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Jezus SVD, Sales CMM, Rissino SDD, Mocelin HJS, Araújo MPDS, Arcêncio RA, Araújo VMS, Terena NDFM, Freitas PDSS, Maciel ELN. Prevalencia de tuberculosis, COVID-19, condiciones crónicas y vulnerabilidades en inmigrantes y refugiados: encuesta electrónica. Rev Lat Am Enfermagem 2023. [DOI: 10.1590/1518-8345.5928.3689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Resumen Objetivo: analizar la prevalencia de tuberculosis, coronavirus, condiciones crónicas y vulnerabilidades en inmigrantes y refugiados en Brasil. Método: se trata de un estudio transversal, del tipo encuesta electrónica, realizado con migrantes internacionales durante la pandemia de COVID-19. Para el análisis se aplicó estadística descriptiva, con cálculo de medidas de posición y dispersión. En cuanto a las variables categóricas, se estimaron las frecuencias relativas y absolutas. Resultados: participaron del estudio 553 inmigrantes y refugiados, la prevalencia de tuberculosis era del 3,07%, de COVID-19 del 7,2% y de condiciones crónicas del 27,3%. Entre las vulnerabilidades, el 32% reportó desempleo, el 37,6% emigró a Brasil por la situación social de su país y el 33,6% vivía en un asilo o albergue. Conclusión: la tuberculosis, las enfermedades crónicas y el COVID-19 fueron más prevalentes en inmigrantes y refugiados que en la población general. Por tratarse de una población que aún tiene grandes dificultades para acceder a los servicios de salud y sistemas de protección social, el estudio contribuirá, con base en la evidencia, a las políticas públicas, la atención de enfermería y la incorporación de nuevas rutinas en el servicio.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Ethel Leonor Noia Maciel
- Universidade Federal do Espírito Santo, Brazil; Rede Brasileira de Pesquisas em Tuberculose REDE-TB, Brazil
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Jezus SVD, Sales CMM, Rissino SDD, Mocelin HJS, Araújo MPDS, Arcêncio RA, Araújo VMS, Terena NDFM, Freitas PDSS, Maciel ELN. Prevalência de tuberculose, COVID-19, condições crônicas e vulnerabilidades entre migrantes e refugiados: inquérito eletrônico. Rev Lat Am Enfermagem 2023. [DOI: 10.1590/1518-8345.5928.3691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Resumo Objetivo: analisar a prevalência de tuberculose, coronavírus, condições crônicas e vulnerabilidades entre migrantes e refugiados no Brasil. Método: trata-se de estudo transversal, do tipo inquérito eletrônico, realizado com migrantes internacionais durante a pandemia de COVID-19. Para a análise, aplicou-se estatística descritiva, com cálculo de medidas de posição e de dispersão. Quanto às variáveis categóricas, estimaram-se as frequências relativas e absolutas. Resultados: participaram do estudo 553 migrantes e refugiados, verificando-se prevalência de 3,07% de tuberculose, 7,2% de COVID-19 e 27,3% de condições crônicas. Entre as vulnerabilidades, 32% referiram desemprego, 37,6% mudaram para o Brasil em decorrência da situação social do seu país e 33,6% residiam em asilo e ou abrigo. Conclusão: a tuberculose, as doenças crônicas e a COVID-19 apresentaram maior prevalência em migrantes e refugiados que na população em geral. Por tratar-se de uma população ainda com grande dificuldade de acesso aos serviços de saúde e aos sistemas de proteção social, o estudo subsidiará, com base em evidências, as políticas públicas, o atendimento do enfermeiro e a incorporação de novas rotinas no serviço.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Ethel Leonor Noia Maciel
- Universidade Federal do Espírito Santo, Brazil; Rede Brasileira de Pesquisas em Tuberculose REDE-TB, Brazil
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Cola JP, do Prado TN, Campos BA, Borges BJP, Alves BMCS, de Jezus SV, Sales CMM, de Araújo WN, Tavares NUL, Noia Maciel EL. Protocol for pragmatic randomized clinical trial to evaluate the completion of treatment of latent Mycobacterium tuberculosis infection with Isoniazid in the 300 mg formulation. PLoS One 2023; 18:e0281638. [PMID: 36802383 PMCID: PMC9942980 DOI: 10.1371/journal.pone.0281638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 01/24/2023] [Indexed: 02/23/2023] Open
Abstract
INTRODUCTION It is essential to strengthen the treatment of latent tuberculosis infection (LTBI) to break the chain of transmission. The drug used worldwide for the treatment of LTBI is Isoniazid. A clinical trial conducted in Brazil has demonstrated the bioequivalence of Isoniazid in the 300 mg formulation with 3 tablets in the 100 mg formulation. Further studies are needed to evaluate the completion of treatment with Isoniazid 300 mg single tablet. OBJECTIVE Describing a protocol for a clinical trial to evaluate the completion of treatment of LTBI with the drug Isoniazid in 300 mg tablet formulation compared to the use of Isoniazid in 100 mg tablet formulation. METHODS This is a pragmatic, multicenter, randomized, open-label clinical trial registered on the Rebec RBR-2wsdt6 platform. Individuals 18 years of age or older with an indication for treatment of LTBI will be included, with only 1 individual per family nucleus. Individuals whose index case of active TB is categorized as retreatment, multidrug-resistant and extremely resistant, individuals transferred from the original center two or more weeks after the onset of treatment, and persons deprived of liberty will be excluded. The study intervention will be the treatment of LTBI with 1 tablet of Isoniazid 300 mg. The control group will receive the treatment of LTBI with 3 tablets of Isoniazid 100 mg. Follow-up will be performed at month 1, month 2 and at the end of treatment. The primary outcome will be completion of treatment. CONCLUSION It is expected that with the treatment with the 300 mg formulation, more patients will complete the treatment based on the complexity index of pharmacotherapy. Our study intends to substantiate theoretical and operational strategies that respond to the demand for incorporation of a new formulation of the drug for the treatment of LTBI in the Unified Health System network.
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Affiliation(s)
- João Paulo Cola
- Postgraduate Program in Collective Health, Laboratory of Epidemiology, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil
| | - Thiago Nascimento do Prado
- Postgraduate Program in Collective Health, Laboratory of Epidemiology, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil
| | - Bárbara Almeida Campos
- Postgraduate Program in Collective Health, Laboratory of Epidemiology, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil
| | - Bárbara Juliana Pinheiro Borges
- Postgraduate Program in Collective Health, Laboratory of Epidemiology, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil
| | | | - Sonia Vivian de Jezus
- Postgraduate Program in Collective Health, Laboratory of Epidemiology, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil
| | - Carolina Maia Martins Sales
- Postgraduate Program in Collective Health, Laboratory of Epidemiology, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil
| | | | - Noemia Urruth Leão Tavares
- Postgraduate Program in Pharmaceutical Sciences, Universidade de Brasília, Brasília, Distrito Federal, Brazil
| | - Ethel Leonor Noia Maciel
- Postgraduate Program in Collective Health, Laboratory of Epidemiology, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil
- * E-mail:
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de Jezus SV, Sales CMM, Rissino SDD, Mocelin HJS, Araújo MPDS, Arcêncio RA, Araújo VMS, Terena NDFM, Freitas PDSS, Maciel ELN. Prevalence of tuberculosis, COVID-19, chronic conditions and vulnerabilities among migrants and refugees: an electronic survey. Rev Lat Am Enfermagem 2023; 31:e3690. [PMID: 36790278 PMCID: PMC10586797 DOI: 10.1590/1518-8345.5928.3690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 06/17/2022] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE to analyze the prevalence of tuberculosis, coronavirus, chronic conditions and vulnerabilities among migrants and refugees in Brazil. METHOD this is a cross-sectional study of the electronic survey type conducted with international migrants during the COVID-19 pandemic. Descriptive statistics was applied for the analysis, with calculation of position and dispersion measures. Regarding the categorical variables, relative and absolute frequencies were estimated. RESULTS the study participants were 553 migrants and refugees, verifying 3.07%, 7.2% and 27.3% prevalence of tuberculosis, COVID-19 and chronic conditions, respectively. Among the vulnerabilities, 32% reported unemployment, 37.6% moved to Brazil as a result of the social situation in their countries and 33.6% were living as refugees or sheltered people. CONCLUSION tuberculosis, chronic diseases and COVID-19 presented higher prevalence values in migrants and refugees than in the general population. As this is a population group that still has significant difficulty accessing health services and social protection systems, based on diverse evidence, the study will subsidize public policies, Nursing care and the incorporation of new routines in the service.
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Affiliation(s)
- Sonia Vivian de Jezus
- Universidade Federal do Espírito Santo, Centro de Ciências da Saúde, Vitória, ES, Brazil
| | | | - Silvia das Dores Rissino
- Universidade Federal do Espírito Santo, Centro Universitário Norte do Espírito Santo (CEUNES), São Mateus, ES, Brazil
| | | | | | - Ricardo Alexandre Arcêncio
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
| | - Vania Maria Silva Araújo
- Rede Brasileira de Pesquisas em Tuberculose REDE-TB, Parque Tecnológico da Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | | | | | - Ethel Leonor Noia Maciel
- Universidade Federal do Espírito Santo, Centro de Ciências da Saúde, Vitória, ES, Brazil
- Rede Brasileira de Pesquisas em Tuberculose REDE-TB, Parque Tecnológico da Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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de Jezus SV, Ilha da Silva A, Alexandre Arcêncio R, de Faria Marcos Terena N, dos Santos Pinheiro J, Souza Sacramento D, de Souza Silva Freitas P, Carminati Siqueira P, Mocelin HJS, Maria Silva Araújo V, da Silva Lima R, Nascimento do Prado T, Maia Martins Sales C, Noia Maciel EL. Local action plan to promote access to the health system by indigenous Venezuelans from the Warao ethnic group in Manaus, Brazil: Analysis of the plan´s development, experiences, and impact through a mixed-methods study (2020). PLoS One 2021; 16:e0259189. [PMID: 34780501 PMCID: PMC8592448 DOI: 10.1371/journal.pone.0259189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 10/14/2021] [Indexed: 11/19/2022] Open
Abstract
Background The provision of care and monitoring of health are essential for indigenous Venezuelans from the Warao ethnic group, who are at risk of decimation. Objective Analyze a Local Action Plan (LAP) to promote access to the health system of indigenous Venezuelans from the Warao ethnic group (IVWEG) in Manaus, Brazil. Method A mixed-methods study was performed. Quantitative data were collected to assess the provision of care and monitoring of health conditions in IVWEG through a survey that was self-completed by healthcare providers. Qualitative narrative data were collected to gain insight into IVWEG that seek care. We applied descriptive statistics, grouping analysis (GA) by hierarchical levels, and multiple correspondence analysis (MCA). Content analysis was applied to qualitative data. Results 106 healthcare providers participated in the study, with the following characteristics: 94 (88.7%) females, 67 (63.2%) pardo race/color, 40 (37.7%) working in primary healthcare, and 49 (46.2%) nurses. In addition, 43 (40.6%) of the healthcare providers reported providing care to IVWEG. Among the providers, 89 (84%) had received training for assisting IVWEG. Additionally, 30 IVWEG were enrolled for interviews in the qualitative phase. The barriers to seeking care were language, distance to health units, and lack of money for transportation. The LAP proved to facilitate access to the health system by indigenous Venezuelans from the Warao ethnic group in Manaus. The study contributed to knowledge on a LAP addressed to IVWEG and helped improved their access to the health system, providing appropriate training for healthcare providers and other relevant actors by implementing a coherent and consistent public health policy at the local level.
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Affiliation(s)
- Sonia Vivian de Jezus
- Graduate Studies Program in Public Health, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil
- Instituto de Ciências da Saúde, Universidade Federal de Mato Grosso, Sinop, Mato Grosso, Brazil
| | - Adriana Ilha da Silva
- Epidemiology Laboratory, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil
| | - Ricardo Alexandre Arcêncio
- Escola de Enfermagem de Ribeirão Preto, Graduate Studies Program in Public Health Nursing, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil
- Brazilian TB Research Network, REDE-TB, Rio de Janeiro, Brazil
| | | | - Jair dos Santos Pinheiro
- Brazilian TB Research Network, REDE-TB, Rio de Janeiro, Brazil
- Municipal Health Department, Manaus, Amazonas, Brazil
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Graduate Studies Program in Tropical Medicine (PhD), Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil
| | | | | | | | | | | | | | | | | | - Ethel Leonor Noia Maciel
- Epidemiology Laboratory, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil
- Brazilian TB Research Network, REDE-TB, Rio de Janeiro, Brazil
- * E-mail:
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Pedroso MRDO, Guidoni LM, Zandonade E, Fregona G, Negri LDSA, Oliveira SMDVLD, Prado TND, Sales CMM, Coimbra RDS, Galavote HS, Maciel ELN. Catastrophic costs and social sequels due to tuberculosis diagnosis and treatment in Brazil. Epidemiol Serv Saude 2021; 30:e2020810. [PMID: 34287550 DOI: 10.1590/s1679-49742021000300012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 02/09/2021] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To evaluate the impact of catastrophic costs on unfavorable tuberculosis treatment outcomes. METHODS This was a prospective cohort study, conducted in five Brazilian state capitals (Manaus, Recife, Vitória, Campo Grande and Porto Alegre) from June 2016 to July 2018. Logistic regression was used to calculate the odds ratio (OR) and 95% confidence intervals (95%CI). RESULTS Of the 350 participants, 310 were included, of whom 30 presented unfavorable outcomes. Catastrophic cost (OR=2.53 -95% CI 1.13;5.67) and divorce (OR=5.29 -95% CI 1.39;20.05) increased the chances of unfavorable outcomes. CONCLUSION Financial difficulties during tuberculosis treatment may impair its outcome. Catastrophic cost and divorce were determining factors for treatment outcomes.
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Affiliation(s)
| | - Leticia Molino Guidoni
- Universidade Federal do Espírito Santo, Laboratório de Epidemiologia, Vitória, ES, Brasil
| | - Eliana Zandonade
- Universidade Federal do Espírito Santo, Programa de Pós-Graduação em Saúde Coletiva, Vitória, ES, Brasil
| | - Geisa Fregona
- Universidade Federal do Espírito Santo, Programa de Pós-Graduação em Saúde Coletiva, Vitória, ES, Brasil
| | | | | | | | | | | | | | - Ethel Leonor Noia Maciel
- Universidade Federal do Espírito Santo, Programa de Pós-Graduação em Saúde Coletiva, Vitória, ES, Brasil
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Comerio T, Siqueira PC, Do Prado TN, Sales CMM, Maciel ELN. Operacionalização da campanha de vacinação contra a Covid -19, no município de Vitória -ES, uma experiência de sucesso. Rev Epidemiol Control Infect 2021. [DOI: 10.17058/reci.v11i3.16826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Carta ao Editor não precisa de resumo
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de Jezus SV, do Prado TN, Arcêncio RA, Mascarello KC, Sales CMM, Fauth MM, de Faria Marcos Terena N, Amorim RF, Araujo VMS, Aragón MAL, Maciel ELN. Correction to: Factors associated with latent tuberculosis among international migrants in Brazil: a cross-sectional study (2020). BMC Infect Dis 2021; 21:591. [PMID: 34154537 PMCID: PMC8218398 DOI: 10.1186/s12879-021-06305-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Sonia Vivian de Jezus
- Epidemiology Laboratory, Universidade Federal do Espírito Santo, Vitória, ES, Brazil
| | | | - Ricardo Alexandre Arcêncio
- Graduate Studies Program in Public Health Nursing, Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil
| | - Keila Cristina Mascarello
- Department of Health Sciences, Centro Universitário Norte do Espírito Santo, Universidade Federal do Espírito Santo, São Mateus, ES, Brazil
| | | | - Maysa Mabel Fauth
- Epidemiology Laboratory, Universidade Federal do Espírito Santo, Vitória, ES, Brazil
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Arcêncio RA, Berra TZ, Terena NDFM, Rocha MP, Ferraz de Araújo Alecrim T, de Souza Kihara FM, Mascarello KC, Martins Sales CM, Maciel ELN. Spatial clustering and temporal trend analysis of international migrants diagnosed with tuberculosis in Brazil. PLoS One 2021; 16:e0252712. [PMID: 34106968 PMCID: PMC8189475 DOI: 10.1371/journal.pone.0252712] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 05/20/2021] [Indexed: 11/18/2022] Open
Abstract
Background Tuberculosis (TB) in migrants is of concern to health authorities worldwide and is even more critical in Brazil, considering the country´s size and long land borders. The aim of the study was to identify critical areas in Brazil for migrants diagnosed with TB and to describe the temporal trend in this phenomenon in recent years. Methods This is an ecological study that used spatial analysis and time series analysis. As the study population, all cases of migrants diagnosed with TB from 2014 to 2019 were included, and Brazilian municipalities were considered as the unit of ecological analysis. The Getis-Ord Gi* technique was applied to identify critical areas, and based on the identified clusters, seasonal-trend decomposition based on loess (STL) and Prais-Winsten autoregression were used, respectively, to trace and classify temporal trend in the analyzed series. In addition, several municipal socioeconomic indicators were selected to verify the association between the identified clusters and social vulnerability. Results 2,471 TB cases were reported in migrants. Gi* analysis showed that areas with spatial association with TB in immigrants coincide with critical areas for TB in the general population (coast of the Southeast and North regions). Four TB clusters were identified in immigrants in the states of Amazonas, Roraima, São Paulo, and Rio de Janeiro, with an upward trend in most of these clusters. The temporal trend in TB in immigrants was classified as increasing in Brazil (+ 60.66% per year [95% CI: 27.21–91.85]) and in the clusters in the states of Amazonas, Roraima, and Rio de Janeiro (+1.01, +2.15, and + 2.90% per year, respectively). The cluster in the state of São Paulo was the only one classified as stationary. The descriptive data on the municipalities belonging to the clusters showed evidence of the association between TB incidence and conditions of social vulnerability. Conclusions The study revealed the critical situation of TB among migrants in the country. Based on the findings, health authorities might focus on actions in regions identified, stablishing an intensive monitoring and following up, ensuring that these cases concluded their treatment and avoiding that they could spread the disease to the other regions or scenarios. The population of migrants are very dynamic, therefore strategies for following up them across Brazil are really urgent to manage the tuberculosis among international migrants in an efficient and proper way.
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Affiliation(s)
- Ricardo Alexandre Arcêncio
- Department of Maternal-Infant and Public Health Nursing, University of São Paulo at Ribeirão Preto School of Nursing, Ribeirão Preto, São Paulo, Brazil
- * E-mail:
| | - Thaís Zamboni Berra
- Department of Maternal-Infant and Public Health Nursing, University of São Paulo at Ribeirão Preto School of Nursing, Ribeirão Preto, São Paulo, Brazil
| | | | - Matheus Piumbini Rocha
- Epidemiology Laboratory, Health Sciences Center, Universidade Federal do Espírito Santo, Vitoria, Brazil
| | | | | | - Keila Cristina Mascarello
- Department of Health Sciences, Centro Universitário Norte do Espírito Santo, Universidade Federal do Espírito Santo, Vitoria, Brazil
| | | | - Ethel Leonor Noia Maciel
- Epidemiology Laboratory, Health Sciences Center, Universidade Federal do Espírito Santo, Vitoria, Brazil
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de Jezus SV, do Prado TN, Arcêncio RA, Mascarello KC, Sales CMM, Fauth MM, de Faria Marcos Terena N, Amorim RF, Araujo VMS, Aragón MAL, Maciel ELN. Factors associated with latent tuberculosis among international migrants in Brazil: a cross-sectional study (2020). BMC Infect Dis 2021; 21:512. [PMID: 34074249 PMCID: PMC8168318 DOI: 10.1186/s12879-021-06227-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 05/20/2021] [Indexed: 02/03/2023] Open
Abstract
Background Migrants are a high priority group for TB control measures due to their high exposure to risk factors such as poverty and social vulnerability. The study aimed to identify factors associated with latent TB among international migrants living in four Brazilian state capitals. This was a cross-sectional study conducted in September and October 2020 in a sample of 903 international migrants living in four Brazilian state capitals: Boa Vista/RR (458), Manaus/AM (136), São Paulo/SP (257), and Curitiba/PR (52). Data were collected with a questionnaire consisting of open and closed questions on personal characteristics, information on TB, and use of preventive measures. Tuberculin skin test (TST) was performed, with reading after 72 h by trained nurses and using 5 mm induration as the positive cutoff. Chi-square test (X2) and Fisher’s exact test, both two-tailed, were used to compare statistically significant levels of association between the migrants´ sociodemographic characteristics, vulnerability, and latent TB infection (LTBI). Binary logistic regression was applied to calculate odds ratios and respective 95% confidence intervals. For all the tests, type I error of 5% was defined as statistically significant (p < 0.05). Results Prevalence of LTBI among migrants was 46.1% in Manaus/AM, 33.3% in São Paulo/SP, 28.1% in Curitiba/PR, and 23.5% in Boa Vista/RR. Factors associated with latent infection were age, male gender, and brown or indigenous race. Conclusions The study showed high prevalence of latent TB among international migrants.
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Affiliation(s)
- Sonia Vivian de Jezus
- Epidemiology Laboratory, Universidade Federal do Espírito Santo, Vitória, ES, Brazil
| | | | - Ricardo Alexandre Arcêncio
- Graduate Studies Program in Public Health Nursing, Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil
| | - Keila Cristina Mascarello
- Department of Health Sciences, Centro Universitário Norte do Espírito Santo, Universidade Federal do Espírito Santo, São Mateus, ES, Brazil
| | | | - Maysa Mabel Fauth
- Epidemiology Laboratory, Universidade Federal do Espírito Santo, Vitória, ES, Brazil
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Cola JP, Prado TND, Sales CMM, Maciel ELN. Family Health Strategy and determinants of directly observed treatment for tuberculosis in Brazil: a cross-sectional study with surveillance system data, 2014-2016. Epidemiol Serv Saude 2020; 29:e2020284. [PMID: 33295589 DOI: 10.1590/s1679-49742020000500010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 07/31/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To assess the association between tuberculosis determinants and performance of directly observed treatment (DOT) under different levels of Family Health Strategy (FHS) coverage in Brazil. METHODS This was a cross-sectional study using data on tuberculosis cases notified between 2014 and 2016 on the Notifiable Health Conditions Information System, as well as data on FHS coverage in the municipality of residence. Logistic regression was used. RESULTS 177,626 individuals were included; being an alcohol user (odds ratio (OR) 1.09 - 95% confidence interval % [95%CI] 1.03;1.16), being deprived of liberty (OR=1.21 - 95%CI 1.12;1.32) and positive sputum smear microscopy (OR=1.15 - 95%CI 1.10;1.21) increased the chances of DOT being performed . When stratified by FHS coverage, these associations became weak in the highest stratum of coverage. CONCLUSION DOT being performed was associated with determinants of tuberculosis. However, association was not confirmed among residents in municipalities with higher FHS coverage.
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Affiliation(s)
- João Paulo Cola
- Universidade Federal do Espírito Santo, Laboratório de Epidemiologia, Vitória, ES, Brasil
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Sales CMM, Silva AID, Maciel ELN. COVID-19 health surveillance in Brazil: investigation of contacts by primary health care as a community protection strategy. Epidemiol Serv Saude 2020; 29:2020373. [PMID: 32756828 DOI: 10.5123/s1679-49742020000400011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Affiliation(s)
| | - Adriana Ilha da Silva
- Departamento de Serviço Social, Universidade Federal do Espírito Santo, Vitória, ES, Brasil
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Freitas PDSS, Soares GB, Mocelin HJS, Lacerda LCX, do Prado TN, Sales CMM, Perez F, Bussinger ECDA, Maciel ELN. [Congenital Zika syndrome: sociodemographic profile of mothersSíndrome congénito por el virus del Zika: perfil sociodemográfico de las madres]. Rev Panam Salud Publica 2019; 43:e24. [PMID: 31093248 PMCID: PMC6459376 DOI: 10.26633/rpsp.2019.24] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 11/12/2018] [Indexed: 11/24/2022] Open
Abstract
Objetivo Descrever o perfil sociodemográfico de mães de crianças com síndrome congênita do Zika. Métodos Trata-se de um estudo descritivo, transversal, de abordagem quantitativa. Foram convidadas a participar todas as 39 mães de bebês nascidos vivos entre os casos notificados em 2015 e 2016 com diagnóstico confirmado de síndrome congênita do Zika no Estado da Saúde do Espírito Santo. Dessas 39 mulheres, 25 concordaram em participar. Para a coleta de dados foram utilizados um formulário para identificar o perfil sociodemográfico e um diário de campo. Resultados Das 25 mães, 19 (74,0%) se declararam não brancas e 16 declararam (64,0%) possuir companheiro. Quanto à escolaridade, 12 (48,0%) possuíam ensino médio completo. A renda domiciliar per capita variou de nenhuma renda até US$ 1 111,11; 12 mulheres (48,0%) tinham entre nenhuma renda e renda de US$ 61,72. Quanto à moradia, 17 (68,0%) residiam em áreas de periferia com condições precárias. Das 25 mulheres, 16 (64,0%) apresentavam vínculo empregatício antes da gestação; e dessas 16 com vínculo, 12 (75,0%) foram demitidas ou pediram demissão após o nascimento do bebê. Conclusões O perfil das mães revelou que a epidemia não foi equânime e atingiu preferencialmente mulheres de baixa renda e de estratos sociais desfavorecidos. Nesse sentido, acredita-se que a doença possa ser determinada pelas desigualdades sociais de saúde presentes no país. Os dados descritos podem fornecer subsídios para o planejamento de ações efetivas para garantir uma rede de proteção social para crianças com síndrome congênita do Zika e suas famílias.
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Affiliation(s)
- Paula de Souza Silva Freitas
- Universidade Federal do Espírito Santo (UFES) Programa de Pós-Graduação em Saúde Coletiva Vitória (ES) Brasil Universidade Federal do Espírito Santo (UFES), Programa de Pós-Graduação em Saúde Coletiva, Vitória (ES), Brasil
| | - Gabriella Barreto Soares
- Universidade Federal do Espírito Santo (UFES) Programa de Pós-Graduação em Saúde Coletiva Vitória (ES) Brasil Universidade Federal do Espírito Santo (UFES), Programa de Pós-Graduação em Saúde Coletiva, Vitória (ES), Brasil
| | - Helaine Jacinta Salvador Mocelin
- Universidade Federal do Espírito Santo (UFES) Programa de Pós-Graduação em Saúde Coletiva Vitória (ES) Brasil Universidade Federal do Espírito Santo (UFES), Programa de Pós-Graduação em Saúde Coletiva, Vitória (ES), Brasil
| | - Larissa Carolina Xavier Lacerda
- Universidade Federal do Espírito Santo (UFES) Departamento de Ciências da Saúde São Mateus (ES) Brasil Universidade Federal do Espírito Santo (UFES), Departamento de Ciências da Saúde, São Mateus (ES), Brasil
| | - Thiago Nascimento do Prado
- Universidade Federal do Espírito Santo (UFES) Programa de Pós-Graduação em Saúde Coletiva Vitória (ES) Brasil Universidade Federal do Espírito Santo (UFES), Programa de Pós-Graduação em Saúde Coletiva, Vitória (ES), Brasil
| | - Carolina Maia Martins Sales
- Universidade Federal do Espírito Santo (UFES) Laboratório de Epidemiologia (LabEpi UFES) Vitória (ES) Brasil Universidade Federal do Espírito Santo (UFES), Laboratório de Epidemiologia (LabEpi UFES), Vitória (ES), Brasil
| | - Freddy Perez
- Pan American Health Organization (PAHO) Communicable Diseases and Environmental Determinants of Health Department Washington (DC) Estados Unidos Pan American Health Organization (PAHO), Communicable Diseases and Environmental Determinants of Health Department, Washington (DC), Estados Unidos
| | - Elda Coelho de Azevedo Bussinger
- Faculdade de Direito de Vitória (FDV) Programa de Pós-Graduação em Direito Vitória (ES) Brasil Faculdade de Direito de Vitória (FDV), Programa de Pós-Graduação em Direito, Vitória (ES), Brasil
| | - Ethel Leonor Noia Maciel
- Universidade Federal do Espírito Santo (UFES) Programa de Pós-Graduação em Saúde Coletiva Vitória (ES) Brasil Universidade Federal do Espírito Santo (UFES), Programa de Pós-Graduação em Saúde Coletiva, Vitória (ES), Brasil
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Santos JND, Sales CMM, Prado TND, Maciel EL. Factors associated with cure when treating tuberculosis in the state of Rio de Janeiro, Brazil, 2011-2014. Epidemiol Serv Saude 2018; 27:e2017464. [PMID: 30365701 DOI: 10.5123/s1679-49742018000300015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2017] [Accepted: 03/05/2018] [Indexed: 11/02/2022] Open
Abstract
OBJECTIVE to analyze factors associated with cure when treating tuberculosis (TB) in the state of Rio de Janeiro, Brazil, from 2011 to 2014. METHODS this was a cross-sectional study with data from the Notifiable Diseases Information System (SINAN); logistic regression was used for data analysis. RESULTS of the 57,142 cases reported, 49,691 (86.96%) were included in the study; schooling ≥13 years (odds ratio (OR) 3.48; 95%CI 2.74;4.41) and residing in rural areas (OR 2.27; 95%CI 1.38; 3.73) were factors associated with a higher chance of cure; being male (OR 0.71; 95%CI 0.66;0.76) and brown skin color/race (OR 0.73; 95%CI 0.68;0.78) stood out as factors associated with less chance of cure. CONCLUSION social and economic determinants were identified that influence the treatment outcome, evidencing the need for social support and guaranteed access to health services.
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Affiliation(s)
| | | | - Thiago Nascimento do Prado
- Universidade Federal do Espírito Santo, Programa de Pós-Graduação em Saúde Coletiva, Vitória, ES, Brasil
| | - Ethel Leonor Maciel
- Universidade Federal do Espírito Santo, Programa de Pós-Graduação em Saúde Coletiva, Vitória, ES, Brasil
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Sales CMM, Sanchez MN, Ramalho W, Bertolde AI, Maciel ELN. Social determinants of tuberculosis via a zero-inflated model in small areas of a city in Southeastern Brazil. Rev Soc Bras Med Trop 2018; 51:638-643. [PMID: 30304270 DOI: 10.1590/0037-8682-0015-2018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 07/27/2018] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION This study aimed to analyze social factors involved in the spatial distribution and under-reporting of tuberculosis (TB) in the city of Vitória, Espírito Santo State, Brazil. METHODS This was an ecological study of the reported cases of TB between 2009 and 2011, according to census tracts. The outcome was TB incidence for the study period and the variables of exposure were proportions of literacy, inhabitants with an income of up to half the minimum monthly wage (MMW), and inhabitants associated with sewer mains or with access to safe drinking water. We used a zero-inflated process, zero-inflated negative binomial regression (ZINB), and selected an explanatory model based on the Akaike Information Criterion (AIC). RESULTS A total of 588 cases of tuberculosis were reported in Vitória during the study period, distributed among 223 census tracts (38.6%), with 354 (61.4%) tracts presenting zero cases. In the ZINB model, the mean value of p i was 0.93, indicating that there is a 93% chance that an observed false zero could be due to sub-notification. CONCLUSIONS It is important to prioritize areas exhibiting determinants that influence the occurrence of TB in the municipality of Vitória. The zero-inflated model can be useful to the public health sector since it identifies the percentage of false zeros, generating an estimate of the real epidemiological condition of TB in Vitória.
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Affiliation(s)
- Carolina Maia Martins Sales
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Espírito Santo, Vitória, ES, Brasil.,Laboratório de Epidemiologia, Universidade Federal do Espírito Santo, Vitória, ES, Brasil
| | | | - Walter Ramalho
- Campus Ceilândia, Universidade de Brasília, Brasília, DF, Brasil
| | - Adelmo Inácio Bertolde
- Laboratório de Epidemiologia, Universidade Federal do Espírito Santo, Vitória, ES, Brasil.,Departamento de Estatística, Universidade Federal do Espírito Santo, Vitória, ES, Brasil
| | - Ethel Leonor Noia Maciel
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Espírito Santo, Vitória, ES, Brasil.,Laboratório de Epidemiologia, Universidade Federal do Espírito Santo, Vitória, ES, Brasil
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Maciel ELN, Sales CMM, Bertolde AI, Reis-Santos B. Can Brazil achieve the new World Health Organization global targets for tuberculosis control? Epidemiol Serv Saude 2018; 27:e0200007. [PMID: 29972471 DOI: 10.5123/s1679-49742018000200007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Affiliation(s)
| | | | - Adelmo Inácio Bertolde
- Universidade Federal do Espírito Santo, Departamento de Estatística, Vitória, ES, Brasil
| | - Barbara Reis-Santos
- Universidade Federal do Espírito Santo, Laboratório de Epidemiologia,Vitória, ES, Brasil
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Honorato T, Lapa PPDA, Sales CMM, Reis-Santos B, Tristão-Sá R, Bertolde AI, Maciel ELN. Spatial analysis of distribution of dengue cases in Espírito Santo, Brazil, in 2010: use of Bayesian model. Rev Bras Epidemiol 2016; 17 Suppl 2:150-9. [PMID: 25409645 DOI: 10.1590/1809-4503201400060013] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2012] [Accepted: 06/12/2013] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To study the relationship between the risk of dengue and sociodemographic variables through the use of spatial regression models fully Bayesian in the municipalities of Espírito Santo in 2010. METHOD This is an ecological study and exploration that used spatial analysis tools in preparing thematic maps with data obtained from SinanNet. An analysis by area, taking as unit the municipalities of the state, was performed. Thematic maps were constructed by the computer program R 2.15.00 and Deviance Information Criterion (DIC), calculated in WinBugs, Absolut and Normalized Mean Error (NMAE) were the criteria used to compare the models. RESULTS We were able to geocode 21,933 dengue cases (rate of 623.99 cases per 100 thousand habitants) with a higher incidence in the municipalities of Vitória, Serra and Colatina; model with spatial effect with the covariates trash and income showed the best performance at DIC and Nmae criteria. CONCLUSION It was possible to identify the relationship of dengue with factors outside the health sector and to identify areas with higher risk of disease.
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Affiliation(s)
- Taizi Honorato
- School of Statistics, Universidade Federal do Espírito Santo, Vitória, ES, Brazil
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dos Santos Dias E, do Prado TN, da Silva Guimarães AL, Ramos MC, Sales CMM, de Fátima Almeida Lima E, Sant'Anna CC, Sanchez M, Maciel EL. Childhood tuberculosis and human immunodeficiency virus status in Brazil: a hierarchical analysis. Int J Tuberc Lung Dis 2016; 19:1305-11. [PMID: 26467582 DOI: 10.5588/ijtld.14.0619] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING Human immunodeficiency virus (HIV) infection may impact tuberculosis (TB) diagnosis, clinical presentation and treatment outcomes in children as the signs and symptoms of both diseases overlap. OBJECTIVE To compare the sociodemographic and clinical profiles of childhood TB according to HIV status in Brazil. METHODS This was a cross-sectional study of data on subjects aged <15 years retrieved from the Brazilian National Electronic Disease Registry (Sistema de Informação de Agravos de Notificação) database on TB to compare TB-HIV coinfected patients and patients with TB only registered between 2007 and 2011. A hierarchical logistic regression model was applied. RESULTS Of 6091 cases analysed, 780 (12%) were TB-HIV patients, while 5311 (87%) presented with TB only. TB-HIV patients were more likely to be institutionalised (OR 2.22, 95%CI 1.43-3.46), to present with relapsed TB (OR 5.03, 95%CI 2.02-12.5) and be readmitted after treatment default (OR 16.7, 95%CI 4.34-64.46). They were also more likely to have unfavourable outcomes, including default (OR 2.85, 95%CI 1.81-4.49), death due to TB (OR 2.76, 95%CI 1.27-6.03) and death from other causes (OR 5.59, 95%CI 2.63-11.8). CONCLUSION Our study highlights the challenges of using national registers for research into childhood TB.
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Affiliation(s)
- E dos Santos Dias
- Laboratory of Epidemiology, Federal University of Espírito Santo, Vitória, Espírito Santo, Rio de Janeiro, Brazil; School of Nursing, Federal University of Espírito Santo, Vitória, Espírito Santo, Rio de Janeiro, Brazil
| | - T N do Prado
- Laboratory of Epidemiology, Federal University of Espírito Santo, Vitória, Espírito Santo, Rio de Janeiro, Brazil; School of Nursing, Federal University of Espírito Santo, Vitória, Espírito Santo, Rio de Janeiro, Brazil; Post-Graduate Programme in Infectious Diseases, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil
| | - A L da Silva Guimarães
- Laboratory of Epidemiology, Federal University of Espírito Santo, Vitória, Espírito Santo, Rio de Janeiro, Brazil; School of Nursing, Federal University of Espírito Santo, Vitória, Espírito Santo, Rio de Janeiro, Brazil
| | - M C Ramos
- School of Nursing, Federal University of Espírito Santo, Vitória, Espírito Santo, Rio de Janeiro, Brazil
| | - C M M Sales
- Laboratory of Epidemiology, Federal University of Espírito Santo, Vitória, Espírito Santo, Rio de Janeiro, Brazil; School of Nursing, Federal University of Espírito Santo, Vitória, Espírito Santo, Rio de Janeiro, Brazil; Post-Graduate Programme in Infectious Diseases, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil
| | - E de Fátima Almeida Lima
- School of Nursing, Federal University of Espírito Santo, Vitória, Espírito Santo, Rio de Janeiro, Brazil
| | - C C Sant'Anna
- Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - M Sanchez
- Department of Public Health, University of Brasilia, Brasilia DF, Brazil
| | - E L Maciel
- Laboratory of Epidemiology, Federal University of Espírito Santo, Vitória, Espírito Santo, Rio de Janeiro, Brazil; School of Nursing, Federal University of Espírito Santo, Vitória, Espírito Santo, Rio de Janeiro, Brazil; Post-Graduate Programme in Infectious Diseases, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil; Post-Graduate Program in Public Health, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil
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Marlow MA, Maciel ELN, Sales CMM, Gomes T, Snyder RE, Daumas RP, Riley LW. Tuberculosis DALY-Gap: Spatial and Quantitative Comparison of Disease Burden Across Urban Slum and Non-slum Census Tracts. J Urban Health 2015; 92:622-34. [PMID: 25840553 PMCID: PMC4524851 DOI: 10.1007/s11524-015-9957-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
To quantitatively assess disease burden due to tuberculosis between populations residing in and outside of urban informal settlements in Rio de Janeiro, Brazil, we compared disability-adjusted life years (DALYs), or "DALY-gap." Using the 2010 Brazilian census definition of informal settlements as aglomerados subnormais (AGSN), we allocated tuberculosis (TB) DALYs to AGSN vs non-AGSN census tracts based on geocoded addresses of TB cases reported to the Brazilian Information System for Notifiable Diseases in 2005 and 2010. DALYs were calculated based on the 2010 Global Burden of Disease methodology. DALY-gap was calculated as the difference between age-adjusted DALYs/100,000 population between AGSN and non-AGSN. Total TB DALY in Rio in 2010 was 16,731 (266 DALYs/100,000). DALYs were higher in AGSN census tracts (306 vs 236 DALYs/100,000), yielding a DALY-gap of 70 DALYs/100,000. Attributable DALY fraction for living in an AGSN was 25.4%. DALY-gap was highest for males 40-59 years of age (501 DALYs/100,000) and in census tracts with <60% electricity (12,327 DALYs/100,000). DALY-gap comparison revealed spatial and quantitative differences in TB burden between slum vs non-slum census tracts that were not apparent using traditional measures of incidence and mortality. This metric could be applied to compare TB burden or burden for other diseases in mega-cities with large informal settlements for more targeted resource allocation and evaluation of intervention programs.
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Affiliation(s)
- Mariel A Marlow
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, 530E Li Ka Shing Health Center, Berkeley, CA, 94720, USA,
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Sales CMM, Figueiredo TAMD, Zandonade E, Maciel ELN. [Spatial analysis on childhood tuberculosis in the state of Espirito Santo, Brazil, 2000 to 2007]. Rev Soc Bras Med Trop 2011; 43:435-9. [PMID: 20802946 DOI: 10.1590/s0037-86822010000400020] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2010] [Accepted: 06/04/2010] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Childhood tuberculosis is responsible for 15% of case notifications. The focus of Tuberculosis Control National Program is on identifying tuberculosis in adults, while leaving children under 15 years of age on the margins of studies, diagnoses and treatment. Spatial analysis quantifies the exposition to the illness and displays the main causes relating to geographical space. The objective of this study was to analyze the spatial distribution of childhood tuberculosis in Espírito Santo, between 2000 and 2007, according to the municipality of notification METHODS An ecological study was conducted on 515 cases of childhood tuberculosis that occurred between 2000 and 2007. The Local Empirical Bayesian Method was used to measure the risk. The Moran Local Index was calculated in order to evaluate autocorrelations between threshold districts RESULTS High incidence rates were found in the Metropolitan Region of Vitória and the northeastern region, and lower rates were found in the southeastern region. Similar data were observed in a study on endemic tuberculosis among adults in Espírito Santo. This is possibly related to contacts within the home CONCLUSIONS This study identified possible areas of recent transmission of the disease. It is important to emphasize that knowledge of the high priority areas for tuberculosis control may help public administrators to diminish healthcare iniquities and enable improvement of resources and teams for controlling childhood tuberculosis.
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Maciel ELN, Brotto LDDA, Sales CMM, Zandonade E, Sant'anna CC. Gastric lavage in the diagnosis of pulmonary tuberculosis in children: a systematic review. Rev Saude Publica 2010; 44:735-42. [PMID: 20585739 DOI: 10.1590/s0034-89102010005000019] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2009] [Accepted: 12/20/2009] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To analyze standardization of gastric lavage protocols in the diagnosis of pulmonary tuberculosis in children. METHODS A systematic review was conducted for the period between 1968 and 2008 in the following databases: LILACS, SCIELO and MEDLINE. The search strategy included the following terms: "gastric lavage and tuberculosis" or "gastric washing and tuberculosis" with the restriction of "children aged up to 15 years;" "gastric lavage and tuberculosis and childhood" or "gastric washing and tuberculosis and childhood." There were retrieved 80 articles and their analysis was based on information on the gastric lavage protocol for the diagnosis of pulmonary tuberculosis in children: preparation of children and fasting; time of gastric aspiration; aspiration of gastric residues; total volume of aspirate; solution used for aspiration of gastric contents; decontaminant solution; buffer solution; and time for forwarding samples to the laboratory. After a thorough analysis, 14 articles were selected. RESULTS No article detailed the whole procedure. Some articles had missing information on: amount of gastric aspirate; aspiration before or after solution injection; solution used for gastric aspiration; buffer solution used; and waiting time between specimen collection and laboratory processing. These results showed inconsistencies of gastric lavage protocols. CONCLUSIONS Although gastric lavage is a secondary diagnostic approach used only in special cases that did not reach the diagnostic scoring as recommended by the Brazilian Ministry of Health, there is a need to standardize gastric lavage protocols for the diagnosis of pulmonary tuberculosis in children.
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Affiliation(s)
- Ethel Leonor Noia Maciel
- Departamento de Enfermagem, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória, ES, Brasil.
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Maciel ELN, Oliveira CB, Frechiani JM, Sales CMM, Brotto LDDA, Araújo MD. Projeto Aprendendo Saúde na Escola: a experiência de repercussões positivas na qualidade de vida e determinantes da saúde de membros de uma comunidade escolar em Vitória, Espírito Santo. Ciênc saúde coletiva 2010; 15:389-96. [DOI: 10.1590/s1413-81232010000200014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2008] [Accepted: 02/18/2009] [Indexed: 11/22/2022] Open
Abstract
Estudo descritivo, de abordagem quantitativa, para avaliar as estratégias realizadas pelo enfermeiro no ambiente escolar de um Centro Municipal de Educação Infantil, através do Projeto de Extensão Aprendendo Saúde na Escola, e ainda analisar o perfil das crianças atendidas. A pesquisa foi realizada com uma amostra de 350 atendimentos de enfermagem. Verificamos que em dez alunos foram encontradas lesões corporais sugestivas de violência/negligência familiar. Estavam registradas atividades educativas, abordando os seguintes temas: dengue, higiene pessoal, parasitose e destino dos resíduos sólidos. Constatamos que 4,6% das crianças atendidas estavam desnutridas, 6,4% encontravam-se em risco nutricional e que 80% das crianças atendidas não apresentavam uma higiene oral adequada, demonstrada através da presença de cáries. Na avaliação dos professores sobre a atuação do projeto, foi possível identificar relatos sobre a diminuição dos episódios de violência doméstica contra a criança. O projeto tem proporcionado a ação do trabalho interdisciplinar, favorecendo as atividades de promoção de saúde tendo a escola como um espaço da atenção básica, devendo ser entendido como um núcleo motivador da atuação participativa dos profissionais de saúde na comunidade escolar.
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