Impact of vaccination during an epidemic of serogroup C meningococcal disease in Salvador, Brazil.

To combat rising incidence of serogroup C meningococcal disease in the city of Salvador, Brazil, the Bahia state immunization program initiated routine childhood immunization with meningococcal C conjugate vaccine (MenC) in February 2010, followed by mass MenC vaccination of city residents 10-24 years of age from May through August 2010. We analyzed trends in incidence of reported cases of meningococcal disease and serogroup distribution among meningococcal isolates identified in hospital-based surveillance in Salvador from January 2000 to December 2011 and estimated vaccine effectiveness using the screening method. Annual incidence of serogroup C meningococcal disease increased from 0.1 cases per 100,000 population during 2000-2006 to 2.3 in 2009 and 4.1 in 2010, before falling to 2.0 per 100,000 in 2011. Estimated coverage of mass vaccination reached 80%, 67% and 41% among 10-14, 15-19 and 20-24 year olds, respectively. Incidence in 2011 was significantly lower than average rates in 2008-2009 among children <5 years, but reductions among 10-24 year olds were not significant. Among 10-24 year olds, a single dose of MenC vaccine was 100% effective (95% confidence interval, 79-100%) against serogroup C meningococcal disease. Low coverage in the population targeted for mass vaccination may have limited impact on ongoing transmission of serogroup C meningococcal disease despite high vaccine effectiveness.

A dor e a delícia de aprender com o SUS: integração ensino-serviço na percepção dos internos em medicina social / Delight and pain in learning with SUS: social medicine trainees perception on the integration of in-service training and teaching

O Internato em Medicina Social da Faculdade de Medicina (FAMEB/UFBA) desenvolve as suas práticas em unidades de Programa Saúde da Família (PSF), mediante convênios com prefeituras municipais. Este estudo objetiva analisar esta experiência de articulação ensino/serviços, na percepção dos estudantes. Trata-se de estudo exploratório, utilizando como fonte de dados os relatórios dos alunos. Dados referentes às três primeiras turmas apontaram que houve boa receptividade e bom entrosamento do interno com as respectivas equipes do PSF. A experiência multiprofissional foi um dos destaques. Atividades de acompanhamento de mulheres, hipertensos e diabéticos, das atividades do médico em geral, visitas domiciliares, educação em saúde e imunização estiveram entre as mais freqüentemente realizadas. Parte dos alunos referiu a necessidade de maior clareza do papel do interno e dos objetivos do internato para todos os envolvidos, bem como problemas em relação ao apoio material e de supervisão, questões que foram contempladas em turmas subseqüentes. Críticas pertinentes em relação ao funcionamento de algumas equipes do PSF foram encaminhadas às Secretarias Municipais de Saúde (SMS). As autoras concluem que o desafio de ensinar num sistema de atenção à saúde em construção, com as suas distorções e imperfeições, tem sido enfrentado com sucesso, utilzando instrumentos adequados de articulação e acompanhamento.

Social medicine in-service training at FAMEB/UFBA provides for its medical practice in PSF unities, by means of formal agreements with municipal government. The objective of this study is to analyze this experience of teaching/in-service training through students’ perceptions, by means of an exploratory study using students’ reports as database. Results of the first three class groups pointed out good receptivity and interaction between trainees and PSF staff. Multiprofessional experience was one of the outstanding points. The most frequently conducted services were woman, hypertension and diabetes care, general clinic activities, home care, health education and immunization. Part of the students interviewed referred the need for more straightforward information on the role of trainees and the objectives of internship, as well as reported problems concerning material support and supervision, all of which were questions cited by subsequent classes. Pertinent criticism with reference to some PSF staffs’ operation was reported to the SMS. The authors conclude that the challenge of teaching within a developing healthcare system setting, in spite of its distortions and inadequacies, has been successfully faced, with the help of appropriate articulation and follow-up instruments.

Vigilância epidemiológica e controle de doenças e agravos à saúde / Epidemiological surveillance and the disease and health damage control

Objetiva discutir o significado e importância da vigilância epidemiológica na organizaçäo dos serviços de saúde, identificar suas funçöes e seus elementos; identificar as doenças e agravos de notificaçäo compulsória e discutir medidas de profilaxia para as doenças sujeitas à investigaçäo epidemiológica

O controle das doenças endêmicas e epidêmicas / Endemic and epidemic diseases control

Objetiva indicar as principais medidas de controle para endemias e epidemias; discutir sua determinaçäo no quadro atual, em nosso país; discutir seus principais problemas de controle no Brasil e analisar as perspectivas para seu controle, após a criaçäo do Sistema Unico de Saúde no Brasil