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1.
BMC Health Serv Res ; 23(1): 276, 2023 Mar 22.
Artigo em Inglês | MEDLINE | ID: mdl-36949423

RESUMO

BACKGROUND: Health providers are under unprecedented pressures to perform in the COVID-19 health crisis and under unprecedented risks. We initiated a large mixed-method survey of health professionals in five large metropolitan areas in Brazil to document the risks and needs of health professionals. To initiate the study, we conducted formative research. METHODS: We conducted 77 open-ended semi-structured interviews online in a convenience sample of physicians, nurses, nurse technicians, and physiotherapists in Belem, Fortaleza, Porto Alegre, Recife, and São Paulo, Brazil. Design, data collection, and analysis were informed by Rapid Ethnographic Analysis (REA). RESULTS: Responses are organized into three themes that emerged in the interviews: the lack of preparation - both locally and nationally-for the pandemic and its effects on staffing and training; the overlap of personal, family, and professional risk and consequences; and inadequately addressed anxiety and suffering among health staff. CONCLUSIONS: Our respondents were unprepared for the epidemic, especially the institutional sequelae and psychological cost. These consequences were exacerbated by both lack of leadership and sweeping changes undercutting the Brazilian health system noted by almost all participants.


Assuntos
COVID-19 , Humanos , COVID-19/epidemiologia , Brasil/epidemiologia , Cidades , Pessoal de Saúde/psicologia , Medo , Pandemias
2.
Sex Transm Dis ; 47(2): 105-110, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31851039

RESUMO

BACKGROUND: In 2016, approximately 42,000 women were incarcerated in Brazil. The objectives of this study were to measure the lifetime prevalence of syphilis and sociodemographic and behavior correlates of antibody positivity among female prisoners in Brazil. METHODS: We conducted a cross-sectional survey of 1327 incarcerated women in 2014 to 2015 sampled through a multistage cluster design to represent the penitentiary system throughout Brazil. A rapid treponemal antibody test approved by the Ministry of Health (Rapid Test DPP Sífilis Bio-Manguinhos) was used to detect lifetime history of infection. Analyses were adjusted using weights based on the inverse of the product of the probabilities of the sampling units at each stage of the design. Variables significantly associated with syphilis infection at P < 0.05 in multivariate analyses were retained in the final model. RESULTS: Prevalence of syphilis antibody among female prisoners in Brazil was 11.6% (95% confidence interval [CI], 9.8%-13.8%). Higher syphilis prevalence was associated with black/Afro-Brazilian or mixed race/ethnicity (adjusted odds ratio [AOR], 1.78; 95% CI, 1.10-2.87), homelessness (AOR, 4.58; 95% CI, 2.78-7.56), abortion (AOR, 1.56; 95% CI, 1.02-2.38), and sexual violence (AOR, 1.59; 95% CI, 1.01-2.49). Syphilis prevalence was lower among women who had received condoms in school (AOR, 0.28; 95% CI, 0.08-1.00) as a marker for reproductive health education. CONCLUSIONS: Women within the vast Brazilian prison system demonstrate a high lifetime cumulative incidence of syphilis. Our data advocate for increased screening and treatment of syphilis of incarcerated women and help identify women at higher risk within the prison system and within their communities of origin.


Assuntos
Anticorpos Antibacterianos/sangue , Prisioneiros/estatística & dados numéricos , Sífilis/epidemiologia , Adolescente , Adulto , Brasil/epidemiologia , Estudos Transversais , Feminino , Infecções por HIV/epidemiologia , Humanos , Incidência , Programas de Rastreamento , Razão de Chances , Prevalência , Prisões/estatística & dados numéricos , Fatores de Risco , Comportamento Sexual/estatística & dados numéricos , Sífilis/imunologia , Adulto Jovem
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