Ana Paula Soares Gondim

Prevalence and factors associated with syphilis in parturient women in Northeast, Brazil

BackgroundCongenital syphilis is a major public health concern, even after the implementation of intervention protocols in several countries. This study aimed to analyze the prevalence and socio-demographic, behavioral and institutional factors associated with syphilis in parturient women attending public maternity hospitals in Northeast, Brazil.MethodsA cross-sectional study was conducted from June to September 2010 with a proportionate stratified sampling of 222 parturient women using a structured questionnaire. The study analyzed socio-demographic, behavioral and institutional variables. The structured questionnaire was conducted with parturient women and complementary information was obtained through hospitals records, admission forms and prenatal cards. Data were stored using the Statistical Package SPSS version 18. A descriptive statistical analysis was performed using frequency distribution, central tendency and measures of spread for the variables. A bivariate analysis was done using chi square test and Fisher’s exact test, with a significance level of 5% and a 95% confidence interval, in order to analyze the relation between the variables and risk factors for syphilis. The multivariate logistic regression analysis was done in the statistical package STATA, version 11.0.ResultsThe prevalence of syphilis in parturient women was 7.7%. The bivariate analyses showed that the rate was higher among women who: were from Fortaleza (p = 0.019), studied for less than nine years (p = 0.044), had more than one sexual partner in life (p = 0.021), did not live with partner (p = 0.022), used illegal drugs (p < 0.0001), whose partner used illegal drugs and had diagnosis of syphilis (p = 0.001 and p < 0.0001 respectively). The non-adjusted analysis found significant positive association between syphilis and the following variable: being from Fortaleza (OR = 7.26; CI 95% = 1.49-100.20), having studied for less than nine years (OR = 7.97; CI 95% = 0.87-12.89), having more than one sexual partner in life (OR = 3.75; CI 95% = 1.59-107.11), not living with partner (OR = 3.75; CI95% = 1.03-12.15), and parturient women and partner used illegal drugs (OR = 7.34; CI95% = 1.69-27.57; OR = 4.93; CI95% = 1.58-16.05), respectively. The adjusted multiple logistic regression analysis showed that none of the variables remained significant.ConclusionThis study enabled to identify a high prevalence of syphilis in parturient women and that this situation is associated with socio-demographic, behavioral and institutional variables.

Anti-PGL1 salivary IgA/IgM, serum IgG/IgM, and nasal Mycobacterium leprae DNA in individuals with household contact with leprosy

OBJECTIVES Leprosy household contacts represent a group at high risk of developing the disease. The aim of this study was to detect Mycobacterium leprae subclinical infection in this group through serological and molecular parameters. METHODS Serum anti-PGL1 IgG/IgM and salivary anti-PGL1 IgA/IgM was investigated using an ELISA, and nasal carriage of M. leprae DNA was detected by PCR, in leprosy household contacts of paucibacillary (PB) and multibacillary (MB) household leprosy patients (n=135), their index cases (n=30), and in persons living in a low endemic city (n=17). RESULTS Salivary anti-PGL1 IgA and IgM and serum anti-PGL1 IgG showed good correlation comparing contacts and index cases (p<0.01, p<0.005, and p<0.0001, respectively). This was not observed for serum anti-PGL1 IgM (p>0.05). A high frequency of anti-PGL1 IgM positivity was found in IgG-negative samples (p<0.0001). For IgG-positive samples, IgM antibodies were also positive in most of the samples. None of the 17 volunteers living in a low endemic city presented seropositivity for IgG; however, two of them showed positivity for anti-PGL1 IgM. M. leprae DNA was found in the nasal swabs of nine out of the 85 MB household leprosy contacts (10.6%) and in three out of the 50 PB household leprosy contacts (6.0%). CONCLUSION We strongly suggest that serum IgG/IgM and salivary anti-PGL1 IgA/IgM measurements are used to follow leprosy household contacts.

Mothers knowledge concerning breastfeeding and complementation food: an exploratory study

Objetivos: investigar os habitos alimentares e os fatores que interferem na pratica do aleitamento materno exclusivo em criancas de 0 a 6 meses de idade. Metodo: pesquisa exploratoria com abordagem qualitativa. Amostra: 16 maes de criancas menores de seis meses de idade em alimentacao mista, residentes em Maranguape–CE. A coleta de dados deu-se de julho a outubro de 2009 mediante entrevista semiestruturada. Resultados: constatou-se uma alimentacao deficiente em nutrientes. Os aspectos positivos frente ao aleitamento materno foram enaltecidos, entretanto observa-se que o desmame precoce e justificado por crencas. Conclusao: e relevante a atuacao dos profissionais de saude na alimentacao infantil a fim de promover e prevenir possiveis danos a saude, mediante a realizacao de estrategias educativas voltadas a comunidade, buscando compreender o motivo do desmame precoce atraves da aproximacao com as maes, considerando as peculiaridades e o cenario que estao inseridas

Uso de medicamentos contínuos e fatores associados em idosos de Quixadá, Ceará

OBJECTIVE To analyze polypharmacy (daily use of two or more) of continuous use medication and its associated factors in the elderly. METHODS A cross sectional study conducted with elderly individuals living in an urban area of the municipality of Quixadá, Ceara, Brazil from May to December, 2009. The sample consisted of 384 individuals who were 60 years old or older and users of continuous medication. The variables studied were sociodemographic, economical, and health characteristics related to use of medications. For the analysis of the association between the dependent variable polypharmacy of continuous-use medication and the independent variables a logistic regression model was developed. RESULTS Results showed a predominance of females, between 60 and 69 years old, married, with incomplete elementary school education, non-paid job, family income of one minimum salary, living in their own home and together with up to three individuals. A prevalence of 70.6% of polypharmacy in the elderly was found, and it was higher in women (66.4%). Factors positively associated with the use of two or more continuous-use medication were: family income over one minimum salary (OR 2.83; CI95% = 1.54-5.32); two or more self-reported chronic conditions (OR 17.71; CI95% = 9.80-31.990) and self-perception of regular to poor quality of life (OR 2.85; CI95% = 1.60-5.07). CONCLUSIONS The study observed a practice of polypharmacy of continuous-use medications in the elderly with family income over one minimum wage, two or more chronic conditions and self-perception of regular to poor quality of life. Such status leads to questions on social, cultural, economic and health aspects.

Fui lá no posto e o doutor me mandou foi pra cá: processo de medicamentalização e (des)caminhos para o cuidado em saúde mental na Atenção Primária

Buscou-se compreender como o cuidado em saude mental vem sendo produzido na Atencao Primaria, com base nas experiencias de profissionais, usuarios e familiares. As informacoes obtidas foram categorizadas pelos aspectos observados na efetivacao da interface entre Atencao Primaria e saude mental, descritos como: medicamentalizacao dos problemas de saude mental apresentados pela populacao; dificuldades no acesso dos usuarios do Centro de Atencao Psicossocial (CAPS) a Unidade de Saude da Familia, e formacao em saude mental para os profissionais da Atencao Primaria. O processo de medicamentalizacao perpassa as praticas dos profissionais e configura-se como a principal demanda dos usuarios do CAPS, indicando a necessidade de acoes desmedicalizantes, que encontram potencia na incorporacao de novas relacoes e dinâmicas sociais no territorio, maior articulacao das equipes e estimulo a participacao social da comunidade neste processo.

Factors associated to the imposition of types of violence against women informed in sentry services

OBJECTIVE to identify the prevalence and the factors associated to the imposition of the different types of violence against women informed in sentry services. METHOD transversal study accomplished through 939 notification forms of cases of violence against women, referring to the three years from 2006 to 2008 in Fortaleza, Ceará. Univariate and multiple analyses by logistic regression were realized. RESULT the results showed a positive association between the imposition of types of violence against women with a schooling varying from illiterate to basic education and the aggression which had occurred other times. CONCLUSION this knowledge contributes to the delineation of specific actions that aim at facing this problem, as well as generates subsidies for adequate attendance proposals and guidance for the victims who call on health services.OBJETIVO: identificar a prevalencia e os fatores associados a sobreposicao dos diferentes tipos de violencia contra a mulher, notificada em servicos sentinela. METODO: estudo transversal, realizado com 939 fichas de notificacao de casos de violencia contra a mulher, referentes ao trienio de 2006 a 2008, em Fortaleza, Ceara. Analises univariada e multipla por regressao logistica foram realizadas. RESULTADO: os resultados mostraram associacao positiva entre a sobreposicao de tipos de violencia contra a mulher com a escolaridade variando de analfabeta a ensino fundamental e a agressao ter ocorrido outras vezes. CONCLUSAO: esse conhecimento contribui para o delineamento de acoes especificas que visam o enfrentamento dessa problematica, assim como gera subsidios para proposta adequada de atendimento e encaminhamento das vitimas que buscam os servicos de saude.

?I went to the health unit and the doctor sent me here?: process of medicationalization and (non)resolution of mental healthcare within primary care

Buscou-se compreender como o cuidado em saude mental vem sendo produzido na Atencao Primaria, com base nas experiencias de profissionais, usuarios e familiares. As informacoes obtidas foram categorizadas pelos aspectos observados na efetivacao da interface entre Atencao Primaria e saude mental, descritos como: medicamentalizacao dos problemas de saude mental apresentados pela populacao; dificuldades no acesso dos usuarios do Centro de Atencao Psicossocial (CAPS) a Unidade de Saude da Familia, e formacao em saude mental para os profissionais da Atencao Primaria. O processo de medicamentalizacao perpassa as praticas dos profissionais e configura-se como a principal demanda dos usuarios do CAPS, indicando a necessidade de acoes desmedicalizantes, que encontram potencia na incorporacao de novas relacoes e dinâmicas sociais no territorio, maior articulacao das equipes e estimulo a participacao social da comunidade neste processo.

Stuck in the muck: an eco-idiom of distress from childhood respiratory diseases in an urban mangrove in Northeast Brazil

The aim of this study was to compare the direct costs of implementation of the Kangaroo Method and an Intermediate Neonatal Care Unit, from the perspective of the Brazilian Unified National Health System (SUS) in Rio de Janeiro, Brazil. Newborns were eligible for inclusion if they were clinically stable and were able to receive care in those two modalities. A decision tree model was developed that incorporated baseline variables and costs into a hypothetical cohort of 1,000 newborns, according to the literature and expert opinions. Daily cost was BR

“Fui al dispensario de salud y el médico me mandó venir aquí”: proceso de medicamentalización y (des)caminos para el cuidado de la salud mental en la atención primaria

343.53 for the second stage of the Kangaroo Unit and BR

Fatores associados a sobreposicao de tipos de violencia contra a mulher notificada em servicos sentinela

394.22 for the Intermediate Neonatal Care Unit. The total cost for the hypothetical cohort was BR