Denise Nacif Pimenta

A urbanização das leishmanioses e a baixa resolutividade diagnóstica em municípios da Região Metropolitana de Belo Horizonte

During the period from 1994 to 1999 cutaneous leishmaniasis was reported in 32 (89%) out of 36 municipalities in the Metropolitan Region of Belo Horizonte, Brazil, of which one (2,8%) municipality was classified as a very high risk area, 16 (44,5%) as high risk, seven (19,4%) as moderate risk areas and 12 (33,3%) as low risk. From 1994 to 1995, visceral leishmaniasis was reported in six (16%) municipalities whereas in 1998 --1999 this number increased to 15 (42%). Annual numbers of cases during 1994 to 1999 were 30, 53, 64, 53 and 84, respectively. In 19 (61.3%) municipalities no reference center for the diagnosis of the infection was available, so that most of the patients (80%) were referred to Belo Horizonte. Twelve (39%) municipalities have a center for leishmaniasis evaluation, however in only eight (67%) of these basic specific diagnostic tests were available. Rapid and extensive increase of leishmaniasis associated with low diagnosis capacity has been observed in the metropolitan area of Belo Horizonte.

Evaluation of informative materials on leishmaniasis distributed in Brazil: criteria and basis for the production and improvement of health education materials

Based on categories related to structure, content, language, and illustrations, the present study provides an evaluation of the quality of educational materials on leishmaniasis available to health services in Brazil. The 18 publications evaluated consisted of four handbooks, four guided studies, four booklets, and six leaflets. Of the total publications assessed, nine were produced by the Brazilian National Health Foundation (FUNASA), five by State and Municipal Health Departments jointly with FUNASA, and one by the Pan-American Health Organization. The evaluations were also performed by three professionals: a physician specialized in leishmaniasis, a parasitologist, and an information/communications expert. The publications failed to specify key items such as target public, objective, and bibliography. The illustrations, especially in the booklets and leaflets, failed to clarify the text, portrayed biased concepts, and omitted credits and scale. According to this study, informative materials on leishmaniasis distributed in Brazil present major limitations which jeopardize the quality of information they contain.

Evaluation of knowledge and practices related to Chagas disease and its vectors among adults and children in an endemic region in Minas Gerais State, Brazil

Despite the success of the Chagas Disease Control Program (PCCD) in Brazil, some endemic areas have experienced difficulty in maintaining the programs activities, especially after the health systems decentralization, since the sustainability of control measures for Chagas disease and vectors is known to depend on information and community participation. This study aimed to analyze knowledge and practices related to vectors and Chagas disease in Bambuí, Minas Gerais State, Brasil. The populations knowledge was tested with a questionnaire, accompanied by six illustrations of triatomine bugs for identification. Both adults and primary and secondary schoolchildren in rural areas of the county participated in the research. The Bambuí population showed good overall knowledge on triatomines and Chagas disease in both groups (adults and children), although the concepts were limited to preventing the insect vector from invading houses. The results emphasize the importance of educational campaigns in the context of the program as a fundamental component of community participation in Chagas disease vector control.

A estética do grotesco e a produção audiovisual para a educação em saúde: segregação ou empatia? O caso das leishmanioses no Brasil

Buscando compreender a producao de imagens sobre saude e doenca e seus efeitos de aprendizagem resultante da educacao em saude mediada pelos videos educativos, o artigo analisa a producao audiovisual sobre as leishmanioses no Brasil. Com base no estudo de 14 videos educativos, verificou-se a predominância de um discurso tecnico-cientifico e uma estetica do grotesco. Observou-se a hegemonia do modelo televisivo-espetacular, em particular o padrao do telejornalismo, com o uso constante de voz off, indutora da fixacao de sentidos. Ao inves de estimular a reflexao critica sobre as circunstâncias sociais do adoecimento, a pratica discursiva e imagetica dos videos encoraja a sua banalizacao, tanto pela abordagem pouco criteriosa da doenca como pela construcao de representacoes estereotipadas. Ha a exposicao visual de pessoas doentes e nao o protagonismo critico e sensivel das populacoes implicadas. O artigo apresenta, entao, com base nos estudos sobre a antropologia visual e da saude, argumentos para uma abordagem inovadora na producao e utilizacao de videos educativos, e da educacao em saude mediada pelo audiovisual. Esta deve respeitar e dialogar com as culturas, a subjetividade e a cidadania, desenvolvendo esteticas audiovisuais (narrativas e imageticas) como praxis educativa no campo da saude coletiva.

Assessment of informative material on leishmaniasis distributed in Brazil: criteria and improvement of health educational material.

Based on categories related to structure, content, language, and illustrations, the present study provides an evaluation of the quality of educational materials on leishmaniasis available to health services in Brazil. The 18 publications evaluated consisted of four handbooks, four guided studies, four booklets, and six leaflets. Of the total publications assessed, nine were produced by the Brazilian National Health Foundation (FUNASA), five by State and Municipal Health Departments jointly with FUNASA, and one by the Pan-American Health Organization. The evaluations were also performed by three professionals: a physician specialized in leishmaniasis, a parasitologist, and an information/communications expert. The publications failed to specify key items such as target public, objective, and bibliography. The illustrations, especially in the booklets and leaflets, failed to clarify the text, portrayed biased concepts, and omitted credits and scale. According to this study, informative materials on leishmaniasis distributed in Brazil present major limitations which jeopardize the quality of information they contain.

A EPIDEMIA DE ZIKA E OS LIMITES DA SAÚDE GLOBAL

Zika virus was first isolated in 1947 in Uganda. If the disease has existed since then, why is it only now that there is attention from the media, science, funding agencies and national and international bodies? From the standpoint of critical global health that considers the social, political and ideological contexts which Zika is framed, we aim to analyse the Zika epidemic in four aspects: (1) investigation of the social, cultural and political processes; (2) analysis of signification practices; (3) study of neglected/silenced zones; and (4) attention to the diversity of individual experiences related to health and disease. The political tensions here identified and discussed - related to the control of neglected diseases, social, class and gender determinants - fall into dynamics, which go beyond national borders. In this sense, processes of signification and responses to the epidemic show the current limits of global health.

A dengue nos livros didáticos de ciências e biologia indicados pelo Programa Nacional do Livro Didático

Dengue is a serious public health problem in Brazil. The National Guidelines for Prevention and Control of Dengue Epidemics recommend the presence of health education action in schools and inclusion of the topic in the curriculum of the disciplines. In formal education, the text book is characterized as one of the main tools for teaching and dissemination of scientific knowledge. Thus, we analyzed the theme of dengue in the text books of science and biology indicated by the Didactic Book National Program (PNLD/2008 and 2011) and the Didactic Book National Program for High School (PNLEM/2009), respectively. The theme was present in the forty text books of the 106 indicated by the PNLD (2008 and 2011) and PNLEM (2009). There were conceptual errors, the use of inappropriate illustrations and sociocultural decontextualization of the content. These factors limit the use of this collaborative resource for action to be carried out in the schools with the aim to control dengue.

CONHECIMENTOS E PRÁTICAS EDUCATIVAS SOBRE DENGUE: A PERSPECTIVA DE PROFESSORES E PROFISSIONAIS DE SAÚDE

RESUMO: Dentre os agravos a saude que tem acometido a populacao brasileira, destaca-se a dengue, a qual requer acoes de controle integradas e participativas. O estudo investigou a existencia ou nao de acoes intersetoriais entre os campos da saude e da educacao em uma area endemica do Rio de Janeiro. Para tal, foram realizadas entrevistas semiestruturadas com sete professores de Ciencias e Biologia de uma escola publica e dezesseis profissionais de saude de uma unidade proxima a escola selecionada. As entrevistas foram submetidas a analise de conteudo tematica. Os resultados indicam que o conhecimento sobre a doenca e superficial, falta dialogo entre os protagonistas dos setores investigados e os materiais informativos de que dispoem sao escassos e por vezes inadequados. Palavras-chave: Dengue. Educacao em Saude. Profissionais de Saude e de Educacao. KNOWLEDGES AND EDUCATIONAL PRACTICES ABOUT DENGUE: THE PERSPECTIVES OF TEACHERS AND HEALTH PROFESSIONALS

A importância do ergodesign na avaliação de CD-ROM sobre dengue e doença de chagas na educação em saúde

In the intersection between health, education and the control and prevention of infectious and parasitic diseases, ergodesign concepts and practices are considered fundamental elements in the generation of interfaces for learning materials in health, reflecting the relationship between user, tasks and environments. The authors conducted CD-ROM assessments based on ergodesign principles, with the aim of contributing to the access and dissemination of information relating to health and assisting in interactive learning for mid- and high-level health professionals. 21 digital materials about the two diseases, from national and international institutions, were surveyed. The materials were assessed through a checklist called the ergolist. It was found that the evaluated materials did not fully meet the evaluation criteria. The evaluation and production of information and communication technologies, such as educational and interactive CD-ROMs, based on ergodesign principles, can be a facilitating instrument in the dissemination of information and shrinking of frontiers between education and health.

Zika, dengue e chikungunya: desafios e questões

Epidemiol. Serv. Saude, Brasilia, 25(2):419-422, abr-jun 2016 Em 2016, o Brasil esta sendo surpreendido por uma avassaladora epidemia do virus Zika (ZIKV), flavivirus que, da mesma forma que o virus da dengue (DENV), e transmitido pelo mosquito Aedes aegypti. Ha pelo menos tres razoes diferenciais para uma situacao tao sui generis, quando se trata do ZIKV: i) total de pessoas afetadas e velocidade de disseminacao do virus; ii) gravidade das manifestacoes possivelmente associadas ao virus, incluindo a microcefalia nos filhos de maes acometidas durante a gravidez e o desenvolvimento de sequelas neurologicas em parte das pessoas que adoeceram; e iii) epidemia de (des)informacao, disseminada tao – ou mais – rapidamente que a propria situacao de Saude Publica. Desde 1986, enfrenta-se, de forma quase ininterrupta, epidemias de dengue. Hoje, os quatro sorotipos do DENV circulam no pais, onde se convive com falhas na prevencao, dependentes de muitos aspectos que extrapolam o setor da Saude. Em particular, merecem destaque aspectos macroestruturais, socioeconomicos e ambientais, historicamente ignorados em prol de intervencoes meramente biomedicas ou tecnologicas. Contudo, um arduo trabalho de tres decadas ensinou muito sobre as formas de enfrentamento das epidemias. Antes do ZIKV, foi a experiencia acumulada contra a dengue que permeou a preparacao do servico publico brasileiro para a entrada no pais do virus chikungunya (CKG), um alphavirus tambem transmitido pelo A. aegypti. A expansao territorial de CKG desde 2004 suscitou o lancamento de um alerta da Organizacao Panamericana da Saude (OPAS), dirigido a todo o continente americano. O Brasil redobrou os esforcos de vigilância epidemiologica e chegou a enviar medicos para o Caribe com o objetivo de capacita-los no reconhecimento dos sinais e sintomas de infeccao por CKG. A entrada desse virus no pais era questao de tempo: em setembro de 2014, foi confirmada a transmissao autoctone de CKG entre os brasileiros.