Epidemiological situation of acquired immunodeficiency syndrome (AIDS)-related mortality in a municipality in northeastern Brazil. A retrospective cross-sectional study

ABSTRACT CONTEXT AND OBJECTIVE: The number of acquired immunodeficiency syndrome (AIDS)-related deaths covers different segments of the population differently, making monitoring of this mortality essential. The aim of this study was to describe the epidemiological situation of AIDS-related mortality in a municipality in the northeastern region of Brazil. DESIGN AND SETTING: Retrospective cross-sectional study based on data from death certificates in the mortality information system of the Health Information Center, Municipal Health Foundation, Brazil. METHODS: Between 2003 and 2013, we investigated death certificates on which AIDS-related mortality was reported. Sociodemographic data, year, place, type of establishment where death occurred and underlying and associated causes that led to AIDS-related death were described. The Mann-Kendall test was used to verify the growth trend of the standardized mortality rate over the period studied. RESULTS: Among the 1,066 AIDS-related deaths, 69.7% were among men; 47.2% of the individuals were 28-41 years of age, 32.7% had had 4-7 years of schooling, 66.9% were pardos (mixed race), 55.7% were unmarried and 15.3% were housekeepers. Hospitals were the site of 97% of the deaths, and 91% occurred at public hospitals. Respiratory failure was the main cause of death. The prevalence of infectious and parasitic diseases was 99.0%. AIDS-related mortality increased by 160% over the period studied, from 5.5/100,000 inhabitants in 2003 to 14.3/100,000 in 2013. CONCLUSION: In the Brazilian municipality studied here, AIDS-related mortality was most prevalent among men and young adults of lower socioeconomic level. Over the period studied, the mortality rate increased.

Aspectos sócio-políticos da implantação da Central de Transplantes do Piauí / Socio-political aspects of the implantation of the Transplant Center of Piauí

Estudo qualitativo objetivando compreender os aspectos sócio-políticos que mediaram a implantação da central de transplante do Piauí, identificar os sujeitos sociais envolvidos nessa implantação e analisar a participação da sociedade civil organizada. Fizeram parte do estudo dez sujeitos diretamente relacionados com a implantação da central, sendo delimitados por meio da técnica de "bola-de-neve". Utilizou-se a entrevista semi-estruturada, gravada, transcrita e submetida à análise temática. Concluiu-se que, a implantação da central de transplante no Piauí, foi fruto de um complexo jogo de negociações e interesses entre Estado e sociedade civil organizada, já que não havia um projeto político para ações na área dos transplantes. Esse distanciamento da responsabilidade da Gestão Pública caracteriza a importância que foi dada a essa implantação.

A qualitative study aiming at understanding the socio-political aspects that mediate the implantation of the Transplant Center of Piauí, identify the social topics involved in this implantation and analyze the participation of the organized civil society. Ten people directly related to the implantation of the transplant center were involved in the study, selected through the "snowball" technique. A loosely structured interview, taped, transcribed and submitted for thematic analysis was used. It was concluded that the implantation of the transplant center in Piauí was the fruit of a complex series of negotiations and interests among the State and organized civil society, as there was no political project for action in the area of transplants. This distancing from the responsibility of the public sector characterizes the importance that was given to this implantation.

El presente documento es un Estudio cualitativo objetivando comprender los aspectos sociopolíticos que mediaron en la implantación de la Central de Trasplante de Piauí, se propone identificar los sujetos sociales involucrados en esa implantación y analizar la participación de la sociedad civil organizada. Hicieron parte del estudio diez sujetos directamente relacionados con la implantación de la central de trasplante, siendo delimitados a través de la técnica de "bola-de-nieve". Se utilizó la entrevista semi-estructurada, grabada, transcrita y sometida al análisis temático. Se concluyó que la implantación de la central de trasplante en Piauí, fue fruto de un complejo juego de negociaciones e intereses entre el Estado y la sociedad civil organizada, ya que no había un proyecto político para acciones en el área de los trasplantes. Ese distanciamiento de la responsabilidad de la Gestión Pública caracteriza la importancia que fue dada a esa implantación.

Análise dos eventos adversos pós-vacinais ocorridos em Teresina / Analysis of after-vacination side-effects occurred in Teresina

Este estudo trata do perfil dos eventos adversos pós-vacinais ocorridos em Teresina em 2006. Os dados foram coletados mediante a aplicação de formulário com 73 participantes em 18 Unidades Básicas de Saúde. Os resultados mostram que as vacinas que mais produziram eventos adversos foram a tetravalente, BCG e DPT. Os eventos mais freqüentes foram: febre, episódio hipotônico hiporresponsivo, irritabilidade e manifestações locais moderadas. Dentre as condutas adotadas pelos profissionais de saúde, aproximadamente 80 por cento foram adequadas. Os menores de ano foram os mais acometidos pelos eventos. Todos os eventos evoluíram para a cura. Conclui-se que a ação de vacinação ainda continua requerendo capacitação constante dos profissionais da área. Sugere-se aprofundar o conhecimento com relação ao manejo, diagnóstico, investigação e tratamento.

This study focuses the profile of the adverse events after-vaccine occurrences in Teresina in 2006. The data had been collected by means of the form application with 73 participants in 18 Basic Units of Health. The results show that the vaccines that had more produced events adverse had been tetravalente, BCG and DPT. The events most frequent had been: fever, hiporresponsivo hipotonic episode, moderate irritability and local manifestations. Amongst the behaviors adopted for the health professionals, 80 percent had been approximately adjusted. The year minors had been accomitted by the events. All the events had evolved for the cure. It was concluded that the action of vaccination still continues requiring constant qualification of the professionals of the area. It is suggested to deepen the knowledge with relation to the handling, diagnosis, inquiry and treatment.

El presente estudio trata del perfil de las ocurrencias adversas de la después-vacuna en Teresina en 2006. Los datos fueron recogidos por medio del uso un formulário a lo cual participaran 73 personas en 18 unidades básicas de salud. Los resultados demuestraran que las vacunas que tenían más ocurrencias adversas fueran la tetravalente, BCG y DPT. Las ocurrencias más frecuentes fueran: fiebre, episodio hipotônico hiporresponsivo, irritabilidad moderada y manifestaciones locales. Entre los comportamientos adoptados por los profesionales de salud, 80 por ciento fueran ajustados aproximadamente. Los menores de edad del año habían sido acometidos por los acontecimientos. Todos los acontecimientos fueran desarrollados para la cura. Se hay concluydo que la acción de la vacunación todavía continúa requiriendo la calificación constante de los profesionales de la área. Se sugiere para profundizar el conocimiento en relación a la dirección, a la diagnosis, a la investigación y al tratamiento.