ABSTRACT
Despite the effectiveness of antiretroviral therapy (ART), human immunodeficiency virus (HIV) infection remains a global public health concern. However, weaknesses in its management regarding access to integrated HIV care include treatment gaps and loss to follow-up (LTFU) from antiretroviral treatment (ART). This study aimed to characterize the epidemiological and clinical profiles of people living with HIV/AIDS (PLHA) in LTFU from HIV care in Campo Grande, Central Brazil. This retrospective cross-sectional study was conducted between January 2021 and April 2022 using secondary data from PLHA who had LTFU in Campo Grande. A total of 852 patients with PLHA were included in this study. The majority of participants in LTFU were male (63.1%), had a CD4 cell count > 200 cells/mm3 (68.2%), and had been treated for ≥ 3 months (86.4%). Only 287 (33.7%) participants had undetectable HIV viral load. Of the total number of patients who returned to treatment during the study period, 448 (54.3%) were LTFU-positive. The tracking strategy was not applied to 556 (65.26%) patients, and 44.4% of the participants had been in spontaneous demand. These results highlight the relevance of patient-centered interventions and the need to ensure early treatment and promote retention in care systems with consequent viral suppression, impacting the healthcare indicators of the population, with emphasis on health managers and stakeholders in HIV care.
Subject(s)
HIV Infections , Lost to Follow-Up , Viral Load , Humans , Male , Brazil/epidemiology , Female , Cross-Sectional Studies , Retrospective Studies , HIV Infections/drug therapy , HIV Infections/epidemiology , Adult , Middle Aged , CD4 Lymphocyte Count , Anti-HIV Agents/therapeutic use , Health Services Accessibility , Medication Adherence/statistics & numerical dataABSTRACT
CDC's National Environmental Public Health Tracking Program (Tracking Program) receives administrative data annually from 25-30 states to track potential environmental exposures and to make data available for public access. In 2019, the CDC Tracking Program conducted a cross-sectional survey among principal investigators or program managers of the 26 funded programs to improve access to timely, accurate, and local data. All 26 funding recipients reported having access to hospital inpatient data, and most states (69.2%) regularly update data user agreements to receive the data. Among the respondents, 15 receive record-level data with protected health information (PHI) and seven receive record-level data without PHI. Regarding geospatial resolution, approximately 50.0% of recipients have access to the street address or census tract information, 34.6% have access to ZIP code, and 11.5% have other sub-county geographies (e.g., town). Only three states receive administrative data for their residents from all border states. The survey results will help the Tracking Program to identify knowledge gaps and perceived barriers to the use and accessibility of administrative data for the CDC Tracking Program. The information collected will inform the development of resources that can provide solutions for more efficient and timely data exchange.
Subject(s)
Health Facilities , Public Health , Centers for Disease Control and Prevention, U.S. , Cross-Sectional Studies , Delivery of Health Care , United StatesABSTRACT
Introdução: Em países em desenvolvimento, os indicadores de morbidade e mortalidade são considerados elevados para o câncer de colo do útero, embora se trate de um tipo de câncer possível de ser evitado quando o diagnóstico e o tratamento das lesões precursoras são realizados na fase inicial. Objetivo: Analisar osindicadores para câncer de colo do útero no período de 2008 a 2012, nos 21 municípios que integram a VUnidade Regional de Saúde Pública-URSAP, do Estado do Rio Grande do Norte, Brasil. Métodos: Trata-se deum estudo do tipo ecológico, com abordagem quantitativa, a partir de dados coletados no SISCOLO, por meio do DATASUS online. A população foi constituída por mulheres que realizaram exame citopatológico nos municípiosque compõe a V USARP. Resultados: Os municípios de São Tomé, Januário Cicco e Lagoa de Velhos tiveramas menores razões de citopatológico, 0,09; 0,15 e 0,18, respectivamente. As amostras insatisfatórias queapresentaram maiores índices foram as dos municípios de Lagoa de Velhos (7,36%), São Tomé (6,36%) eBarcelona (5,74%). Por meio do cálculo de Odds Ratio, viu-se que as lesões de baixo grau têm mais chances deserem diagnosticadas do que as lesões de alto para todos os municípios estudados. Conclusões: Todos osmunicípios tiveram amostra satisfatória e alguns não atingiram a meta pactuada para a razão do citológico, o quedeve ser avaliado pelos municípios
Introduction: In developing countries, morbidity and mortality indicators are considered high for cervical, althoughit is a preventable type of cancer, provided the diagnosis and treatment of the precursor lesions are performed inits initial phase. Objective: To analyze the indicators for cervical cancer in the period 2008-2012 in the 21municipalities that comprise the V Regional Public Health Unit, in the state of Rio Grande do Norte, Brazil.Methodology: This is an ecologic type of study, with a quantitative approach, from data collected in theSISCOLO, through the online DATASUS. The population consisted of women who had the Pap test done in themunicipalities comprising the V USARP. Results: The municipalities of São Tomé, Januário Cicco, and Lagoa deVelhos had the lowest ratios of Pap smear, 0.09; 0.15 and 0.18, respectively. The unsatisfactory samples with the highest rates were those of the municipalities Lagoa de Velho (7.36%), São Tomé (6.36%) and Barcelona(5.74%). Through the odds ratio calculation it could be seen that low-grade lesions are more likely to occur than high-grade ones for all municipalities studied. Conclusions All the municipalities had a satisfactory sample and some municipalities did not reach the agreed goal for the Pap test ratio
