculino, prática sexual vaginal insertivo, divulgação do diagnóstico do HIV para a parceria sexual e considera importante a divulgação do HIV para o parceiro. Quanto as estratégias de gerenciamento de risco entre as parcerias sexuais sorodiscordantes as estratégias mais utilizadas foi a ingestão da medicação antirretroviral e o uso do preservativo, o diálogo com a parceria sexual sobre métodos de prevenção do HIV foi frequente entre os casais. Verificou-se associação estatística entre a sorologia do parceiro e uso do preservativo masculino, combinações de estratégia de prevenção, uso de PEP quando o preservative estourasse e frequência com que você e seu parceiro (a) conversam sobre o melhor método de prevenção para o casal. A oferta de ações dispostas pelos Serviços de saúde ainda é limitada, aquém das reais necessidades dos pacientes. Conclui-se que as PVHA no município de Teresina, acompanhadas ambulatorialmente estabelecem parcerias sexuais, a sorologia do parceiro foi influenciada pelas variáveis sociodemográficas, afetivo-sexuais, de gerenciamento de risco. Assim, faz-se necessário o desenvolvimento de estratégias para o atendimento das parcerias sexuais, com foco na promoção da saúde e prevenção do HIV para o parceiro sorodiscordante, a atuação do serviço deve ser integral de forma a atender os pacientes de forma holística

This is a cross-sectional, analytical study aimed at describing and characterizing sociodemographic, clinical, affective-sexual, risk management of people living with HIV/AIDS, characterizing the educational actions offered in the health service of these people, to analyze sociodemographic, clinical, affective-sexual factors and the use of risk management strategies for people living with HIV/AIDS and its association with serology of the sexual partner in people living with HIV/AIDS. The data collection was performed in a Specialized Care Services (SAE) of the municipality of Teresina, from November 2016 to March 2017. Individuals with age >= 18 years were included; who were in a fixed or casual relationship maintaining sexual intercourse and with HIV serological test result and excluded pregnant women and patients in situations of deprivation of liberty and those who obtained access to antiretroviral drugs by the program but with follow-up in private service. The data collection was performed in a Specialized Care Services (SAE) of the municipality of Teresina, from November 2016 to March 2017. Individuals with age >= 18 years were included; who were in a fixed or casual relationship maintaining sexual intercourse and with HIV serological test result and excluded pregnant women, patients in situations of deprivation of liberty and those who obtained access to antiretroviral drugs by the program but with follow-up in private service. A non-probabilistic sample consisted of 173 individuals. Data were collected through individual interviews, in a private room. We used a characterization tool for socioeconomic, demographic, clinical, affective-sexual, risk management evaluation and the educational actions offered by specialized care services built for study. The project was approved by the ethics committee under protocol No. CAAE 59293316.6.0000.5393/2016. Among the sexual partnerships, a profile of serodiscordant patients, mostly males, adults, young people, from Teresina, with full secondary education, "brown", with income of up to three minimum salaries, residing with 1 to 2 persons at home , among the clinical variables serodiscordant sexual partners had a predominance of CD4 cell counts above 500 with undetectable viral load. There was a statistical association between the serology of the partner and the sex, marital status, having a child, number of children. As for the affective-sexual variables among serodiscordant couples there was a predominance of heterosexuals with fixed sexual partners, consistent condom use was present in most couples, the most prevalent coinfection was syphilis, in relation to sexual practices, oral and anal sex were the most prevalent, most used alcohol in sexual relations and the disclosure of the serological condition for the partner was performed between more than half of the sexual partnerships, however a minority consider it important to carry out this revelation. As for risk management strategies among serodiscordant sexual partnerships, the most commonly used strategies were ingestion of antiretroviral medication and condom use, dialogue with sexual partners on HIV prevention methods was frequent among couples. There was a statistical association between the partner's serology and male condom use, combinations of prevention strategies, PEP use when the condom burst and how often you and your partner talk about the best method of prevention for the couple. The offer of actions provided by the Health Services is still limited, below the real needs of the patients. We conclude that the PLWHA in the city of Teresina, accompanied ambulatory establish sexual partners, the partner's serology were influenced by sociodemographic, sexual-affective variables, risk management. Thus, it is necessary the development of strategies for the service of sexual partnerships, with a focus on health promotion and HIV prevention for the serodiscordant partner, the service's performance must be integral so as to attend patients holistically

Ações de planejamento e monitoramento para o controle da tuberculose na atenção primária à saúde / Planning and monitoring actions for tuberculosis control in primary health care

Introdução: a forma de organização dos serviços de saúde para detectar e tratar a tuberculose pode está relacionado com o aumento do número de casos desta patologia, que dispõe de tratamento eficaz, mas continua sendo um grande problema de saúde pública. Objetivo: descrever as ações de planejamento e monitoramento nos serviços de saúde para o controle da tuberculose na atenção primária à saúde. Método: estudo descritivo, com profissionais de saúde do município de Natal, no período de novembro de 2013 a janeiro de 2014. Resultados e Discussão: 47% referiram que as informações aos portadores de TB eram realizadas de forma generalizada; 67% relataram registros nos prontuários sobre os diagnósticos e medicamentos; 73% referiram inexistência na comunicação com a unidade de saúde. No planejamento da atenção à TB, 71% afirmaram haver registros apenas da enfermagem e, quanto ao monitoramento das metas e do plano de cuidado, 75% citaram que eram realizados e registrados pelo profissional responsável pelo portador de TB. Conclusão: é necessária a realização de outras pesquisas focadas neste tema, de modo a identificar e refletir como o sistema de saúde integra as ações na atenção à pessoa com TB.

Introduction: the way health services are organized to detect and treat TB may be related to the increase in the number of cases in which this pathology is receiving effective treatment, but it remains a major public health problem. Objective: to describe the health services planning and monitoring actions for tuberculosis control in primary health care. Methods: a descriptive study, with health professionals in Natal, from November 2013 to January 2014. Results and discussion: 47% reported that the information was made available to TB sufferers across the board; 67% reported patient history records on diagnoses and drugs; 73% reported no communication with the health unit. In the planning of TB care, 71% said there were only nursing records and, for the monitoring of goals and care planning, 75% said this was performed and recorded by the professional responsible for the TB patient. Conclusion: additional research focused on this issue is needed in order to identify and reflect how the health system integrates actions in caring for the person with TB.

Ações de enfermagem na Atenção Primária e o controle de doenças imunopreveníveis / Acciones de enfermería en la Atención Primaria y el control de enfermedades inmunoprevenibles / Nursing actions in primary care and the control of diseases preventable through vaccines

RESUMOObjetivo:discutir as ações desenvolvidas pelo enfermeiro para o controle e a erradicação de doenças imunopreveníveis no cenário assistencial frente à Política Nacional de Atenção Básica.Método:pesquisa qualitativa apoiada na abordagem da fenomenologia sociológica de Schutz. Teve como cenário uma Clínica de Saúde da Família na cidade Rio de Janeiro e contou com a participação de dez enfermeiros. A coleta das informações ocorreu mediante entrevista.Resultados:as ações dos enfermeiros envolvem a atualização do cartão, a vacinação e a orientação ao usuário do serviço, tendo como propósito evitar doenças. No entanto, a Política Nacional de Atenção Básica e os manuais do Ministério da Saúde enfatizam a importância de deslocar o foco da atenção para o usuário.Conclusão:Faz-se relevante considerar o estilo de vida do usuário e favorecer seu acesso aos serviços de saúde, para que seja ampliado o controle de doenças imunopreveníveis.

RESUMENObjetivo:discutir las acciones realizadas por los enfermeros en el control y erradicación de las enfermedades imunoprevenibles frente la Política Nacional de Atención Primaria.Método:una investigación cualitativa apoyada en la fenomenología social de Schutz. Tenía como un escenario una Clínica de la Salud Familiar, situado en Río de Janeiro (Br.), y participaron diez enfermeros. Los datos fueron colectados a través de entrevistas.Resultados:los enfermeros realizan para el control y erradicación de las enfermedades imunoprevenibles principalmente actualizar la tarjeta de vacunación y orientación al usuario de la unidad, con el propósito de prevenir enfermedades. La Política Nacional de Atención Primaria y especialmente manuales del Ministerio de Salud reconocen la importancia de centrarse en el usuario de la unidad.Conclusión:Hace relevante considerar el estilo de vida del usuario y facilitar su acceso a servicios de salud para ser mayor el control de las enfermedades imunoprevenibles.

ABSTRACTObjective:to discuss the actions performed by nurses in the control and eradication of diseases preventable with vaccines in healthcare setting, according to the National Primary Health Care Policy.Method:qualitative research supported by the social phenomenology of Schutz. It had as its setting a Family Health Clinic, located in the city of Rio de Janeiro (Brazil), with ten nurses. The data collection occurred through interviews.Results:nurses’ actions aimed at the control and eradication of preventable diseases mainly involve updating a vaccination card, administering the vaccine, and guiding the user of the Health Unit, with the purpose of preventing diseases. The National Primary Care Policy and all manuals from the Ministry of Health recognize the importance of focusing on the service user.Conclusion:the user’s lifestyle must be considered, and his access to services aiming at the expansion of the control of diseases preventable with vaccines should be promoted.