Asunto(s)
Virus del Dengue , Dengue , Humanos , Brasil/epidemiología , Virus del Dengue/genética , Dengue/epidemiología , GenotipoRESUMEN
OBJECTIVE: analyzing the effectiveness of an educational intervention on the knowledge of nursing professionals regarding the immunization of people with the human immunodeficiency virus. METHOD: a quasi-experimental study evaluated professionals' knowledge through a knowledge test applied before and after the development of an online training course. The data was analyzed using frequency, median, mean, standard deviation, and association tests. RESULTS: the sample consisted of 77 nursing professionals whose mean age was 43.2 years (SD+/-8.2). More than half of the individuals worked in basic health units (58.4%), 22.1% worked in specialized services that provide clinical monitoring for people with the human immunodeficiency virus, and 42 (54.5%) were nursing assistants or technicians. The professionals' performance improved after the intervention, with an increase in the median number of correct answers from 23.0 to 27.0 (p<0.001). CONCLUSION: offering an online training course on the immunization of people with the human immunodeficiency virus, as a continuing education activity, proved to be effective in improving nursing professionals' knowledge on this subject. HIGHLIGHTS: (1) Services do not evaluate the vaccination status of people living with HIV.(2) The knowledge of health professionals may influence vaccination rates.(3) Health professionals' knowledge of immunization may be insufficient.
Asunto(s)
Síndrome de Inmunodeficiencia Adquirida , Infecciones por VIH , Vacunación , Humanos , Adulto , Femenino , Masculino , Infecciones por VIH/enfermería , Infecciones por VIH/prevención & control , Síndrome de Inmunodeficiencia Adquirida/enfermería , Síndrome de Inmunodeficiencia Adquirida/prevención & control , Persona de Mediana Edad , Conocimientos, Actitudes y Práctica en Salud , Educación a Distancia/métodos , Competencia Clínica , Educación en Enfermería , Enfermería , Educación Continua en EnfermeríaRESUMEN
Background: Dengue virus (DENV) and Chikungunya virus (CHIKV) pose significant public health threats in Brazil, where favorable conditions facilitated the proliferation of Aedes mosquitoes. Since the mid-1980s, Brazil has experienced annual outbreaks of DENV, with recent increases in confirmed cases. In addition, CHIKV, which was first reported in 2014, has spread across the country. The concurrent presence of these viruses has triggered public health alerts in endemic regions, underscoring the complexity of managing vector-borne diseases. Case Presentation: This report details a case of simultaneous DENV and CHIKV infections. A 77-year-old female patient who has diabetes and arrhythmia exhibited symptoms including fever, myalgia, and severe arthralgia. Laboratory tests confirmed the coinfection through RNA detection. The patient received supportive care, showed gradual improvement, and was eventually discharged. Conclusions: Coinfection with DENV and CHIKV cases reported here developed with mild outcomes. However, one of the patients did not recover from the arthralgia after presenting diagnostic challenges, which underscores the need for accurate differentiation to manage symptoms effectively. The reported cases, amidst increasing DENV outbreaks, highlight the urgency for preparedness in the healthcare system. The Ribeirão Preto region's endemicity for DENV, coupled with the rising incidence of CHIKV, emphasizes the evolving landscape of arbovirus transmission. Studies on Aedes mosquitoes suggest potential implications for human infection dynamics, warranting further investigation into arbovirus transmission efficacy and coinfection dynamics.
RESUMEN
We aimed to describe the landscape, including molecular, epidemiological, and clinical aspects of CHIKV infections in the Ribeirao Preto region, an area endemic to dengue. We randomly screened 3744 plasma samples that had undergone DENV diagnosis to evaluate CHIKV-RNA using an in-house RT-PCR assay. Positive samples were followed clinically, and RNA samples were submitted to whole genome sequencing. Seventeen cases (0.5 %) were positive for CHIKV-RNA despite being negative for DENV-RNA. Notably, half of the patients experienced prolonged arthralgia lasting more than 90 days. Compared with the healthy control group, leukopenia and thrombocytopenia were observed in all CHIKV-positive individuals with statistically significant P values (P < 0.0001 and P = 0.0003, respectively). The genomic analysis revealed that the CHIKV strains being studied are classified within the East-Central-South-African (ECSA) genotype. This analysis identified new mutations, E1: K211E and E2: V264A, while the previously known mutation E1: A226V was not detected among these strains. This study highlights the need for epidemiological surveillance and preparedness for potential CHIKV epidemics in Brazil, particularly where other arboviruses co-circulate.
Asunto(s)
Fiebre Chikungunya , Virus Chikungunya , Dengue , Genotipo , ARN Viral , Humanos , Brasil/epidemiología , Fiebre Chikungunya/epidemiología , Fiebre Chikungunya/sangre , Fiebre Chikungunya/virología , Virus Chikungunya/genética , Virus Chikungunya/aislamiento & purificación , Dengue/epidemiología , Dengue/virología , Masculino , Femenino , Adulto , Persona de Mediana Edad , ARN Viral/genética , Adulto Joven , Enfermedades Endémicas , Adolescente , Secuenciación Completa del Genoma , Anciano , Niño , Filogenia , Mutación , Preescolar , Virus del Dengue/genética , Virus del Dengue/aislamiento & purificación , Virus del Dengue/clasificación , Trombocitopenia/epidemiología , Trombocitopenia/virologíaRESUMEN
After the Zika virus (ZIKV) epidemic in the Americas in 2016, both Zika and dengue incidence declined to record lows in many countries in 2017-2018, but in 2019 dengue resurged in Brazil, causing ~2.1 million cases. In this study we use epidemiological, climatological and genomic data to investigate dengue dynamics in recent years in Brazil. First, we estimate dengue virus force of infection (FOI) and model mosquito-borne transmission suitability since the early 2000s. Our estimates reveal that DENV transmission was low in 2017-2018, despite conditions being suitable for viral spread. Our study also shows a marked decline in dengue susceptibility between 2002 and 2019, which could explain the synchronous decline of dengue in the country, partially as a result of protective immunity from prior ZIKV and/or DENV infections. Furthermore, we performed phylogeographic analyses using 69 newly sequenced genomes of dengue virus serotype 1 and 2 from Brazil, and found that the outbreaks in 2018-2019 were caused by local DENV lineages that persisted for 5-10 years, circulating cryptically before and after the Zika epidemic. We hypothesize that DENV lineages may circulate at low transmission levels for many years, until local conditions are suitable for higher transmission, when they cause major outbreaks.
Asunto(s)
Virus del Dengue/inmunología , Dengue/epidemiología , Susceptibilidad a Enfermedades/inmunología , Epidemias/estadística & datos numéricos , Infección por el Virus Zika/inmunología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Anticuerpos Antivirales/inmunología , Brasil/epidemiología , Niño , Preescolar , Dengue/inmunología , Dengue/transmisión , Dengue/virología , Virus del Dengue/genética , Virus del Dengue/aislamiento & purificación , Epidemias/prevención & control , Monitoreo Epidemiológico , Femenino , Genoma Viral/genética , Humanos , Inmunidad Heteróloga , Incidencia , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Tipificación Molecular , Mosquitos Vectores/virología , Filogeografía , Serotipificación , Adulto Joven , Virus Zika/inmunología , Infección por el Virus Zika/epidemiologíaRESUMEN
INTRODUCTION: This epidemiological household survey aimed to estimate the prevalence of the current and past SARS-CoV-2 infections in Ribeirão Preto, a municipality of southeast Brazil. METHODS: The survey was conducted in two phases using a clustered sampling scheme. The first phase spanned May 1-3 and involved 709 participants. The second phase spanned June 11-14, 2020, and involved 646 participants. RESULTS: During the first phase, RT-PCR performed on nasopharyngeal swabs was positive at 0.14%. The serological tests were positive in 1.27% of the patients during the first phase and 2.79% during the second phase. People living in households with more than five members had a prevalence of 10.83% (95%CI: 1.58-74.27) higher than those living alone or with someone other. Considering the proportion of the positive serological test results with sex and age adjustments, approximately 2.37% (95%CI: 1.32-3.42) of the population had been cumulatively infected by mid-June 2020, which is equivalent to 16,670 people (95%CI: 9,267-24,074). Considering that 68 deaths from the disease in the residents of the city had been confirmed as at the date of the second phase of the survey, the infection fatality rate was estimated to be 0.41% (95%CI: 0.28-0.73). Our results suggest that approximately 88% of the cases of SARS-CoV-2 infection at the time of the survey were not reported to the local epidemiological surveillance service. CONCLUSIONS: The findings of this study provide in-depth knowledge of the COVID-19 pandemic in Brazil and are helpful for the preventive and decision-making policies of public managers.
Asunto(s)
COVID-19 , SARS-CoV-2 , Brasil/epidemiología , Humanos , Pandemias , PrevalenciaRESUMEN
Objetivo: descrever o processo de condução de um caso com manifestação oftálmica pela mpox, destacando o trabalho da enfermagem na prevenção de complicações da doença. Método: relato de experiência da condução de um caso de mpox ocorrido em setembro de 2022 com manifestação oftálmica. Resultados: a pronta identificação da complicação oftálmica, com a presença de conjuntivite e edema palpebral, apresentada por um paciente com suspeita de mpox pela equipe de enfermagem da vigilância epidemiológica durante as ações de monitoramento, e o envolvimento da equipe com outras equipes de diversos níveis da assistência à saúde permitiram a instituição precoce do tratamento com antiviral recomendado pelo Ministério da Saúde, o que contribuiu para um melhor desfecho. Conclusão: é importante que se dissemine o conhecimento sobre as manifestações oftálmicas associadas à mpox para que a equipe de enfermagem, que atua nos diversos níveis de atenção à saúde, esteja atenta para implementar, de forma precoce, medidas de prevenção, diagnóstico e tratamento adequados.
Objective: to describe the process of conducting a case with ophthalmic manifestation by mpox, highlighting the work of nursing in preventing complications of the disease. Method: experience report of managing a case of mpox that occurred in September 2022 with ophthalmic manifestation. Results: the prompt identification of the ophthalmic complication, with the presence of conjunctivitis and eyelid edema, presented by a patient with suspected mpox by the epidemiological surveillance nursing team during monitoring actions and the team's involvement with other teams from different levels of the health care allowed the early initiation of antiviral treatment recommended by the Ministry of Health, which contributed to a better outcome. Conclusion: it is important to disseminate knowledge about ophthalmic manifestations associated with mpox for the nursing team that works at different levels of health care to be attentive to implement preventive measures, diagnosis and adequate and early treatment.
Objetivo: describir el proceso de manejo de un caso con manifestación of- talmológica por mpox, destacando la labor de enfermería en la prevención de complica- ciones de la enfermedad. Material y método: relato de experiencia de manejo de un caso de mpox ocurrido en septiembre de 2022 con manifestación oftálmica. Resultados: la rápida identificación de la complicación oftálmica, con la presencia de conjuntivitis y edema de párpados, presentada por un paciente con sospecha de mpox por el equipo de enfermería de vigilancia epidemiológica durante las acciones de monitoreo y la partici- pación del equipo con otros equipos de diferentes niveles de la asistencia sanitaria per- mitió el inicio precoz del tratamiento antiviral recomendado por el Ministerio de Salud, lo que contribuyó a un mejor resultado. Conclusión: es importante difundir el conoci- miento sobre las manifestaciones oftálmicas asociadas a la viruela del mono para que el equipo de enfermería que actúa en los diferentes niveles de atención a la salud esté atento a implementar medidas preventivas, diagnósticas y de tratamiento adecuado y precoz.
Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Vigilancia Sanitaria , Mpox/diagnóstico , Mpox/prevención & control , Mpox/terapia , Manifestaciones Oculares , Antivirales , Monitoreo del Ambiente/instrumentación , Enfermería , Conjuntivitis/diagnóstico , Conjuntivitis/prevención & control , Conjuntivitis/terapia , Informes de Casos como Asunto , Investigación sobre Servicios de SaludRESUMEN
Abstract INTRODUCTION: This epidemiological household survey aimed to estimate the prevalence of the current and past SARS-CoV-2 infections in Ribeirão Preto, a municipality of southeast Brazil. METHODS: The survey was conducted in two phases using a clustered sampling scheme. The first phase spanned May 1-3 and involved 709 participants. The second phase spanned June 11-14, 2020, and involved 646 participants. RESULTS: During the first phase, RT-PCR performed on nasopharyngeal swabs was positive at 0.14%. The serological tests were positive in 1.27% of the patients during the first phase and 2.79% during the second phase. People living in households with more than five members had a prevalence of 10.83% (95%CI: 1.58-74.27) higher than those living alone or with someone other. Considering the proportion of the positive serological test results with sex and age adjustments, approximately 2.37% (95%CI: 1.32-3.42) of the population had been cumulatively infected by mid-June 2020, which is equivalent to 16,670 people (95%CI: 9,267-24,074). Considering that 68 deaths from the disease in the residents of the city had been confirmed as at the date of the second phase of the survey, the infection fatality rate was estimated to be 0.41% (95%CI: 0.28-0.73). Our results suggest that approximately 88% of the cases of SARS-CoV-2 infection at the time of the survey were not reported to the local epidemiological surveillance service. CONCLUSIONS: The findings of this study provide in-depth knowledge of the COVID-19 pandemic in Brazil and are helpful for the preventive and decision-making policies of public managers.
Asunto(s)
Humanos , SARS-CoV-2 , COVID-19 , Brasil/epidemiología , Prevalencia , PandemiasRESUMEN
O objetivo deste estudo qualitativo foi compreender a percepção do enfermeiro sobre a supervisão das atividades realizadas em sala de vacina de unidades de atenção primária à saúde. As salas selecionadas fizeram parte de estudo preliminar, com abordagem quantitativa, que analisou as melhores salas de vacina da Macrorregião Oeste de Minas Gerais, das quais 12 salas atenderam a 100% dos critérios estruturais. Foram entrevistados os enfermeiros responsáveis por essas salas e os dados obtidos submetidos à análise de conteúdo na modalidade temática. Os resultados demonstraram ausência de um processo de supervisão pelos enfermeiros, o que pode ter ocorrido pela quantidade de ações assumidas por eles. O enfermeiro necessita de atitude proativa com ações educativas e acompanhamento mais efetivo das atividades em sala de vacina, evitando a ocorrência de falhas nos procedimentos que podem acarretar reflexo na qualidade dos imunobiológicos, disponibilizados para a população.
The objective of this qualitative study was to understand the nurse's perception of the supervision of vaccination activities carried out in Primary Care Centers. The vaccination rooms selected for this study were from a preliminary quantitative study which analyzed the best vaccination rooms in the macroregion of western Minas Gerais, Brazil, in which 12 rooms met 100% of the structural criteria. The nurses responsible for these rooms were interviewed and the data obtained was analyzed through thematic content analysis. The results show the lack of a supervision process by nurses, which might have occurred due to the quantity of actions under their responsibility. The nurses need a proactive attitude with educational actions and more effective monitoring of vaccination room activities, avoiding the occurrence of flaws in the procedures which might influence the quality of the immunobiological preparation made available for the population.
El objetivo de este estudio cualitativo fue comprender la percepción de las enfermeras sobre la supervisión de actividades realizadas en las consultas de vacunación de las unidades de atención primaria de salud. Las consultas seleccionadas formaron parte de un estudio preliminar con abordaje cuantitativo, que analizó las mejores consultas de vacunación de la Macrorregión Oeste de Minas Gerais, Brasil, y de las cuales 12 consultas obtuvieron 100% de los criterios estructurales. Fueron entrevistados los enfermeros responsables de estas consultas, y los datos obtenidos fueron sometidos a un análisis temático de contenido. Los resultados demostraron que hay ausencia de un proceso de supervisión enfermera y que tal vez, eso ocurra por la cantidad de acciones asumidas por estos profesionales. El enfermero debe tener una actitud pro-activa con acciones educativas y un acompañamiento más efectivo de las actividades en consulta de vacunación, con el fin de evitar la ocurrencia de fallos en los procedimientos, los cuales pueden tener un impacto en la calidad de los preparados imunobiológicos disponibles para la población.
Asunto(s)
Humanos , Organización y Administración , Atención Primaria de Salud , Inmunización , Supervisión de EnfermeríaRESUMEN
Objetivando quantificar e analisar a formaçäo de anticorpos neutralizantes e detectar a resposta imune celular pelo índice de transformaçäo linfoblástica em indivíduos vacinados com a vacina do tipo Fuenzalida & Palácios no esquema reduzido de vacinaçäo em dias alternados, foram estudados 106 indivíduos estudantes de cursos com risco de exposiçäo ao vírus rábico por manipularem animais. As amostras de sangue foram colhidas nos dias pré determinados sendo a primeira antes do início da vacinaçäo, a segunda no D10, a terceira no D24 e a quarta no D56. Todas as vacinas utilizadas foram do mesmo lote e procedência e aplicadas em dias alternados no D0, D2, D4. Os resultados mostraram que após o término do esquema vacinal, após 10 dias, todos os indivíduos haviam formado anticorpos neutralizantes em níveis considerados como protetores pela OMS; após 24 dias 90,6 por cento e após 56 dias 53 por cento dos indivíduos ainda mantiveram tais níveis. Os dados relativos ao teste de transformaçäo linfoblástica, através do qual foi avaliada a resposta imune celular nos revelam que apenas 50 por cento dos 12 indivíduos apresentaram positividade na coleta do D10. No D24 100 por cento deles apresentaram resultados negativos.