Ethel Leonor Noia Maciel

Inhibition of Isoniazid-Induced Expression of Mycobacterium tuberculosis Antigen 85 in Sputum: Potential Surrogate Marker in Tuberculosis Chemotherapy Trials

ABSTRACT Mycobacterium tuberculosis antigen 85 is induced in vitro by isoniazid (INH); its sustained induction in sputum during tuberculosis (TB) therapy predicts relapse. In this trial, rifampin or rifalazil inhibited the induction of sputum antigen 85 by INH in a dose-dependent fashion. This approach may facilitate the evaluation of new TB drugs.

A percepção dos usuários sobre a oferta de programas de promoção da saúde e prevenção de doenças: o caso de uma operadora de autogestão

A coexistencia do setor publico e privado de saude no Brasil e antiga e os arranjos percorridos tem contribuido para a construcao de um sistema fragmentado e complexo. Na busca por estabelecer politicas setoriais em harmonia com o Sistema Unico de Saude, a Agencia Nacional de Saude Suplementar tem estimulado o desenvolvimento de programas de promocao da saude e prevencao de doencas no setor. Essas acoes sao consideradas como um conjunto heterogeneo de estrategias na consolidacao de politicas que visem a saude da populacao. Este e um estudo de carater qualitativo que objetiva analisar esses programas em uma operadora de autogestao, com o intuito de compreender se eles produzem dispositivos biopoliticos. Foram coletados os discursos dos usuarios dos programas por meio de um roteiro semiestruturado e utilizou-se a tecnica de analise de conteudo. Os resultados mostram que se encontram em curso alguns processos de reestruturacao da producao do cuidado, e os aspectos relacionais tem sido priorizados nesses programas. Essas acoes configuram-se em dispositivos biopoliticos conduzindo formas de viver. E importante a existencia de equilibrio entre as praticas desses poderes e a producao de liberdade, atentando para que nao haja intervencoes biopoliticas arbitrarias e autoritarias na producao das acoes de saude.

Fatores que interferem na qualidade das amostras e dos procedimentos de coleta de escarro em sintomáticos respiratórios

RESUMO| Introdução: O êxito na identificação dos portadores de tuberculose está relacionado aos métodos diagnósticos utilizados e às boas práticas clínicas, sobretudo no que se refere aos procedimentos e orientações de coleta do escarro fornecidas pelos profissionais das Unidades Básicas de Saúde (UBS), ao transporte e ao armazenamento dos espécimes clínicos. Objetivo: Descrever a qualidade das amostras de escarro e dos procedimentos de coleta e seu impacto nas estratégias de busca de Sintomáticos Respiratórios (SR). Métodos: Trata-se de um corte transversal, realizado em UBS. Na primeira etapa, os SR foram entrevistados sobre procedimentos de orientação para coleta e percurso do material biológico até a entrega na Unidade. Na segunda etapa, os escarros dos SR foram analisados quanto à qualidade e correlacionados com resultados de baciloscopia e cultura. Foram realizadas análises de frequência relativa e absoluta, teste qui-quadrado e regressão logística. Resultados: Dos 182 pacientes entrevistados, 92,3% confirmaram ter recebido orientações quanto a procedimentos para realização da coleta de escarro. Entretanto, das nove variáveis estudadas sobre informações da coleta de escarro, em sete delas, mais da metade dos pacientes não realizaram os procedimentos informados de forma adequada. Com relação às informações sobre transporte e armazenamento do material coletado, observou-se que das seis variáveis estudadas, em quatro delas mais da metade dos pacientes não realizaram os procedimentos informados de forma adequada. Na análise da qualidade da amostra de acordo com a orientação, forma de coleta e armazenamento, observou-se que a qualidade da amostra é influenciada por cinco variáveis, com significância estatística. Conclusão: O fornecimento de educação em saúde sobre a importância do exame de escarro e da necessidade de produzir uma amostra de boa qualidade para o SR deve ser contínuo e prioridade do programa de tuberculose.

Mortalidade Infantil no estado Espírito Santo: uma análise via modelos Completamente Bayesianos

Introduction: The infant mortality may be considered a strong social indicator of population life quality as may be inversely associated with social determinants in health. Objective: To present Fully Bayesian regression models to detect patterns of variation through mapping the risk of infant mortality in Espirito Santo state in 2010, and correlate with socioeconomic covariates. Methods: It is an ecological study with emphasis on spatial analysis where were evaluated the factors probably associated to infant mortality (proportion of mothers under 20 years, proportion of mothers with income up to half basic pay and proportion of coverage of sewage) in Espirito Santo state in 2010. The data were showed with spatial effect and covariates by the WinBugs program (Version 1.4) and R (Version 2.12).Results: From the analysis of different models it was found that the model that uses the spatial structure and adds the covariates income and sewage shows the better performance by DIC (Deviance Information Criterion) criterion. Through mapping risk estimated by fully Bayesian method was possible to realize a considerable gain on interpretation of infant death risk of Espirito Santo municipalities with this modeling.Conclusion: The methodological model adopted provides better visualization of infant mortality risk, overcoming inequalities distributions, allowing better assess the relationships between spatial factors and infant mortality rates by neighborhood.

Prevalência de tuberculose em profissionais da área de Enfermagem obtida por método de relacionamento de bancos de dados, 2000 a 2008, Espírito Santo, Brasil

Objective: To estimate the prevalence of tuberculosis in professional nursing and analyze the profile of these professionals in the period 2000 to 2008 in the Espirito Santo State-Brazil. Methods: We conducted a descriptive study used secondary data from databases of morbidity due to tuberculosis and registration nursing professional of Espirito Santo State (COREN). We included all records of patients with tuberculosis were reported in the Health Information System for Diseases Reported (SINAN-TB) for the years 2000 to 2008 and all registered nursing staff in the COREN from May 1975 to July 2008. To evaluate the professionals listed in both databases was carried out the relationship of banks using the Reclink III. Results: There were 43 health care workers with tuberculosis notification. Of these, 5 had notification dated prior to class registration. Therefore, the study sample was composed of 38 professionals. Of these, 21 are nursing assistants, nurses are 8 and 9 nursing technicians. The prevalence of tuberculosis in these health professionals was 246/100.000 professionals. Conclusion: The results of this study indicate the need for training professionals to improve the completion of notification forms, and the urgent incorporation in the health services of biosafety norms recommended by the Tuberculosis Control Program.

P1-261 Prediction of dropout tuberculosis treatment on prioritary cities to control in EspÍrito Santo State, Brazil

Objectives To identify the epidemiological factors related to the abandonment of TB treatment in the priority municipalities for TB control and to establish a score for use in TB control programs to identify patients most likely to abandon treatment. Methods case-control study matched by sex and notification place to compare patients who dropped out of the treatment (cases) with those who were cured (control) in eight priority municipalities for TB control in the Espirito Santo state, from January 2006 to July 2008. Patients were interviewed directly by one of the researchers, at the clinic or at home. To data analysis we performed a bivariate analysis and the significant results obtained from these analysis were for the logistic regression analysis and network neural artificial (NNA). The questionnaire score was created and validated. Results The study involved 21 cases and 41 controls. In the bivariate analysis, the epidemiological factors involved in the TB treatment dropout were identified as follows: average income, smoking, age, occupation, religion, drugs, previous treatment for TB and willingness to abandon. The logistic regression analysis and neural network revealed that the use of illicit drugs and patient without religion was strongly related to the abandonment. It was found that the neural classification was not more effective than logistic regression for the score marks preparation. Conclusions The score created was able to estimate the treatment dropout cases identified in the study and can be used in programs of TB control to identify patients most likely to abandon TB treatment.