ABSTRACT
Epidemiological literature on occupational accidents among rural workers is scarce in Brazil. This population-based cross-sectional study was designed to investigate the characteristics of farming accidents occurring in the rural area of Pelotas, Southern Brazil. A multi-stage sampling scheme was used to select a representative sample of farms. From January to April 1996, a total of 258 rural families were visited, and all 580 rural workers identified in these families answered a standardized questionnaire. Sixty-three rural workers (11%) reported at least one work-related accident in the previous twelve months. There were 82 accidents during the study period, mainly related to the use of hand farm tools (29%) and handling farm animals (27%). The main types of injuries were cuts (50%), bruises (13%), and burns (9%). The body areas most frequently involved were hands (34%), feet (29%), and legs (18%). Among the injured rural workers, only 32% used health services to treat the resulting lesions (46% went to primary health care facilities and 36% to emergency services).
Subject(s)
Accidents, Occupational/statistics & numerical data , Rural Population/statistics & numerical data , Adolescent , Adult , Brazil/epidemiology , Child , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Occupational Exposure , Socioeconomic FactorsABSTRACT
With the aim of implementing an intervention program on physician's prescribing behaviour for diarrhoea in children under five, an ethnoepidemiological study was conducted in Pelotas (Brazil), from February to April 1993. Information on prescription of drugs was obtained through record review of 381 cases of diarrhoea provided by 33 medical doctors from eight health centres. Trained field workers observed a total of 54 clinical consultations due to diarrhoea. Brief exit interviews with the mothers were performed just after the observations. Twenty-seven open-ended home interviews were made with the mothers the day after they had been observed. After all observations had been completed, open-ended interviews were conducted with 21 physicians. The results showed that there is a misunderstanding of the role of ORS in the treatment of diarrhoea: mothers want something to "cut" diarrhoea and they notice that ORS does not act in this way and doctors do not explain the action of ORS in diarrhoea management. Comparing with record reviews, during observations a child had a lower probability of receiving an antibiotic or antidiarrheal drug prescription. This finding indicates that other variables than technical skills are involved in doctor's prescribing behaviour. A lack of ability or of motivation to deal with "anxious or difficult mothers" led some doctors to enhance antibiotic or other non-recommended drugs to manage diarrhoea. Therefore, efforts to improve the quality of case management of diarrhoea, through intervention programmes in the government health sector, are needed in Pelotas.
