ABSTRACT
BACKGROUND: Tungiasis is a disease associated with extreme poverty. We aimed to evaluate the prevalence of tungiasis in six different settlements of the Sanumás indigenous community in a remote area in the Auaris region, Yanomami territory, Brazil. METHODS: We conducted an observational study to detect clinical and epidemiological factors associated with tungiasis using a cross-sectional strategy and multivariate logistic regression. Soil analysis was performed by visual and microscopic methods. RESULTS: We examined 555 persons, 45 of whom had active tungiasis; 18 cases were classified as mild, 16 as moderate and 11 as severe. The disease was significantly more prevalent in children than in adults (odds ratio (OR) 15.77; 95% confidence interval (CI) = 5.34-67.91; p < 0.001). Soil infestation was significantly related to the occurrence of human tungiasis (OR = 12.29; 95% CI = 3.75-45.88). The sex and GPS location of the houses were not related to the occurrence of tungiasis. CONCLUSIONS: We conclude that tungiasis is an important problem in the Sanumás community, especially for children. We suggest that interruption of the off-host transmission cycle, together with regular treatment [human and animal interventions], must be prioritized to achieve control of tungiasis in indigenous populations.
ABSTRACT
Background: A paramount factor in the control of neglected tropical diseases from both medical and social aspects is education. New strategies must be constantly pursued to test and provide educational information related to diseases affecting vulnerable populations. We applied the Q method as a model to measure educational neglect based on the burden of disseminated tungiasis. Methods: Using a saturation method for sample size calculation, we recruited students and healthcare professionals to evaluate and classify 27 statements related to the prevention, control and treatment of tungiasis. After quantitative analysis, the Q method was applied based on the paired use of the centroid method and Varimax rotation, and 4 factors were extracted representing the main sets of viewpoints among the participants. Results: We included 119 healthcare professionals with different academic degrees. Statements classified by specialists with a + agreement were also classified as a + agreement by most of the participants. However, we detected 5 important disagreements related to the topical treatment of tungiasis and control of the disease in the environment and animals. The Q method showed that almost no consensus was detected for four statements. The classification of each statement was not related to the participants' academic degree. Conclusions: There is significant educational neglect related to tungiasis prevention and treatment in healthcare sciences in Brazil. We conclude that the Q method may be an interesting strategy alone or associated with quantitative strategies for detecting educational limitations related to neglected diseases. In countries where neglected diseases are endemic, a detailed study evaluating the quality of education related to these diseases must be prioritized.
ABSTRACT
The recent change in model of primary health care introduced for the Family Health Strategy, to one centred on the user and territorialisation, provided the ideal opportunity to implement the AcolheSUS Project in a Basic Health Unit (UBS) of the Central Region of Brasília, in Brazil's Federal District. The UBS team conducted a situational diagnosis of the unit and situational strategic planning with a view to reorganising the service to address the problems identified, focusing on the work processes. With introduction of AcolheSUS, the number of individual user registrations performed by the teams increased from 135 to 3525, the number of nursing visits increased by 193.7% and the number of procedures performed by nurses increased by 121.2%. During changeover to the new care model, 71% of residents in the catchment area attended the basic health unit; after introduction of AcolheSUS, the percentage reached 90.5%. The monthly average of users received and classified was 1099.8. The joint construction of solid protocols and adjustments to work processes contributed to improving service delivery and afforded users greater access to the health care unit.
A recente mudança de modelo da atenção primária à saúde para estratégia de Saúde da Família, com foco centrado no usuário e na territorialização foi o momento ideal para implantação do Projeto AcolheSUS em uma Unidade Básica de Saúde (UBS) da Região Central de Brasília, Distrito Federal. A equipe de servidores da UBS realizou o diagnóstico situacional da unidade e o planejamento estratégico situacional, com o objetivo de reorganizar o serviço a partir da problematização e com foco nos processos de trabalho. Com o AcolheSUS houve aumento do número de cadastros individuais realizados pelas equipes de 135 para 3.525, o número de atendimentos de enfermagem aumentou em 193,7% e o número de procedimentos realizados por enfermeiros teve um acréscimo 121,2%. O percentual de residentes da área adstrita que procuravam a unidade básica de saúde durante o processo de mudança de modelo de atenção era 71% do total e alcançou 90,5% após o AcolheSUS. A média mensal de usuários acolhidos e classificados foi de 1.099,8. A construção conjunta de protocolos sólidos e o ajuste de processos de trabalho contribuíram para a melhoria na oferta de serviços e propiciaram maior acesso do usuário à unidade de saúde.
Subject(s)
Delivery of Health Care/organization & administration , Family Health , National Health Programs/organization & administration , Primary Health Care/organization & administration , Brazil , Health Services Accessibility , Humans , Models, Organizational , Strategic PlanningABSTRACT
Resumo A recente mudança de modelo da atenção primária à saúde para estratégia de Saúde da Família, com foco centrado no usuário e na territorialização foi o momento ideal para implantação do Projeto AcolheSUS em uma Unidade Básica de Saúde (UBS) da Região Central de Brasília, Distrito Federal. A equipe de servidores da UBS realizou o diagnóstico situacional da unidade e o planejamento estratégico situacional, com o objetivo de reorganizar o serviço a partir da problematização e com foco nos processos de trabalho. Com o AcolheSUS houve aumento do número de cadastros individuais realizados pelas equipes de 135 para 3.525, o número de atendimentos de enfermagem aumentou em 193,7% e o número de procedimentos realizados por enfermeiros teve um acréscimo 121,2%. O percentual de residentes da área adstrita que procuravam a unidade básica de saúde durante o processo de mudança de modelo de atenção era 71% do total e alcançou 90,5% após o AcolheSUS. A média mensal de usuários acolhidos e classificados foi de 1.099,8. A construção conjunta de protocolos sólidos e o ajuste de processos de trabalho contribuíram para a melhoria na oferta de serviços e propiciaram maior acesso do usuário à unidade de saúde.
Abstract The recent change in model of primary health care introduced for the Family Health Strategy, to one centred on the user and territorialisation, provided the ideal opportunity to implement the AcolheSUS Project in a Basic Health Unit (UBS) of the Central Region of Brasília, in Brazil's Federal District. The UBS team conducted a situational diagnosis of the unit and situational strategic planning with a view to reorganising the service to address the problems identified, focusing on the work processes. With introduction of AcolheSUS, the number of individual user registrations performed by the teams increased from 135 to 3525, the number of nursing visits increased by 193.7% and the number of procedures performed by nurses increased by 121.2%. During changeover to the new care model, 71% of residents in the catchment area attended the basic health unit; after introduction of AcolheSUS, the percentage reached 90.5%. The monthly average of users received and classified was 1099.8. The joint construction of solid protocols and adjustments to work processes contributed to improving service delivery and afforded users greater access to the health care unit.
