Early detection of M. leprae by qPCR in untreated patients and their contacts: results for nasal swab and palate mucosa scraping.

To verify if the hard palate mucosa can be a site of relevance in the early molecular detection of Mycobacterium leprae in leprosy cases and their household contacts and if there is a correlation of results in nasal swab with those of the scraping of the palate mucosa. The quantitative polymerase chain reaction technique was used. Sample included 78 patients with untreated leprosy (G1), their 54 household contacts (G2), and 80 healthy individuals for the negative control (G3). The presence of M. leprae in both G1 and G2 was observed with the nasal swab and the palate mucosa scrapings methods, and it was shown that the sensitivity between the qPCR exams for RLEP and 85B genes is equivalent, with no statistically significant differences (G1 positivity of 35% in the hard palate mucosa and 44% for the nasal one, p = 0.3731 and for G2 of 31 and 38%, respectively, p = 0.6774). Results support the fact that the buccal mucosa and nasal mucosa may be important sites of primary infection of leprosy with repercussion in the transmission chain and that asymptomatic household contacts are heavily harbored by the causative agent of leprosy, which has a critical significance in the prevention and control action of this disease, since the evaluation of these sites arises as of importance in the early detection of M. leprae. Close monitoring and chemoprophylaxis of household contacts appear to be critical to attain interruption of the transmission of leprosy in endemic countries.

Early detection of M. leprae by qPCR in untreated patients and their contacts: results for nasal swab and palate mucosa scraping

To verify if the hard palate mucosa can be a site of relevance in the early molecular detection of Mycobacterium leprae in leprosy cases and their household contacts and if there is a correlation of results in nasal swab with those of the scraping of the palate mucosa. The quantitative polymerase chain reaction technique was used. Sample included 78 patients with untreated leprosy (G1), their 54 household contacts (G2), and 80 healthy individuals for the negative control (G3). The presence of M. leprae in both G1 and G2 was observed with the nasal swab and the palate mucosa scrapings methods, and it was shown that the sensitivity between the qPCR exams for RLEP and 85B genes is equivalent, with no statistically significant differences (G1 positivity of 35% in the hard palate mucosa and 44% for the nasal one, p = 0.3731 and for G2 of 31 and 38%, respectively, p = 0.6774). Results support the fact that the buccal mucosa and nasal mucosa may be important sites of primary infection of leprosy with repercussion in the transmission chain and that asymptomatic household contacts are heavily harbored by the causative agent of leprosy, which has a critical significance in the prevention and control action of this disease, since the evaluation of these sites arises as of importance in the early detection of M. leprae. Close monitoring and chemoprophylaxis of household contacts appear to be critical to attain interruption of the transmission of leprosy in endemic countries

Programa saúde da família sob a visão do usuário / Family health program under the users perspective

Introdução: O Programa Saúde da Família (PSF), atualmente conhecido como Estratégia Saúde da Família (ESF), foi implantado no Brasil em 1994, e é apontado como uma das principais estratégias de reorganização dos serviços e reorientação das práticas profissionais no nível de promoção da saúde, prevenção de doenças e reabilitação. Objetivos: Este estudo objetivou avaliar a Estratégia Saúde da Família no município de Tangará da Serra, Mato Grosso, sob a visão dos usuários. Métodos: Participaram do estudo 609 pessoas cadastradas, escolhidas aleatoriamente, nas dez Unidades de Saúde da Família. Estas pessoas responderam a um instrumento elaborado pelos pesquisadores, com questões abertas e fechadas, avaliando os aspectos de acesso e disponibilidade, infraestrutura, acolhimento, relação usuário-profissional de saúde, eficácia ou resolutividade, territorialidade e descentralização, informação e participação na gestão. Resultados: Os resultados demonstraram perspectivas favoráveis dos usuários em relação à ESF, destacando-se alguns aspectos que mereceram atenção como acolhimento, falta de medicamentos e acesso às consultas. Conclusão: Esse resultado permite contribuir para um planejamento mais adequado da gestão das unidades, a fim de possibilitar a melhoria da satisfação dos usuários e aprimoramento deste modelo de atenção básica.

Introduction: The Family Health Program (FHP), currently known as Family Health Strategy (FHS), was implemented in Brazil in 1994, and is now regarded as one of the main strategies for service reorganization and professional practice reorientation in health promotion, disease prevention and rehabilitation. Objective: This study aimed at the evaluation of Family Health Strategy in the city of Tangará da Serra, Mato Grosso state, from the users perspective. Methods: Six hundred and nine participants were enrolled in the study. They were randomly chosen from ten Family Health Units. These people answered to an instrument developed by the researchers, with open and closed questions, in order to evaluate aspects of access and availability, infrastructure, hospitality, relationship between users and health professionals, effectiveness or resolvability, territoriality and decentralization, information and management participation.Results: The results showed favorable prospects of users towards the FHS, whilst certain aspects deserve particular attention, such as hospitality, lack of medications and difficulty in scheduling medical appointments. Conclusion: The results allow a more adequate planning for the management of units, in order to enable improvements on user satisfaction and also on this basic attention model.