Socio-geographical factors and vulnerability to leptospirosis in South Brazil.

BACKGROUND: Leptospirosis, caused by the Leptospira bacteria, is an acute infectious disease that is mainly transmitted by exposure to contaminated soil or water, thereby presenting a wide range of subsequent clinical conditions. This study aimed to assess the distribution of cases and deaths from leptospirosis and its association with social vulnerability in the state of Rio Grande do Sul, Brazil, between 2010 and 2019. METHODS: The lethality rates and incidence of leptospirosis and their association with gender, age, education, and skin color were analyzed using chi-square tests. The spatial relationship between the environmental determinants, social vulnerability, and the incidence rate of leptospirosis in the different municipalities of Rio Grande do Sul was analyzed through spatial regression analysis. RESULTS: During the study period, a total of 4,760 cases of leptospirosis, along with 238 deaths, were confirmed. The mean incidence rate was 4.06 cases/100,000 inhabitants, while the mean fatality rate was 5%. Although the entire population was susceptible, white-colored individuals, males, people of the working-age group, along with less-educated individuals, were more affected by the disease. Lethality was higher in people with dark skin, and the prime risk factor associated with death was the direct contact of the patients with rodents, sewage, and garbage. The social vulnerability was positively associated with the incidence of leptospirosis in the Rio Grande do Sul, especially in municipalities located in the center of the state. CONCLUSIONS: It is evident that the incidence of the disease is significantly related to the vulnerability of the population. The use of the health vulnerability index showed great relevance in the evaluation of leptospirosis cases and can be used further as a tool to help municipalities identify disease-prone areas for intervention and resource allocation.

Ineffective breastfeeding techniques and associated factors among breastfeeding mothers who gave birth in the last 6 months in Sinan Woreda, Northwest Ethiopia.

Background: Optimal infant feeding is critical for children's growth and development during their first years of life. Plenty of evidence on ineffective breastfeeding techniques, yet the problem is still deep-rooted and requires further research in Ethiopia. Objective: To determine the proportion of ineffective breastfeeding techniques and associated factors among breastfeeding mothers who gave birth in the last 6 months in Sinan Woreda. Design and methods: A community-based cross-sectional study was conducted from March 10 to April 8, 2021 with a total of 389 samples. A computer-generated simple random sampling was used to select mothers. An observational checklist and interviewer-administered questionnaires were used. EpiData 4.2 for data entry and SPSS 25 for cleaning and analysis were used. Variables with a p-value < 0.05 and 95% confidence interval (CI) corresponding adjusted odds ratio (AOR) were used to identify factors of ineffective breastfeeding techniques. Results: The proportion of ineffective breastfeeding techniques was 66.8%. The mean (SD) age of mothers was 29.4 ± 5.95 years. No formal education [AOR: 5.88 (95% CI: (2.97, 11.65)], primipara [AOR: 4.34 (95% CI: 2.25, 8.36)], home delivery [AOR: 3.02 (95% CI: 1.12, 8.14)], not received breastfeeding counseling during antenatal care [AOR: 4.94 (95% CI: 1.83, 13.36)], breast problem [AOR: 2.62 (95% CI: 1.25, 5.48)], and breastfeeding experience [AOR: 1.82 (95% CI: 1.01, 3.28)] were statistically significant factors. Conclusions: The proportion of ineffective breastfeeding techniques 66.8% was unacceptable. Socio-demographic and maternal health care services were identified factors. Strengthening maternal care, improving health education and promotions, and designing appropriate strategies were required.

COVID-19 and zoonoses in Brazil: Environmental scan of one health preparedness and response.

The emergence of the COVID-19 pandemic reinforced the central role of the One Health (OH) approach, as a multisectoral and multidisciplinary perspective, to tackle health threats at the human-animal-environment interface. This study assessed Brazilian preparedness and response to COVID-19 and zoonoses with a focus on the OH approach and equity dimensions. We conducted an environmental scan using a protocol developed as part of a multi-country study. The article selection process resulted in 45 documents: 79 files and 112 references on OH; 41 files and 81 references on equity. The OH and equity aspects are poorly represented in the official documents regarding the COVID-19 response, either at the federal and state levels. Brazil has a governance infrastructure that allows for the response to infectious diseases, including zoonoses, as well as the fight against antimicrobial resistance through the OH approach. However, the response to the pandemic did not fully utilize the resources of the Brazilian state, due to the lack of central coordination and articulation among the sectors involved. Brazil is considered an area of high risk for emergence of zoonoses mainly due to climate change, large-scale deforestation and urbanization, high wildlife biodiversity, wide dry frontier, and poor control of wild animals' traffic. Therefore, encouraging existing mechanisms for collaboration across sectors and disciplines, with the inclusion of vulnerable populations, is required for making a multisectoral OH approach successful in the country.

The Effect of Diabetes and Prediabetes on Antituberculosis Treatment Outcomes: A Multicenter Prospective Cohort Study.

BACKGROUND: It is unclear whether diabetes or prediabetes affects unfavorable treatment outcomes and death in people with tuberculosis (PWTB). METHODS: Culture-confirmed, drug-susceptible PWTB, enrolled in the Regional Prospective Observational Research in Tuberculosis (RePORT)-Brazil cohort between 2015 and 2019 (N = 643) were stratified based on glycemic status according to baseline glycated hemoglobin. Unfavorable tuberculosis (TB) outcome was defined as treatment failure or modification, recurrence, or death; favorable outcome was cure or treatment completion. We corroborated the findings using data from PWTB reported to the Brazilian National System of Diseases Notification (SINAN) during 2015-2019 (N = 20 989). Logistic regression models evaluated associations between glycemic status and outcomes. RESULTS: In both cohorts, in univariate analysis, unfavorable outcomes were more frequently associated with smoking, illicit drug use, and human immunodeficiency virus infection. Diabetes, but not prediabetes, was associated with unfavorable outcomes in the RePORT-Brazil (adjusted relative risk [aRR], 2.45; P < .001) and SINAN (aRR, 1.76; P < .001) cohorts. Furthermore, diabetes was associated with high risk of death (during TB treatment) in both RePORT-Brazil (aRR, 2.16; P = .040) and SINAN (aRR, 1.93; P = .001). CONCLUSIONS: Diabetes was associated with an increased risk of unfavorable outcomes and mortality in Brazilian PWTB. Interventions to improve TB treatment outcomes in persons with diabetes are needed.

Bee stings in Brazil: Epidemiological aspects in humans.

Bees are insects of the order Hymenoptera and are involved in human accidents. In Brazil, bees that cause accidents are crosses derived from Europeans with African bees and are known for their aggressive behavior. Despite being considered an important public health concern, epidemiological studies at the national level are scarce. The objective of this study was to verify the epidemiological profile of bee accidents in humans in Brazil, using data from 2009 to 2019 of the Brazilian Ministry of Health. It was found that bee accidents increased by 207.61% from the first to the last year of the present study. The incidence varied according to the geographical region; the southern region had more bee accidents, but the Northern region had more deaths caused by bee accidents. Besides, climatic conditions were associated with susceptibility to bee stings; the incidence was higher during spring and summer. Age was also associated with fatality rate, with the elderly being the group with the highest fatality rate. Our results demonstrate that accidents caused by bees involve factors related to patients, the environment, and the behavior of bees. It is important to know the epidemiological aspects to help prevent apidic accidents.

Spatial distribution of anti-rabies post-exposure treatments associated with the decentralization process in Belo Horizonte, 2007 to 2011

Cases of canine attacks on people are reported because of the proximity of the dog to the households in several Brazilian cities. In the present study, we aim to evaluate post-exposure anti-rabies treatments with canine accidents between the years 2007 to 2011 in Belo Horizonte - MG. Duly notified data were obtained from the National System of Notifiable Diseases (SINAN). The spatial characteristics of the cases during the period of the study referred to the neighborhoods and the nine sanitary districts of the municipality of Belo Horizonte - MG. For georeferencing and spatial analysis, we used the software Maporama to identify the coordinates and the Geographic Information System ArcGIS for mapping. Considering the 6.153 prophylactic services that were georeferenced, the Norte, Venda Nova, Leste, and Centro Sul regions were highlighted due to the higher frequency of registered cases. It is suggested that an integrative action focused on canine population control, health education and epidemiological surveillance studies could contribute to the reduction of canine aggression cases.

Evolução da notificação de violência contra mulher no município de São Paulo, 2008-2015 / Notification of violence against women in the city of São Paulo, 2008-2015

Resumo Introdução A violência demanda assistência em saúde devido às lesões físicas e psíquicas que ocasiona e consequentemente compromete a qualidade de vida do indivíduo. A notificação é uma dimensão da linha de cuidado, que também possibilita dar visibilidade ao problema da violência e subsidia as políticas públicas. Objetivo Descrever as características da violência contra as mulheres notificadas no município de São Paulo, 2008-2015. Método Estudo ecológico descritivo sobre os casos de violência interpessoal contra mulheres de 20 a 59 anos registrados na Prefeitura de São Paulo, sendo avaliada a tendência temporal por regressão linear simples e as características dos envolvidos e da violência. Resultados 43.256 casos foram notificados, evidenciando aumento no período (β = 0,001; p = 0,006); a violência física foi predominante (81,3%) entre mulheres de 20 a 29 anos (37,6%). O agressor era do sexo masculino (47,7%) e conhecido (62,5%), com ocorrência na residência da vítima (31,6%); as partes do corpo mais atingidas foram a cabeça (31,7%) e os membros (21,4%), ocasionando principalmente traumas (60%). Conclusão As notificações de violência contra a mulher têm aumentado no município de São Paulo, mas a violência física, que tem maior visibilidade, ainda se sobressai, sugerindo a existência de subnotificação.

Abstract Background Violence demands health care due to the physical and psychological injuries it causes and consequently compromises the individual's quality of life. Notification is a dimension of the care line, which also enables to give visibility to the problem of violence and subsidizes public policies. Objective To describe the characteristics of violence against women reported in the city of São Paulo, 2008-2015. Method a descriptive ecological study on the cases of interpersonal violence against women aged 20 to 59 years registered in the city of São Paulo, evaluating the temporal trend by simple linear regression and the characteristics of those involved and violence. Results We identified 43,256 reported cases, evidencing an increase in the period (β = 0.001; p = 0.006); with physical aggression as predominant (81.3%) and among women aged 20-29 years old (37.6%). The aggressor was male (47.7%) and known (62.5%), occurring at victim's home (31.6%); the head (31.7%) and limbs (21.4%) were the most affected parts of the body causing mainly trauma (60.0%). Conclusion Reports of violence against women have increased in the city of São Paulo, but physical violence, which has greater visibility, still stands out, suggesting the existence of underreporting.

Perfil sociodemográfico e epidemiológico de pacientes com AIDS residentes na região de saúde que compreende o município de Alagoinhas ­ BA, no período de 2007-2017 / Sociodemographic and epidemiological profile of AIDS patients residing in the health region comprising the Alagoinhas ­ BA county, period 2007-2017

Objetivo: este estudo teve como objetivo traçar o perfil sociodemográfico e epidemiológico de pacientes com AIDS residentes microrregião na região de saúde que compreende o município de Alagoinhas ­ BA, no período de 2007-2017. Metodologia: trata-se de um estudo epidemiológico descritivo, exploratório de fonte secundária de dados. As variáveis investigadas foram: gênero, faixa etária, grau de escolaridade, município de residência, cor, categoria de exposição e evolução do caso. Resultados: durante o período 2007 ­ 2017 constataram-se 459 casos registrados no SINAN, de AIDS em adultos na Região de Saúde do município. Assim, verificou-se em adulto uma tendência de crescimento no número de casos na microrregião de Alagoinhas, acentuado no ano de 2014 (95 casos), e com considerável aumento constatado no ano de 2017 (90 casos). Evidenciou-se que 227 pacientes pertenciam ao sexo masculino e 232 ao sexo feminino, havendo predomínio de casos, todavia, na faixa etária entre 20 a 34 anos. Houve maior número de casos em adultos, faixa etária de 20-34 e 35-49, e dentre estes, o número de casos foi maior em indivíduos que têm relação heterossexual, seguido de indivíduos que têm relação homossexual; houve alto número de casos em indivíduos que possuem relações sexuais só com homens, totalizando 258, seguido de só com mulheres (135). Conclusão: o presente estudo permitiu compreender que os indivíduos adultos vivendo com HIV/AIDS, no período de 2007 a 2017, seguem a tendência nacional, contudo a melhoria do acesso aos serviços, qualidade da atenção, proporciona uma maior qualidade de vida aos pacientes.

Objective: this study aimed to outline the sociodemographic and epidemiological profile of AIDS patients living in ­ the health region of the Health Region comprising the municipality of Alagoinhas ­ BA, in the period 2007-2017. Methodology: this is a descriptive, exploratory epidemiological study of a secondary source of data. The variables investigated were: gender, age group, education level, municipality of residence, color, category of exposure and evolution of the case. Results: during the period 2007-2017, 459 cases were recorded in the SINAN of AIDS in adults in the Health Region of the municipality. Thus, in adults, there was a trend of growth in the number of cases in the Alagoinhas microregion, accentuated in 2014 (95 cases), and with a considerable increase observed in 2017 (90 cases), it was evidenced that 227 patients belonged were male, and 232 were female, with cases predominating, however, in the age group between 20 and 34 years. There were more cases in adults, age range 20-34 and 35-49, and among these, the number of cases was higher in individuals who have a heterosexual relationship, followed by individuals who have a homosexual relationship, there were a high number of cases in individuals who have sex with men alone, totaling 258, followed by only with women (135). Conclusion: the present study made it possible to understand that adult individuals living with HIV / AIDS, from 2007 to 2017, follow the national trend, however, improving access to services and quality of care provides a better quality of life for patients

Evaluation of emerging infectious disease and the importance of SINAN for epidemiological surveillance of Venezuelans immigrants in Brazil.

BACKGROUND: Following socio-economic turmoil in Venezuela, millions of the Venezuelan people are migrating to the neighboring Latin American countries including Brazil. Besides the social and economic burden of these migrants, Brazil must manage the health-related issues arising as consequence of these Venezuelan migrants. Poor health services in Venezuela along with unhygienic travelling conditions, lack of food (malnutrition) and potable water, unhealthy and overcrowded refugee camps or shelters, poor availability of medical services have made the migrant Venezuelan population susceptible to various diseases, especially infectious diseases. SINAN system is a health-related system in Brazil that keeps track of different health occurrences in the society and allows health care workers and policymakers free access to these data. OBJECTIVES: To evaluate the emergence of infectious diseases as a consequence of the arrival of Venezuelans immigrants in Brazil and to assess the importance of SINAN for epidemiological surveillance. METHODS: Observational retrospective study. Data were collected from the SINAN system between 2015 and 2017 and was analyzed using descriptive statistics, and Mann-Whitney test (using SPSS tool version 12). Evaluated infectious diseases in this study were tuberculosis, sexually transmitted infections (STIs), HIV/AIDS, syphilis, viral hepatitis, leishmaniasis, and malaria. RESULTS: STIs were the most commonly reported diseases. Compared to Brazilians, Venezuelan migrants reported significantly higher number of HIV/Aids (p < 0.046) and leishmaniasis cases (p < 0.049), while Brazilians reported significantly higher number of hepatitis cases (p < 0.046). Malaria was also more prevalent among Venezuelan migrants than native Brazilians. CONCLUSION: Increased incidence of infectious diseases among the migrant population should be considered seriously as lack of adequate control of these diseases might lead to outbreaks.

Divergences between the Brazilian national information systems for recording deaths from venomous animals.

BACKGROUND: This paper aims to highlight and analyze discrepancies in reporting of deaths due to venomous animals in Brazil, from 2001 to 2015, between two national information systems: The Notifiable Diseases Information System (Sistema de Informação de Agravos de Notificação - SINAN) and the Mortality Information System (Sistema de Informações sobre Mortalidade - SIM). METHODS: Descriptive and comparative study of the SINAN and SIM information systems, was conducted via the following steps: collecting the death notices from SINAN and SIM; constructing tables and comparative graphics; and, only in scorpion sting fatalities, analyzing the distribution of deaths by age group as described in the specialized literature. RESULTS: While SINAN identifies strong growth in the number of deaths from scorpion stings, SIM shows greater increase in the number of reported deaths from bee stings, especially in the South and Southeast regions. Notably, bees are the sole etiological agent that received more reports in SIM than in SINAN for every year in the period studied. The age-group distribution of the data on deaths from scorpion stings reinforced the indication of problems occurring in their registration in SINAN, especially since 2007, which may have an effect on analyses based on these data. CONCLUSION: Comparative analysis of these databases permits identification of important differences between profiles presented by these systems, which have equal relevance for Brazil as a whole and for its regions. These differences may influence the construction of various scenarios.

Divergences between the Brazilian national information systems for recording deaths from venomous animals

This paper aims to highlight and analyze discrepancies in reporting of deaths due to venomous animals in Brazil, from 2001 to 2015, between two national information systems: The Notifiable Diseases Information System (Sistema de Informação de Agravos de Notificação - SINAN) and the Mortality Information System (Sistema de Informações sobre Mortalidade - SIM). Methods: Descriptive and comparative study of the SINAN and SIM information systems, was conducted via the following steps: collecting the death notices from SINAN and SIM; constructing tables and comparative graphics; and, only in scorpion sting fatalities, analyzing the distribution of deaths by age group as described in the specialized literature. Results: While SINAN identifies strong growth in the number of deaths from scorpion stings, SIM shows greater increase in the number of reported deaths from bee stings, especially in the South and Southeast regions. Notably, bees are the sole etiological agent that received more reports in SIM than in SINAN for every year in the period studied. The age-group distribution of the data on deaths from scorpion stings reinforced the indication of problems occurring in their registration in SINAN, especially since 2007, which may have an effect on analyses based on these data. Conclusion: Comparative analysis of these databases permits identification of important differences between profiles presented by these systems, which have equal relevance for Brazil as a whole and for its regions. These differences may influence the construction of various scenarios.(AU)

Descriptive analysis of syphilis cases reported in Mato Grosso do Sul, Brazil identifies failure in treatment

Abstract INTRODUCTION: Syphilis infection remains an alarming public health problem worldwide. METHODS: This study analyzed syphilis cases listed in the Information System on Diseases of Compulsory Declaration (SINAN) of Mato Grosso do Sul state in Brazil between January 2013 and December 2014. RESULTS: Most of the evaluated syphilis cases would have been preventable through public education, particularly congenital syphilis in children of previously diagnosed mothers and infection by untreated sexual partners. CONCLUSIONS: The incidence rate of syphilis could be reduced by improving prevention through counselling on the risk of infection, improving access to condoms, and increasing the frequency of diagnostic tests.

Intoxicações por agrotóxicos no estado do Tocantins: 2010­2014 / Intoxications by pesticides in the State of Tocantins: 2010­2014

Introdução: O Brasil é o maior consumidor mundial de agrotóxicos, que é um sério problema de saúde pública pela exposição da população e do ambiente a estes produtos. Objetivo: Caracterizar as intoxicações por agrotóxicos no Tocantins no período 2010­2014. Método: Estudo descritivo e exploratório, tendo como fonte de dados secundários o Sistema de Informação de Agravos de Notificação (SINAN), utilizando-se variáveis selecionadas. Resultados: No total das intoxicações exógenas, o sexo feminino é o mais afetado e nas intoxicações, já por agrotóxicos, é o masculino, principalmente a categoria ocupacional dos "trabalhadores da agropecuária diversos". As faixas etárias mais atingidas por agrotóxico de uso agrícola são: 20­29 anos e 30­39 anos. Os agentes tóxicos mais referidos foram os inseticidas (29,28%) e os herbicidas (27,07%). As atividades mais frequentes foram a pulverização (29,28%) e a diluição (15,47%); e as principais vias de exposição/contaminação foram a digestiva e a respiratória. Quanto à exposição/contaminação, as mais presentes foram a acidental (49,17%), a tentativa de suicídio (32,60%) e a ambiental (14,64%). Conclusões: Os dados revelam uma situação preocupante que demanda atenção dos gestores no enfrentamento deste problema de saúde pública. Esse cenário é desafiador especialmente no componente assistencial, nas vigilâncias sanitárias, epidemiológica e em saúde ambiental e do trabalhador.

Introduction: Brazil is the world's largest consumer of agricultural pesticides. That represents a serious public health problem caused by the population and environment exposure to those products. Purpose: To identify intoxications by agricultural pesticides in Tocantins during the years 2010­2014. Method: descriptive and exploratory study, having as a secondary data source the Notifiable Disease Information System (SINAN), making use of selected variables. Results: In the total, women are shown as the most affected by exogenous intoxications and men by agriculture pesticides, mainly the general farmer workers. The age groups most affected by agriculture pesticides are 20-29 years and 30-39 years. The most commonly reported toxic agents were insecticides (29.28%) and herbicides (27.07%). The most frequent activities were spraying (29.28%) and dilution (15.47%) and the main routes of exposure/contamination were the digestive and respiratory ones. In terms of exposure/contamination the accidental (49.17%), suicide attempt (32.60%) and environmental (14.64%) were the most present ones. Conclusions: The data reveal a serious picture that requires attention from the managers in facing that public health problem. This scenario represents a great and challenging issue for Brazil, the public health system ­ SUS, especially concerning health care, sanitary and epidemiological surveillance and environmental and worker health.

Characterization of rabies post-exposure prophylaxis in a region of the eastern Amazon, state of Pará, Brazil, between 2000 and 2014.

Animal bites are a serious public health issue, and prevention strategies have been consistently documented worldwide. The aim of this study was to characterize human anti-rabies treatment in 11 counties of the Salgado microregion, Pará state, Brazil, which borders the Bragantina microregion, where exposures of human rabies were reported in 2004 and 2005. A descriptive retrospective study was conducted using anti-rabies treatment notifications registered in the Information System for Notifiable Diseases (SINAN) database of the State Department of Public Health of Pará (SESPA) from January 2000 to December 2014. In this period, 13,403 exposures were reported, with a growing annual trend (Y = 68.571x + 344.96). The years 2012 and 2013 presented the highest exposure incidence. Salinópolis was the county with the highest average annual incidence per 10,000 persons (62.83), followed by São João de Pirabas (43.28) and São Caetano de Odivelas (41.27). Most patients were males (59.6%) and were 1-19 years old (48.7%). The main species involved in aggressions were dogs (74.1%), followed by bats (13.1%) and cats (7.4%). Biting was the most common kind of exposure, mostly on the lower limbs (39.6%). This study shows that aggression by bats was the second most common cause of demand for the service in the region for the past 14 years. The low quality of records may increase the difficulty of rabies surveillance in Pará.

Sistemas de informação em saúde no Brasil

Este recurso educacional visa descrever a importância das informações em saúde na construção das Análises de Situação de Saúde. São abordados os diferentes sistemas de informação em saúde que existem no Brasil, explicitando-se a importância de cada um e da constante alimentação de dados, para que seja realizada uma correta análise da situação de saúde. Além deste, há mais de 30 e-books tratando sobre diversas questões relacionadas à Vigilância em Saúde. Todos eles fornecem conteúdos interessantes para a formação dos profissionais que atuam no SUS, especialmente os vinculados à Vigilância em Saúde, e acadêmicos da área da saúde. Compõe o conjunto de cursos sobre Vigilância em Saúde ofertados pela UNA-SUS/UFMA.

Dietary diversity and associated factors among children aged 6-23 months in Sinan Woreda, Northwest Ethiopia: a cross-sectional study.

BACKGROUND: Child malnutrition accounted by poor dietary diversity is common in developing countries contributing for child morbidity and mortality. It also has an impact on child growth and development. Almost all nutritional related problems are preventable by implementing infant and child feeding strategies. The first two years of life are particularly important to reverse the nutritional problems by achieving dietary diversity feeding.The study aimed to assess dietary diversity and its associated factors among 6-23 months old children in Sinan Woreda, Northwest Ethiopia. METHODS: We conducted community based cross-sectional study among children aged 6-23 months in Sinan Woreda from February 16 to March 10, 2016. Random sampling technique was used to select 740 samples. Data on children's dietary diversity of the last 24 h were collected through interview of mothers. Data were entered into EpiData version 3.1 and analysis was performed using SPSS version 20. The bivariate and multivariable logistic regression analyses were done to identify the independent factors associated with sub-optimal dietary diversity among children aged 6-23 months. RESULTS: Seven hundred thirty six samples were included in the analysis with the response rate of 99%. Optimum dietary diversity was observed in 13% children. The dominant food groups consumed were grains. Availability of media sources at household [Adjusted Odds Ratio (AOR) = 2.77 (1.65-4.68)], availability of cow milk in the household [AOR = 2.39 (1.31-4.35)], women's involvement in decision-making at household level [AOR = 2.07 (1.02-4.20)], institutional delivery service utilization [AOR = 2.40 (1.24-4.67)], receiving assisted delivery service [AOR = 2.36 (1.12-4.98)], receiving postnatal care [AOR = 2.07 (1.18-3.63)], distance far from the health center [AOR = 3.11 (1.66-5.83)] and meal frequency being four and above [AOR = 3.31 (1.53-7.18)] were associated with dietary diversity. CONCLUSION: This study concluded that optimum dietary diversity among children aged 6-23 months in Sinan Woreda is low. Meal frequency is positively associated with dietary diversity. Women involvement at household decision making improves dietary diversity of children. Ensuring maternal health service utilization can contribute for better dietary diversity of children aged 6-23 months. Large scale an interventional based research has to be conducted.

Vigilância da violência no Rio Grande do Sul: panorama da qualidade e da quantidade das informações no sistema de informação de agravos de notificação (2014 a 2017) / Surveillance of violence in Rio Grande do Sul: overview of the quality and quantity of information in the notifiable diseases (2014 to 2017)

Tem como objetivo analisar a qualidade da informação relacionada à violência no Estado do Rio Grande do Sul, com enfoque na população negra, indígena, lésbicas, gays, bissexuais, travestis e transexuais (LGBT) e em situação de rua. A metodologia utilizada foi a de estudo descritivo dos casos notificados no SINAN entre 2014 e 2017, o que totalizou 76.478 casos de violência.(AU)

Acute Chagas disease in the state of Pará, Amazon Region: is it increasing?

Acute Chagas disease (ACD) has a distinct epidemiological profile in the Amazon Region, with cases and outbreaks of Trypanosoma cruzi infection being possibly related to the ingestion of contaminated food. Data on ACD in the state of Pará retrieved from 2000 to 2016 from the Brazilian Notifiable Diseases Information System (SINAN) were evaluated. During this period, 2,030 of the 16,807 reported cases were confirmed, with a higher incidence between the months of August and December, thus characterising a seasonal pattern of acute infection, and coinciding with the higher production of "açaí", one fruit likely involved in the oral transmission of the disease. Evaluation of the absolute numbers of confirmed ACD cases secondary to oral infection suggests that infection through this route increased during the 2010-2016 period, differing from what was recorded in terms of vectorial or other infection routes. These findings point to the need of intensifying strategies to prevent or substantially reduce oral transmission.

Prevalência de acidentes de trabalho em Dourados-MS ocorridos no período de 2012 a 2014 / Work accidents prevalence in Dourados-MS occurred in the period 2012-2014

No Brasil os acidentes de trabalho representam sérios problemas de saúde pública com aproximadamente 25% de lesões por causas externas atendidas nos serviços de urgências e emergências. Os trabalhadores adoecem e morrem por causas relacionadas ao trabalho em decorrência direta das atividades profissionais exercidas e das indiretas por doenças relacionadas com o trabalho. Objetivo: Descrever o perfil epidemiológico de todos os trabalhadores acometidos por acidentes de trabalhos assistidos pelos serviços de saúde públicos do Sistema Único de Saúde (SUS) e privados, notificantes do Sistema de Informação de Agravos de Notificação (SINAN) de Dourados-MS, no período de 2012 a 2014. Materiais e Métodos: Estudo transversal pautado na consulta do sistema de informação do banco de dados do SINAN, entre 2012 e 2014. Resultados: Em Dourados, no período considerado, foram notificados 262 casos de agravos e doenças relacionadas ao trabalho, sendo: acidentes graves (n=60/22,9%); acidentes biológicos (n=167/63,8%); intoxicações exógenas (n=4/1,5%); LER/DORT (n=29/11%); transtornos mentais (n=2/0,8%). Predominaram os acidentes e doenças entre trabalhadoras (68,7%). Houve predomínio de acidentes na faixa etária dos 28 aos 37 anos (29%). Conclusão: Prevaleceram os acidentes biológicos, entre mulheres, no período pesquisado. A avaliação epidemiológica dos agravos à saúde e acidentes envolvendo os trabalhadores é fundamental para o desenvolvimento das políticas públicas voltadas a esse grupo, contudo é necessário o aperfeiçoamento do sistema de informação, das ações de promoção, prevenção, controle e reabilitação do trabalhador.

In Brazil, industrial accidents pose serious public health problem with approximately 25% of injuries from external causes in the emergency care services. Workers get sick and die from causes related to work as a direct result of the exercised professional activities and indirect related diseases work. Objective: To describe the epidemiological profile of all affected workers work accidents assisted by the public health services of the Unified Health System (SUS) and private notifying the Notifiable Diseases Information System (SINAN) in Dourados-MS, period from 2012 to 2014. Materials and Methods: cross-sectional study guided by the consultation in the information system of the SINAN database between 2012 and 2014. Results: in Dourados, in the period considered, were reported 262 cases of injuries and illnesses related to work, as follows: serious accidents (n = 60 / 22.9%); biological accidents (n = 167 / 63.8%); exogenous intoxication (n = 4 / 1.5%); RSI / MSDs (n = 29/11%); mental disorders (n = 2 / 0.8%). Predominated accidents and diseases among workers (68.7%). There was a predominance of accidents in the age group of 28 to 37 years (29%). Conclusion: Prevailed biological accidents among women, in the period surveyed. Epidemiological evaluation of health hazards and accidents involving workers is key to the development of public policies aimed at this group, however it is necessary to improve the information system of promotion, prevention, control and rehabilitation of the worker.