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2.
Acta sci., Health sci ; 44: e58157, Jan. 14, 2022.
Article in English | LILACS | ID: biblio-1366147

ABSTRACT

Some mycoses are endemic. They develop through hematogenous spread, causing a generalized infection, usually with secondary mucosal involvement.The aim of this observational and retrospective study was to report the prevalence and characteristics of oral lesions in patients diagnosed with systemic fungal infections (SFI) over a 25-year period in southern Brazil. Demographic (age, sex, ethnicity, occupation) and clinical (anatomical location, symptoms,histopathological diagnosis and management) data from the medical records of patients with SFI were collected from 1995 to 2019. 34 cases of SFI were found, of which 31 (91.18%) were diagnosed as paracoccidioidomycosis (PCM) and 3 (8.82%) as histoplasmosis. Men were much more affected (n = 31; 91.18%), with an average age of 46.9 years. Most patients (n = 18; 58.06%) were Caucasian; 48% (n = 15) were farm/rural workers and the most affected region was the jugal mucosa (n = 13; 25.49%) followed by the alveolar ridge (n = 12; 23.52%). All patients with histoplasmosis were immunocompetent men (mean age: 52.67 years), and the palate was the most affected. All patients underwent incisional biopsy and were referred to an infectologist. The dentist has an essential role in the recognition of SFI, whose oral manifestations may be the first sign. SFI should be included in differential diagnosis in patients from endemic areas. In addition, the inevitable human mobility and globalization make knowledge of these mycosesnecessary worldwide, especially since advanced cases in immunocompromised patients can be fatal.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Oral Manifestations , Endemic Diseases/prevention & control , Mycoses , Palate/pathology , Paracoccidioidomycosis/pathology , Tongue/pathology , Medical Records/statistics & numerical data , Retrospective Studies , Dentists/education , Alveolar Process/pathology , Health Services Research/statistics & numerical data , Histoplasmosis/pathology , Mucous Membrane/pathology
3.
Epidemiol. serv. saúde ; 30(1): e2019500, 2021. tab
Article in English, Portuguese | LILACS, ColecionaSUS, SES-SP | ID: biblio-1142939

ABSTRACT

Objetivo: Descrever o processo de integração do agente de combate às endemias (ACE) na Estratégia Saúde da Família (ESF). Métodos: Estudo transversal descritivo. Os dados foram coletados por questionário semiestruturado autoaplicável, de fevereiro a maio de 2017, em quatro unidades de Saúde da Família na região urbana de Campo Grande, Mato Grosso do Sul, Brasil. Resultados: Participaram 57 agentes comunitários de saúde (ACS) e 8 ACEs. Todos os participantes informaram realizar orientações ao morador e 58 realizavam controle mecânico durante a vistoria de imóveis, visando evitar e eliminar possíveis criadouros do Aedes aegypti. Quanto à integração dos ACEs na ESF, 18 participantes destacaram o trabalho em equipe como aspecto positivo, enquanto 15 referiram falta de autonomia para intervenções legais como aspecto negativo. Conclusão: A integração do ACE na ESF é viável; contudo, ajustes devem ser realizados para potencializar as atividades, na perspectiva do trabalho compartilhado em uma mesma base territorial.


Objetivo: Describir el proceso de integración del Agente de Combate a las Endemias (ACE) en la Estrategia de Salud Familiar (ESF). Métodos: Estudio descriptivo transversal. Los datos se recopilaron por un cuestionario semiestructurado autoadministrado, de febrero a mayo de 2017, en cuatro Unidades de Salud Familiar en la región urbana de Campo Grande, Mato Grosso do Sul, Brasil. Resultados: Participaran 57 Agentes de Salud Comunitaria (ACS) y 8 ACE. Todos informaron que proporcionaron orientación a los habitantes y 58 realizaron control mecánico durante la inspección de las propiedades, buscando evitar y eliminar posibles sitios de reproducción para Aedes aegypti. En cuanto a la integración de los ACE en la ESF, 18 participantes destacaron el trabajo en equipo como un aspecto positivo, y 15, la falta de autonomía para las intervenciones legales como un aspecto negativo. Conclusión: La integración de los ACE en la ESF es factible, sin embargo, son necesarios ajustes para mejorar las actividades en la perspectiva del trabajo compartido sobre la misma base territorial.


Objective: To describe the process of Endemic Disease Control Worker (EDCW) integration into the Family Health Strategy. Methods: This was a descriptive cross-sectional study. Data were collected through a self-administered semi-structured questionnaire, from February to May 2017, in four Family Health centers in the urban region of Campo Grande, Mato Grosso do Sul, Brazil. Results: 57 Community Health Agents (CHW) and eight EDCWs participated. All participants reported providing guidance to property dwellers and 58 carried out mechanical vector control during the inspection of properties, in order to avoid and eliminate possible Aedes aegypti breeding sites. With regard to EDCW integration in the Family Health Strategy, 18 participants highlighted teamwork as a positive aspect; while 15 highlighted lack of autonomy to undertake legal interventions as a negative aspect. Conclusion: EDCW integration in the Family Health Strategy is feasible, however, adjustments need to be made to optimize activities within the perspective of shared work in the same territorial area.


Subject(s)
Humans , Endemic Diseases/prevention & control , National Health Strategies , Health Promotion/organization & administration , Brazil/epidemiology , Cross-Sectional Studies , Community Health Workers/statistics & numerical data , Dengue/prevention & control , Dengue/epidemiology , Neglected Diseases
4.
Rev. cuba. med. trop ; 72(2): e461, mayo.-ago. 2020. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1149913

ABSTRACT

RESUMEN Introducción: La enfermedad de Chagas es de alta endemia en Colombia y es considerada un problema de salud pública por la morbilidad y mortalidad que ocasiona. Conocer la percepción de las comunidades frente a esta enfermedad es relevante en cuanto a las estrategias oportunas que se pueden establecer para su prevención. Objetivo: Evaluar la fiabilidad y validez de un instrumento que permita medir los conocimientos, actitudes y prácticas frente a la enfermedad de Chagas en comunidades endémicas. Métodos: Se desarrolló un estudio de corte transversal para la validación del contenido de un instrumento, diseñado con base en la literatura, el cual se sometió a la valoración por un panel de expertos que determinaron la eficiencia, relevancia, claridad y coherencia de cada uno de los ítems. Se determinó el índice Kappa de Randolph para evaluar concordancia. Luego se aplicó a 135 personas de áreas endémicas y se estableció el alfa de Cronbach para determinar consistencia interna. Resultados: El instrumento estudiado demostró concordancia según el índice de Randolph con una Kappa entre 0,7-0,8 para los ítems evaluados, con un alfa de Cronbach de 0,855 lo cual denota una consistencia adecuada. El cuestionario finalmente se estructuró con un total de 27 ítems que abordan: factores epidemiológicos y conocimientos de la enfermedad junto con actitudes y prácticas frente a esta. Conclusiones: El instrumento tiene un nivel adecuado de consistencia interna y concordancia, que permitiría su aplicación en áreas endémicas con poblaciones en riesgo a adquirir la enfermedad de Chagas.


ABSTRACT Introduction: Chagas disease is highly endemic in Colombia and considered to be a public health problem due to its morbidity and mortality. Learning about community perception of this disease is relevant to devise timely strategies for its prevention. Objective: Evaluate the reliability and validity of an instrument to measure knowledge, attitudes and practices in response to Chagas disease in endemic communities. Methods: A cross-sectional study was conducted to validate the content of a tool based on the literature and assessed by an expert panel to determine the efficiency, relevance, clarity, and coherence of each of its items. Determination was made of Randolph's kappa index to evaluate agreement. Then it was applied to 135 people from endemic areas and Cronbach's alpha was established to determine internal consistency. Results: The tool studied showed agreement by Randolph's index with a kappa between 0.7 and 0.8 for the items evaluated and a Cronbach's alpha of 0.855, denoting appropriate consistency. The questionnaire was finally structured with a total 27 items addressing epidemiological factors and knowledge about the disease as well as attitudes and practices in response to it. Conclusions: The tool has an adequate level of internal consistency and agreement, which makes its application advisable in endemic areas with populations at risk of acquiring Chagas disease.


Subject(s)
Humans , Epidemiologic Factors , Health Knowledge, Attitudes, Practice , Chagas Disease/epidemiology , Endemic Diseases/prevention & control , Epidemiology, Descriptive , Cross-Sectional Studies , Reproducibility of Results , Colombia , Validation Study , Evaluation of Research Programs and Tools
5.
Palmas; [Secretaria de Estado da Saúde]; 15 abr. 2020. 2 p.
Non-conventional in Portuguese | LILACS, ColecionaSUS, CONASS, SES-TO | ID: biblio-1120806

ABSTRACT

Traz reflexões e recomendações aos gestores e trabalhadores na discussão coletiva de medidas que minimizem os riscos à saúde dos Agentes de Combates à Endemias-ACE, como também, reduzam a disseminação do COVID-19 para seus familiares e a população em geral. Complementa os informes e protocolos emitidos pela SES-TO e seu Comitê Operacional de Emergências em Saúde e pelo Ministério da Saúde.


It brings reflections and recommendations to managers and workers in the collective discussion of measures that minimize the health risks of Agents to Combat Endemics-ACE, as well as reduce the spread of COVID-19 to their families and the population in general. It complements the reports and protocols issued by SES-TO and its Operational Committee for Health Emergencies and the Ministry of Health.


Aporta reflexiones y recomendaciones a directivos y trabajadores en la discusión colectiva de medidas que minimicen los riesgos para la salud de los Agentes de Lucha contra las Endemias-ACE, así como reduzcan la propagación del COVID-19 a sus familias y a la población en general. Complementa los informes y protocolos emitidos por la SES-TO y su Comité Operativo de Emergencias Sanitarias y el Ministerio de Salud.


Subject(s)
Humans , Animals , Endemic Diseases/prevention & control , Zoonoses/prevention & control , Coronavirus Infections/prevention & control , Animal Technicians , Home Care Agencies/standards , Sanitary Management/methods , Personal Protective Equipment/veterinary
6.
Epidemiol. serv. saúde ; 29(4): e2019465, 2020. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1124750

ABSTRACT

Objetivo: Analisar a vulnerabilidade institucional/programática de serviços de saúde no desenvolvimento das ações de atenção a pessoas acometidas pela hanseníase e de vigilância de contatos. Métodos: Estudo transversal, conduzido em 2017, sobre dados primários de amostra de casos de hanseníase notificados no período 2001-2014, com sobreposição de casos em redes de convívio domiciliar (RCD), em municípios dos estados da Bahia, Piauí e Rondônia, Brasil. Resultados: Dos 233 casos de hanseníase analisados, 154 (66,1%) pertenciam a RCD com 3 ou mais casos de hanseníase. Em 53,2% dos casos, houve acometimento de duas ou mais gerações, um desfecho significativamente associado a não realização do exame dermato-neurológico (razão de prevalências [RP] 1,32; intervalo de confiança [IC95%1,10;1,59]; p-valor=0,004). Conclusão: Falhas operacionais na vigilância de contatos de hanseníase em áreas de alta endemicidade reforçam o caráter de vulnerabilidade institucional/programática em contextos de RCD com mais de um caso de hanseníase, nos três estados analisados.


Objetivo: Analizar la vulnerabilidad institucional/programática de los servicios de salud para el desarrollo de acciones de atención a personas afectadas por lepra y de vigilancia de sus contactos. Métodos: Estudio transversal realizado en 2017 basado en datos primarios de una muestra de casos de lepra notificados entre 2001-2014 con casos superpuestos en redes de convivencia domiciliar (RCD) en Municipios de los Estados de Bahía, Piauí y Rondônia, Brasil. Resultados: Del total de 233 casos de lepra analizados, 154 (66,1%) pertenecían a RCD con 3 o más casos de lepra. En el 53.2% de los casos hubo 2 o más generaciones afectadas, resultado significativamente asociado con la no realización del dermato-neurológico (razón de prevalencias [RP] 1,32; intervalo de confianza [IC95%1,10;1,59]; valor-p=0.004). Conclusión: Las fallas operativas en la vigilancia de los contactos de lepra en áreas de alta endemicidad refuerzan el carácter de vulnerabilidad institucional/programática en los contextos de redes de convivencia domiciliar (RCD) con más de un caso de lepra en los tres estados analizados.


Objective: To analyze institutional/programmatic vulnerability of health services in the development of health care actions for people affected by leprosy and contact surveillance. Methods: This was a cross-sectional study conducted in 2017 based on primary data from a sample of leprosy cases notified between 2001-2014 with overlapping cases in household social networks (HSN) in municipalities in the states of Bahia, Piauí and Rondônia, Brazil. Results: A total of 233 leprosy cases were analyzed, 154 (66.1%) belonged to HSN with 3 or more leprosy cases. In 53.2% of cases, 2 or more generations were affected, this being an outcome associated with absence of dermato-neurological examination (prevalence ratio 1.32; confidence interval [95%CI 1.10;1.59]; p-value=0.004). Conclusion: Operational failures in the surveillance of leprosy contacts in areas of high endemicity reinforce the character of institutional/programmatic vulnerability in HSN contexts with more than one case of leprosy in the three states analyzed.


Subject(s)
Humans , Communicable Disease Control , Epidemiological Monitoring , Leprosy/epidemiology , Brazil/epidemiology , Cross-Sectional Studies , Endemic Diseases/prevention & control , Neglected Diseases , Leprosy/prevention & control
7.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 11(5): 1333-1339, out.-dez. 2019. tab
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1022140

ABSTRACT

Objective: The study's purpose has been to identify the actions to fight the dengue fever vector, and also the way that patients bearing the symptoms have being handled. Methods: This research describes the semiological and pathophysiological aspects of dengue fever through the perception of health professionals, who assisted the patients bearing the symptoms of this disease. Furthermore, this study addresses the perception of endemic diseases combat agents and community health agents regarding the efficiency of vector control measures. Results: The health professionals are working according to the World Health Organization recommendations. The majority of the population contributes to the mosquito breeding sites elimination. The elevated number of closed properties and houses with difficult access has been the greatest obstacle to control the vector. Conclusion: These services need to be aware of the disease trends in order to quickly detect changes in its profile and guide control actions


Objetivo: Identificar as ações adotadas de combate ao vetor e as formas de manejo dos pacientes com sinais e sintomas de alarme para dengue grave. Métodos: Estudo que descreve, na percepção dos profissionais de saúde que atenderam pacientes com suspeita de dengue, os aspectos semiológicos e fisiopatológicos da doença. Apresenta a percepção dos Agentes de Combate a Endemias e Agentes Comunitários de Saúde sobre a eficiência das medidas de controle do vetor. Resultados: Os profissionais de saúde procedem o cuidado conforme orientações da Organização Mundial da Saúde. A maior parte da população contribui com a eliminação dos criadouros do mosquito. Imóveis fechados e o difícil acesso têm sido os principais desafios para o controle do vetor. Conclusão: Esses serviços precisam estar atentos às tendências dessa doença para rapidamente conseguir detectar mudanças em seu perfil e orientar ações de controle


Objetivo: Identificar la satisfacción de los pacientes seguidos en un ambulatorio de Educación para la Salud y evaluar el efecto de las variables antecedentes sobre el nivel de satisfacción de los pacientes. Método: Se trata de un estudio transversal realizado en un ambulatorio la Educación para la Salud. La muestra estuvo constituida por todos los pacientes cardíacos en el ambulatorio (17 pacientes). La satisfacción del paciente se evaluó a través del Instrumento de Satisfacción del Paciente (ISP). Resultados: Todos los pacientes informaron un alto nivel de satisfacción. Los dominios con los puntajes más altos y más bajos fueron el profesional y el educacional, respectivamente. No hubo correlación significativa entre los niveles de satisfacción con cualquiera de las variables antecedentes. Conclusión: Pacientes informaron un alto nivel de satisfacción y no hubo correlación significativa entre variables y los niveles de satisfacción


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Patient Satisfaction , Community Health Workers , Endemic Diseases/prevention & control , Dengue/prevention & control , Aedes/pathogenicity , Epidemiological Monitoring
8.
Clinics ; 74: e675, 2019. tab, graf
Article in English | LILACS | ID: biblio-1019708

ABSTRACT

The present study aimed to review literature on studies of dengue cases conducted over 30 years in the state of Ceará. Between November 2015 and January 2016, articles published in Portuguese and English in 7 databases were searched using keywords and a Boolean operator. A total of 191 articles were identified in the databases; 133 were excluded according to the exclusion criteria, and 58 were included in the study. Of the 58 articles analyzed, 6 reported data from Brazil; including the Northeast region and the state of Ceará; 41 reported data for only the city of Fortaleza; 7 reported data for the state of Ceará; 4 reported data for cities in the interior of the state; and 3 included only children. The studies adopted different approaches and focused on different aspects of the disease. Study outcomes included the identification of serological, epidemiological, clinical, and laboratory characteristics; potential larvicides and biological predators of mosquitoes; potential antiviral agents; vector density characteristics; and educational dengue prevention and control strategies. Additionally, one vaccine trial was included. Although studies on dengue in the state of Ceará are scarce, they are encompassing, including several lines of research, and the number of studies and reports on dengue in the state of Ceará continues to increase.


Subject(s)
Humans , Animals , Endemic Diseases/statistics & numerical data , Aedes/classification , Dengue/epidemiology , Mosquito Vectors/physiology , Predatory Behavior , Research Design , Species Specificity , Brazil/epidemiology , Endemic Diseases/prevention & control , Aedes/physiology , Dengue/prevention & control , Dengue/transmission
9.
Epidemiol. serv. saúde ; 28(2): e2018085, 2019. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1012082

ABSTRACT

Objetivo: avaliar a implantação das ações de controle da esquistossomose mansônica do Programa de Enfrentamento às Doenças Negligenciadas em três municípios de Pernambuco, Brasil. Métodos: análise de implantação, realizada em 2014, considerando-se os componentes de gestão, vigilância epidemiológica, assistência ao paciente e apoio laboratorial, e educação em saúde; utilizaram-se observação direta e entrevistas com gestores e técnicos dos níveis estadual, regional e municipal. Resultados: verificou-se implantação parcial nos municípios A e B 69,7%; 62,2%, enquanto o município C classificou-se como implantado 79,5%; houve fragilidades de contexto relativas à comunicação entre instâncias gestoras, insuficiente autonomia técnico-gerencial dos níveis descentralizados e instabilidade profissional; como potencialidades, identificaram-se educação permanente, articulação política, conhecimento sobre o programa e avaliação de desempenho. Conclusão: categorias contextuais relacionadas com o desenvolvimento e implantação destacaram-se pela influência positiva no nível de implantação dos três municípios; recomenda-se intervir nas fragilidades observadas, para garantia da sustentabilidade e institucionalização do programa.


Objetivo: evaluar la implantación de las acciones de control de la esquistosomiasis mansoni del Programa de Afrontamiento de Enfermedades Desatendidas en tres municipios de Pernambuco, Brasil. Métodos: análisis de implantación, realizado en 2014, considerando los componentes gestión, vigilancia epidemiológica, asistencia al paciente y apoyo de laboratorio, y educación en salud; se utilizó la observación directa y entrevistas con gestores/técnicos de niveles estadual, regional y municipal. Resultados: implantación parcial en los municipios A y B 69,7%; 62,2%, mientras que el C se clasificó como implantado 79,5%; el contexto demostró fragilidades de comunicación entre instancias gestoras, insuficiente autonomía técnico-gerencial de los niveles descentralizados e inestabilidad profesional; como potencialidades, se identificaron educación permanente, articulación política, conocimiento del programa y evaluación de desempeño. Conclusión: las categorías contextuales relacionadas al desarrollo e implantación se destacaron por la influencia positiva a nivel de implantación de los tres municipios; se recomienda intervenir sobre las fragilidades observadas, para garantizar la sostenibilidad e institucionalización del programa.


Objective: to evaluate the implementation of schistosomiasis mansoni control actions under the Program to Combat Neglected Diseases in three municipalities in Pernambuco state, Brazil. Methods: implementation analysis was done in 2014, considering the following components - management, epidemiological surveillance, patient care, laboratorial support and health education -; direct observation and interviews were carried out with managers and technical personnel at the state, regional, and municipal levels. Results: partial implementation was found in municipalities A and B 69.7%; 62.2%, while there was full implementation in municipality C 79.5%; contextual weaknesses were found in communication between management levels, insufficient technical-management autonomy of decentralized levels, and professional staff job instability; potentialities identified were - continuing education, political articulation, knowledge about the program, and performance evaluation. Conclusion: contextual categories related to development and implementation stood out for their positive influence on the degree of implementation in the municipalities; we recommend intervention in the weaknesses found, in order to ensure program sustainability and institutionalization.


Subject(s)
Humans , Health Programs and Plans/organization & administration , Schistosomiasis mansoni/prevention & control , Schistosomiasis mansoni/epidemiology , Neglected Diseases/epidemiology , Health Evaluation/statistics & numerical data , Brazil/epidemiology , Endemic Diseases/prevention & control , Disease Prevention , Public Health Surveillance , Epidemiological Monitoring
10.
Gac. méd. boliv ; 41(1): 24-30, jun. 2018. ilus, graf, map, tab
Article in Spanish | LILACS, LIBOCS | ID: biblio-953633

ABSTRACT

Objetivo: proporcionar datos de la adaptación del Aedes aegypti en altitudes superiores a los de su hábitat natural en el departamento de Cochabamba. Métodos: la notificación así como la vigilancia entomológica, permitieron caracterizar taxonómicamente y geográficamente la infestación por Aedes aegypti, en municipios del eje metropolitano del departamento de Cochabamba y observar el cambio de escenario epidemiológico producido. La utilización de materiales de investigación entomológica, además del estudio integral permitió identificar factores predisponentes para la colonización del vector. Resultados: se encontró la presencia del vector en diferentes altitudes geográficas y en varios municipios del departamento de Cochabamba, en los que anteriormente no se encontraba. Se observó una variación de temperatura inusitada y lluvia en el mes de enero de 2016, que proporcionó climáticas favorables para la proliferación de Aedes aegypti y otros vectores. Se identificó una mayor infestación en la zona sur de la ciudad de Cochabamba, además de ser el área que ha presentado más factores de riesgo como son la presencia de criaderos artificiales comunes y no comunes, con presencia incalculable de desechos inservibles intradomiciliarios. Conclusiones: observar la presencia del vector en municipios grandes como Cercado, denota Riesgo de gran magnitud para la población por lo que representa un ESPII-ESPIN. El cambio climático como uno de los factores para la variación de los diversos nichos ecológicos, ha permitido que los Valles hayan brindado condiciones propicias para la colonización del Aedes aegypti y que este se adapte a altitudes mayores a 2 200 m s.n.m. La ciudad de Cochabamba es un punto importante de entrada para el ingreso de personas provenientes de áreas endémicas de trasmisión de Dengue, Zika y Chikungunya, tanto del exterior como del interior, lo que representa alto riesgo para la transmisión de estas enfermedades en las nuevas áreas de dispersión del vector. Hasta el momento julio 2016 solo se evidencio la presentación autóctona de un caso en la ciudad de Cochabamba. La dificultad en la provisión y almacenamiento de agua en las viviendas, son factores fundamentales para la proliferación de criaderos potenciales para Aedes aegypti.


Objetive: to provide data of the adaptation of Aedes aegypti at higher altitudes than its natural habitat in the department Cochabamba. Methods: notification as well as Entomological Surveillance allowed taxonomic and geographic characterization of Aedes aegypti infestation in municipalities of the metropolitan axis of Cochabamba department and to observe the change in the epidemiological scenario produced. The use of entomological research materials, besides the integral study allowed to identify predisposing factors for the colonization of the vector. Results: the presence of the vector was found at different geographic altitudes and in several municipalities in the department of Cochabamba, where it was previously not found. An unusual temperature variation and rainfall in January 2016 provided favorable climatic conditions for the proliferation of Aedes aegypti and other vectors. Greater infestation was identified in the southern area of the city of Cochabamba, besides being the area that has presented more risk factors such as the presence of common and non-common artificial breeding grounds, with an incalculable presence of intradomiciliary waste. Conclusions: observing the presence of the vector in large municipalities such as Cercado, denotes a high risk for the population, which represents an ESPII-ESPIN. Climate change as one of the factors for the variation of the various ecological niches has allowed the Valleys to provide conditions conducive to the colonization of Aedes aegypti and that it overcomes adaptation to altitudes higher than 2200 m s.n.m. The city of Cochabamba is an important entry point for the entry of people from endemic areas of Dengue, Zika and Chikungunya transmission, both from the outside and the interior, which represents a high risk for the transmission of these diseases in the new areas of vector dispersion. Until July 2016 only the autochthonous presentation of a case in the city of Cochabamba was evidenced. The difficulty in the provision and storage of water in the dwellings are fundamental factors for the proliferation of potential breeding sites for Aedes aegypti.


Subject(s)
Endemic Diseases/prevention & control , Aedes/parasitology , Adaptation, Biological
11.
Prensa méd. argent ; 104(2): 59-63, 20180000. fig
Article in Spanish | LILACS, BINACIS | ID: biblio-1370592

ABSTRACT

Leishmaniasis, a parasitic disease produced by a protozoan of the genus Leishmania, is triggered by the bite of an infected sandfly. It is endemic in tropical and subtropical areas of the Americas, places of poor socioeconomic health conditions and malnutrition. These conditions favor the entry of other pathogens such as the dimorphic fungus Paracoccidioides brasiliensis, responsible for Paracoccidioidomycosis (PCM), deep mycosis of inhalatory entry that initially affects the lungs; then skin, mucous membranes, lymph nodes and adrenal glands. The association of reported cases of Leishmaniasis and Paracoccidiodoimicosis in the same patient is infrequent. We point out the importance of the multidisciplinary approach for the correct diagnosis and treatment.


Subject(s)
Humans , Male , Aged , Paracoccidioidomycosis/diagnosis , Socioeconomic Factors , Leishmaniasis, Mucocutaneous/immunology , Amphotericin B/therapeutic use , Itraconazole/therapeutic use , Endemic Diseases/prevention & control , Malnutrition
12.
Cad. Saúde Pública (Online) ; 34(1): e00196216, 2018. tab, graf
Article in Portuguese | LILACS | ID: biblio-889864

ABSTRACT

O objetivo deste estudo foi analisar indicadores operacionais de controle da hanseníase e sua tendência temporal, na perspectiva de gênero, no Estado da Bahia, Brasil, de 2001 a 2014. Trata-se de estudo de série temporal baseado em dados epidemiológicos da hanseníase no Sistema de Informação de Agravos de Notificação, com análise de regressão de Poisson por joinpoints e de regressão polinomial. Dos 40.054 casos novos de hanseníase analisados, 47,1% dos contatos registrados não foram examinados, mas com tendência significativa de aumento, de forma mais acentuada entre as mulheres (variação percentual anual média - AAPC = 5,6; IC95%: 3,5; 7,7) em comparação aos homens (AAPC = 3,0; IC95%: 0,5; 5,6). A proporção de cura na coorte 2003-2014 foi de 85%, com tendência de redução mais acentuada nos homens (AAPC = -0,5; IC95%: -0,9; 0,0), comparados às mulheres (AAPC = -0,4; IC95% -0,7; -0,1). A proporção de casos em abandono de tratamento no período foi de 5,5%, com tendência de redução mais significativa entre mulheres (AAPC = -4,9; IC95%: -8,7; -1,1) do que em homens (AAPC = -2,7; IC95%: -4,4; -1,0). Recidiva foi verificada em 3,8% de todas as entradas do período; as mulheres apresentaram tendência de redução significativa (AAPC = -2,2; IC95%: -3,3; -1,0) e os homens, de crescimento significativo (AAPC = 4,9; IC95%: 2,9; 6,8). A análise por regressão polinomial foi consistente com a análise de joinpoints. A hanseníase no Estado da Bahia apresenta indicadores operacionais com magnitude e tendência temporal significativas, em especial entre a população masculina. O desempenho insuficiente dos serviços de saúde em realizar a vigilância de contatos e a longitudinalidade do cuidado revelam diferentes dimensões de vulnerabilidade.


The aim of this study was to analyze operational indicators and time trends in leprosy control from a gender perspective in Bahia State, Brazil, from 2001 to 2014. This was a time series study based on epidemiological data on leprosy from the Brazilian National System of Diseases of Notification, using joinpoint Poisson and polynomial regression. Of the 40,054 new cases of leprosy, 47.1% of the recorded contacts were not examined, with a significant upward trend, especially in women (average annual percentage change - AAPC = 5.6; 95%CI: 3.5; 7.7) when compared to men (AAPC = 3.0; 95%CI: 0.5; 5.6). The proportion of cure in the 2003-2014 cohort was 85%, with a downward trend, especially in men (AAPC = -0.5; 95%CI: -0.9; 0.0), compared to women (AAPC = -0.4; 95%CI: -0.7; -0.1). Treatment dropout rate was 5.5%, with a more significant downward trend in women (AAPC = -4.9; 95%CI: -8.7; -1.1) than in men (AAPC = -2.7; 95%CI: -4.4; -1.0). Relapse was recorded in 3.8% of all the entries during the same period; women showed a significant downward trend (AAPC = -2.2; 95%CI: -3.3; -1.0) and men a significant upward trend (AAPC = 4.9; 95%CI: 2.9; 6.8). Polynomial regression analysis was consistent with joinpoint regression. Leprosy in Bahia State shows operational indicators with significant magnitude and time trends, especially in the male population. Health services' insufficient performance in conducting contact surveillance and longitudinal care reveal various dimensions of vulnerability.


El objetivo de este estudio fue analizar indicadores operacionales de control de la lepra y su tendencia temporal, desde la perspectiva de género, en el estado de Bahía, Brasil, de 2001 a 2014. Se trata de un estudio de serie temporal, basado en datos epidemiológicos de la lepra en el Sistema Nacional de Enfermedades de Notificación Obligatoria, con análisis de regresión de Poisson por joinpoints y de regresión polinomial. De los 40.054 casos nuevos de hanseniasis analizados, un 47,1% de los contactos registrados no fueron examinados, pero con una tendencia significativa de aumento, de forma más acentuada entre las mujeres (AAPC = 5,6; IC95%: 3,5; 7,7), en comparación a los hombres (AAPC = 3,0; IC95%: 0,5; 5,6). La proporción de cura en la cohorte 2003-2014 fue de un 85%, con una tendencia de reducción más acentuada en los hombres (AAPC = -0,5; IC95%: -0,9; 0,0), comparados con las mujeres (AAPC = -0,4; IC95%: -0,7; -0,1). La proporción de casos en abandono de tratamiento durante el período fue de un 5,5%, con tendencia de reducción más significativa entre mujeres (AAPC = -4,9; IC95%: -8,7; -1,1) que en hombres (AAPC = -2,7; IC95%: -4,4; -1,0). La recidiva se verificó en un 3,8% de todas las entradas del período; las mujeres presentaron una tendencia de reducción significativa (AAPC = -2,2; IC95%: -3,3; -1,0) y los hombres, de crecimiento significativo (AAPC = 4,9; IC95%: 2,9; 6,8). El análisis por regresión polinomial fue consistente con el análisis de joinpoints. La hanseniasis en el estado de Bahía presenta indicadores operacionales con magnitud y tendencia temporal significativas, en especial entre la población masculina. El desempeño insuficiente de los servicios de salud al realizar la vigilancia de contactos y la longitudinalidad del cuidado revelan diferentes dimensiones de vulnerabilidad.


Subject(s)
Humans , Male , Female , Leprosy/prevention & control , Socioeconomic Factors , Brazil/epidemiology , Sex Factors , Regression Analysis , Cohort Studies , Endemic Diseases/prevention & control , Endemic Diseases/statistics & numerical data , Interpersonal Relations , Leprosy/transmission , Leprosy/epidemiology
13.
Rev. med. Rosario ; 83(3): 111-118, sep.-dic. 2017. graf, tab, ilus
Article in Spanish | LILACS | ID: biblio-973314

ABSTRACT

La fiebre Hemorrágica Argentina es una enfermedad viral aguda grave, de carácter sistémico, con duración de una a dos semanas, con cuadros clínicos de gravedad variable. Su agente transmisor es el virus Junín cuyo reservorio natural es el llamado ratón maicero y su zona endémica de distribución comprende sur de la provincia de Santa Fe, Córdoba, Noroeste de Buenos Aires y La Pampa, en Argentina. La primera medida preventiva para la enfermedad es la vacuna llamada Candid 1. Se realizó una encuesta poblacional para dimensionar en la zona de Venado Tuerto y localidades vecinas el alcance de la vacunación y estimar el conocimiento de la existencia de dicha vacuna, que no es de aplicación obligatoria.


Population survey on vaccination against Argentine Hemorrhagic fever in endemic area in the Province of Santa Fe. Argentine Hemorrhagic Fever is a serious systemic, acute viral disease, with a duration of one or two weeks and of variable gravity. Its transmitting agent is Junín Virus, whose natural reservoir is the corn mouse. Its endemic zone is the south of the province of Santa Fe, Cordoba, northwest of Buenos Aires and La Pampa; in Argentina. The first preventive measure for the disease is the vaccine called Candid 1. A population survey was carried out to measure the extent of vaccination and the knowledge of the vaccine, that is not of compulsory application.


Subject(s)
Humans , Endemic Diseases/prevention & control , Hemorrhagic Fever, American/prevention & control , Junin virus , Health Surveys , Public Health , Vaccines , Virus Diseases/prevention & control
14.
Prensa méd. argent ; 103(7): 394-400, 20170000. tab, fig
Article in Spanish | LILACS, BINACIS | ID: biblio-1372368

ABSTRACT

La Paracoccidioidomicosis es la micosis endémica más frecuente en América latina en enfermos HIV negativos. Objetivo: analizar las características clínicas, epidemiológicas, evolución y tratamiento de los pacientes con diagnóstico de paracoccidioidomicosis asistidos en un hospital de referencia en enfermedades infecciosas en un período de 10 años. Materiales y métodos: Estudio descriptivo y retrospectivo. Se analizaron las historias clínicas de 70 pacientes con diagnóstico de paracoccidioidomicosis en el período comprendido entre Enero de 2001 y Diciembre de 2010. Resultados: se incluyeron 70 pacientes. Cincuenta y nueve presentaron la forma crónica de la enfermedad, siete la infanto-juvenil y solo cuatro resultaron positivos para el HIV. La mayoría de los enfermos fueron de nuestro país y habían nacido en Chaco y Misiones. Veintiséis eran oriundos de Paraguay. El 81,4% de los casos tuvieron compromiso pulmonar y el patrón radiológico hilio-fugal, en "alas de mariposa", fue el más frecuente. Se observaron lesiones cutáneo-mucosas en 38,57% de los enfermos. El examen directo en fresco de esputo y la escarificación de las lesiones mucocutáneas resultó ser la prueba más útil para el diagnóstico de esta micosis endémica. La serología fue positiva en el 81,3 % de los pacientes con formas crónicas y en el 42,8% de la forma infanto-juvenil. La mayoría de los enfermos fueron tratados con itraconazol; sólo dos fallecieron. Conclusión: El diagnóstico de la paracoccidioidomicosis se basa principalmente en el examen microscópico directo; los cultivos de muestras clínicas pueden fallar. La paracoccidioidomicosis debe incluirse en el diagnóstico diferencial de los pacientes que provengan de áreas endémicas y presenten compromiso de piel, mucosas o del aparato respiratorio asociado a un síndrome infeccioso inespecífico


Paracoccidioidomycosis is the most frequent endemic mycosis in Latin America in HIV negative patients. Objective: to analyze the clinical, epidemiological and treatment characteristics and the evolution of patients with diagnosis of paracoccidioidomycosis. Materials and methods: Descriptive and retrospective study. The clinical records of 70 patients with paracoccidioidomycosis were analyzed in the period between January 2001 and December 2010. Results: 70 patients were included. Fifty-nine presented the chronic form, seven had the juvenile (acute) clinical picture and only four were HIV positive. The majority of the Argentinian patients had been born in Chaco and Misiones provinces. Twenty-six were from Paraguay. 81.4% of the patients had lung involvement, the "butterfly wing" pattern was the most frequent. Muco cutaneous lessions were observed in 38.57% of the patients. Wet mount microscopy examination of sputum and mucocutaneous scarification proved to be the most useful tests for the disease diagnosis Serology tests were positive in 81.3% of patients with the chronic form and in 42.8% of those with the juvenile clinical presentation. Most of the patients were treated with itraconazole. Only two deceased. Conclusion: The diagnosis of paracoccidiodomycosis is mainly based on direct microscopic examination of clinical smears. Cultures of clinical samples may fail. Paracoccidioidomycosis should be included in the differential diagnosis of patients who come from the endemic area and present skin, mucous membranes or respiratory system compromise associated with a non-specific infectious syndrome


Subject(s)
Humans , Adolescent , Adult , Middle Aged , Paracoccidioidomycosis/therapy , Epidemiology, Descriptive , Retrospective Studies , HIV/immunology , Itraconazole/therapeutic use , Endemic Diseases/prevention & control , Mycoses/therapy , Diagnosis, Differential
15.
RECIIS (Online) ; 11(1): 1-13, jan.-mar. 2017. tab
Article in Portuguese | LILACS | ID: biblio-835242

ABSTRACT

A dengue é uma arbovirose de grande impacto na saúde pública. Fundamentando-se na importância dos agentes de combate às endemias (ACE) para prevenção e controle da doença, este artigo objetiva analisar a temática da formação dos ACE nas políticas públicas com base em pesquisa qualitativa, documental e descritiva de fontes primárias dos acervos eletrônicos do Ministério da Saúde e Ministério da Educação, disponibilizados até fevereiro de 2016. No total, 14 documentos foram analisados conforme análise de conteúdo. Os resultados indicam escassez de publicações sobre as políticas de formação profissional no contexto da dengue. Embora exista uma política incipiente visando à formação dos ACE, ainda não há regulamentação do seu trabalho técnico. É necessário discutir e aprofundar quem é esse trabalhador e os motivos pelos quais a regulamentação da formação não consta nas pautas das políticas de controle da dengue e seus vetores.


Dengue is an arbovirus of great public health impact. Based on the importance of community health workers(CHW) in the prevention and control of dengue, this article aims to analyze the professional qualification of CHW in public health policies related to dengue; using a qualitative descriptive document analysis of the primary sources of electronic documents of the Ministry of Health and the Ministry of Education, available online until February 2016. In total, 14 documents were analyzed based on content analysis. The results show few publications about training policies in the context of the dengue. Even though there is an incipient policy for CHW qualification, there is no regulation of their technical work. It is necessary to discuss who are these workers and the reasons why the regulation of CHW training does not appear in the agenda of dengue control policies and its vectors.


El dengue es un arbovirus de alto impacto en la salud pública. Basándose en la importancia de los agentes para combatir las enfermedades endémicas en la prevención y control de la dengue, este artículo tiene como objetivo analizar el tema de la formación de esos agentes en las políticas públicas, utilizando un estudio cualitativo, descriptivo y documental de fuentes primarias de investigación de documentos electrónicos del Ministerio de Salud y del Ministerio de Educación, disponibles hasta febrero de 2016. En total, 14 documentos fueron analizados de acuerdo con el análisis de contenido. Los resultados indican la escasez de publicaciones sobre políticas de formación profesional en el contexto del dengue. Aunque exista una política incipiente a la formación de los mencionados agentes, no existe una regulación de su trabajo técnico. Es necesario discutir y profundizar quién es ese trabajador y las razones por las que la regulación de la formación no aparece en las agendas de las políticas de control del dengue y sus vectores.


Subject(s)
Humans , Community Health Workers , Dengue/prevention & control , Endemic Diseases/prevention & control , Health Human Resource Training , Brazil , Health Education , Health Policy
17.
Interface comun. saúde educ ; 20(59): 1027-1039, oct.-dic. 2016.
Article in English, Portuguese | LILACS | ID: lil-796305

ABSTRACT

O artigo apresenta ambiente, saúde e trabalho como temas geradores necessários à construção de uma tecnologia social para educação profissional, considerando a ergologia como perspectiva de análise, e, o diálogo, como estratégia de ensino em Saúde e Segurança no Trabalho para Agentes de Combate a Endemias em Rio Branco, Acre, Brasil. A definição dos temas geradores é resultado do diálogo entre pesquisadores de diferentes áreas, trabalhadores que atuam ou atuaram no combate às endemias, bem como de discentes e docentes do Curso Técnico em Segurança do Trabalho no Instituto Federal do Acre (IFAC), mediante exercício de atividades de ensino, pesquisa e extensão. As pesquisas histórica e documental permitiram que se estabelecessem os nexos entre os projetos de desenvolvimento que impactaram significativamente o ambiente e as relações de trabalho na saúde daí resultantes.


Este artículo presenta ambiente, salud y trabajo como temas generadores necesarios a la construcción de una tecnología social para la educación profesional, considerando la ergología como perspectiva de análisis y el diálogo como estrategia de enseñanza en Salud y Seguridad en el Trabajo para los Agentes de Combate a Endemias, en Rio Branco, Acre, Brasil. La definición de los temas resulta del diálogo entre investigadores de distintas áreas, trabajadores que actúan o actuaron en el combate a endemias, así como entre los discentes y docentes del Curso Técnico en Seguridad del Trabajo en el Instituto Federal de Acre (IFAC), mediante actividades de enseñanza, investigación y extensión. Las investigaciones históricas y documentales posibilitaron que se establecieran nexos entre los proyectos de desarrollo, que resultaron significativos en el ambiente y en las relaciones laborales en el área de la salud.


The paper proposes that environment, health and work are generating subjects, necessary to build a social technology for professional education, considering ergology as the perspective for analysis and dialogue as a teaching strategy in Health and Safety at Work for Agents that fight endemic diseases in Rio Branco, Acre, Brazil. The definition of these main generating subjects is the result of a dialogue between researchers from different areas, workers in the fight against endemic diseases, teachers and students of the Technical Course in Occupational Safety at the Federal Institute of Acre (IFAC). The historical and documentary research allowed to establish the links between the development projects that impacted significantly with outcomes in the environment and labor relations in health.


Subject(s)
Public Health , Health Education , Occupational Health , Endemic Diseases/prevention & control
18.
Espaç. saúde (Online) ; 17(2): 59-65, dez. 2016. Ilustrações, Tabelas
Article in Portuguese | LILACS | ID: biblio-833038

ABSTRACT

A Leishmaniose Tegumentar Americana (LTA) é uma doença causada por protozoários do gênero Leishmania e é transmitida ao homem pela picada do mosquito flebotomíneo. O Brasil nos últimos anos tem apresentado aumento do número de casos e a doença tem ampliado sua extensão geográfica. Na região Sul, o estado do Paraná registra mais de 90% das notificações e o município de Jussara, situado a noroeste do estado, tem um dos maiores coeficientes de detecção da doença (299,4 casos/100.000 hab). O objetivo do estudo foi descrever as características clínico-epidemiológicas da endemia da LTA no município, no período de 1994 a 2014. Observou-se que os coeficientes flutuaram ao longo dos anos. Foram notificados 399 casos. A doença foi mais frequente nos homens, adultos jovens, que adquiriram a LTA especialmente relacionada ao trabalho rural. A autoctonia da doença foi de 97,5%. A forma clínica predominante foi a cutânea e o acesso ao exame diagnóstico foi observado para todos os portadores da infecção. São reconhecidos na literatura os avanços no diagnóstico e tratamento e as dificuldades das medidas de controle da doença, especialmente aquelas relacionadas ao vetor (AU)


American Tegumentary Leishmaniasis (ATL) is a disease caused by protozoa of the genus Leishmania, and is transmitted to humans by the bite of phlebotominae mosquitos. In recent years, Brazil has presented an increase in the number of cases and the disease has expanded its geographic extension. The Brazilian Southern region, state of Paraná, registers more than 90% of notifications, and the city of Jussara, located on the northwest of the State, has one of the largest coefficients of disease detection (299.4 cases/100,000 inhabitants). The objective of this study was to describe the clinical and epidemiological features of endemic ATL in the city between 1994 and 2014. Coefficients fluctuation over the years was observed. There were 399 cases notified. The disease was more frequent in men, young adults, with transmission especially related to rural work. The autochthonism of the disease was of 97.5%. The predominant clinical form was cutaneous, and access to diagnostic examination was observed for all the infected hosts. The advances in diagnosis and treatment, and the difficulties of disease control measures, especially those related to the vector, are acknowledged. (AU)


Subject(s)
Endemic Diseases/prevention & control , Epidemiology , Leishmaniasis, Cutaneous/prevention & control
19.
Ciênc. saúde coletiva ; 21(11): 3621-3629, Nov. 2016. graf
Article in Portuguese | LILACS | ID: biblio-828507

ABSTRACT

Resumo O objetivo deste artigo é analisar a atuação de Emmanuel Dias (1908-1962), pesquisador do Instituto Oswaldo Cruz (IOC) e diretor do Centro de Estudos e Profilaxia da Moléstia de Chagas (posto do IOC criado em 1943 na cidade de Bambuí, Minas Gerais), como ator decisivo no processo de reconhecimento da doença de Chagas como problema de saúde pública no Brasil e no continente americano. Busca-se evidenciar que a conquista deste reconhecimento, que teve como marco fundamental a realização da primeira campanha de combate à enfermidade no Brasil em 1950, foi viabilizada pela intensa mobilização política de Dias junto a diversos grupos sociais, como médicos, políticos e moradores das áreas rurais, profissionais dos serviços públicos de saúde, governos e associações internacionais. Tal mobilização, ao longo das décadas de 1940 e 1950, num contexto histórico marcado por intensos debates sobre as relações entre saúde e desenvolvimento, levou à construção de uma rede de apoios decisiva para que a doença, caracterizada como cardiopatia crônica a ameaçar a produtividade do trabalhador rural, fosse considerada um problema médico-social a merecer ações e programas de saúde pública voltados para seu controle.


Abstract The scope of this article is to analyze the trajectory of Emmanuel Dias (1908-1962), a researcher at the Oswaldo Cruz Institute (OCI) and director of the Center for Studies and Prophylaxis of Chagas Disease (OCI outpost established in 1943 in the city of Bambuí, Minas Gerais), as a key actor in the acknowledgement of Chagas disease as a public health problem in Brazil and the Americas. It seeks to show that the conquest of this acknowledgement, the cornerstone of which was the staging of the first campaign to combat the disease in Brazil in 1950, was made possible by the intense political mobilization of Dias together with the various social groups, such as physicians, politicians and residents of rural areas, public health officials, governments and international organizations. This mobilization occurred during the 1940s and 1950s in a historical context marked by intense debate about the relationship between health and development and helped to construct a network of alliances that was critical for the recognition of Chagas disease as a chronic cardiopathy, which threatened the productivity of rural workers and represented a medical and social problem that merited public health actions and programs geared to get it under control.


Subject(s)
Humans , Chagas Disease/prevention & control , Endemic Diseases/prevention & control , Public Health/history , Brazil/epidemiology , Chagas Disease/epidemiology , Chagas Disease/history , Endemic Diseases/history , History, 20th Century , Rural Population
20.
Ciênc. saúde coletiva ; 21(8): 2329-2338, ago. 2016.
Article in Portuguese | LILACS | ID: lil-792985

ABSTRACT

Resumo A dengue é um dos principais desafios de saúde pública no Brasil e as atividades de prevenção e controle dessa patologia vêm sendo baseadas na estratégia de gestão integrada proposta em políticas de saúde, nas quais os atores centrais são o Agente de Combate à Endemias (ACE) e o Agente Comunitário de Saúde (ACS). O estudo objetivou analisar os consensos produzidos pelos ACS e ACE sobre estas ações integradas com a implantação da Portaria de Incorporação dos ACE nas equipes da Estratégia Saúde da Família (ESF). Trata-se de uma pesquisa qualitativa com a realização de grupo focal com profissionais de um município de grande porte e com endemia de dengue do Brasil. O encontro foi gravado e as falas transcritas por meio da Análise do Discurso do Sujeito Coletivo, com apoio do WebQDA. Os resultados apontam consenso em relação a: I) dificuldade no processo de integração do ACS e ACE para o controle da dengue; II) inclusão dos ACE na atenção primária na ESF; III) inexistencia de acompanhamento e avaliação das ações integradas. Conclui-se que é necessário sensibilizar os participantes, buscando mudanças de comportamento, oferecer um ambiente de suporte aos envolvidos com cursos de capacitação sobre dengue, acompanhar o processo de integração e avaliar periodicamente criando indicadores de qualidade e quantidade.


Abstract Dengue is one of Brazil’s most important public health challenges. Activities for its prevention and control have been based on the strategy of integrated management proposed in health policies, in which the central actors are the Endemic Disease Control Agent(ACE) and the Community Health Agent (ACS). This study analyzes consensus opinions produced by ACSs and ACEs on theactions for incorporating ACEs into the teams of the Family Health Strategy (ESF). It is a qualitative study from a large municipality in Brazil in which dengue is endemic, using a focus group of professionals that is subsequently analyzed using Collective Subject Discourse Analysis, supported by WebQDA. The results indicate consensus positions in relation to the following subjects: I) difficulty in the process of integration of ACSs and ACEs for control of dengue; II) inclusion of ACEs in the primary healthcare of the ESF; and III) absence of monitoring and assessment of the integrated actions. In conclusion, there are needs: to make participants more aware, seeking changes in behavior; to offer an environment of support to those involved with training courses about dengue; and to monitor the process of integration, and evaluate it periodically, creating indicators of quality and quantity.


Subject(s)
Humans , Community Health Workers , Consensus , Dengue/prevention & control , Endemic Diseases/prevention & control , Brazil/epidemiology , Dengue/epidemiology , Qualitative Research
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