Perception of newly graduated physicians toward ethical education in medical schools: a Brazilian cross-sectional nationwide study

SUMMARY OBJECTIVE: The objective of this study was to evaluate fresh medical graduates' perceptions regarding the general aspects of ethics teaching in Brazilian medical schools. METHODS: A structured questionnaire was applied to 4,601 participants among the 16,323 physicians who registered in one of the 27 Regional Medical Councils of Brazil in 2015. Answers to four questions regarding general aspects of ethics education in medical school were analyzed. Sampling procedures involved two stratification variables: legal nature (public vs. private) of medical schools and monthly household income higher than 10 minimum wages. RESULTS: A large percentage of the participants had witnessed unethical behaviors during contact with patients (62.0%), toward coworkers (51.5%), and in relationships with patients' families (34.4%) over the course of their medical training. Even though most of the responders (72.0%) totally agreed that patient-physician relationship and humanities education were part of their medical school curriculum, important topics such as conflicts of interest and end-of-life education were not satisfactorily addressed in the participants' medical training. Statistically significant differences were found between the answers of public and private school graduates. CONCLUSION: Despite great efforts to improve medical ethics education, our findings suggest the persistence of deficits and inadequacies in the ethics training currently given in medical schools in Brazil. Further modifications in ethics training must be made to address the deficiencies shown in this study. This process should be accompanied by continuous evaluation.

There is no shortage, but inequality: demographic evolution of neurologists in Brazil (2010-2020) / Não há escassez, mas sim desigualdade: evolução demográfica de neurologistas no Brasil (2010-2020)

Abstract Background Neurology is a medical specialty that deals with prevalent diseases such as stroke, headache, epilepsy, and neurodegenerative diseases. Many countries, such as Brazil, struggle to provide neurological care for their populations, but the inadequacy and unequal distribution of the neurologist workforce are real challenges. Objective To analyze the demographic evolution of neurologists and the first-year Neurology residency positions in Brazil during the last decade (2010-2020) and the distribution imbalance between regions. Methods The demographic and geographic distribution of neurologists was calculated based on data extracted from the Brazilian Federal Medical Council reports, and the number of Neurology residency positions was based on the Brazilian National Commission of Medical Residency reports. Indicators of wealth were associated with demographic data. Results The number of neurologists per 100,000 population has increased since 2011, with a similar increase in the geographic distribution of neurologists. However, there was a marked inequality of distribution of neurologists through regions, with a gap between the Northern (lowest) and Southeastern (highest) regions. Furthermore, the imbalance of distribution of neurologists strongly correlated with social inequality. The number of Neurology residency positions increased, but with an imbalance between North and Southeast regions. Conclusions Brazil has advanced in providing neurologists. However, instead of a shortage, inequality between regions is the greatest challenge regarding the neurological workforce. The training of new neurologists is unequal between regions and occurs at a slower rate than needed. Neurologists, public health authorities, and patients should discuss solutions for these issues.

Resumo Antecedentes A Neurologia é uma especialidade médica que lida com doenças prevalentes, como acidente vascular cerebral, cefaleia, epilepsia e doenças neurodegenerativas. Muitos países, como o Brasil, se esforçam para oferecer assistência neurológica à população, mas a distribuição insuficiente e desigual da força de trabalho de neurologistas são desafios. Objetivo Analisar a evolução demográfica dos médicos neurologistas e das vagas de Programas de Residência Médica em Neurologia no Brasil durante a última década (2010-2020) e o desequilíbrio de distribuição entre as regiões. Métodos A distribuição demográfica e geográfica de neurologistas foi calculada com base nos dados extraídos de relatórios do Conselho Federal do Medicina do Brasil, e o número de vagas em Programas de Residência Médica em Neurologia foi extraído de dados da Comissão Nacional de Residência Médica. Os indicadores de riqueza foram associados aos dados demográficos. Resultados O número de neurologistas por 100.000 habitantes aumentou desde 2011, com um aumento similar na distribuição geográfica de neurologistas. Entretanto, houve uma nítida desigualdade na distribuição de neurologistas entre as regiões, com um hiato entre as regiões Norte e a Sudeste. Além disso, a desigualdade da distribuição de neurologistas se correlacionou fortemente com a desigualdade social. O número de vagas em Programas de Residência Médica aumentou, porém com desigualdade entre as regiões Norte e Sudeste. Conclusões O Brasil tem avançado na geração de neurologistas. Porém, ao invés de uma escassez, a desigualdade entre regiões é o maior desafio em relação à força de trabalho neurológica. O treino de novos neurologistas é desigual entre regiões e ocorre em um ritmo mais lento do que o necessário. Neurologistas, autoridades em saúde pública e pacientes devem discutir soluções para estes problemas.

Attitude and knowledge of medical students toward donation after circulatory death

SUMMARY OBJECTIVE: A survey among medical students in a Brazilian public university was performed to investigate the acceptance of organ donation in Brazil, particularly donation after circulatory death (DCD). METHODS: A questionnaire including 26 objectives and Likert scale questions was validated and sent to all medical students of our institution. The answers were analyzed considering the whole set of individuals as well as by dividing the medical students into two groups: less graduated students and more graduated students. RESULTS: From 1050 students, 103 spontaneous answers (9.8%) were retrieved after 3 weeks. A total of 89.3% agreed totally with deceased donor organ donation and 8.7% agreed partially. However, only 50.5% of the students agreed totally and 31.1% agreed partially to living donation. Students revealed that 82.6% know the concept of brain death. On the other hand, 71.8% of them declared not knowing the concept of planned withdrawal of life-sustaining therapy, mainly cardiorespiratory support. A total of 85.4% of students agreed totally with donation after brain death and 11.7% agreed partially. However, when questioned about donation in awaiting circulatory death after a planned withdrawal of life-sustaining therapy, only 18.4% agreed totally and 32% agreed partially. Both groups of less and more graduated students showed similar results. CONCLUSIONS: Our study found a clear lack of information and consequently in acceptance of DCD. Education in the field of end-of-life management may improve not only the acceptance of DCD donation but also the whole understanding of planned withdrawal of life-sustaining therapy.

C-peptide level as predictor of type 2 diabetes remission and body composition changes in non-diabetic and diabetic patients after Roux-en-Y gastric bypass

OBJECTIVES: Several predictors of type 2 diabetes mellitus (T2DM) remission after metabolic surgery have been proposed and used to develop predictive scores. These scores may not be reproducible in diverse geographic regions with different baseline characteristics. This study aimed to identify predictive factors associated with T2DM remission after Roux-en-Y gastric bypass (RYGB) in patients with severe obesity. We hypothesized that the body composition alterations induced by bariatric surgery could also contribute to diabetes remission. METHODS: We retrospectively evaluated 100 patients with severe obesity and T2DM who underwent RYGB between 2014 and 2016 for preoperative factors (age, diabetes duration, insulin use, HbA1c, C-peptide plasma level, and basal insulinemia) to identify predictors of T2DM remission (glycemia<126 mg/dL and/or HbA1c<6.5%) at 3 years postoperatively. The potential preoperative predictors were prospectively applied to 20 other patients with obesity and T2DM who underwent RYGB for validation. In addition, 81 patients with severe obesity (33 with T2DM) underwent body composition evaluations by bioelectrical impedance analysis (InBody 770®) 1 year after RYGB for comparison of body composition changes between patients with and those without T2DM. RESULTS: The retrospective analysis identified only a C-peptide level >3 ng/dL as a positive predictor of 3-year postoperative diabetes remission, which was validated in the prospective phase. There was a significant difference in the postoperative body composition changes between non-diabetic and diabetic patients only in trunk mass. CONCLUSION: Preoperative C-peptide levels can be useful for predicting T2DM remission after RYGB. Trunk mass is the most important difference in postoperative body composition changes between non-diabetic and diabetic patients.

Cultural adaptation and updating of the Risk assessment and management of exposure of health care workers in the context of covid-19 questionnaire / Adaptación cultural y actualización del cuestionario Risk assessment and management of exposure of health care workers in the context of covid-19 / Adaptação cultural e atualização do questionário Risk assessment and management of exposure of health care workers in the context of covid-19

Objective: to translate and culturally adapt the Risk assessment and management of exposure of health care workers in the context of covid-19 questionnaire to the Brazilian context and to develop and evaluate a sociodemographic and occupational characterization questionnaire to compose the adapted questionnaire. Method: five stages were conducted to adapt the Risk assessment and management of exposure of health care workers in the context of covid-19 questionnaire, namely: translation, synthesis of the translations, evaluation by a committee of judges, back translation and pre-test. As for the complementary questionnaire, it was elaborated and evaluated by a committee of judges and a pre-test was carried out. Results: the questionnaires were validated and the pre-test stage was conducted with health workers and students. Conclusion: the final version adapted to the Brazilian context was called Questionário de avaliação de risco e gestão da exposição de trabalhadores e estudantes de saúde no contexto da covid-19 and is available for use, together with the final version of the Sociodemographic and occupational questionnaire: Risk assessment and management of exposure of health care workers and students in the context of covid-19. These questionnaires may assist in mitigating the risks of infection, illness and death of health workers and students due to covid-19.

Objetivo: traducir y adaptar culturalmente el cuestionario Risk assessment and management of exposure of health care workers in the context of covid-19 al contexto brasileño y elaborar y evaluar un cuestionario de caracterización sociodemográfica y ocupacional para formular el cuestionario adaptado. Método: se llevaron a cabo cinco pasos para adaptar el cuestionario Risk assessment and management of exposure of health care workers in the context of covid-19: traducción, síntesis de traducciones, evaluación por un comité de jueces, retrotraducción y pretest. En cuanto al cuestionario complementario, fue elaborado y evaluado por un comité de jueces y se realizó una prueba previa. Resultados: se validaron los cuestionarios y se realizó la etapa de pretest con trabajadores y estudiantes del área de la salud. Conclusión: la versión final adaptada al contexto brasileño se denominó Questionário de avaliação de risco e gestão da exposição de trabalhadores e estudantes de saúde no contexto da covid-19 y está disponible para su uso, junto con la versión final del Questionário de avaliação de risco e gestão da exposição de trabalhadores e estudantes de saúde no contexto da COVID-19. Estos cuestionarios pueden ayudar a disminuir los riesgos de infección, enfermedad y muerte de los trabajadores y los estudiantes del área de la salud por covid-19.

Objetivo: traduzir e adaptar culturalmente o questionário Risk assessment and management of exposure of health care workers in the context of covid-19 para o contexto brasileiro e elaborar e avaliar um questionário de caracterização sociodemográfica e ocupacional para compor o questionário adaptado. Método: cinco etapas foram realizadas para adaptação do questionário Risk assessment and management of exposure of health care workers in the context of covid-19: tradução, síntese das traduções, avaliação por comitê de juízes, retrotradução e pré-teste. Quanto ao questionário complementar, foi construído e avaliado por um comitê de juízes e realizado pré-teste. Resultados: os questionários foram validados e a etapa de pré-teste foi realizada com trabalhadores e estudantes da área de saúde. Conclusão: a versão final adaptada para o contexto brasileiro foi denominada Questionário de avaliação de risco e gestão da exposição de trabalhadores e estudantes de saúde no contexto da covid-19 e está disponibilizada para uso, juntamente com a versão final do questionário sociodemográfico e ocupacional: avaliação de risco e gestão da exposição de trabalhadores e estudantes da área de saúde no contexto da covid-19. Estes questionários podem auxiliar na mitigação dos riscos de infecção, adoecimento e morte de trabalhadores e estudantes da área de saúde pela covid-19.

Hepatitis B viremia in HIV-coinfected individuals under antiretroviral therapy

ABSTRACT Background: Antiretroviral therapy (ART) has decreased AIDS incidence and mortality, rendering comorbidities, such as hepatitis B more relevant for people living with human immunodeficiency virus (HIV). Since antiretroviral drugs may also inhibit hepatitis B virus (HBV) replication, analyzing the impact of ART on management of hepatitis B in this population is important. Objective: To assess HBV viremia among HIV/HBV coinfected individuals on ART and its associated factors. Method: For this cross-sectional study, HIV/HBV-coinfected individuals, aged over 18 years, who were on ART for over six months and receiving care at an outpatient clinic in São Paulo were recruited. Sociodemographic characteristics, information about viral exposure, clinical and laboratory data, including evaluation of liver fibrosis were obtained. Plasma HBV DNA was measured by polymerase chain reaction. Viral genome sequencing was conducted for genotyping and identification of drug resistance-conferring mutations if viral load exceeded 900 IU/mL. Results: Out of 2,946 patients who attended the clinic in 2015, 83 were eligible and 56 evaluated. Plasma HBV DNA was detected in 16 (28.6%) (95% CI: 18.0-41.3%), all on lamivudine and tenofovir treatment. HBV DNA detection was associated with lower education (p = 0.015), higher international normalized ratios (p = 0.045), history of an AIDS-defining illness [OR: 3.43 (95% CI: 1.10-11.50)], and HBeAg detection [OR: 6.60 (95% CI: 1.84-23.6)]. In contrast, a last CD4+ count above 500 cells/mm3 in the year prior to inclusion [OR: 0.18 (95% CI: 0.04-0.71)] and detection of anti-HBe [OR: 0.21 (95% CI: 0.04-0.99)] were negatively associated. Patients with HBV DNA above 900 IU/mL were infected with subgenotypes A1 (n = 3) and D2 (n = 1), and exhibited viral mutations associated with total resistance to lamivudine and partial resistance to entecavir. Conclusions: Despite being on ART, a significant proportion of HIV/HBV-coinfected individuals present HBV viremia. Characterization of factors that are associated with this finding may help professionals provide better management to these patients.

Who and Where are the University of São Paulo Medical School Graduates?

OBJECTIVE: To evaluate the impact of a complex-care-based medical school in the context of the Brazilian health care system on students' career choices. METHODS: This was a retrospective cross-sectional study based on medical regulatory organization records. It included records for 7,419 physicians who graduated from FMUSP. Geographic data were analyzed using Kernel maps, and the statistical analysis was performed with SPSS® version 24.0. A p-value less than 0.05 was considered significant. RESULTS: Of the 7,419 physicians, 68.6% (95% CI 67.5-69.7) were male, and 20.7% (95% CI 19.8%-21.7%) had no medical specialty, compared to 46.4% nationwide. Internal medicine and surgery-based specialties were more popular, accounting for 39.4% (95% CI 38.3%-40.5%) and 16.8% (95% CI 15.5%-17.6%) of our study group, compared to the Brazilian averages of 25.9% and 13.5%. Our graduates also had a higher probability of staying in São Paulo City, especially when born outside the city. CONCLUSION: We believe that FMUSP remains an interesting model for studying the impact of a highly specialized center on the education and career choices of medical students.

Brazilian infectious diseases specialists: who and where are they?

Abstract Background The infectious diseases specialist is a medical doctor dedicated to the management of infectious diseases in their individual and collective dimensions. Objectives The aim of this paper was to evaluate the current profile and distribution of infectious diseases specialists in Brazil. Methods This is a cross-sectional study using secondary data obtained from institutions that register medical specialists in Brazil. Variables of interest included gender, age, type of medical school (public or private) the specialist graduated from, time since finishing residency training in infectious diseases, and the interval between M.D. graduation and residency completion. Maps are used to study the geographical distribution of infectious diseases specialists. Results A total of 3229 infectious diseases specialist registries were counted, with 94.3% (3045) of individual counts (heads) represented by primary registries. The mean age was 43.3 years (SD 10.5), and a higher proportion of females was observed (57%; 95% CI 55.3–58.8). Most Brazilian infectious diseases specialists (58.5%) practice in the Southeastern region. However, when distribution rates were calculated, several states exhibited high concentration of infectious diseases specialists, when compared to the national rate (16.06). Interestingly, among specialists working in the Northeastern region, those trained locally had completed their residency programs more recently (8.7 yrs; 95% CI 7.9–9.5) than physicians trained elsewhere in the country (13.6 yrs: 95% CI 11.8–15.5). Conclusion Our study shows that Brazilian infectious diseases specialists are predominantly young and female doctors. Most have concluded a medical residency training program. The absolute majority practice in the Southeastern region. However, some states from the Northern, Northeastern and Southeastern regions exhibit specialist rates above the national average. In these areas, nonetheless, there is a strong concentration of infectious diseases specialists in state capitals and in metropolitan areas.

O controle do câncer de mama na atenção primária: desafios na elaboração do plano amostral / Breast cancer control in primary health care: challenges in building a sampling plan

Objetivo: descrever a amostragem para identificar as ações no controle do câncer de mama na atenção básica. Mé- todo: estudo descritivo. Apresentam-se os critérios de escolha do objeto e local de pesquisa, dos informantes- chave e da técnica amostral. Resultados: para identificar as ações consensuadas, na região sudeste de São Paulo, selecionaram-se amostras de serviços, usuárias, gestores e enfermeiros. Várias fontes informatizadas foram consulta- das devido à incompletude dos cadastros locais. A hetero- geneidade populacional conduziu a um plano complexo de amostragem em dois estágios. Considerou-se o nível de confiança de 95%, efeito de delineamento igual a dois com erro amostral de 5%, resultando em amostra de 760 usuárias e a totalidade de gestores e enfermeiros de 38 ser- viços. Conclusão: os critérios adotados foram adequados para definição de uma amostra que satisfizesse aos obje- tivos propostos. No entanto a incompletude e a incon- sistência das informações nas bases de dados consultadas foram os principais desafios deste estudo.

Objective: Describe sampling to identify the breast cancer control actions in primary health care. Methods: Descriptive study. We present the criteria for selecting the study object and locale, as well as the key respondents and sampling techniques. Results: Samples from services, users, managers, and nurses were selected to identify consensual breast cancer control actions in the southeast region of São Paulo. The incompleteness of local records led us to consult several computerized sources to carry out the sampling. A complex, two-stage sampling plan was employed due to the heterogeneity of the main population. A 95% confidence interval, a design effect of 2, with a sampling error of 5%, was considered, resulting in a sample of 760 users and a universe of managers and nurses from 38 services. Conclusion: The criteria used were adequate to define a sample that met the intended goals. However, the incompleteness and inconsistency of the information in the databases consulted were the main challenges in this study.

A feminização da medicina no Brasil / The feminization of Medicine in Brazil

Objetivando traçar a evolução histórica da distribuição de médicos no Brasil segundo sexo, foi realizado estudo epidemiológico do tipo ecológico, por meio do cruzamento de bancos de dados secundários (linkage). Para a caracterização geral dos médicos foram consideradas as bases de dados dos 27 conselhos regionais de medicina, complementadas pelas bases de dados da Comissão Nacional de Residência Médica e da Associação Médica Brasileira. Os resultados mostram que, desde 2009, entre os novos médicos registrados há mais mulheres que homens. Na população de médicos em atividade os homens ainda predominam (60,1 por cento), mas no grupo com 29 anos ou menos as mulheres já são maioria. A tendência consistente de maior participação das mulheres na profissão médica no Brasil, observada ao longo das últimas décadas e acentuada nos últimos anos, indica a necessidade de reavaliar e readequar as propostas para implementação de políticas públicas na área.

Aiming to settle the historical evolution of physicians’ distribution in Brazil by gender, an ecological study wasconducted by secondary database cross-checking (linkage). For a general characterization of the physicianswere considered the 27 Regional Medicine Council, complemented by the National Medical Residency andthe Brazilian Medical Association databases. The results show that since 2009, among new registered doctorsthere are more women than men. Although men still prevail (60.1%) in the active physicians population, inthe group aged less than 29 years old, women have become majority. The consistent trend of increased participation of women in the medical profession in Brazil, observed over the past decades and intensified overthe past few years, indicates the need to reassess and readjust the proposals for implementation of publicpolicies in the area.

Análise do controle dos contatos intradomiciliares de pessoas atingidas pela hanseníase no Brasil e no estado de São Paulo de 1991 a 2012 / Analysis of control household contacts of people affected by leprosy in Brazil and the state of São Paulo de 1991 a 2012

A hanseníase constitui um relevante problema de Saúde Pública no Brasil, e o controle dos comunicantes é fundamental para o controle da endemia e o alcance das metas de eliminação. Objetivo: Descrever e analisar a evolução das medidas de controle dos comunicantes intradomiciliares das pessoas atingidas pela hanseníase e seu impacto prático no Brasil e no estado de São Paulo, entre 1991 a 2012.Métodos: Trata se de revisão narrativa, realizada em teses, portarias, manuais, dissertações, artigos de periódicos e boletins informativos, disponíveis em Bases de Dados online, de relevância no meio científico, filtrando apenas publicações entre 1991 a 2012.Os dados foram inicialmente catalogados e, posteriormente aplicadas técnicas de leituras/fichamento com a formação de um banco de dados. Resultados e Discussão: Todas as normatizações aqui citadas, com relação à vigilância dos contatos que foram sendo expedidas e revogadas a partir de 1991, não causaram impacto significativo no controle dos comunicantes. O controle não foi incrementado e/ou priorizado pelos órgãos oficiais e unidades de saúde, contribuindo para que dezenas de comunicantes intra domiciliares continuem alimentando o “iceberg” da endemia. Conclusão: Defendemos a ampliação do conceito de comunicante para além dos contatos intradomiciliares. As intervenções devem ser constantes e mantidas,para que se assegure a redução da ocorrência dos casos,que não serão alcançadas caso as atividades de eliminação fiquem restritas apenas ao diagnóstico e tratamento dos casos novos, deixando para segundo plano a vigilância epidemiológica, o exame rotineiro dos comunicantes, a vacinação, o tratamento, a educação do paciente, da família e da comunidade.

Leprosy is still a significant public health problem in Brazil, and the control of house hold contacts is primordialto control this endemic and achieve the eliminationgoal. Objective: To describe and analyzethe evolution of the control measures of household contacts of people affected by leprosy and its practical impact in Brazil and in the state of São Paulo, from1991 to 2012. Methods: This was a narrative review, held in thesis, ordinances, manuals, dissertations, journal articles and newsletters, available in online databases, of relevance in scientific circles, filteringout only publications from 1991 to 2012. The datawere first cataloged and subsequently it was applie dreading techniques, forming a database. Results and Discussion: All standardizations cited here, related to the surveillance of contacts that have been issued andrevoked since 1991, did not have significant impacton the evaluation of the contacts. The control was not incremented and/or prioritized by official agencies and health units, contributing to dozens of household contacts continue feeding the problem of endemics.Conclusion: We support the expansion of the conceptof communicating beyond the household contacts. Interventions should be constant and maintained to ensure the reduction of cases that will not be achieved if elimination activities remain restricted only to the diagnosis and treatment of new cases, leaving behind the epidemiological surveillance, routine examination of communicating, vaccination, treatment, patient education, family and community.

Contaminação do solo por ovos de geo-helmintos com potencial zoonótico na municipalidade de Fernandópolis, Estado de São Paulo, entre 2007 e 2008 / Soil contamination by eggs of soil-transmitted helminths with zoonotic potential in the town of Fernandópolis, State of São Paulo, Brazil, between 2007 and 2008

INTRODUÇÃO: A concentração de cães e gatos em áreas urbanas, associada a um número cada vez mais crescente da população errante desses animais, tem um papel epidemiológico importante na contaminação de solos de praças e parques públicos e na disseminação de infecções por variados gêneros de parasitas. O objetivo do presente estudo foi determinar a frequência de geo-helmintos com potencial zoonótico em solo de praças públicas e escolas municipais infantis da Cidade de Fernandópolis, Estado de São Paulo, Brasil, no período compreendido entre março de 2007 e fevereiro de 2008. MÉTODOS: Foram avaliadas todas as praças (32) e escolas (13) da cidade. As amostras foram testadas pelos métodos de Rugai adaptado, Willis e Caldwell e Caldwell. RESULTADOS: Foram avaliadas 225 amostras de solo com 30,2 por cento (68) de positividade. Nas amostras provenientes de praças públicas, a positividade foi de 40 por cento (64), ao passo que, nas escolas, foi de apenas 6,1 por cento (6). Os ovos de parasitas encontrados foram Toxocara spp. 79,3 por cento (47), Trichuris spp. 13,8 por cento (8) e ancilostomídeos 6,9 por cento (4). Variáveis relacionadas ao local, como o número de cães (OR 21,18 - IC95 por cento: 10,81-41,51), de espécimes de fezes (OR 6,87 - IC95 por cento: 3,51-13,47) e a utilização de cerca (OR 0,1 - IC95 por cento: 0,05-0,20) tiveram impacto na contaminação do solo. CONCLUSÕES: Foram observados, nas amostras contaminadas, parasitas com potencial zoonótico, entre os quais estão os agentes etiológicos de doenças como a larva migrans visceral e cutânea, fato que representa risco a saúde da população que frequenta tais ambientes.

INTRODUCTION: The concentration of dogs and cats in urban areas, associated with an ever-increasing wandering population of these animals, has an important epidemiological role in the soil contamination of public spaces and the spread of infections of several types of parasites. This study aimed to determine the frequency of soil-transmitted helminths with zoonotic potential in public squares and municipal primary schools in Fernandópolis, State of São Paulo, Brazil, conducted between 2007 and 2008. METHODS: All the squares (32) and schools (13) in the town were evaluated. Soil samples were tested using the Rugai method modified by Willis, Caldwell and Caldwell. RESULTS: A total of 225 soil samples were evaluated and 30.2 percent (68) were positive for helminths. In samples from public squares, 40 percent (64) contamination was observed; however, contamination in schools was only 6.1 percent (6). The parasites eggs identified were Toxocara spp. 79.3 percent (47), Trichuris spp. 13.8 percent (8) and Ancylostomatidae 6.9 percent (4). Variables related to the site, such as the number of dogs (OR 21.18, 10.81 - 41.51), fecal samples (OR 6.87, 3.51 - 13.47) and the use of fences (OR 0.1, 0.05 - 0.20), had an impact on soil contamination. CONCLUSIONS: In the contaminated samples, parasites with zoonotic potential were identified, including the etiologic agents of diseases like cutaneous and visceral larva migrans, a fact that poses a risk to health of the population that frequent such environments.