ABSTRACT
Objetivo: analisar a prevalência de tuberculose, coronavírus, condições crônicas e vulnerabilidades entre migrantes e refugiados no Brasil. Método: trata-se de estudo transversal, do tipo inquérito eletrônico, realizado com migrantes internacionais durante a pandemia de COVID-19. Para a análise, aplicou-se estatística descritiva, com cálculo de medidas de posição e de dispersão. Quanto às variáveis categóricas, estimaram-se as frequências relativas e absolutas. Resultados: participaram do estudo 553 migrantes e refugiados, verificando-se prevalência de 3,07% de tuberculose, 7,2% de COVID-19 e 27,3% de condições crônicas. Entre as vulnerabilidades, 32% referiram desemprego, 37,6% mudaram para o Brasil em decorrência da situação social do seu país e 33,6% residiam em asilo e ou abrigo. Conclusão: a tuberculose, as doenças crônicas e a COVID-19 apresentaram maior prevalência em migrantes e refugiados que na população em geral. Por tratar-se de uma população ainda com grande dificuldade de acesso aos serviços de saúde e aos sistemas de proteção social, o estudo subsidiará, com base em evidências, as políticas públicas, o atendimento do enfermeiro e a incorporação de novas rotinas no serviço.Alternate :Goal:to analyze the prevalence of tuberculosis, coronavirus, chronic conditions and vulnerabilities among migrants and refugees in Brazil. Method:this is a cross-sectional study, of the electronic survey type, carried out with international migrants during the COVID-19 pandemic. For the analysis, descriptive statistics were applied, with the calculation of position and dispersion measures. As for categorical variables, relative and absolute frequencies were estimated. Results:553 migrants and refugees participated in the study, verifying a prevalence of 3.07% of tuberculosis, 7.2% of COVID-19 and 27.3% of chronic conditions. Among the vulnerabilities, 32% reported unemployment, 37.6% moved to Brazil due to the social situation in their country and 33.6% resided in asylum and/or shelter. Conclusion:tuberculosis, chronic diseases and COVID-19 were more prevalent in migrants and refugees than in the general population. As this is a population that still has great difficulty in accessing health services and social protection systems, the study will support, based on evidence, public policies, nursing care and the incorporation of new routines in the service.
ABSTRACT
Introdução: o Brasil demorou a implementar uma política de testagem ampliada para COVID-19 no qual pode ter afetado o acesso da população mais vulnerável aos serviços de testagem. Objetivo: analisar os fatores associados à realização de testes moleculares para o diagnóstico da COVID-19. Método: estudo transversal de dados secundários do painel COVID-19 do estado do Espírito Santo. Foram incluídas fichas de notificação de suspeita de COVID-19 entre 11 de setembro de 2020 a 02 de março de 2021. Empregou-se regressão logística hierárquica para estimativa de razão de chances (odds ratio, OR) com intervalo de confiança de 95% (IC95%). Resultados: Foram incluídos no estudo 419.771 fichas de notificação. A prevalência da realização do teste molecular para COVID-19 foi 81,1 % (IC95% 81,0%;81,2%). Idosos (OR= 2,70 – IC95% 2,56-2,85), profissional da saúde (OR=1,43 – IC95% 1,36-1,50), doença cardiovascular crônica (OR=1,13 – IC95% 1,09-1,17), diabetes mellitus (OR=1,07 – IC95% 1,01-1,14) e hospitalização (OR=5,95 – IC95% 4,53;7,82) apresentaram maior chance de ter realizado o teste molecular. Sexo masculino (OR=0,96 – IC95% 0,94-0,98), cor da pele preta (OR= 0,75 – IC95% 0,73-0,78), cor da pele amarela (OR=0,74 – IC95% 0,71-0,77), residir na região norte de saúde (OR=0,37 – IC95% 0,36-0,39) e a população em situação de rua (OR=0,76 – IC95% 0,67-0,85) apresentaram a menor chance de ter realizado o teste molecular. Conclusão: Fatores sociais, econômicos e o risco de agravamento da doença foram associados a realização do teste molecular para COVID-19 no estado do Espírito Santo. É necessário ações que garantam o acesso da população mais vulnerável ao teste molecular.Alternate : Backgroung: Brazil was slow to implement an expanded testing policy for COVID-19, which may have affected the most vulnerable population's access to testing services. Objective: to evaluate the factors associated with performing the molecular test for COVID-19. Methods: cross-sectional study of secondary data from the COVID-19 panel in the state of Espírito Santo. COVID-19 suspicion notification forms were included between September 11, 2020 and March 2, 2021. Hierarchical logistic regression was used to estimate the odds ratio (OR) with 95% confidence interval (CI95%). Results: 419,771 notification forms were analyzed. The prevalence of performing the molecular teste for COVID-19 was 81.1% (CI95% 81.0-81.2). Elderly (OR= 2.70 – CI95% 2.56-2.85), health professional (OR=1 .43 – CI95% 1.36-1.50), chronic cardiovascular disease (OR=1.13 – CI95% 1.09-1.17), diabetes mellitus (OR=1.07 – CI95% 1.01- 1.14) and hospitalization (OR=5.95 – CI95% 4.53;7.82) were more likely to have undergone the molecular test. Male sex (OR=0.96 – CI95% 0.94-0.98), black skin color (OR=0.75 – CI95% 0.73-0.78), yellow skin color (OR=0.74 – CI95% 0.71-0.77), residing in the northern health region (OR=0.37 – CI95% 0.36-0.39) and the homeless population (OR=0.76 – CI95% 0.67-0.85) had the lowest chance of having undergone the molecular test. Conclusion: Social, economic, contextual factors and the risk of aggravation of the disease were associated with carrying out the molecular test for COVID-19 in the state of Espírito Santo. Actions are needed to guarantee the access of the most vulnerable population to molecular testing.
ABSTRACT
BACKGROUND: COVID-19 is affecting almost the entire world, causing more than four hundred thousand deaths and undermining the health care systems, as much as the economy, of the afflicted countries. The strategies for prevention depend on largely lacking information, as infection prevalence and virus pathogenicity. This study aimed to determine the prevalence, the pathogenicity, and the speed of infection spreading in a large population in Brazil. MATERIALS AND METHODS: This is a serial cross-sectional study designed on a population basis and structured over houses as the sampling units. The sampling consisted of four visits at 15 days intervals in randomly selected census-designated sectors of the State major municipalities (reference municipalities) and two visits at 30 days intervals in smaller municipalities of the same regions of those of reference. At each visit, the investigators sampled houses and sampled one individual in each house for data collection. After the informed consent, the investigators performed a rapid antibody detection test (Celer Technology, Inc) and applied a questionnaire containing clinical and demographic questions. RESULTS: From May 13th to 15th, the investigators performed 6,393 rapid tests in 4,612 individuals of the reference municipalities, 1,163 individuals of the smaller municipalities, and 166 contacts of the positive individuals. Ninety-seven dwellers were positive in the reference municipalities, giving a prevalence of 2.1% (CI 95%: 1.67-2.52%). In the smaller municipalities, the figure was 0.26% (CI 95%: 0.05%-0.75%) (three positives). There was an association of the positive result with female sex (p = 0.013) and houses with five dwellers or more (p = 0.003). Seventy-eight positive individuals reported symptoms in the previous 15 days (80.4%), being anosmia (45.4%), cough (40.2%), and myalgia (38.1%) the more frequent. About one-third of them reported fever (28.9%). CONCLUSIONS: The results reveal a still small prevalence of infection in the study area, despite the significant number of sick people overloading the health system. The figures indicate an important underreporting in the area and a frequency that still can grow, making necessary public health actions for the containment of the transmission.