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ABSTRACT Background: Malaria is a parasitosis conditioned by several factors. This study sought to analyze the spatial distribution of malaria considering environmental, socioeconomic, and political variables in São Félix do Xingu, Pará, Brazil, from 2014 to 2020. Methods: Epidemiological, cartographic, and environmental data were obtained from the Ministry of Health, Brazilian Geographical and Statistical Institute, and National Space Research Institute. Statistical and spatial distribution analyses were performed using chi-squared tests of expected equal proportions and the kernel and bivariate global Moran's techniques with Bioestat 5.0 and ArcGIS 10.5.1. Results: The highest percentage of cases occurred in adult males with brown skin color, mainly placer miners, with a primary education level, living in rural areas, who were infected with Plasmodium vivax and with parasitemia of two or three crosses as diagnosed by the thick drop/smear test. The disease had a non-homogeneous distribution, with distinct annual parasite indices associated with administrative districts and clusters of cases in locations with deforestation, mining, and pastures close to Conservation Units and Indigenous Lands. Thus, a direct relationship between areas with cases and environmental degradation associated with land use was demonstrated, along with the precarious availability of health services. Pressure on protected areas and epidemiological silence in Indigenous Lands were also noted. Conclusions: Environmental and socioeconomic circuits were identified for development of diseases associated with precarious health services in the municipality. These findings highlight the need to intensify malaria surveillance and contribute to the systematic knowledge of malaria's epidemiology by considering the complexity of its conditioning factors.
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Resumo: Introdução: A parada cardiorrespiratória (PCR) é caracterizada pela interrupção brusca da circulação sistêmica e da respiração. Devido à redução de oxigênio e de nutrientes para os tecidos corporais, há maior risco de morte do indivíduo, o que torna a PCR uma grave emergência médica. Nesse contexto, a correta realização do suporte básico de vida no atendimento pré-hospitalar (APH) é de fundamental importância para diminuir a taxa de mortalidade e as sequelas em vítimas de PCR. Considerando a importância do assunto no ensino médico, o presente estudo teve o objetivo de identificar os conhecimentos dos estudantes de medicina sobre o tema, de modo a verificar se os discentes reconhecem os sinais indicativos de parada cardiorrespiratória; a sequência de medidas aplicadas durante o atendimento pré-hospitalar de vítimas em PCR e as técnicas indicadas para prestação do atendimento. Método: Trata-se de uma abordagem observacional, exploratória, descritiva e quantitativa, com uma amostra constituída por 245 alunos do curso de medicina da Universidade Estadual do Pará. Na realização da coleta de dados foi utilizado um questionário contendo 18 questões, aplicado por meio da Plataforma Google Forms. Resultados: O conhecimento foi satisfatório, com acertos significativos nos semestres mais avançados do curso. Os conhecimentos mais limitados incluíram o manejo da técnica de compressão, uso correto do DEA e manobras de retificação das vias aéreas. Conclusões: Apesar da quantidade significativa de acertos, observou-se a necessidade de uma melhor abordagem do tema durante a formação médica, a fim de possibilitar a correta realização do atendimento pré-hospitalar às vítimas de PCR, haja vista sua importância nos cenários de urgência e emergência.
Abstract: Introduction: Cardiorespiratory Arrest (CRA) is characterized as an interruption or reduction of mechanical activity of the heart and breath activity. As a result of reduction of oxygen and nutrients for the corporal tissue, there is risk of death, which makes the CRA a severe medical emergency. In this context, the correct performance of basic life support in prehospital treatment is of fundamental importance to diminish the mortality rate and complications in CRA victims. Considering the importance of the topic in medical teaching, the present study was aimed at identifying the knowledge of medical students about the subject, in a way to verify whether the students know how to identify the signals that indicate a cardiorespiratory arrest, the sequence of measures applied during the prehospital care of CRA victims, and the adequate techniques for the medical procedure. Method: The present study adopted an observational, exploratory, descriptive and quantitative approach, with a sample of 245 students of the medicine course at Universidade Estadual do Pará. To collect the samples, one quiz containing 18 questions was used and applied with Google Forms. Results: The knowledge of the students was satisfactory, with significant increase of performance at later periods of the course. The more limited knowledge included the management of compression techniques; the correct use of the automated external defibrillator (AED) and airway management. Conclusions: Although there was a high amount of hits, the necessity of a better approach on the topic was observed during medical training, to enable the correct prehospital treatment of CRA victims, due to the importance of such procedure in medical emergency.