Prevalencia de la infección por Sporothrix schenckii en agricultores del Cantón Shushufindi de la Provincia de Sucumbíos / Prevalence of Sporothrix schenckii infection in farmers of the Shushufindi Canton of the Sucumbíos Province

La esporotricosis es una micosis subcutánea causada por la inoculación traumática en la piel de especies de hongos del género Sporothrix. La enfermedad tiene diferentes manifestaciones clínicas (cutáneas, linfocutáneas y diseminadas), y también puede progresar a una infección sistémica. A pesar de tener una distribución mundial, la esporotricosis es más frecuente en los países tropicales y subtropicales. La esporotricosis es la micosis subcutánea más frecuente en América Latina, donde se considera endémica. Ciertos grupos de personas pueden estar más expuestos al agente causal de la enfermedad, como los agricultores. Así, este trabajo tuvo como objetivo determinar la prevalencia de la esporotricosis en 3.133 agricultores, en el cantón de Shushufindi de la provincia de Sucumbíos, Ecuador. En este estudio, se utilizó una prueba de intradermorreacción con el antígeno esporotriquina obtenido del hongo Sporothrix schenckii. Los datos obtenidos mostraron una prevalencia de 35,45%. La distribución de la prevalencia de la esporotricosis con respecto a los grupos de edad no mostró diferencias estadísticas significativas (p=0,2054). Para la variable sexo, si hubo significancia estadística (p=0,01995). 51 de los casos positivos presentaron gomas y/o úlceras en alguno de sus miembros. La esporotricosis ha demostrado ser una de las micosis subcutáneas más frecuente en los trabajadores de la agricultura en la región ecuatoriana evaluada(AU)

Sporotrichosis is a subcutaneous mycosis caused by traumatic skin inoculation of fungal species of the genus Sporothrix. The disease has different clinical manifestations (cutaneous, lymphocutaneous, and disseminated), and it can also progress to a systemic infection. Despite having a worldwide distribution, sporotrichosis is more common in tropical and subtropical countries. Sporotrichosis is the most frequent subcutaneous mycosis in Latin America, where it is considered endemic. Certain groups of people may be more exposed to the causative agent of the disease, such as farmers. Thus, this work aimed to determine the prevalence of sporotrichosis in 3133 farmers, in the canton of Shushufindi in the province of Sucumbíos, Ecuador. In this study, an intradermal test was used with the sporotrichin antigen obtained from the fungus Sporothrix schenckii. The data obtained showed a prevalence of 35.45%. The distribution of the prevalence of sporotrichosis with respect to age groups did not show significant statistical differences (p=0.2054). For the sex variable, there was statistical significance (p=0.01995). 51 of the positive cases presented gums and/or ulcers in one of their members. Sporotrichosis has proven to be one of the most frequent subcutaneous mycoses in agricultural workers in the evaluated Ecuadorian region(AU)

Conocimientos, actitudes y prácticas sobre el uso de plaguicidas por agricultores en una zona rural de Copán Ruinas, Honduras, año 2019 / Knowledge, attitudes, and practices on the use of pesticides by farmers in a rural area of Copán Ruinas, Honduras, 2019

Resumen Introducción: Las prácticas de uso por parte de pequeños agricultores en zonas rurales empobrecidas se relacionan con riesgo alto ocupacional y paraocupacional de exposición a plaguicidas. Objetivo: Describir las características de los conocimientos, actitudes y prácticas de uso de plaguicidas por agricultores en una zona rural de Copán Ruinas, Honduras. Materiales y métodos: Estudio descriptivo, transversal, llevado a cabo en Copán Ruinas, Honduras, C.A, 2019, incluyó 81 agricultores (n=81) mayores de 18 años procedentes de tres comunidades rurales contiguas. Resultados: Los agricultores entrevistados refieren capacitación 3.7% (3/81), almacenan plaguicida en el hogar 39.5% (32/81), manipulan veneno sin guantes 30.9% (26/81), eliminan residuos en el ambiente 19.8% (16/81), lavan equipo en hogar 27.2% (22/81). Un agricultor (1.2%, 1/81) refirió conocer el significado de los colores en las etiquetas. Discusión: el bajo nivel de escolaridad podría ser la causa de bajo porcentaje de conocimiento con respecto al riesgo de exposición a plaguicidas. Coincide con otros autores, la actitud positiva del agricultor hacia la prevención de riesgo. Algunas prácticas referidas por los agricultores inducen riesgo de exposición paraocupacional, coincidiendo con lo reportado en la literatura. Conclusión: El bajo porcentaje de conocimientos, actitudes y prácticas en el uso de plaguicidas por los agricultores de la zona rural evaluada coincide con lo reportado por la literatura regional y latinoamericana, posiblemente asociada a un contexto de bajo nivel socioeconómico que conlleva baja capacidad de inversión en prevención y que podría ser una causa importante que contribuye al riesgo de exposición ocupacional y paraocupacional por uso de plaguicidas.

Abstract Introduction: Use practices by small farmers in impoverished rural areas are related to high occupational and para-occupational risk of exposure to pesticides. Objective: To describe the characteristics of the knowledge, attitudes and practices of pesticide use by farmers in a rural area of Copán Ruinas, Honduras. Methods: Descriptive, cross-sectional study, carried out in Copán Ruinas, Honduras, C.A. 2019, it included 81 farmers (n = 81) older than 18 years from three contiguous rural communities. Results: Only 3.7% of the farmers referred training, 39.5% (32/81) store pesticide at home, 30.9% handle poison without gloves, 19.8% (16/81) eliminate waste in the environment, 27.2%, 22/81) wash equipment at home. One farmer (1.2%, 1/81) reported knowing the meaning of the colors on the labels. Discussion: The very low level of schooling could be the cause of low percentage of knowledge regarding the risk of exposure to pesticides. The positive attitude of the farmer towards risk prevention coincides with other authors. Some practices referred by farmers induce risk of para-occupational exposure, coinciding with what has been reported in the literature. Conclusion: The low percentage of knowledge, attitude and practices in the use of pesticides by farmers in rural areas evaluated coincide with that reported by regional and Latin American literature, possibly associated with a context of low socioeconomic level that entails low investment capacity in prevention and that could be an important cause that contributes to the risk of occupational and para-occupational exposure due to the use of pesticides.

Resistencia antimicrobiana y producción porcina de cría intensiva / Antimicrobial resistance and intensive swine production: mini review

Introducción: el impacto de la resistencia antimicrobiana (RAM) generará un aumento de las muertes relacionadas de 10 millones anuales hacia 2050. El 70% de la dispensación de antimicrobianos (ATB) se utiliza en la agroveterinaria y no en salud humana. Es fundamental conocer la portación de RAM en trabajadores de cría de animales y en los animales, para acciones tempranas de salud pública. Métodos: bajo metodología PRISMA se realizó la búsqueda bibliográfica en distintas fuentes disponibles hasta octubre de 2020. Se priorizaron revisiones sistemáticas, metanálisis, ensayos clínicos y estudios observacionales para determinar la RAM en trabajadores de cría de cerdos. De 990 artículos identificados se incluyeron 8 estudios. Resultados: la tasa de colonización por Staphylococcus aureus resistente a la meticilina (SAMR) en trabajadores fue mayor que la de la población general. La prevalencia de SAMR fue significativamente mayor en trabajadores en contacto directo con animales y los de granjas de cría intensiva con respecto a los de extensiva. En cerdos, la prevalencia de RAM en cría intensiva fue significativamente mayor que la de los de cría extensiva. También fue significativa la asociación entre el suministro de antibióticos en la cría intensiva y la presencia de RAM. Las granjas de más de 1250 cerdos presentaron mayor prevalencia de RAM (p < 0,001). El fenotipo de SAMR en cerdos, trabajadores y el ambiente fue el mismo. Conclusiones: existe evidencia de asociación entre la producción agrícola de cría intensiva y la RAM en cerdos y trabajadores. No se encontraron estudios de vigilancia epidemiológica en la Argentina en trabajadores de cría de animales. (AU)

Introduction: it is estimated that the impact of antimicrobial resistance (AMR) will generate an increase of 10 million deaths by 2050, being reflected to a greater extent in low-income countries. 70% of the annual use of antimicrobials is concentrated in agroveterinary but not in human health. Considering the presence of AMR in ranchers and agricultural workers is essential for early public health actions. Methods: using the PRISMA methodology, bibliography was searched in different sources until October 2020. Systematic reviews, meta-analyses, clinical trials and observational studies were prioritized to determine AMR in pig workers. Eight studies of the 990 found have been included. Results: the rate of colonization by methicillin-resistant Staphylococcus aureus (MRSA) in farming workers was higher than the general population. MRSA prevalence was significantly higher in workers who reported direct contact with animals. And also in those workers of intensive farms compared to those of extensive farms. The same situation is observed in swines, in which the prevalence of AMR in intensive farming was significantly higher than in extensive farming. The association between the supply of antibiotics in intensive farming workers and the presence of AMR was also significant. Farms with more than 1,250 swines had a higher prevalence of AMR (p<0.001). The MRSA phenotype found in swine, agricultural workers, and the environment was the same. Conclusions: there is scientific evidence of an association between agricultural production in intensive livestock farming and AMR in swine and farming workers. There aren't Argentine studies of epidemiological surveillance in farming workers. (AU)

Caracterização dos sistemas de criação de caprinos e ovinos da Ilha de São Luís no estado do Maranhão, Brasil / Characterization of goat and sheep breeding systems at São Luis Island in the state of Maranhão, Brazil

Objetivou-se descrever o perfil dos sistemas de criação de caprinos e ovinos da Ilha de São Luís no estado do Maranhão. Para isso, realizou-se um estudo descritivo, exploratório e quali-quantitativo com 80 produtores rurais selecionados pela técnica Snowball, no período de fevereiro a abril de 2021. Em relação ao perfil do produtor rural, verificou-se predominância do gênero masculino (93,8%), apresentando faixa etária entre 25 a 60 anos (86,2%). A maioria dos produtores apresentavam ensino médio completo (23,8%) ou ensino superior completo (23,8%) e 88,8% dos produtores não estavam vinculados a organizações coletivas, associações, cooperativas ou sindicatos. Nas propriedades rurais o sistema de criação predominante era o semi-extensivo (73,8%) com presença de apriscos (76,2%) e as criações eram consorciadas com caprinos e ovinos (58,8%). A principal causa de morte nos animais verificada foi a verminose (58,8%). Conclui-se que se faz necessário o estabelecimento de medidas de estímulo às criações na Ilha de São Luís por meio de políticas públicas voltadas aos produtores locais, requerendo, sobretudo, assistência técnica, orientações zootécnicas, educação sanitária e acesso ao crédito, para, assim, deixar de ser apenas uma atividade de subsistência e passar a gerar maiores rendas para as famílias produtoras.

The objective of this research was to describe the profile of the goat and sheep rearing systems on the Island of São Luís in the state of Maranhão. For this, a descriptive, exploratory and qualitative-quantitative study was carried out with 80 rural producers selected by the Snowball technique, from February to April 2021. Regarding the profile of the rural producer, there was a predominance of males (93.8%), aging between 25 and 60 years (86.2%). Most producers had completed high school (23.8%) or higher education (23.8%) and 88.8% were not members of collective organizations, associations, cooperatives or unions. In rural properties, the predominant rearing system was semi-extensive (73.8%) with the presence of sheepfolds (76.2%) and mutual goats and sheep farming (58.8%). The main cause of death of animals was warm infections (58.8%). In conclusion, it is necessary to establish measures to support sheep and goat farming on the Island of São Luís through public policies focused on local producers, which require, above all, technical assistance, zootechnical guidelines, health education and access to credit in order to the farms stop being just a subsistence activity and start generating higher incomes for producing families.

Produção de fumo e insônia: relato de caso sobre os determinantes socioeconômicos para o uso contínuo de benzodiazepínicos em uma zona rural no Sul do Brasil / Tobacco production and insomnia: case report on socioeconomic determinants of the continuous use of benzodiazepines in a rural area in southern Brazil / Producción de tabaco e insomnio: Reporte de caso sobre determinantes socioeconómicos del uso continuo de benzodiacepinas en una zona rural del sur de Brasil

Introdução: A fumicultura concentra-se sobretudo em áreas rurais do Sul do país. Reconhecidamente, as áreas rurais apresentam disparidades socioeconômicas, desigualdades no acesso geográfico, bem como dificuldade de retenção de profissionais na Atenção Primária à Saúde (APS). Apresentação do caso: Descrevem-se, neste artigo, as intersecções de determinantes socioeconômicos de saúde ao se abordar um paciente masculino, de 57 anos, em uso crônico de benzodiazepínicos para o tratamento de insônia. Ao se aprofundar a anamnese, os determinantes socioeconômicos que levaram ao desenvolvimento da insônia foram identificados como: dificuldades financeiras na produção de tabaco, preocupações excessivas com o trabalho e presença de depressão como comorbidade. Nesse sentido, ser produtor de tabaco e a relação com a empresa podem ser considerados determinantes socioeconômicos da saúde para o desenvolvimento de insônia. Conclusões: No contexto deste caso, a rotatividade de profissionais e a falta de criação de vínculo fez com que o paciente permanecesse cronicamente a tratar a insônia como benzodiazepínico, o que é proscrito. Assim, revelam-se a fragmentação do cuidado e a alta rotatividade de profissionais como determinantes socioeconômicos da saúde.

Introduction: Tobacco production is mainly concentrated in rural areas of the southern region of the country. Rural areas present socioeconomic disparities, inequalities in geographic access, and difficulties in retaining professionals in primary care. Mental health problems, such as insomnia, are common in clinical practice. Case presentation: This article describes the intersections of the social determinants of health when approaching a patient with chronic use of benzodiazepines for treatment of insomnia. By delving deep into anamnesis, the socioeconomic determinants that led to the development of insomnia were identified as: financial trouble with tobacco production, excessive concern about work and presence of depression as comorbidity. Conclusions: In this context, the turnover of health professionals and lack of doctor-patient relationship meant that the patient continued using benzodiazepines, which are not recommended for long-term treatment. Therefore, fragmented care and high professional turnover stand out as socioeconomic determinants of health.

Introducción: La producción de tabaco se concentra principalmente en las zonas rurales del sur del país. Se reconoce que las zonas rurales presentan desigualdades socioeconómicas, desigualdades en el acceso geográfico, así como dificultad para retener profesionales en Atención Primaria de Salud (APS). Los problemas de salud mental como el insomnio son comunes en la práctica clínica. Presentación de caso: Este artículo describe las intersecciones de los determinantes socioeconómicos de la salud al abordar a un paciente uso crónico de benzodiazepinas para el tratamiento del insomnio. Al profundizar la anamnesis, se identificaron los determinantes socioeconómicos que llevaron al desarrollo del insomnio como: dificultades económicas en la producción de tabaco, excesiva preocupación por el trabajo y la presencia de depresión como comorbilidad. En este sentido, ser productor de tabaco y la relación con la empresa pueden considerarse determinantes socioeconómicos de la salud para el desarrollo del insomnio. Conclusiones: En el contexto de este caso, la rotación de profesionales y la falta de vinculación hicieron que el paciente continuara crónicamente tratando el insomnio como una benzodiazepina, lo que no es recomendable. Así, la fragmentación de la atención y la alta rotación profesional se evidencia como un determinante socioeconómico de la salud.

Knowledge, attitudes, and practices on pesticide among farmers in the Philippines

Introduction@#Pesticides are widely used in the agricultural sector to increase production by cutting down costs and improving the quality of produce. However, these chemicals come with serious health effects when an individual is exposed to large quantities at once, or low quantities over time. @*Objectives@#The objective of the study is to investigate the knowledge, attitude, and practices of farmers, as well as investigate the correlation among knowledge, attitude, and practice variables. @*Methods@#This research study used a cross-sectional design. Samples were drawn based on a multistage sampling of 387 agricultural workers. The target site was in Southern Philippines and the sample was selected using multi-stage sampling from the identified municipalities. Survey questionnaires were given to the respondents to measure knowledge, attitude, and practices (KAP) on pesticide exposure among farmers. The data were encoded using SPSS 13.0. The statistics used were both descriptive and inferential. Correlation analysis was used to study the relationship among knowledge, attitudes, and practices. @*Results@#The results showed that farmers used pesticides in their farms on an average of 2.31 days per week (SD 2.13). The respondents reported that they were exposed to pesticides for about 3.46 months per cropping season (SD: 2.76), as well as from 3.34 (SD 5.92) cropping seasons per year. The mean score of the respondents on the knowledge aspect of the questionnaire was 5.91 out of 10 items (SD 3.28). The average score on practices on pesticide use among respondents was 3.37 (SD 1.75) with 8 items to evaluate practices. Lastly, the mean score on attitude on pesticide use among respondents was 5.34 (SD 3.31) over 12 items. Analysis showed a moderate correlation between knowledge and attitude with Pearson’s r = 0.651 (P <0.0001), also a moderate correlation between knowledge and practices at r = 0.521 (P <0.0001), and a moderate correlation between practices and attitudes at r = 0.443 (P <0.0001). Factor analysis revealed three components for items within practices and attitudes and two for items within knowledge. @*Conclusion@#Pesticide use in the Philippines continues to present various challenges in terms of its safety to humans and the environment. Farmers do not have adequate knowledge of pesticides and their proper management from use to disposal. They need to improve knowledge, encourage a healthy and safe attitude and correct practices on the hazards from pesticides, as well as its proper usage and handling. It is recommended that capacity building and training for farmers are initiated to address inadequacies in their knowledge, attitudes and practices.

Perception of fungi by farmers in the Cerrado / Percepção de agricultores do Cerrado sobre os fungos

Fungi are important in several aspects of human life. In particular, to agriculture, pathogenic fungi are of great importance, as they are responsible for production losses of the most diverse types. Because of this, knowledge about pathogenic fungus is of extreme importance for farmers and professionals working in agricultural areas. Among farmers who use specific agroecological practices, this knowledge is even more valuable, since by not adopting conventional methods of production, they resort to non-invasive alternatives that are less or not harmful at all to the environment in consideration of production management methods. This study aimed to assess farmer perception in the Cerrado biome in the city of Goiás (GO), Brazil, in order to understand their ethnomycological perceptions to verify historical management practices, their knowledge about phytopathogenic fungi, and how these producers perceive fungi. We used the theoretical reference method "From peasant to peasant" formulated by ANPA - National Association of Small Farmers. Some aspects of farmers' ethnomycological knowledge are discussed. These ease identification the representatives of the Fungi Kingdom is associated with organisms that present easily recognizable characteristics, such as wood-ears or disease-causing fungi. In general, farmers are able to identify representatives of the Fungi Kingdom that are found in their daily lives. The perception of farmers about fungi, a group still much unknown by society, is very relevant for future actions of ethnomycology.

Percepção dos fungos por agricultores do Cerrado ­ Fungos são organismos importantes em vários aspectos da vida humana. Em particular, para a agricultura, fungos patogênicos são de grande importância, pois são responsáveis por perdas de produção dos mais diversos tipos. Por isso, o conhecimento sobre fungos patogênicos é de extrema importância para agricultores e profissionais que trabalham em áreas agrícolas. Entre os agricultores que utilizam práticas agroecológicas, esse conhecimento é ainda mais valioso, pois, ao não adotar métodos convencionais de produção, recorrem a alternativas não invasivas que são menos ou não prejudiciais ao meio ambiente, considerando os métodos de gerenciamento da produção. Este estudo teve como objetivo avaliar a percepção de um grupo de agricultores do bioma Cerrado, na cidade de Goiás (GO), Brasil, a fim de compreender suas percepções etnomicológicas, de modo a verificar práticas históricas de manejo, seu conhecimento sobre fungos fitopatogênicos e como esses produtores percebem os fungos, de modo geral. Utilizamos o método "de camponês para camponês", formulado pela ANPA ­ Associação Nacional de Pequenos Agricultores. Discutimos alguns aspectos do conhecimento etnomicológico destes agricultores. A facilidade de identificação de representantes fúngicos está associada a organismos que apresentam características facilmente reconhecíveis, como estereótipo orelha-de-pau ou fungos causadores de doenças em cultivares. Em geral, os agricultores do estudo são capazes de identificar representantes do Reino Fungi que são encontrados em suas vidas cotidianas. A percepção dos agricultores sobre os fungos, um grupo ainda muito desconhecido pela sociedade, é muito relevante para ações futuras dentro da etnomicologia.

Prevalence and factors associated with urinary incontinence in women farmers / Prevalência e fatores associados à incontinência urinária em agricultoras

Abstract Introduction: Urinary incontinence (UI) is any involun-tary loss of urine, exhibiting a relationship with pelvic floor muscle weakness and overload. The physical exertion required of the woman farmer may predispose her to higher frequency of UI. Objective: To evaluate the prevalence of UI and associated factors in women farmers. Methods: Cross-sectional study, with appli-cation of an evaluation form and the International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF) in women aged between 25 and 50 years old. Women with urinary loss responded to the King's Health Questionnaire (KHQ). Data were collected by individual interview. The data were analyzed by absolute and relative frequency, using the Mann-Whitney test for intergroups and Spearman's Correlation Coefficient to relate the variables, considering p < 0.05. Results: Two hundred farmers were interviewed, where 52 (26%) reported involuntary urine loss. The incontinent group had a higher number of annual urinary infection (3.23 ± 1.40). Most incontinent women reported escape 1x/week or less (73.08%), in small amounts (82.69%), during stress (57.69%). Quality of life was classified as very good by 59.62%. The intensity of the work was considered strong by 25% of the incontinent women. Only 30.5% of the volunteers were able to define UI and 97.7% considered it not normal. Conclusion: The prevalence of UI was equivalent to the average of the female population in general, with urinary infection as an associated factor. The loss occurs mainly to stress, and lack of knowledge can reflect in the identification treatment.

Resumo Introdução: Incontinência urinária (IU) é qualquer perda involuntária de urina, apresentando relação com sobrecarga e fraqueza da musculatura do assoalho pélvico. O esforço físico exigido da mulher agricultora pode predispor à maior frequência de IU. Objetivo: Avaliar a prevalência e fatores associados à IU em mulheres agricultoras. Métodos: Estudo de corte transversal, com aplicação de ficha de avaliação e do International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF) em mulheres com idade entre 25 e 50 anos. As mulheres com perda urinária responderam ao King's Health Questionnaire (KHQ). A coleta de dados foi por entrevista individual. Os dados foram analisados por frequência absoluta e relativa, sendo empregado o teste de Mann-Whitney para intergrupos e o coeficiente de correlação de Spearman para relacionar as variáveis, considerando p < 0,05. Resultados: Duzentas mulheres agricultoras foram entrevistadas, das quais 52 (26%) referiram perda involuntária de urina. O grupo incontinente apresentou maior número de infecção urinária anual (3,23 ± 1,40). A maior parte das mulheres incontinentes referiram escape 1x/semana ou menos (73,08%), em pequena quantidade (82,69%) e durante o esforço (57,69%). A qualidade de vida foi classificada como muito boa por 59,62%. A intensidade do trabalho foi considerada forte por 25% das mulheres incontinentes. Apenas 30,5% das voluntárias souberam definir IU a e 97,7% consideram não ser normal. Conclusão: A prevalência de IU foi equivalente à média da população feminina em geral, tendo a infecção urinária como fator associado. A perda ocorre principalmente por conta de esforços e a falta de conhecimento pode dificultar a identificação e procura por tratamento.

Factors associated with common mental disorders among farmers in a medium-sized municipality in Northeastern Brazil / Fatores associados aos transtornos mentais comuns entre agricultores em um município de médio porte no nordeste do Brasil

ABSTRACT OBJECTIVE To identify the prevalence and factors associated with common mental disorders among farmers living in a medium-sized municipality in Northeastern Brazil between 2019 and 2020. METHODS Trained interviewers applied the standardized questionnaire in 450 participants. Sociodemographic, health, income and working characteristics were assessed. The screening of common mental disorders was performed using the Self-Reporting Questionaire, with the cutoff point ≥ 7 for women and ≥ 5 for men. Poisson regression with robust estimation was applied to verify the prevalence ratios in the bivariate and multivariate analysis. RESULTS The prevalence of common mental disorders among farmers was 55.1% (95%CI: 50.4-59.6). The variables that remained significant and associated with common mental disorders were: men (PR = 1.7), > 60 years old (PR = 0.5), poor or very poor self-assessment of health (PR = 1.4), previous mental health treatment (PR = 1.2), alcohol abuse (PR = 1.2) and loss of production (PR = 1.3). CONCLUSION These results indicate that common mental disorders are associated with individual factors and with the farmers' context of life and work, which shows the importance of social, economic and health services support to this group of workers.

RESUMO OBJETIVO Identificar a prevalência e os fatores associados aos transtornos mentais comuns entre agricultores residentes em um município de médio porte no nordeste do Brasil, entre 2019 e 2020. MÉTODOS Entrevistadoras treinadas aplicaram o questionário padronizado em 450 participantes. Investigou-se características sociodemográficas, de saúde, renda e trabalho. O rastreamento dos transtornos mentais comuns foi realizado mediante a utilização do questionário SRQ-20 ( Self-Reporting Questionaire ), com o ponto de corte ≥ 7 para mulheres e ≥ 5 para homens. Foi aplicada a regressão de Poisson com estimação robusta para verificar as razões de prevalência na análise bivariada e multivariada. RESULTADOS A prevalência dos transtornos mentais comuns entre agricultores foi de 55,1% (IC95% 50,4-59,6). As variáveis que permaneceram significativas e associadas aos transtornos mentais comuns foram: ser do sexo masculino (RP = 1,7), ter mais de 60 anos (RP = 0,5), ter autoavaliação de saúde ruim ou muito ruim (RP = 1,4), ter realizado tratamento anterior para saúde mental (RP = 1,2), fazer uso abusivo do álcool (RP = 1,2) e ter tido perda de produção (RP = 1,3). CONCLUSÃO Esses resultados indicam que os transtornos mentais comuns estão associados a fatores individuais e do contexto de vida e trabalho dos agricultores, o que demonstra a importância do suporte social, econômico e dos serviços de saúde a esse grupo de trabalhadores.

Exploring the role and lived experiences of people with disabilities working in the agricultural sector in northern Nigeria

It is estimated that over 75.0% of households in sub-Saharan Africa are involved in agriculture, and the majority of the poor in rural areas rely on agriculture for their livelihoods. One billion people living with disabilities in low- and middle-income countries are argued to make up the poorest of the poor, yet to our knowledge, no literature has captured the livelihood of people living with disabilities in the context of farming in Nigeria, specifically northern Nigeria where most of the households are involved in agriculture and related activities. Objectives: This article reports on findings from a study that sought to understand disability in the context of northern Nigerian farming, with a particular focus on the role and lived experiences of people living with disabilities working in the agricultural sector. Method: A survey questionnaire was developed and captured the experiences of 1067 people living with disabilities working in the agricultural sector across five states (Adamawa, Bauchi, Jigawa, Kaduna and Yobe) in northern Nigeria. Results: Findings indicate that people with disabilities are actively participating in agricultural activities for several reasons, which specifically included 'forced to and for survival'. When participants reported needing care, this was predominantly provided by family members. Findings also showed that participants with disabilities experienced several economic and sociocultural challenges because of their impairments. Conclusion: This study adds to the very limited literature on farmers living with disabilities in sub-Saharan Africa and so highlights the need for more research to be conducted with farmers living with disabilities in Nigeria, particularly female farmers living with disabilities. These will provide more evidence pertaining to the experiences of farmers living with disabilities in order to provide effective disability- and gender-inclusive agricultural and entrepreneurship programs in Nigeria. Contribution: The results of this research reveal important insights relating to the experiences of farmers living with disabilities in northern Nigeria, which can contribute to informing future developmental projects to achieve effective inclusion and actively benefit people living with disabilities.

Exploring the role and lived experiences of people with disabilities working in the agricultural sector in northern Nigeria

It is estimated that over 75.0% of households in sub-Saharan Africa are involved in agriculture, and the majority of the poor in rural areas rely on agriculture for their livelihoods. One billion people living with disabilities in low- and middle-income countries are argued to make up the poorest of the poor, yet to our knowledge, no literature has captured the livelihood of people living with disabilities in the context of farming in Nigeria, specifically northern Nigeria where most of the households are involved in agriculture and related activities. Objectives: This article reports on findings from a study that sought to understand disability in the context of northern Nigerian farming, with a particular focus on the role and lived experiences of people living with disabilities working in the agricultural sector. Method: A survey questionnaire was developed and captured the experiences of 1067 people living with disabilities working in the agricultural sector across five states (Adamawa, Bauchi, Jigawa, Kaduna and Yobe) in northern Nigeria. Results: Findings indicate that people with disabilities are actively participating in agricultural activities for several reasons, which specifically included 'forced to and for survival'. When participants reported needing care, this was predominantly provided by family members. Findings also showed that participants with disabilities experienced several economic and sociocultural challenges because of their impairments. Conclusion: This study adds to the very limited literature on farmers living with disabilities in sub-Saharan Africa and so highlights the need for more research to be conducted with farmers living with disabilities in Nigeria, particularly female farmers living with disabilities. These will provide more evidence pertaining to the experiences of farmers living with disabilities in order to provide effective disability- and gender-inclusive agricultural and entrepreneurship programmes in Nigeria. Contribution: The results of this research reveal important insights relating to the experiences of farmers living with disabilities in northern Nigeria, which can contribute to informing future developmental projects to achieve effective inclusion and actively benefit people living with disabilities

Condições de vida, trabalho e acesso aos serviços de saúde em trabalhadores agrícolas e não agrícolas, Brasil, 2013 / Living and working conditions and access to health services for agricultural and non-agricultural workers, Brazil, 2013

Resumo No Brasil, o crescimento do agronegócio em detrimento da agricultura familiar ocorreu ocultando danos sociais, ambientais e à saúde humana. Objetivou-se comparar as condições de vida, de trabalho e o acesso aos serviços de saúde, entre trabalhadores agrícolas e não agrícolas. Utilizaram-se os dados da Pesquisa Nacional de Saúde (PNS) sobre condições de vida e trabalho, características sociodemográficas, econômicas e de acesso aos serviços de saúde de uma amostra representativa da população ocupada brasileira. Empregou-se o teste qui-quadrado de Pearson, com nível de significância de 0,05, considerando-se o desenho complexo da amostragem. Os trabalhadores agrícolas apresentaram piores condições de vida, menor poder aquisitivo, maior exposição à radiação solar e agentes químicos e maior frequência e gravidade de acidentes de trabalho em comparação aos não agrícolas. A população agrícola teve maior cobertura da ESF, buscou atendimento médico no SUS para tratar doenças, enquanto a não agrícola, buscou atendimento médico privado para ações preventivas. As diferenças encontradas entre esses trabalhadores implicam em padrões de adoecimento distintos e definem necessidades de saúde específicas.

Abstract In Brazil, the growth of agribusiness to the detriment of family agriculture occurred while concealing social, environmental and human health damages. The objective was to compare living and working conditions and access to health services between agricultural and non-agricultural workers. Data from the National Health Survey (PNS) on living and working conditions, sociodemographic, economic characteristics, and access to health services from a representative sample of the employed Brazilian population were adopted. Pearson's chi-square test was used, with a significance level of 0.05, taking the complex sampling design into consideration. Agricultural workers suffered from worse living conditions, lower purchasing power, greater exposure to solar radiation and chemical agents, and a higher frequency and severity of occupational accidents compared to non-agricultural workers. The agricultural population had greater coverage of the Family Health Service and sought medical care from the Unified Health System (SUS) to treat diseases, while the non-agricultural workers sought private medical care for preventive actions. The differences found between these workers imply different patterns of illness and define specific health needs.

The acetylcholinesterase as indicative of intoxication for pesticide in farmers of conventional and organic cultivation / A acetilcolinesterase como indicativo de intoxicação por pesticidas em agricultores de cultivo convencional e orgânico

Abstract In this sense the objective of assessing the levels of pesticide poisoning in rural farmers of San Sebastian and take AL, using acetylcholinesterase enzymes Erythrocyte and plasma as biological indicator of intoxication. This is a prospective, transversal and descriptive variables analyzed were: year whose, sex, age group, education, location, condition, route of exposure. The data were acquired by collecting blood samples and socio demographic information of farmers. Was put as the determining factor the type of conventional and organic farming, and periods of drought and rainy. 56 volunteers were analyzed. The analyses were performed in the automatic biochemical Analyzer Cobas Integra 400 plus®. According to the results of the analyses, it was the largest number of individuals with reduced values of cholinesterase, specifically the Group of conventional farming, the period of greatest change index was in the rainy season, where the activity of AChE, expressive values presented in the city of São Sebastião, with 80% result of intoxicated, in the city of the foot - take, 21.73% over the same period. On analysis of the AChP, São Sebastião has obtained the highest number of contaminated with 18.75% and 30% respectively, in the District Take Foot stood between 10 and 21.73% of reduced levels of cholinesterase. This sets the organic system of cultivation, as the best alternative for prevention of future diseases, in addition to bringing quality of life for rural workers, as well as for consumers.

Resumo Nesse sentido objetivou-se avaliar os níveis de intoxicação por agrotóxicos em agricultores rurais de São Sebastião e Pé Leve - AL, utilizando as enzimas acetilcolinesterase Eritrocitária e Plasmática, como indicador biológico de intoxicação. Trata - se de um estudo prospectivo, transversal e descritivo cujas variáveis analisadas foram: ano, sexo, faixa etária, escolaridade, local, circunstância, via de exposição. Os dados foram adquiridos através da coleta das amostras de sangue e das informações sócio demográficas dos agricultores. Foi posto como fator determinante o tipo de cultivo convencional e orgânico, e os períodos de estiagem e chuvoso. Foram analisados 56 voluntários. As análises foram realizadas no analisador automático de bioquímica Cobas Integra® 400 plus. De acordo com os resultados das análises, percebeu-se maior número de indivíduos com valores diminuídos da colinesterase, especificamente no grupo de cultivo convencional, o período de maior índice de alteração foi na época chuvosa, onde a atividade da AChE, apresentou valores expressivos na cidade de São Sebastião, com resultado de 80% de intoxicados, na cidade do Pé - Leve, obteve-se 21,73% no mesmo período. Na análise da AChP, São Sebastião obteve maior número de contaminados com 18,75% e 30% respectivamente, já no Distrito Pé Leve ficou entre 10 e 21,73% de níveis diminuídos da colinesterase. Isso define o sistema orgânico de cultivo, como a melhor alternativa para prevenção de futuras patologias, além de trazer qualidade de vida para os trabalhadores rurais, como também para os consumidores.

Prevalência da queilite actínica em agricultores de uma região do sertão brasileiro / Prevalencia de queilitis actínica en agricultores de una región del interior brasileño / Prevalence of actinic cheilitis in Brazilian semi-arid region farmers

Introdução: A queilite actínica é uma lesão inflamatória com potencial de transformação maligna e desenvolvimento associado à exposição solar excessiva. Objetivo: Avaliar a prevalência de queilite actínica em um grupo de agricultores, bem como a percepção e conhecimento desse grupo sobre a lesão. Métodos: O estudo observacional de levantamento epidemiológico envolveu uma população de agricultores de uma região do sertão brasileiro. A amostra foi obtida por acessibilidade a essa população, e alcançou-se o total de 219 agricultores. Além do exame físico intraoral, utilizou-se um questionário estruturado para coleta dos dados. Resultados: A queilite actínica foi diagnosticada em 30,6 porcento dos agricultores examinados. A lesão foi encontrada com maior frequência no sexo masculino (86,6 porcento), com mais de 60 anos (64,2 porcento) e leucodermas (58,2 porcento). A maioria dos indivíduos com queilite actínica se expunham à radiação solar por mais de 30 anos (65,7 porcento), por mais de 6h por dia (73,1 porcento) e não se protegiam adequadamente (94 porcento). Sexo, idade, escolaridade, hábito de beber e tempo de exposição solar tiveram uma correlação estatisticamente significante com a presença da queilite actínica (p<0,05). Verificou-se que 76,1 porcento dos participantes não notavam sinais e 61,2 porcento não percebiam sintomas da lesão. O conhecimento sobre queilite actínica foi baixo para 97 porcento dos indivíduos com lesão. Conclusões: Os resultados demonstraram alta prevalência de queilite actínica, além de uma baixa percepção e conhecimento sobre esta lesão, o que indica a necessidade de realização de ações de educação em saúde(AU)

Introducción: La queilitis actínica es una lesión inflamatoria con potencial de transformación maligna y desarrollo asociado con la exposición excesiva al sol. Objetivo: Evaluar la prevalencia de queilitis actínica en un grupo de agricultores brasileños y la percepción y conocimiento que estos tienen sobre la lesión. Métodos: Estudio observacional epidemiológico. Incluyó una población de agricultores de una región rural brasileña. La muestra, constituida por 219 agricultores, se obtuvo por accesibilidad a esta población. Además del examen físico intraoral, se utilizó un cuestionario estructurado para recopilar los datos. Resultados: Se diagnosticó queilitis actínica en el 30,6 por ciento de los agricultores examinados. La lesión se encontró con mayor frecuencia en hombres (86,6 por ciento), mayores de 60 años (64,2 por ciento) y leucodermos (58,2 por ciento). La mayoría de las personas con queilitis actínica estuvieron expuestas a la radiación solar durante más de 30 años (65,7 por ciento), más de seis horas al día (73,1 por ciento) que no se protegieron adecuadamente (94 por ciento). El género, la edad, el nivel de educación, los hábitos de bebida y el tiempo de exposición al sol tuvieron una correlación estadísticamente significativa con la presencia de queilitis actínica (p < 0,05). Se encontró que el 76,1 por ciento de los participantes no notó signos y el 61,2 por ciento no percibió síntomas de la lesión. El conocimiento sobre la queilitis actínica fue bajo para el 97 por ciento de las personas con lesiones. Conclusión: Los resultados mostraron una alta prevalencia de queilitis actínica, además de una baja percepción y conocimiento al respecto de esta lesión, lo que indica la necesidad de acciones de educación para la salud(AU)

Introduction: Actinic cheilitis is an inflammatory, potentially malignant lesion associated with excessive sun exposure. Objective: To evaluate the prevalence of actinic cheilitis in a group of farmers, as well as the perception and knowledge of that group about this lesion. Methods: The observational epidemiological study included Brazilian semi-arid region farmers. The sample was obtained for accessibility to this population and a total of 219 farmers was reached. A structured questionnaire was used to collect the data in addition to the intraoral physical examination. Results: Actinic cheilitis was diagnosed in 30.6 percent of the examined farmers. The lesion was found more frequently in males (86.6 percent), older than 60 years (64.2 percent), and leukoderma (58.2 percent). Most individuals with actinic cheilitis were exposed to solar radiation for more than 30 years (65.7 percent), for more than 6 hours a day (73.1 percent), and did not adequately protect themselves (94 percent). Sex, age, education level, drinking habits, and time of sun exposure had a statistically significant correlation with the presence of actinic cheilitis (p < 0.05). It was found that 76.1 percent of the participants did not notice signs and 61.2 percent did not perceive symptoms of this injury. Knowledge about actinic cheilitis was low for 97 percent of individuals with the lesion. Conclusions: The results showed a high prevalence of actinic cheilitis, in addition to low perception and knowledge about it, which indicates the need for health education actions(AU)

Exposição a agrotóxicos ou práticas agroecológicas: ideação suicida entre camponeses do semiárido no Brasil / Exposure to pesticides or agroecological practices: suicidal ideation among peasant farmers in Brazil's semi-arid region

Resumo Diferentes práticas agrícolas estão associadas a diferentes riscos para a saúde de camponeses. Objetivou-se analisar a associação entre ideação suicida e exposição a agrotóxicos, comparando camponeses vivendo sob exposição ambiental a agrotóxicos em relação a camponeses envolvidos com práticas agroecológicas, sem o uso de agrotóxicos, no semiárido norte mineiro. As famílias avaliadas foram amostradas, por conveniência, a partir da prática agrícola a qual estavam vinculadas, e os dados coletados por meio de entrevistas com instrumento previamente validado. Foram realizadas análises bivariadas seguidas de regressão logística. Foram entrevistados 547 camponeses, de ambos os sexos, sendo 311 sob exposição a agrotóxicos. Os camponeses expostos a agrotóxicos, em relação a camponeses envolvidos com práticas agroecológicas, tiveram maiores chances para ideação suicida (OR=2,30; IC95% 1,16-4,56), consumo problemático de álcool (OR=2,30; IC95% 1,18-4,48) e episódios prévios de intoxicação aguda por agrotóxicos (OR=8,58; IC95% 2,98-24,72).Conclui-se que as práticas agrícolas que implicam em exposição crônica a agrotóxicos se associam a maiores chances de ideação suicida, independentemente de episódios prévios de intoxicação aguda por agrotóxicos ou do uso problemático do álcool.

Abstract Health risks faced by peasant farmers may vary depending on the type of agriculture they practice. This study examined the association between suicide ideation and exposure to pesticides by comparing two groups of peasant farmers of both sexes living in the semi-arid region of the north of Minas Gerais, Brazil: exposed to pesticides and adopting agroecological practices without the use of pesticides. Group participants were selected using convenience sampling and data was collected using a previously validated questionnaire administered through face-to-face interviews. Bivariate analysis was performed, followed by logistic regression. A total of 547 peasant farmers were interviewed (311 in the group exposed to pesticides and 236 in the group adopting agroecological practices). Respondents from the group exposed to pesticides were more likely to report suicidal ideation (OR=2.30; 95%CI 1.16-4.56), harmful alcohol consumption (OR=2.30; 95%CI 1.18-4.48), and lifetime acute pesticide poisoning (OR=8.58; 95%CI 2.98-24.72). The findings suggest that agricultural practices that lead to chronic pesticide exposure are associated with a greater likelihood of suicide ideation, regardless of previous episodes of acute pesticide poisoning or harmful alcohol consumption.

Epidemiología de la Leptospirosis en el departamento del Huila, Colombia. 2011- 2017 / Epidemiology of leptospirosis in the department of Huila. 2011 to 2017

Resumen Objetivo: Describir la epidemiología de la Leptospirosis en el departamento del Huila durante el período 2011 -2017. Materiales y métodos: Estudio descriptivo de corte transversal, retrospectivo. La población analizada fueron pacientes de los diferentes municipios del departamento del Huila que se reportaron como casos probables o confirmados de leptospirosis. Se estructuraron registros por cada año en bases de datos recopiladas por el área de epidemiología de la Secretaría de Salud del Huila, basadas en las fichas de notificación de vigilancia en salud pública para leptospirosis y generadas por cada Unidad Primaria Generadora de Datos (UPGD) ante la presencia del evento. Los datos fueron discriminados de acuerdo a las variables de interés para el estudio en una nueva base de datos en Excel; tabuladas con el programa estadístico R - Studio 3.3.3 y Epidat 4.2, para luego ser procesados con estadísticos descriptivos y finalmente ser expresados en porcentajes y en tasas de incidencia. Resultados: Se reportaron 268 casos, de los cuales 61 (23%) fueron confirmados por laboratorio y 207 (77%) sospechosos o probables. El 69% de los pacientes presentaron fiebre, mialgias y cefalea como síntomas representativos. El grupo etario más afectado tenía entre 27 y 59 años de edad (44%). La población se caracterizó por ser del área urbana (65%), con mayor frecuencia en hombres (72%). En relación a la ocupación laboral, se encontró mayor frecuencia en agricultores (20%) y en el personal de aseo (17%). Los factores de riesgo evidenciados fueron la presencia de animales domésticos en un 67% de los casos, así como la presencia de ratas en el hogar (51%) y el posible mal manejo del agua. Conclusiones: El incremento en el número de casos de Leptospirosis probablemente está asociado a la mala manipulación del agua y a la presencia de animales en el domicilio.

Abstract Objective: Describe the epidemiology of Leptospirosis in the department of Huila during the years 2011 to 2017. Materials and methods: This article is a descriptive, cross-sectional, retrospective study. The population analyzed were patients from the different municipalities of the department of Huila who were reported as probable or confirmed cases for leptospirosis, structuring records for each year in databases compiled by the epidemiology area of ​​the department's health secretary, based on the public health surveillance notification sheets for leptospirosis, and generated by each Primary Data Generating Unit (UPGD) in the presence of the event; The data were discriminated according to the variables of interest for the study in a new database in Excel; tabulated with the statistical program R - Studio 3.3.3 and Epidat 4.2, to later be processed with descriptive statistics and finally expressed in percentages and incidence rates. Results: 268 cases were reported, which 61 (23%) were confirmed by laboratory and 207 (77%) suspicious or probable. 69% of the patients presented fever, myalgia and headache as representative symptoms. The most affected group range in ages from 27 and 59 (44%). The population was characterized for being part of the urban area (65%), and the cases were more frequent in men (72%). Regarding to employment, it was found that farmers (20%) and the cleaning staff (17%) were the most common cases. The risk factors identified were the presence of domestic animals in 67% of the cases, as well as the presence of rats at home (51%) and the possible poor water management. Conclusions: The increase in the number of cases of Leptospirosis is probably associated with the poor water management and the presence of animals at home.

Occupational risk exposures and adverse health findings among farmers in Southern Philippines

Introduction@#Pesticides are widely used in the agricultural sector to increase production by cutting costs and improving product quality. However, these chemicals come with serious health effects when individuals are exposed to large quantities at once or low amounts over time. @*Objective@#This study aimed to identify the health symptoms and physical assessment findings affecting farmers from their repeated occupational exposure to pesticides in a rural region in the Philippines. @*Methods@#This research study used a cross-sectional design, and samples were drawn based on a multistage sampling of 387 agricultural workers. The target site was in the southern Philippines, and the sample was selected randomly from the identified municipalities. Survey questionnaires were given to the respondents, and a physical assessment was made by medical doctors and trained registered nurses. The data were encoded using SPSS™ 13.0. The statistics used were both descriptive and inferential. @*Results@#The farmers used pesticides in their farms with an average of 2.3 days per week (SD: 2.13). The mean total spraying time was 3.07 hours (SD: ± 14.76) per day. The average amount of pesticide used in an application was 1.33 L per application (SD: ± 6.53). Sixty-three percent (63%) had spills while spraying, and 47% reported having spilled pesticides while mixing. Farmers were assessed and found to have experienced symptoms and exhibited physical assessment findings surrounding the following body systems: general, EENT, neurologic, gastrointestinal, respiratory, cardiovascular, and integumentary systems. Abnormalities in laboratory parameters were also observed among the respondents. The mini-mental state examination was done to test if the respondents showed signs of cognitive impairment. The results showed that most respondents (93.95%) had normal cognitive function, while 6.05% of respondents had some level of cognitive impairment. Associations were also tested using Phi Coefficient, and certain pesticide exposure variables were associated with farmers' physical findings and symptoms experienced by farmers. @*Conclusion@#This study translates pesticide’s health impact by identifying the common symptoms experienced by farmers and concerning physical assessment findings. The study found that farmers suffered from various symptoms concerning the general health, eye, ears, nose, and throat region, neurological system, gastrointestinal system, respiratory system, cardiovascular system, and the integumentary system. In addition, the laboratory parameters of the participants also exhibited abnormalities indicative of exposure and possible adverse effects from pesticides.

Fatores associados ao pensamento de morte e comportamento suicida entre agricultores do município de Caicó-RN / Factors associated with thoughts of death and suicidal behavior among farmers in the municipality of Caicó-RN

Introdução: O comportamento suicida é frequentemente precedido por pensamentos de morte e configura-se como uma conduta autodeliberada com o propósito de provocar um dano ou morte, e pode ser compreendido como um interim entre a ideação suicida, tentativas de suicídio e que podem culminar no ato de suicidar. Os agricultores encontram-se em risco de ideação suicida em decorrência da vulnerabilidade e exposição a diferentes fatores associados às condições de vida e ao trabalho no campo. Objetivo: Analisar os fatores associados ao pensamento de morte e comportamento suicida em agricultores. Método: Trata-se de um estudo de diferentes métodos. 1) desenvolveu-se uma revisão sistemática de estudos observacionais sobre os fatores associados ao comportamento suicida em agricultores, com buscas nas bases de dados PubMed, LILACS, Web of Science, Scopus, PsycInfo e CINAHL; 2) estudo transversal, realizado no período de agosto de 2019 a março de 2020, com 450 agricultores de Caicó/Rio Grande do Norte, onde avaliou-se a prevalência de pensamentos de morte e ideação suicida através da The Beck Scale for Suicide Ideation (BSSI), e foram analisadas variáveis sociodemográficas, de saúde, renda, trabalho; 3) estudo caso-controle, a fim de avaliar o pensamentos de morte ou comportamento suicida (PS e CS) em que a amostra correspondeu a quatro controles por caso e, para compensar possíveis perdas, aumentou-se 15%, sendo o tamanho final definido em 62 casos e 288 controles. Resultados: Foram incluídos 14 estudos na revisão sistemática, e identificados fatores associados ao comportamento suicida em agricultores na saúde mental (depressão), impactos sazonais (seca) e exposições no trabalho (herbicidas e inseticidas). Na etapa transversal, a prevalência de pensamentos de morte ou ideação suicida foi de 12,4% (IC95% 9,69-15,84). No modelo multivariado final, as variáveis associadas à maior prevalência de PS/IS foram: sexo feminino (RP=3,28), ter diagnóstico de transtorno mental na família (RP=2,37), presença de transtorno mental comum (RP=2,50), uso abusivo do álcool (RP=2,22) e ser assalariado ou temporário (R=1,91). No estudo caso-controle observou-se associação positiva e significativa entre OS/CS e ter diagnóstico de transtorno mental na família (OR=2,30), ter transtorno mental comum (OR=3,16), ter realizado previamente tratamento para saúde mental (OR=3,08), realizar trabalho assalariado ou temporário (OR=2,69) e ter tido intoxicação por agrotóxicos (OR=3,34). Conclusão: pensamentos de morte e comportamento suicida em agricultores estão associados principalmente a aspectos de saúde, especialmente saúde mental, ao trabalho e ao sexo, e sinaliza para a necessidade do fortalecimento das políticas públicas de prevenção do suicídio com o direcionamento de estratégias efetivas para o trabalhador rural (AU).

Introduction: Suicidal behavior is configured as a self-deliberate conduct with the purpose of causing harm or death, and can be understood as an interim between suicidal ideation, suicide attempts and that may culminate in the act of committing suicide. Farmers are at risk of suicidal ideation due to vulnerability and exposure to different factors associated with living conditions and work in the field. Objective: To analyze factors associated with death thought, ideation and suicide attempts in farmers. Method: This is a study of different methods. 1) a systematic review of observational studies on factors associated with suicidal behavior in farmers was developed, with searches in PubMed, LILACS, Web of Science, Scopus, PsycInfo and CINAHL databases; 2) cross-sectional study, carried out from August 2019 to March 2020, with 450 farmers in Caicó/Rio Grande do Norte, where the prevalence of suicidal ideation was assessed through the The Beck Scale for Suicide Ideation (BSSI), and sociodemographic variables were analyzed, of health, income, work; 3) case-control study, in order to assess suicidal behavior considering suicidal ideation and suicide attempt, in which the sample corresponded to four controls per case and, to compensate for possible losses, 15% was increased, with the final size defined in 62 cases and 288 controls. Results: 14 studies were included in the systematic review, and factors associated with suicidal behavior in farmers were identified in mental health (depression), seasonal impacts (drought) and occupational exposures (herbicides and insecticides). In the cross-sectional stage, the prevalence of suicidal ideation was 12.4% (95%CI 9.69-15.84). In the final multivariate model, the variables associated with the highest prevalence of IS were: female gender (PR=3.28), having a diagnosis of mental disorder in the family (PR=2.37), presence of common mental disorder (PR=2. 50), alcohol abuse (RP=2.22) and being salaried or temporary (R=1.91). In the case-control study, a positive and significant association was observed between suicidal behavior and having a diagnosis of mental disorder in the family (OR=2.30), having a common mental disorder (OR=3.16), having previously undergone health treatment mental (OR=3.08), perform salaried or temporary work (OR=2.69) and have been poisoned by pesticides (OR=3.34). Conclusion: suicidal ideation and suicide attempt in farmers are mainly associated with health aspects, especially mental health, work and the female gender, and signals the need to strengthen public policies for suicide prevention with targeting strategies effective for the rural worker (AU).

Efeitos dos agrotóxicos na saúde do agricultor familiar dos municípios de Capitólio e Pimenta - Minas Gerais: avaliação de biomarcadores colinesterase eritrocitárias e plasmática / Effects of pesticides on the health of family farmers in the cities of Capitólio and Pimenta - Minas Gerais: evaluation of erythrocyte and plasma cholinesterase biomarkers

portuguêsO Brasil é o maior consumidor global de agrotóxico tendo como consequência intoxicações de um grande número de trabalhadores, com altos gastos com a saúde e prejuízos ambientais. Objetivo geral: avaliar os efeitos do uso de agrotóxicos sobre a saúde de trabalhadores atuantes na agricultura familiar. Método: estudo transversal, analítico e comparativo entre o Grupo (1) composto por 80 trabalhadores rurais atuantes na agricultura familiar, expostos diretamente a agrotóxicos e o Grupo (2) composto por 60 usuários dos Programas de Saúde da Família (PSF) dos municípios de Capitólio e Pimenta - Minas Gerais - não diretamente expostos a agrotóxicos sendo o grupo controle por meio da análise de biomarcadores colinesterase eritrocitária e plasmática. Resultados: dos 140 participantes deste estudo, a maioria (51,2%) não referiu problemas de saúde e tratamento medicamentoso, 6,3% deles, expostos a agrotóxicos, referiram intoxicações e 42,5% relataram terem algum sinal e/ou sintoma de intoxicação com predominância (33,8%) para a dor de cabeça. O biomarcador colinesterase eritrocitária apresentou normalidade em 63,8% dos trabalhadores rurais e 36,2% com alteração na butirilcolinesterase. Conclusão: a butirilcolinesterase encontrada em 1/3 dos participantes expostos a agrotóxicos correlacionam-se à presença dos sintomas dor de cabeça e irritabilidade/nervosismo. Existe, portanto, a necessidade da educação e capacitação dos agricultores no uso de agrotóxicos para limitar níveis de exposição e efeitos nocivos à saúde para prevenir, diagnosticar e tratar possíveis disfunções causadas por esses produtos químicos

Brazil is the largest global consumer of pesticides, resulting in the intoxication of a large number of workers, with high expenditures on health and environmental damage. General objective: to evaluate the effects of the use of pesticides on the health of rural workers working in family farming in terms of intoxication through the evaluation of the erythrocyte and plasma cholinesterase biomarkers. Method: cross-sectional, analytical and comparative study between Group (1) of rural workers working in family farming, directly exposed to pesticides and Group (2) of users of Family Health Programs (PSF), in the municipalities of Capitólio and Pimenta - Minas Gerais State (Brazil) - not directly exposed to pesticides, being a control group through the analysis of biomarkers. Results: in this study of 140 participants, the most of them did not report health problems and drug treatment, 6.3% of participants, exposed to pesticides, reported poisoning and 42.5% reported having any signs and/or symptoms of intoxication with predominance for headache. The erythrocyte cholinesterase biomarker showed normality in 63.8% rural workers and 36.2% with alteration in butyrylcholinesterase. Conclusion: butyrylcholinesterase alteration was proven in 36.2% of participants exposed to pesticides and these results correlate with the presence of headache and irritability/nervousness symptoms. There is, therefore, a need for education and training of farmers to limit levels of exposure and harmful health effects to prevent, diagnose and treat possible dysfunctions caused by these chemicals applied to agriculture

Food availability and food and nutrition (in)security of families providing for the National School Feeding Program / A disponibilidade de alimentos e a (in)segurança alimentar e nutricional de famílias fornecedoras do Programa Nacional de Alimentação Escolar

ABSTRACT Objective The natural probiotic kefir is fermented milk, and may have effects on satiety and voluntary energy intake. This randomized crossover trial aimed to determine whether kefir, consumed with low- or high-glycemic index meals, affects appetite and subsequent food intake. Methods This is a cross-sectional study with families of farmers who supplied Programa Nacional de Alimentação Escolar from 2011 to 2016 in the city of Viçosa, Minas Gerais, Brazil. To assess Food Insecurity, the Brazilian Food Insecurity Scale was applied to the person responsible for purchasing and producing meals in the family. The nutritional aspect was analyzed through the measurement of hemoglobin to check for anemia among family members and using the household food availability survey, where it was possible to analyze the amount of calories available for consumption, as well as the origin and kind of food. Results 27 families were evaluated, totalizing 91 individuals. With the Escala Brasileira de Insegurança Alimentar, it was found that 25.9% of the families were in light food insecurty situation. When caloric availability was assessed, 11.0% of families were considered insecure. In contrast, 59.0% of families had high calorie availability per capita (>3000 calories). Of the total households, 14.8% had more than 50.0% of the calories available for consumption coming from their own production. The foods most commonly produced for self-consumption were fresh vegetables, which are the most common ones supplied to Programa Nacional de Alimentação. In addition, the main source of kilocalories for the families were fresh and minimally processed foods. The presence of anemia in at least 1 resident was detected in 29.6% of households, with a negative correlation between the hemoglobin value (g/dL) and the Escala Brasileira de Insegurança Alimentar score. Conclusion It appears that the majority of the families of farmers supplying Programa Nacional de Alimentação Escolar are in a situation of Food and Nutritional Security, both by Escala Brasileira de Insegurança Alimentar and by the household availability of food. However, we cannot ignore the percentage of insecure families, since this situation can lead to other problems. Therefore, it is necessary to constantly assess the family situation of Fodd Insecurty and encourage production for self-consumption so that it contributes to food availability and quality. For this reason, the we highlight relevance of programs that strengthen the production and commercialization of food from family farming.

RESUMO Objetivo O objetivo do estudo foi avaliar a disponibilidade de alimentos e a situação de (In)Segurança Alimentar e Nutricional em famílias de agricultores fornecedores do Programa Nacional de Alimentação Escolar. Métodos Trata-se de um estudo transversal com famílias de agricultores fornecedores do Programa Nacional de Alimentação no período de 2011 a 2016 em Viçosa, Minas Gerais, Brasil. A Escala Brasileira de Insegurança Alimentar foi aplicada ao responsável pela compra e produção de refeições na família para avaliação da Insegurança Alimentar. Analisou-se o aspecto nutricional por meio da dosagem de hemoglobina para verificação de anemia entre os membros da família e utilizando-se o inquérito de disponibilidade domiciliar de alimentos, o que permitiu analisar a quantidade de calorias disponíveis para consumo, assim como a procedência e o tipo do alimento. Resultados Avaliaram-se 27 famílias, totalizando 91 indivíduos. Com a Escala Brasileira de Insegurança Alimentar, constatou-se que 25,9% das famílias encontravam-se em situação de Insegurança Alimentar, sendo todas consideradas de Insegurança Alimentar leve. Quando avaliada a disponibilidade calórica, 11,0% das famílias estavam inseguras. Em contrapartida, 59,0% das famílias apresentaram disponibilidade calórica per capita alta (>3.000 calorias). Do total das famílias, 14,8% possuíam mais de 50,0% das calorias disponíveis para consumo advindas de produção própria. Os alimentos mais produzidos para autoconsumo foram os vegetais in natura, que são os mais fornecidos ao Programa Nacional de Alimentação Escolar. Além disso, a principal fonte de quilocalorias das famílias eram alimentos in natura e minimamente processados. A presença de anemia em pelo menos 1 morador foi detectada em 29,6% dos domicílios, havendo correlação negativa entre o valor de hemoglobina (g/dL) e a pontuação da Escala Brasileira de Insegurança Alimentar. Conclusão Verifica-se que a maioria das famílias de agricultores fornecedores do Programa Nacional de Alimentação Escolar encontra-se em situação de Insegurança Alimentar, tanto pela Escala Brasileira de Insegurança Alimentar, quanto pela disponibilidade domiciliar de alimentos. Contudo, não se pode desconsiderar o percentual de famílias inseguras, uma vez que esse quadro pode levar a outros agravantes. Logo, faz-se necessária a constante avaliação da situação familiar de (in)Insegurança Alimentar e incentivar a produção para autoconsumo para que esta contribua para a disponibilidade e a qualidade alimentar. Por isso a relevância de programas que fortaleçam a produção e comercialização de alimentos da agricultura familiar.