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Introducción: Los brotes recurrentes de dengue subrayan la necesidad de abordajes más efectivos en la prevención y control de vectores. A menudo, las intervenciones se centran en un enfoque biomédico y de promoción de la salud desde un enfoque individual, sin integrar factores socioambientales ni ser evaluados científicamente Objetivo: Evaluar el impacto de la recolección de residuos domésticos de gran tamaño sobre potenciales criaderos de mosquitos transmisores del dengue en Asunción, Paraguay durante los años 2017 a 2021. Material y métodos: Estudio cuasiexperimental, longitudinal, donde se encuestaron 350 hogares, como línea de base durante el 2017 y una línea de cierre en 108 hogares en 2021. Se utilizó el método de Diferencia en Diferencia (DID) para comparar la presencia de criaderos antes y después de la intervención en 43 hogares intervenidos y 65 no intervenidos. Resultados: La recolección diferenciada fue utilizada principalmente por aquellos hogares que tenían una gran cantidad de residuos sólidos de gran tamaño, pero no para deshacerse de todos estos objetos, sino sólo de una parte (DID de -52% en el número total de criaderos y DID de 1% en número de hogares con criaderos). Encontramos una reducción significativa en el número de total de criaderos de gran tamaño, pero no observamos diferencias en el número total de hogares con criaderos. Factores subjetivos, como la creencia de que los objetos en desuso podrían llegar a ser útiles en el futuro explicaban en gran medida su presencia en los hogares, incluso con el servicio disponible. Conclusiones: El enfoque de la gestión municipal en los residuos voluminosos puede contribuir a la prevención del dengue por el hecho de que no constituyen residuos de generación rápida en los hogares, y su eliminación puede tener un impacto relativamente duradero. El factor subjetivo relacionado con la presencia de estos criaderos en los hogares debe ser objeto de mayores estudios.
Introduction: Recurrent dengue outbreaks underscore the need for more effective approaches to vector prevention and control. Often, interventions focus on a biomedical and health promotion approach from an individual approach, without integrating socio-environmental factors or being scientifically evaluated. Objetive: To evaluate the impact of large household waste collection on potential breeding sites of dengue-transmitting mosquitoes in Asuncion, Paraguay during the years 2017 to 2021. Material and methods: Quasi-experimental, longitudinal study, where 350 households were surveyed, as a baseline during 2017 and a closing line in 108 households in 2021. The Difference-in-Difference (DID) method was used to compare the presence of breeding sites before and after the intervention in 43 intervened and 65 non-intervened households. Results: Differentiated collection was mainly used by those households that had a large amount of large solid waste, but not to dispose of all these objects, but only part of them (DID of -52% in the total number of breeding sites and DID of 1% in the number of households with breeding sites). We found a significant reduction in the total number of large breeding sites but did not observe differences in the total number of households with breeding sites. Subjective factors, such as the belief that disused objects could become useful in the future, were largely responsible for the reduction in the number of large breeding sites. Conclusions: The municipal management approach to bulky waste can contribute to dengue prevention because it does not constitute rapidly generated waste in households, and its disposal can have a relatively long-lasting impact. The subjective factors related to the presence of these breeding sites in households warrant further study.
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Background: Non-communicable diseases continue to be an important public health problem in India. These diseases are responsible for a major proportion of morbidity and mortality. In view of this, study was conducted among patients suffering from non-communicable diseases attending outpatient department of an urban health training center of a medical college to know their profile. Methods: A cross-sectional study was conducted in the month of September, 2023 at an urban health training center. All the patients suffering from non-communicable diseases attending outpatient department during above month were included in the study using purposive sampling method. Predesigned and pretested proforma was used to collect the data. Data was analyzed using Microsoft Excel and appropriate statistical methods. The statistical level of significance was fixed at p<0.05. Results: 4670 new patients attended outpatient department, of which 269 (05.76%) were suffering from non-communicable diseases. 136 (52.92%) were suffering from hypertension, 105 (40.86%) were of diabetes, 07 (02.72%) were of stroke and 09 (03.50%) were of other non-communicable diseases. 12 (04.46%) patients were suffering from both hypertension and diabetes. 131 (50.97%) were above 60 years of age. 139 (54.09%) were males and 118 (45.91%) were females. 50 (19.46%) patients were illiterate while 207 (80.54%) were literate (p<0.05). 42 (16.34%) patients were having family history of non-communicable diseases. 40 (15.56%) and 62 (24.12%) patients were doing yoga and exercise respectively. 77 (29.96%) patients were smokers or consuming tobacco or alcohol. Conclusions: The growing problem of non-communicable diseases can be effectively controlled by empowerment of community through effective health education, utilizing services of trained health care workers, advanced health care services and social insurance.
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Introdução: a PrEP é uma estratégia de prevenção biomédica que consiste no uso de antirretrovirais (ARV) orais com o objetivo de mitigar o risco de adquirir o HIV e, consequentemente, de desenvolver a AIDS. O presente estudo tem como objetivo descrever o perfil sociodemográfico dos usuários com dispensação da PrEP no Ceará, no período de 2018 a 2023. Métodos: trata-se de um estudo transversal descritivo. Os dados foram obtidos por meio do Departamento de HIV/Aids, Tuberculose, Hepatites Virais e Infecções Sexualmente Transmissíveis (DATHI) do Ministério da Saúde por meio do Painel de monitoramento da PrEP. Resultados: observou-se um predomínio de usuários gays e homens que fazem sexo com homens, mas não se consideram gays; autodeclarados como pardos, com alta escolaridade e com faixa etária entre 30 e 39 anos. As dispensações da PrEP apresentaram progressão no período analisado, apesar dos anos de pandemia. Conclusão: embora a PrEP tenha-se mostrado eficaz no controle e declínio no número de infecções pelo HIV, esses dados demonstram que há uma lacuna entre quem se beneficia dela. É um desafio fazer com que a PrEP chegue a quem se pode beneficiar dela e com maior probabilidade de exposição ao HIV indivíduos de baixa escolaridade, pessoas trans, travestis, jovens adultos /adolescentes e não brancos.
Introduction: PrEP is a biomedical prevention strategy that consists of the use of oral antiretrovirals (ARV) to mitigate the risk of acquiring HIV and, consequently, of developing AIDS. The present study aims to describe the sociodemographic profile of users dispensed with PrEP in Ceará from 2018 to 2023. Methods: this is a descriptive cross-sectional study. The data was obtained from the Department of HIV/Aids, Tuberculosis, Viral Hepatitis, and Sexually Transmitted Infections (DATHI) of the Ministry of Health through the PrEP Monitoring Panel. Results: there was a predominance of Gay users and Men who have Sex with Men but do not consider themselves gay; they self-declared as mixed race, highly educated, and aged between 30 and 39 years old. PrEP dispensations showed progression in the period analyzed despite years of pandemic. Conclusion: although PrEP is effective in controlling and declining the number of HIV infections, these data demonstrate that there is a gap between who benefits from it. It is a challenge to make PrEP reach those who can most benefit from it and who are most likely to be exposed to HIV, individuals with low education, trans people, transvestites, young adults/adolescents, and non-whites.
Sujet(s)
Humains , Mâle , Adulte , Infections à VIH , Prophylaxie pré-exposition , Maladies sexuellement transmissibles , Études transversales , Syndrome d'immunodéficience acquise , VIH (Virus de l'Immunodéficience Humaine) , Antirétroviraux , Prévention des Maladies , Minorités sexuellesRÉSUMÉ
OBJECTIVE: To evaluate whether the attributes of Primary Healthcare are present in leprosy control actions in Londrina from Community Health Workers' (CHW) perspectives. METHOD: Observational and evaluative study. Data collection occurred between January and March 2020 in Londrina, Paraná, using the questionnaire "Primary Care Assessment Tool (PCATool) - Hansen's disease - CHW version" and a population-based census of 246 CHWs from 52 Primary Healthcare Units. The analyses used a cutoff point (≥ 6.6), central tendency, and dispersion measures. One-way ANOVA and Tukey's post hoc tests were used to analyze differences. Results: The general performance towards the primary healthcare attributes were evaluated as strong (mean = 6.95 / SD = 1.08) and the essential score (mean = 7.39 / SD = 1.0). On the other hand, the derived score was evaluated as poor (mean = 6.07 / sd = 1.06). Concerning the Access attribute, the rural zone had a lower score than the urban (mean = 4.47 / SD = 1.63). Conclusion: The study highlights issues that can be improved, such as first contact access, catalog of services offered to leprosy patients, information provided to the community, professional training, and differences in PHC performance between urban and rural regions.
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Humains , Mâle , Femelle , Adulte , Adulte d'âge moyen , Sujet âgé , Soins de santé primaires , Agents de santé communautaire , Lèpre/prévention et contrôle , Études transversalesRÉSUMÉ
Objective: to describe the epidemic curves and analyze the epidemiological profile of patients hospitalized with COVID-19 in a triple border city. Method: descriptive-quantitative. The population consisted of COVID-19 cases that required hospitalization, analyzing variables such as: age, gender, race/color, city where they lived, occupation, pregnant woman, institutionalized patient and evolution. Descriptive statistical analysis and analysis of variance and chi-square tests were used. Results: four epidemic curves were identified in the studied period. Among hospitalized cases, males predominated (55%). Cure was the most frequent outcome in curves 1, 2 and 4, but with no statistical difference (p = 0.2916). Curve 3 showed a higher frequency of deaths (41.70%) in relation to cures (38.77%). The mean ages were significantly different between the curves, with curve 4 having the lowest mean age. Conclusion: it was concluded that the epidemic curves were influenced by different situations; unvaccinated population, easing of restrictive measures, reopening of the Brazil-Paraguay border, interruption of control actions, crowding of people and circulation of new variants of the disease. Through the epidemiological profile of hospitalized patients, it was concluded that being male, of mixed race/color, aged between 61 and 85 years, and being deprived of freedom were associated with hospitalization and the occurrence of death.
Objetivo: describir las curvas epidémicas y analizar el perfil epidemiológico de los pacientes hospitalizados por COVID-19 en un municipio de triple frontera. Método: descriptivo-cuantitativo. La población se configuró de casos de COVID-19 que requirieron hospitalización, analizando variables como: edad, sexo, raza/color, municipio de residencia, ocupación, gestante, paciente institucionalizado y evolución. Se utilizó el análisis estadístico descriptivo y las pruebas de análisis de varianza y chi-cuadrado. Resultados: se identificaron cuatro curvas epidémicas en el período estudiado. Entre los casos hospitalizados, predominó el sexo masculino (55%). La cura fue el desenlace más frecuente en las curvas 1, 2 y 4, aunque sin diferencia estadística (p = 0,2916). La curva 3 presentó una mayor frecuencia de fallecimientos (41,70%) en relación a la cura (38,77%). El promedio de edad fue significativamente diferente entre las curvas, siendo que la curva 4 presentó el menor promedio de edad. Conclusión: se concluyó que las curvas epidémicas fueron influenciadas por diferentes situaciones; población no vacunada, flexibilización de las medidas restrictivas, reapertura de la frontera Brasil-Paraguay, interrupción de las acciones de control, aglomeración de personas y circulación de nuevas variantes. Por medio del perfil epidemiológico de los enfermos hospitalizados, se concluyó que ser del sexo masculino, de raza/color pardo, en el rango de edad de 61 a 85 años, estar privado de libertad se asociaron con la hospitalización y ocurrencia de fallecimiento.
Objetivo: descrever as curvas epidêmicas e analisar o perfil epidemiológico dos pacientes hospitalizados pela COVID-19 em um município de tríplice fronteira. Método: descritivo-quantitativo. A população configurou-se de casos de COVID-19 que necessitaram de hospitalização, analisando variáveis como: idade, sexo, raça/cor, município de residência, ocupação, gestante, paciente institucionalizado e evolução. Utilizou-se a análise estatística descritiva e os testes análise de variância e qui-quadrado. Resultados: identificaram-se quatro curvas epidêmicas no período estudado. Dentre os casos hospitalizados, predominou o sexo masculino (55%). A cura foi o desfecho mais frequente nas curvas 1, 2 e 4, porém sem diferença estatística (p = 0,2916). A curva 3 apresentou uma maior frequência de óbitos (41,70%) em relação à cura (38,77%). As médias de idade foram significativamente diferentes entre as curvas, sendo que a curva 4 apresentou a menor média de idade. Conclusão: concluiu-se que as curvas epidêmicas foram influenciadas por diferentes situações; população não vacinada, flexibilização das medidas restritivas, reabertura da fronteira Brasil-Paraguai, interrupção das ações de controle, aglomeração de pessoas e circulação de novas variantes. Por meio do perfil epidemiológico dos doentes hospitalizados, concluiu-se que ser do sexo masculino, de raça/cor parda, na faixa etária de 61 a 85 anos, estar privado de liberdade se associaram com a hospitalização e ocorrência de óbito.
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Objectives: This study aims to determine the differences in home physical conditions consisting of residential density, home ventilation, air humidity, room temperature and lighting, between TB and non-TB patients. Material and Method: This cross-sectional study used convenience sampling with 84 cases and 85 control group participants. The instruments used were an observation sheet, tape measure, digital thermohygrometer, and digital lux meter LX-90. Chi-square tests were used for data analysis. Results: Home environmental conditions were associated with the risk of TB transmission, namely residential density (p= 0.006/ OR= 3.811), house ventilation (p< 0.001/ OR= 51.066), air humidity (p= 0.001/ OR= 3.496), room temperature (p= 0.029/ OR= 3.046), and lighting (p< 0.001, OR= 54.175). Conclusions: The study found that all elements of the home physical environment have been shown to contribute significantly to tuberculosis transmission, so improving the home physical environment is necessary to control tuberculosis transmission.
Objetivos: Determinar las diferencias entre pacientes con y sin tuberculosis en las condiciones físicas de las residencias respecto a densidad residencial, ventilación residencial, humedad del aire, temperatura ambiente e iluminación. Material y Método: Este estudio transversal utilizó un muestreo intencional con 84 casos y 85 participantes del grupo control. Los instrumentos utilizados fueron hoja de observación, cinta métrica, termohigrómetro y luxómetro digitales LX-90. Se utilizaron pruebas de chi-cuadrado para el análisis de los datos. Resultados: Las condiciones ambientales del hogar están relacionadas con el riesgo de transmisión de tuberculosis, a saber: densidad residencial (p= 0,006/ OR= 3,811), ventilación de la casa (p< 0,001/ OR= 51,066), humedad del aire (p= 0,001/ OR= 3,496), temperatura ambiente (p= 0.029/ OR= 3,046) e iluminación (p< 0,001/ OR= 54,175). Conclusiones: Todos los elementos del entorno físico del hogar contribuyen significativamente a la transmisión de la tuberculosis, por lo que es necesario mejorar el entorno físico del hogar para controlar la transmisión de la tuberculosis.
O objetivo deste estudo é determinar as diferenças nas condições físicas das residências, consistindo em densidade residencial, ventilação residencial, umidade do ar, temperatura ambiente e iluminação entre pacientes com TB e não TB. Material e Método: Estudo transversal que utilizou amostragem intencional com 84 casos e 85 participantes do grupo controle. Os instrumentos utilizados foram folha de observação, fita métrica, termohigrômetro digital e luxímetro digital LX-90. Foram utilizados testes de qui-quadrado para análise dos dados. Resultados: As condições ambientais domiciliares estão relacionadas ao risco de transmissão de TB, nomeadamente densidade residencial (p= 0,006/ OR= 3,811), ventilação da casa (p <0,001/ OR= 51,066), umidade do ar (p= 0,001/ OR= 3,496), temperatura ambiente (p= 0,029/ OR= 3,046) e iluminação (p= <0,001/ OR= 54,175). Conclusões: O estudo concluiu que todos os elementos do ambiente físico da casa demonstraram contribuir significativamente para a transmissão da tuberculose, pelo que é necessário melhorar o ambiente físico da casa para controlar a transmissão da tuberculose.
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O estudo buscou compreender as percepções sobre a dengue em uma comunidade rural de Córdoba, Colômbia, com o objetivo de orientar ações específicas de enfermagem comunitária voltadas para o cuidado e a educação em saúde de pessoas, famílias e comunidades rurais. Foram realizadas 20 entrevistas semiestruturadas com chefes de família (13 homens e 7 mulheres), selecionados com base nos critérios de serem membros da comunidade há mais de 20 anos, se autoidentificarem como camponeses e terem no mínimo 18 anos de idade. O número de participantes foi determinado após alcançar a saturação teórica. As entrevistas foram transcritas e organizadas em uma matriz de análise para codificação, categorização e análise dos dados. Os achados revelaram três categorias analíticas: busca pelo conhecimento sobre a doença, práticas in situ e cuidados do passado e do presente. As famílias entrevistadas possuem conhecimento básico sobre a doença e o vetor causador, mantendo práticas familiares relacionadas ao uso de plantas medicinais para cuidados familiares e automedicação nas fases iniciais, devido à baixa percepção do risco. As famílias camponesas constroem representações socioculturais baseadas em solidariedade, apoio familiar e respeito pelo conhecimento dos idosos. A enfermagem é apresentada como ator essencial na coleta de práticas de cuidado para a elaboração e aplicação de planos de cuidado contextualizados de acordo com as necessidades do território. A pesquisa foi aprovada com o código SI-FCS-02-22, autorizando sua implementação.
The study sought to understand perceptions about dengue fever in a rural community in Córdoba, Colombia, with the aim of guiding specific community nursing actions aimed at health care and education for people, families and rural communities. 20 semi-structured interviews were carried out with heads of families (13 men and 7 women), selected based on the criteria of being members of the community for more than 20 years, self-identifying as peasants and being at least 18 years of age. The number of participants was determined after reaching theoretical saturation. The interviews were transcribed and organized into an analysis matrix for coding, categorization and data analysis. The findings revealed three analytical categories: search for knowledge about the disease, in situ practices and past and present care. The families interviewed have basic knowledge about the disease and the causative vector, maintaining family practices related to the use of medicinal plants for family care and self-medication in the early stages, due to low risk perception. Peasant families build sociocultural representations based on solidarity, family support and respect for the knowledge of the elderly. Nursing is presented as an essential actor in the collection of care practices for the elaboration and application of care plans contextualized according to the needs of the territory. The research was approved with code SI-FCS-02-22, authorizing its implementation.
El estudio buscó comprender las percepciones sobre el dengue en una comunidad rural de Córdoba, Colombia, para orientar acciones específicas de Enfermería comunitaria sobre cuidado y educación en salud para personas, familias y comunidades rurales, mediante la realización de 20 entrevistas semiestructuradas a los jefes de familia (13 hombres y 7 mujeres), seleccionados a partir de los siguientes criterios: miembros de la comunidad con permanencia de más de 20 años, autorreconocerse como campesinos y tener mínimo 18 años. El número de participantes se obtuvo una vez se alcanzó el punto de saturación teórica. Las entrevistas fueron transcritas y organizadas en una matriz de análisis para su codificación, categorización y análisis. Los hallazgos arrojaron tres categorías analíticas: en búsqueda del conocimiento acerca de la enfermedad, las praxis in situ y cuidados del ayer y del hoy. Las familias entrevistadas poseen conocimiento básico sobre la enfermedad y el vector que la causa, conservan prácticas familiares relacionadas con el uso de plantas medicinales para el cuidado familiar y la automedicación en las fases iniciales ante la baja percepción del riesgo. Las familias campesinas construyen representaciones socioculturales a partir de la solidaridad, apoyo familiar y respeto por el conocimiento de los adultos mayores. Se presenta a Enfermería como actor esencial en la recopilación de prácticas de cuidado para la elaboración y aplicación de los planes de cuidado contextualizados y de cara a las necesidades del territorio. La investigación fue aprobada con el código SI-FCS-02-22, a partir del cual se autoriza su implementación.
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Background: Non-communicable diseases (NCD) are becoming a larger concern for individuals and the healthcare system. Poor diet and sedentary lifestyle are becoming more prevalent. Digital technologies have the potential to be useful tools for managing NCDs and altering health-related behaviours. Objectives were to estimate the proportion of users of digital technology for health, to know the type of digital devices use for health and to know the reasons and barriers of using and non-using it for health. Methods: A cross sectional study was conducted among 303 people whose age more than fourteen year residing at one area of Ektanagar urban health centre of central Gujrat by doing house to house survey from July 2022 to August 2022. Data was collected by using semi-structured questionnaire in local language based on socio-demographic characteristics, various types of digital technology and reasons and barriers of using and non-using digital technology. Data was entered in MS excel sheet and was analysed using Medcalc software. Results: Around 55% were male, mean age was 42.2 year. Only 33% were using digital technology. Among them more than half around 62% were using it because they were health conscious. Among users not having time and non-affordability to use digital devices are an important reason for non-usage. Conclusions: Majority were not using digital technology for improving their health. Health consciousness was the main reason behind usage. Main barriers of usage are non-affordability and not having time to use the devices.
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El asma bronquial sigue siendo la enfermedad crónica más frecuente en la infancia. Su prevalencia continúa aumentando a pesar de que en la actualidad se disponen de eficaces manuales terapéuticos para el correcto manejo de los principales síntomas de la enfermedad. El tratamiento no farmacológico de este padecimiento se fundamenta en tres pilares esenciales: la educación sobre la enfermedad, las guías para profesionales y pacientes y la fisioterapia respiratoria. Los pacientes que tienen un tratamiento fisioterapéutico y rehabilitador de manera habitual, tienen una mejoría significativa en el control del asma, especialmente si estos se practican bajo la supervisión de un fisioterapeuta. Los beneficios que los pacientes asmáticos logran con la fisioterapia y la rehabilitación son numerosos y uno de los efectos más importante es el impacto positivo sobre la calidad de vida.
Bronchial asthma continues to be the most common chronic disease in childhood. Its prevalence continues to increase despite the fact that effective therapeutic manuals are currently available for the correct management of the main symptoms of the disease. The non-pharmacological treatment of this condition is based on three pillars: education about the disease, guides for professionals and patients, and respiratory physiotherapy. Patients who have regular physiotherapy and rehabilitation treatment have a significant improvement in asthma control, especially if these are practiced under the supervision of a physiotherapist. The benefits that asthmatic patients achieve with physiotherapy and rehabilitation are numerous and one of the most important effects is the positive impact on quality of life.
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Background: Primary hypertension is becoming common among apparently healthy children. Measures for early diagnosis of pre hypertension and hypertension along with its risk factors during childhood could benefit from earlier intervention and follow-up. Methods: This cross sectional study was conducted among 270 urban school students of Belagavi of class 10th in 2016 by using a structured questionnaire followed by anthropometry and blood pressure measurement. Results: About 39% of children had family history of hypertension and 27% had family history of chronic diseases. Majority had inadequate consumption of vegetables (84.07%) and fruits (83.70%). The overall physical activity among the students was inadequate (78.15%) and about 46.30% of them got easily angered, stressed or irritated. The waist circumference of 14.07% students was falling in obese category. About 11.48% of them were overweight and 7.04% were obese according to their body mass index. Among the students, 71.85% had normal blood pressure and 18.15% had pre-hypertension. Hypertension was detected among 10.00% of students of which 5.56% belonged to stage I and 4.44% belonged to stage II hypertension. Statistical association between the blood pressures of school children showed significance with family history of chronic diseases (p=0.025), body mass index and waist circumference (p<0.001). Conclusions: One tenth of the children had hypertension and one fifth of the children had pre-hypertension. The children who were obese had increased blood pressure than those with normal weight. Health promotion at early phase of life can help in the prevention of hypertension.
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Introducción. Las tasas de éxito del tratamiento de la tuberculosis continúan siendo subóptimas. Objetivo. Identificar los factores asociados al tratamiento no exitoso para tuberculosis en pacientes con antecedentes de tratamiento para la tuberculosis. Materiales y métodos. Se realizó un estudio observacional retrospectivo, analítico, de cohorte de pacientes que reingresaron a un programa de micobacterias en Cali, Colombia. Se incluyeron mayores de 15 años con tuberculosis pulmonar entre el 2015 y el 2019 con antecedentes de tratamiento para la tuberculosis. Se excluyeron los pacientes con tuberculosis resistente. Resultados. Ingresaron 605 pacientes con antecedentes de tratamiento, 60 % por tratamiento inconcluso y 40 % por recaída. En comparación con los pacientes que reingresaron por recaída (ORa= 2,34; IC=1,62-3,38), las variables que explicaron de manera independiente el no tener éxito con el tratamiento para la tuberculosis al egreso fueron: estar en situación de calle (ORa = 2,45; IC = 1,54-3,89), ser farmacodependiente (ORa = 1,95; IC=1,24-3,05), tener coinfección tuberculosis/VIH (ORa = 1,69; IC =1,00- 2,86) o diabetes (ORa =1,89; IC=1,29-2,77), y el incumplimiento de un tratamiento previo por pérdida de seguimiento, abandono u otras causas. Las variables programáticas que favorecieron el éxito del tratamiento fueron la asesoría de la prueba voluntaria de VIH (p < 0,001) y la realización de la prueba de VIH (p < 0,001). Conclusión. Estar en situación de calle, ser farmacodependiente, tener coinfección de tuberculosis y VIH, o diabetes, así como el incumplimiento del tratamiento previo por pérdida del seguimiento, abandono o fracaso del mismo, dificultaron el éxito del tratamiento antituberculoso. En la primera atención al reingreso de los pacientes con tuberculosis se deben identificar y abordar estas características.
Introduction. The success rates in the treatment of tuberculosis are suboptimal. Objective. To identify associated factors with the lack of success of antituberculosis treatment in patients with a tuberculosis treatment history. Materials and methods. We performed a retrospective, analytical, observational, and cohort study of patients reentering the Mycobacterium program in Cali, Colombia. We included patients over 15 years old with pulmonary tuberculosis between 2015 and 2019 and a history of tuberculosis treatment. Patients with drug-resistant tuberculosis were excluded. Results. A total of 605 patients with a treatment history were included, 60% due to unfinished treatment and 40% due to relapse. Compared to patients reentering due to relapse (ORa=2.34, CI=1.62-3.38), the independent variables associated with treatment failure at discharge were homelessness (ORa=2.45, CI=1.54-3.89), substance dependence (ORa=1.95, CI=1.24-3.05), tuberculosis/HIV coinfection (ORa=1.69, CI=1.00-2.86), diabetes (ORa=1.89, CI=1.29-2.77), and unfinished previous tuberculosis treatment due to follow-up loss, abandonment, or other causes. Programmatic variables favoring treatment success were voluntary HIV testing counseling (p<0.001) and HIV testing (p<0.001). Conclusion. Homelessness, substance dependence, tuberculosis/HIV coinfection, diabetes, and incomplete previous treatment due to loss to follow-up, abandonment, or treatment failure hindered the success of antituberculosis. These characteristics should be identified and addressed during the initial care of patients reentering treatment for tuberculosis.
Sujet(s)
Tuberculose , Tuberculose pulmonaire , Facteurs épidémiologiques , Contrôle des maladies transmissibles , Adhésion et observance thérapeutiques , Accessibilité des services de santéRÉSUMÉ
La equinococosis quística es una zoonosis de origen parasitario con distribución cosmopolita. En nuestro país continúa siendo una enfermedad endémica, afectando principalmente pequeños centros poblados y áreas rurales pobres relacionadas a la producción ovina. Los planes de control requieren de un abordaje holístico, con la participación de diferentes instituciones, profesionales y en especial de la comunidad. La cooperación regional busca monitorizar el avance de la enfermedad y centrar las medidas de acción sobre cuatro ejes, definidos según los puntos de intervención más comunes para la quiebra del ciclo de transmisión y la consecuente reducción en incidencia y prevalencia de la enfermedad. La presente revisión utilizó literatura obtenida en diferentes bases de datos, bibliotecas virtuales y sitios web regionales y locales con el objetivo describir las principales estrategias de control, vigilancia y prevención aplicadas actualmente en nuestro país.
Cystic echinococcosis is a zoonosis of parasitic origin with cosmopolitan distribution. In our country it continues to be an endemic disease, affecting mainly small population centers and poor rural areas related to sheep production. Control plans require a holistic approach, with the participation of different institutions, professionals and especially the community. Regional cooperation seeks to monitor the progress of the disease and focus action measures on four axes, defined according to the most common points of intervention to break the transmission cycle and consequently reduce the incidence and prevalence of the disease. This review used literature obtained from different databases, virtual libraries and regional and local websites with the aim of describing the main control, surveillance and prevention strategies currently applied in our country.
A equinococose cística é uma zoonose de origem parasitária com distribuição cosmopolita. Em nosso país, continua a ser uma doença endêmica, afetando principalmente pequenos centros populacionais e áreas rurais pobres relacionadas à produção de ovinos. Os planos de controle exigem uma abordagem holística, com a participação de diferentes instituições, profissionais e, principalmente, da comunidade. A cooperação regional busca monitorar o progresso da doença e concentrar as medidas de ação em quatro eixos, definidos de acordo com os pontos de intervenção mais comuns para interromper o ciclo de transmissão e, consequentemente, reduzir a incidência e a prevalência da doença. Esta revisão utilizou a literatura obtida em diferentes bases de dados, bibliotecas virtuais e sites regionais e locais com o objetivo de descrever as principais estratégias de controle, vigilância e prevenção aplicadas atualmente em nosso país.
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Humains , Animaux , Surveilance de Santé , Échinococcose/prévention et contrôle , Surveillance des zoonoses , Uruguay/épidémiologie , Échinococcose/diagnosticRÉSUMÉ
Introducción: La tuberculosis es una de las principales causas de morbimortalidad en todo el mundo. Las medidas de prevención son clave para evitar su propagación y el contagio entre profesionales de salud. Objetivo: Determinar las actitudes del autocuidado sobre la tuberculosis en el personal de enfermería luego de un brote infeccioso hospitalario. Métodos: Estudio transversal, en personal de enfermería (n= 94; personal técnico n= 44; 46,8 %). Se incluyó al personal de enfermería voluntario > 18 años, de ambos sexos, que trabaje en el Departamento de Emergencia. Se usó el cuestionario de 15 ítems de Valle (2017), para estimar los conocimientos y actitudes sobre el autocuidado, 3 dimensiones: prevención, diagnóstico y tratamiento de la tuberculosis. Resultados: El promedio de edad de los participantes fue de 44,7 ± 8,8 años, el 88,3 % mujeres y el tiempo promedio de trabajo fue 11,2 ± 7,8 años. Se hallaron diferencias entre los años de servicio, entre los técnicos (8,55 ± 7,94 años) y profesionales (13,48 ± 6,98 años) (p< 0,001). El 100 % presentaron actitudes de aceptación del autocuidado en todas las dimensiones. El 4,5 % y el 27,3 % de técnicos presentaron actitudes de indiferencia en la dimensión diagnóstico y tratamiento de tuberculosis (p= 0,001). Conclusiones: Existen actitudes favorables en el personal de enfermería sobre autocuidado de la tuberculosis luego de un brote en un hospital de Lima, aunque en técnicos de enfermería se reportan actitudes de indiferencia en el diagnóstico y tratamiento de tuberculosis.
Introduction: Tuberculosis continues to be one of the main causes of morbidity and mortality worldwide. Prevention measures are key to prevent its spread and contagion among health professionals. The objective of the present study was to determine the self-care attitudes about tuberculosis in the nursing staff after a hospital infectious outbreak in Perú. Method: A cross-sectional study was conducted in nursing staff (n= 94; technical staff n= 44, 46.8%). Volunteer nursing staff > 18 years old, of both sexes, and who work in the Emergency Department were included. The 15-item questionnaire from Valle (2017) was used to estimate knowledge and attitudes about self-care in nursing staff in 3 dimensions: prevention, diagnosis and treatment of tuberculosis. Results: The average age of the participants was 44.7±8.8 years, 88.3 % were women, and the average working time was 11.2 ± 7.8 years. Difference was found between the years of service, among technicians (8.55 ± 7.94 years) and nursing professionals (13.48 ± 6.98 years) (p< 0.001). A hundred percent of nurses presented attitudes of acceptance of self-care in all dimensions; 4.5 % and 27.3% of nursing technicians presented attitudes of indifference in the tuberculosis diagnosis and treatment dimension (p= 0.001). Conclusions: There are favorable attitudes in the nursing staff about self-care of tuberculosis after an outbreak in a hospital in Lima, although in nursing technicians we report attitudes of indifference in the diagnosis and treatment of tuberculosis.
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Background: Hypertension has not just remained the disease of adults, but the prevalence is also increasing in children and adolescents. Knowledge of the predisposing risk factors of hypertension is an important step in the modification of lifestyle behaviours to prevent further morbidity and mortality. Methods: This cross sectional study was conducted among 270 students of 10th standard, belonging to 3 urban schools of Belagavi in 2016 using a structured questionnaire with an intention to assess their knowledge regarding hypertension and its risk factors. Results: Majority students (69.26%) belonged to class II and III of B.G Prasad socio-economic status and 70.37% came from nuclear family. While headache (80%) was the most answered symptom, heart diseases (67%) was the commonly answered complication. Most students had good knowledge regarding prevention and risk factors like unhealthy diet, physical inactivity etc. Majority had fair knowledge about general factors (54.81%), symptoms (41.11%) and complications (34.11%). Knowledge about stress factors (46.67%) and preventive measures (62.22%) was very good. All these differences were statistically significant (p<0.001). Conclusions: The overall knowledge about hypertension and its risk factors among the school students was good (68.52%) and there was significant association between the overall knowledge levels with the mothers education and family history of chronic diseases.
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Hypertension is an important worldwide public-health challenge and it is accountable for 7% of Disability Ad-justed Life Years (DALY) loss, and by the end of 2025 about 29% of world’s population is likely to suffer from hypertension. Tribal population constitute about 8% of the total population in India. Among tribal population, study on hypertension will provide an interesting outcome because studies across the world have shown a lower prevalence. The objective of the study was to estimate the pooled prevalence of hypertension among adult tribal populations in India and also to analyse the possible sources of heterogeneity in the estimate. A systematic search was performed in PubMed, Google scholar, Scopus, Embase MEDLINE, and journals for arti-cles published between 2001 and 2020. This is a systematic review and meta-analysis done on hypertension among tribal populations of India. Three authors independently reviewed the articles, performed quality as-sessment and data was extracted. Pooled estimate of hypertension was calculated. Subgroup analyses was performed. A total of 26 articles with a total number of subjects of 75,543 were included in the study. The pooled estimate of hypertension prevalence was 25.1% (95% CI: 24.7, 25.4). There was significant heteroge-neity among the studies (I2 = 98.2 and Q = 1289.37). It is essential to conduct larger cohort studies and ran-domised controlled trials to determine the causes of the increased prevalence of hypertension among the tribal population. The prevalence of hypertension among tribal population are essential as a source of prima-ry information and for rational planning of health services and will help public-health policy-makers to assign sufficient priority and resources for its management and prevention.
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Objetivo: analisar como as recomendações sobre adesão terapêutica presentes em manuais de controle da tuberculose constituem estratégias biopolíticas de Promoção da Saúde na vertente neoliberal. Método: pesquisa documental e qualitativa que analisou cinco manuais publicados entre 2002 e 2019, a partir da metodologia pós-crítica de inspiração foucaultiana. Resultados: foram identificadas quatro estratégias biopolíticas, que correspondem às categorias analítica deste estudo: i) Exaltação do saber da estatística como fortalecimento da lógica gerencialista; ii) Priorização do tratamento dos casos bacilíferos e instituição de medidas de controle do risco da contaminação como forma de manter a segurança da população saudável; iii) Ênfase discursiva na população vulnerável como forma de omitir corpos precarizados; e iv) Discurso do empreendimento de si para superação da pobreza, como compensação da falta de políticas de proteção social. Conclusões: algumas recomendações de controle da tuberculose consistem em estratégias biopolíticas de Promoção da Saúde na vertente neoliberal, promovendo discursos sanitários que enfatizam os aspectos individuais, como o autocuidado, a autorresponsabilização, a autonomia e o empoderamento do sujeito. Mesmo nos casos em que percebemos associação do adoecimento com determinantes sociais da saúde e com situações de vulnerabilidade, as ações de controle da tuberculose insistem em ações inscritas numa perspectiva gerencialista da saúde. Na prática, parece haver um vazio de políticas de proteção social e de ações capazes de combater as iniquidades, o que é imprescindível para a efetiva adesão terapêutica e para a cura.(AU)
Objective: to analyze how the recommendations on therapeutic adherence present in tuberculosis control manuals constitute biopolitical Health Promotion strategies in the neoliberal perspective. Method: documentary and qualitative research that analyzed five manuals published between 2002 and 2019, based on the post-critical methodology inspired by Foucault. Results: four biopolitical strategies were identified, which correspond to the analytical categories of this study: i) Exaltation of statistical knowledge as a strengthening of managerial logic; ii) Prioritizing the treatment of bacilliferous cases and establishing measures to control the risk of contamination as a way of maintaining the safety of the healthy population; iii) Discursive emphasis on the vulnerable population as a way of omitting precarious bodies; and iv) Discourse about self-employment to overcome poverty, as compensation for the lack of social protection policies. Conclusions: some recommendations for tuberculosis control consist of biopolitical Health Promotion strategies in a neoliberal perspective, promoting health discourses that emphasize individual aspects, such as self-care, self-responsibility, autonomy, and empowerment of the subject. Even in cases where we perceive an association between illness and social determinants of health and situations of vulnerability, tuberculosis control actions insist on actions based on a health managerial perspective. In practice, there appears to be a lack of social protection policies and actions capable of combating inequities, which is essential for effective therapeutic adherence and cure.(AU)
Objetivo: el propósito es examinar de qué manera las directrices sobre el cumplimiento terapéutico en los manuales de control de la tuberculosis representan estrategias biopolíticas de Promoción de la Salud en el contexto neoliberal. Método:Se llevó a cabo una investigación documental cualitativa que analizó cinco Manuales publicados entre 2002 y 2019, utilizando un enfoque postcrítico inspirado en las ideas de Foucault.Resultados: se identificaron cuatro tácticas biopolíticas (categorías de análisis): 1) Enfatizar el valor del conocimiento estadístico como refuerzo de la lógica administrativa; 2) Priorizar el tratamiento de los casos con bacilos y establecer medidas de control del riesgo de contagio para salvaguardar a la población sana; 3) Poner un énfasis discursivo en la población vulnerable para dejar de lado a los cuerpos en situación precaria; y 4) Promover el autoempleo como solución para superar la pobreza, en sustitución de políticas de protección social insuficientes.Conclusiones: algunas recomendaciones dirigidas al control de la tuberculosis adoptan tácticas biopolíticas de fomento de la salud en el marco neoliberal, empleando discursos relacionados con la salud que ponen un énfasis en aspectos individuales como el autocuidado, la asunción de responsabilidad personal, la autonomía y el empoderamiento del individuo. Aun en situaciones en las que se percibe una correlación entre la enfermedad y los factores sociales que afectan la salud, así como con contextos de vulnerabilidad, las medidas de control de la tuberculosis siguen promoviendo enfoques alineados con una perspectiva de gestión...(AU)
Sujet(s)
Humains , Stratégies de Santé , Déterminants sociaux de la santé , Adhésion et observance thérapeutiques , Promotion de la santé , Observance par le patient , Recommandations comme sujet , Vulnérabilité Aux Catastrophes , Politique de santéRÉSUMÉ
ObjectiveBy using bibliometrics and scientific knowledge mapping technology, this study systematically combs and visually analyzes the research hotspots, frontiers and trends of infectious disease prevention and control in China in the past 30 years, summarizes the research direction in this field, combs the knowledge structure, and provides guidance and reference for subsequent research. MethodsThe databases of CNKI and Wanfang were searched by ("infectious diseases" or " communicable diseases") and "prevention and control" not "chronic diseases", The bibliometric software VOSviewer 1.68 and CiteSpace 5.8.3 were used to analyze the co-occurrence network of scientific knowledge maps from the keywords, emerging words, research authors, institutions and other aspects, and summarized the research hotspots, frontiers and trends in the field of infectious disease prevention and control in China. ResultsA total of 10 777 literatures were retrieved, and 7 676 literatures were included after screening. From the perspective of research trend, the number of published literatures in the field of infectious disease prevention and control in China showed an overall upward trend, and the number of studies was closely related to the outbreak of infectious diseases. The Chinese Center for Disease Control and Prevention has played a leading role in the research. In terms of researchers' cooperation, Hao Mo, Li Chengyue, Wang Ying and others from Fudan University were the main researchers' cooperation teams. Tu Wenxiao, Meng Ling and Xiang Nijuan from the Chinese Center for Disease Control and Prevention were the main researchers. Wang Quanyi, Li Xinyu, Wang Xiaoli from the Beijing Center for Disease Control and Prevention were the main researchers' research teams. Yang Zhicong, Li Meixia, Luo Lei and other research teams from Guangzhou Center for Disease Control and Prevention have formed a relatively obvious cooperation network. Analysis of the keyword cluster atlas showed that the articles related to the prevention and control of infectious diseases mainly were focused on the epidemiology of new coronavirus infection (new infectious diseases), school infectious diseases, common infectious diseases, and the related research of vector infectious diseases. The analysis of salient words indicated the research focus and trend change in different time periods. At present, the research focus and frontier in the field of infectious diseases are mainly concentrated in the field of prevention and control of new infectious diseases, such as the monitoring, early warning, reporting, emergency management, laws and regulations of the new coronavirus infection. ConclusionOur country attaches great importance to the prevention and control of infectious diseases, with extensive and in-depth research hotspots. In particular, research on emerging infectious diseases has developed rapidly and achieved remarkable results. With the application of molecular biology, big data, AI and other technologies in the field of infectious disease prevention and control, China's infectious disease prevention and control capabilities will be greatly improved. At the same time, it is necessary to strengthen the linkage between universities, disease control institutions, and medical institutions, and establish and improve a long-term normal prevention and control mechanism.
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Objective To evaluate the quality of infectious disease surveillance data and provide scientific basis for improving data quality and health decision-making. Methods The comprehensive index of infectious disease monitoring system evaluation and the integrity, accuracy and reliability of infectious disease report data were used to evaluate the quality of infectious disease monitoring data in multiple dimensions. Results In 2021, The comprehensive evaluation index of infectious disease surveillance system was 98.40%. In terms of data integrity, 1 105 data were missing, and the incomplete rate was 1.46%; In terms of data accuracy, 1978 cases were not accurately, rate of accuracy was 26.72%; In terms of data reliability, the card reporting rate of tertiary medical institutions accounted for 67.05%, the diagnosis rate of confirmed cases was 27.74%, and the correction rate of report card was 28.48%. Conclusion The accuracy and reliability of infectious disease data are insufficient, and new methods for infectious disease monitoring data quality are expanded to make up for the lack of data quality evaluation of the current national epidemic system.
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With the development of perinatal medicine in China for more than 30 years, great progress has been made in the fight against infectious diseases associated with pregnancy, including better knowledge, improved clinical treatment, and more effective preventive measures. This article reviews and prospects the prevention and treatment of infectious diseases in pregnancy in China from the four aspects: mother-to-child transmission of acquired immune deficiency syndrome, syphilis, and hepatitis B; toxoplasma, others, rubella virus, cytomegalovirus, and herpes simplex virus infection; influenza and novel coronavirus infection; and sepsis.
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The incidence and mortality of infectious diseases are high among neonates owing to the immature development of various organ systems, thereby prevention and control are critical. This paper summarizes the epidemiological characteristics, prevention strategies, current problems, and challenges in neonatal infectious diseases and emphasizes the important role of continuous quality improvement in the prevention of neonatal infectious diseases.