Perfil epidemiológico e clínico de crianças hospitalizadas com cardiopatias congênitas / Perfil epidemiológico y clínico de niños hospitalizados con cardiopatias congénitas / Clinical and epidemiological profile of hospitalized children with congenital heart diseases

Objetivo: Descrever o perfil epidemiológico e clínico de crianças com cardiopatias congênitas admitidas entre 2018 e 2019 em um hospital de referência em Pernambuco. Métodos: Trata-se de um corte transversal envolvendo 310 crianças com cardiopatias congênitas. Foram obtidos dados epidemiológicos e clínicos em prontuários através de formulários padronizados. Houve tabulação em planilha Excel e análise estatística descritiva por meio do Software SPSS 25. Resultados: Verificou-se média de 21,69 meses de idade e predominância do sexo masculino (55,5%). Os principais fatores de risco maternos foram infecção durante a gestação (21,3%) e idade avançada (15,8%). Dentre as doenças crônicas, destacaram-se hipertensão arterial (6,1%) e diabetes mellitus (4,2%). Os predisponentes do paciente foram prematuridade (16,1%), baixo peso ao nascer (17,7%), trissomia do 21 (17,7%) e malformações extracardíacas (7,1%). Sinais e sintomas respiratórios constituíram o principal motivo de hospitalização, sendo registradas dispneia (55,8%), tosse (30,3%) e alterações de ausculta pulmonar (16,1%). Também motivou o internamento a presença de cianose (20,3%). O sopro cardíaco se apresentou na maioria dos pacientes (80,0%). Em percentual relevante dos casos, o diagnóstico ocorreu durante a hospitalização (16,8%). Conclusão: O conhecimento acerca do perfil das cardiopatias congênitas auxilia o diagnóstico, sendo necessária a ampliação do conhecimento científico nesta temática... (AU)

Objetivo: Describir el perfil epidemiológico y clínico de niños con cardiopatías congénitas ingresados entre 2018 y 2019 en un hospital de referencia de Pernambuco. Métodos: estudio transversal con 310 niños con cardiopatías congénitas. Los datos epidemiológicos y clínicos se obtuvieron de las historias clínicas mediante formularios estandarizados. Se realizó tabulación en planilla de Excel y análisis estadístico descriptivo con el Software SPSS 25. Resultados: La edad media fue 21,69 meses y predominio del sexo masculino (55,5%). Los principales factores de riesgo maternos fueron infección durante el embarazo (21,3%) y edad avanzada (15,8%). Las principales enfermedades crónicas fueron hipertensión arterial (6,1%) y diabetes mellitus (4,2%). Los predisponentes del paciente fueron prematuridad (16,1%), bajo peso al nacer (17,7%), trisomía 21 (17,7%) y malformaciones extracardiacas (7,1%). Signos y síntomas respiratorios fueron el principal motivo de hospitalización, con disnea (55,8%), tos (30,3%) y alteraciones en la auscultación pulmonar (16,1%). Cianosis (20,3%) también motivó la hospitalización. El soplo cardíaco estuvo presente en la mayoría de los pacientes (80,0%). En un porcentaje relevante de casos, el diagnóstico se produjo durante la hospitalización (16,8%). Conclusión: El conocimiento sobre el perfil de las cardiopatías congénitas ayuda al diagnóstico, siendo necesario ampliar el conocimiento científico sobre este tema... (AU)

Objective: Describe the clinical and epidemiological profile of children with congenital heart diseases admitted between 2018 and 2019 to a referencial hospital in Pernambuco. Methods: Cross-sectional study involving 310 children with congenital cardiopathy. The data was obtained in the medical charts, using standardized forms. Tabulation was made in an Excel spreadsheet and descriptive statistical analysis done through SPSS 25 Software. Results: The average age was 21,69 months and most patients were male (55,5%). The main risk factors were infection during pregnancy (21,3%) and advanced age (15,8%). Among chronic diseases, hypertension (6,1%) and diabetes mellitus (4,2%) stood out. Predisposing factors related to the patient were prematurity (16,1%), low weight at birth (17,7%), trisomy 21 (17,7%) and extracardiac malformations (7,1%). Respiratory signs and symptoms were the main cause of hospitalization, such as dyspnea (55,8%), cough (30,3%) and changes in pulmonary auscultation (16,1%). Cyanosis also motivated admission (20,3%). Most patients presented heart murmur (80%). In a significant amount of cases, the diagnosis was made during the hospital admission (16,8%). Conclusion: the awareness about the profile of congenital heart diseases helps the diagnosis, and is necessary to expand scientific knowledge on this topic... (AU)

Effectiveness of an action-oriented educational intervention in ensuring long term improvement of knowledge, attitudes and practices of community health workers in maternal and infant health: a randomized controlled study.

BACKGROUND: The potential role of Community Health Workers (CHWs) in improving maternal and child health outcomes, particularly in low and middle-income countries and in disadvantaged communities, is receiving increased attention. Adequate and focused training is among the key requisites for enhancing CHWs performances and research is necessary to identify effective training methods. METHODS: A randomized controlled study was designed to assess the effectiveness of a training course in improving knowledge, attitudes and practices (KAP) of CHWs regarding maternal and infant health. Seventy-eight CHWs belonging to Family Health Units in the city of Recife, Brazil were randomly allocated to intervention and control groups. The intervention group took part in a four-day interactive training course based on an action-oriented guide to perform home visits to pregnant women and their infants throughout pregnancy and infancy until 9 months of age. KAP in intervention group after training and after 1 year were compared to control group and to baseline. RESULTS: Fifty-nine CHWs completed all KAP assessments (31 in intervention and 28 in control group). Baseline characteristics were similar in both groups. At 1 year from training, the intervention group had higher overall KAP score (120.65 vs. 108.19, p <  0.001) as well as knowledge (47.45 vs. 40.54, p <  0.001), practice (53.45 vs. 49.11, p <  0.001) and attitudes scores (19.74 vs. 18.81, p = 0.047) than the control group. Moreover, at 1 year from training, the intervention group maintained significant improvements in overall KAP score (120.65 vs. 106.55, p <  0.001) as well as in knowledge (45.45 vs. 42.13, p <  0.001), and practice (53.45 vs. 45.29, p <  0.001) scores with respect to baseline. In the control group, overall KAP (106.59 vs. 108.19, p = 0.345) as well as separate knowledge, attitudes and practices scores remained unchanged. CONCLUSIONS: A four-day interactive training course on action-oriented home visits to pregnant women and infants produced a sustained improvement of CHWs' KAP and may represent a model to ensure retention of acquired competences. TRIAL REGISTRATION: RBR-9gchqr . Date registered: July 21, 2018 (Retrospectively registered).