Spatial distribution of leprosy in municipalities of the state of Goiás in the year 2020

Leprosy is a chronic infectious disease caused by an acid-resistant bacillus called Mycobacterium leprae and the disease is characterized by its slow multiplication, with an excessively long incubation period. The objective of the research was to evaluate the spatial distribution of leprosy cases among the municipalities of the State of Goiás in 2020. This is a descriptive study and the data collection took place from the Notifiable Diseases Information System (SINAN) in November, 2021 and it considered the diagnosis´ year and the patient's municipality of residence. The following indicators were adopted in the analysis: a) annual prevalence rate per 10,000 inhabitants; b) annual rate of new cases detection in the general population; and c) annual rate of new cases detection in individuals under 15 years of age, these last two per 100,000 inhabitants. The analysis of the spatial occurrence pattern of leprosy in Goiás State municipalities was carried out in the free software Terraview version 4.2.2. A higher prevalence of distribution of the gross rate of the disease was observed in the Central-North and Central-West macro-regions, with a concentration of cases also in the Northeast region of the State. From the 246 Goiás municipalities, 68.7% (n = 169) had cases of leprosy, 18.3% (n = 45) were in a situation of hyperendemia and 23.2% (n = 57) had a very high detection coefficient. Considering the rate of detection in those people under 15 years of age, only 11 municipalities (4.5%) were in a situation of hyperendemia and 1.2% (n = 3) had a very high detection coefficient (5.00 to 9.99/ 10.000 inhabitants). The current investigation indicates the maintenance of leprosy hyperendemic areas in the State of Goiás, when compared to previous studies. This finding highlights the importance of readjustment of leprosy management and assistance in municipalities at greater risk of leprosy hyperendemicity in order to interrupt the M. leprae transmission chain.

Educação permanente em saúde: práticas desenvolvidas nos municípios do estado de Goiás / Ongoing education in health: practices developed in the unicipalities of the state of Goiás, Brazil / Educación continua en salud: prácticas desarrolladas en los unicipios del estado de Goiás, Brasil

Resumo A educação permanente em saúde é orientadora de processos significativos de aprendizagem e propõe a produção de resultados efetivos nas ações de saúde. O estudo teve por objetivo delinear o perfil das práticas de educação permanente em saúde nos municípios de Goiás, na perspectiva dos representantes da área. Esta pesquisa transversal utilizou questionário semiestruturado, respondido online pelos participantes. A maioria dos informantes é referência local da educação permanente em saúde (68,9%), são enfermeiros e com função de Coordenadores da Atenção Primária (31,8%). Predominaram municípios que identificam a existência de educação permanente em saúde em seu território (66,2%). Em geral, as ações são promovidas pelo próprio município (61,3%) ou pela regional de saúde (37,9%), destacando-se a educação continuada, seguida da (re)organização dos processos de trabalho e a educação em saúde. Fatores atitudinais, de relações interpessoais e de recursos humanos foram apontados como os desafios mais frequentes. Com base nesse diagnóstico, entende-se que a maioria dos problemas identificados é passível de intervenção. Este estudo apresenta subsídios para planejamento estratégico de educação permanente em saúde, apoio às instâncias responsáveis pelo seu fomento e gerenciamento nos municípios, bem como fortalecimento de suas ações nos serviços de saúde.

Abstract Ongoing education in health guides significant learning processes, and proposes the production of effective results in health actions. This study had the goal of outlining the profile of the practices of ongoing education in health in the municipalities of the state of Goiás, Brazil, under the perspective of the representatives of the field. The present cross-sectional research used a semi-structured questionnaire that was filled out online by the participants. Most of the respondents are local references regarding ongoing education in health (68.9%); they are nurses who also work as primary care coordinators (31.8%). There was a predominance of municipalities that identify the existence of ongoing education in their territories (66.2%). In general, the actions are promoted by the municipalities themselves (61.3%) or by the regional health department (37.9%), and ongoing education stands out, followed by the (re)organization of the work processes and education in health. Factors regarding attitude, interpersonal relationships and human resources were pointed out as the most frequent challenges. Based on this diagnosis, we understand that most of the problems identified could be subjected to intervention. This study provides inputs for the strategic planning of ongoing education in health, for the support to the agencies responsible for its promotion and management in the municipalities, and to strengthen the ongoing education actions in the health services.

Resumen La educación continua en salud es orientadora de procesos significativos de aprendizaje, y propone la producción de resultados efectivos en las acciones de salud. El estudio tuvo el objetivo de describir el perfil de las prácticas de educación continua en salud en los municipios del estado de Goiás, Brasil, bajo la perspectiva de los representantes del área. Esta investigación transversal utilizó un cuestionario semiestructurado, contestado online por los participantes. La mayoría de los informantes es referencia local de la educación continua en salud (68,9%); son enfermeros que tienen la función de coordinadores de la atención primaria (31,8%). Predominaron municipios que identifican la existencia de educación continua en salud en su territorio (66,2%). En general, las acciones son promovidas por el municipio mismo (61,3%) o por el departamento regional de salud (37,9%), y se destacan la educación continua, seguida de la (re)organización de los procesos de trabajo y de la educación en salud. Factores actitudinales, de relaciones interpersonales y de recursos humanos fueron apuntados como los retos más frecuentes. Con base en ese diagnóstico, se entiende que la mayoría de los problemas identificados son pasibles de intervención. Este estudio presenta contribuciones para la planificación estratégica de educación continua en salud, para el apoyo a las instancias responsables por su fomento y gestión en los municipios, y para el fortalecimiento de sus acciones de educación continua en los servicios de salud.