Conselhos da comunidade: controle social e interlocução para a saúde prisional

This article aims to analyze the performance of Community Councils in penal institutions in Rio Grande do Sul State, related to prison health. This is an exploratory and descriptive research, with a qualitative approach, using Bardin’s data triangulation strategy and Content Analysis. Eight Community Councils participated in the study. The analysis of the collected data resulted in five thematic categories for discussion: Public Policies; Tuberculosis control; Infrastructure; Actions by Community Councils; Difficulties in the performance of Community Councils. It was identified that the Community Councils are potent devices of social control and dialogue for health in the prison system. In this way the presence of health professionals as effective members of Community Councils could qualify the actions focused at the health of prisoners and the professionals of these institutions.  Este artigo tem por objetivo analisar a atuação dos Conselhos da Comunidade nas instituições penais do Rio Grande do Sul, em questões da saúde prisional. Trata-se de uma pesquisa de caráter exploratório e descritivo, de abordagem qualitativa, utilizando a estratégia de triangulação de dados e Análise de Conteúdo de Bardin. Participaram do estudo 8 Conselhos da Comunidade. A análise dos dados coletados resultou em cinco categorias temáticas para discussão: Políticas Públicas; Controle da tuberculose; Infraestrutura; Ações dos Conselhos da Comunidade; Dificuldades de atuação dos Conselhos da Comunidade. Identificou-se que os Conselhos da Comunidade se configuram como potentes dispositivos de controle social e interlocução para saúde no sistema prisional, contudo a presença de profissionais de saúde como membros efetivos poderiam qualificar as ações voltadas à saúde das Pessoas Privadas de Liberdade e aos profissionais destas instituições.

Pooling of sputum samples to increase tuberculosis diagnostic capacity in Brazil during the COVID-19 pandemic

Objectives We assessed whether combining (pooling) four individual's samples and testing with Xpert Ultra has the same accuracy as testing samples individually, as a more efficient testing method. Methods We conducted a cross-sectional study of individuals with presumptive TB attending primary health care or general hospital facilities in Alagoas, Brazil. Sputum samples of four consecutive individuals were pooled and the pool and individual samples were tested with Xpert Ultra. The agreement of the tests was compared using kappa statistics. We estimated the sensitivity and specificity of pooling using the individual test as the reference standard and potential cartridge savings. Results Three hundred and ninety-six participants were tested. Ninety-five (24.0%) individual samples were MTB-positive, 300 (75.8%) MTB-not detected, including 20 MTB-trace, and one reported an error. Ninety-nine pools of four samples were tested, of which 62 (62.6%) had MTB-detected and 37 (37.4%) MTB-not detected, including six (6.1%) with MTB-trace. The agreement of individual and pooled testing was 96.0%. Pooling had sensitivity of 95.0% (95%CI 86.9%–99%), specificity of 97.1% (95%CI 85.1%–99.9%) and Kappa of 0.913. The method saved 12.4% of cartridge costs. Conclusion The pooled testing of specimens had a high level of agreement with individual testing. Pooling of samples for testing improves the efficiency of testing, potentially enabling the screening and testing of larger numbers of people more cost-effectively

Conhecimento dos profissionais de educação infantil sobre a obstrução de vias aéreas por corpo estranho (OVACE) em crianças: uma revisão integrativa

Introduction: In Brazil, in 2021, 2,339 deaths were recorded in the age group from 0 to 5 years of age due to accidental causes, among the causes, Foreign Body Airway Obstruction (OVACE) is in third place in the ranking. Objective: Identify existing knowledge and presence of training on OVACE for early childhood education teachers. Method: This is an integrative literature review. The PICO strategy was used to establish the following guiding question: “do early childhood education professionals receive training and have sufficient knowledge to act in OVACE situations?”. The study included articles published in the last 5 years (2019 to 2022), in Portuguese and English. The databases used to search for scientific articles were: Pubmed and Virtual Health Library (VHL). Results: 172 studies were identified and, after excluding the 11 duplicates, 161 remained for analysis: 133 in the National Library of Medicine (Pubmed) and 28 in the Virtual Health Library (VHL). After applying the inclusion and exclusion criteria, 5 articles were included in the sample. The lack of preparation of educators in relation to identification and intervention measures in cases of OVACE was evident, as well as deficiencies related to training.Introdução: No Brasil, em 2021 foram registrados 2.339 óbitos na faixa etária dos 0 aos 5 anos de idade por causas acidentais, dentre as causas a Obstrução de Vias Aéreas por Corpo Estranho (OVACE) se encontra em terceiro lugar no ranking. Objetivo: Identificar o conhecimento existente e a presença de treinamento sobre OVACE para professores da educação infantil. Método: Trata-se de uma revisão integrativa da literatura. A estratégica PICO foi utilizada para estabelecer a seguinte pergunta norteadora: “os profissionais da educação infantil recebem treinamento e apresentam conhecimento suficiente para agir em situações de OVACE?”. Integraram o estudo artigos publicados nos últimos 5 anos (2019 a 2022), nos idiomas Português e Inglês. As bases de dados utilizadas para a busca de artigos científicos foram: Pubmed e Biblioteca Virtual da Saúde (BVS). Resultados: Foram identificados 172 estudos e, após exclusão dos 11 duplicados, restaram 161 para análise: 133 na National Library of Medicine (Pubmed) e 28 na Biblioteca Virtual em Saúde (BVS). Após aplicação dos critérios de inclusão e exclusão, 5 artigos foram incluídos na amostra. Evidenciou-se o despreparo dos educadores em relação a medidas de identificação e intervenção em casos de OVACE, assim como, deficiências relacionadas ao treinamento

Hepatitis C: evaluation of outcomes and georeferencing of cases in Santa Cruz do Sul, Brazil, between 2002 and 2015. A cross-sectional study

<div><p>ABSTRACT BACKGROUND: Hepatitis C virus infection is one of the main causes of chronic liver disease, with high death rates. The aim here was to analyze case outcomes, sociodemographic and clinical characteristics and spatial distribution among patients diagnosed with hepatitis C in the city of Santa Cruz do Sul (RS), Brazil. DESIGN AND SETTING: Cross-sectional study on 200 cases of hepatitis C in Santa Cruz do Sul that were notified between 2002 and 2015. METHODS: Secondary data including sociodemographic and clinical variables and type of outcome (death, follow-up, abandonment or clinical cure) were gathered. The spatial distribution analysis on hepatitis C virus cases according to outcome was based on information regarding residential address. RESULTS: 58.5% of the patients were 41 years of age and over, 67% were males and 92.5% had the chronic form of the disease. The most frequent transmission route was illicit drug injection (29%); 15.1% of the patients presented coinfection with the human immunodeficiency virus (HIV). Regarding outcomes, 31% achieved clinical cure, 10% died and 20% abandoned follow-up. The cases studied were mainly located in regions of the city characterized by lower socioeconomic status, with high frequency of places used for drug trafficking. CONCLUSION: The population consisted of adults aged 41 years and over, mostly with chronic hepatitis C. The most common transmission routes were illicit drug injection and blood transfusions. There were high rates of HIV coinfection and abandonment of disease monitoring and predominance of cases in neighborhoods with low socioeconomic status.</p></div

Pooling of sputum samples to increase tuberculosis diagnostic capacity in Brazil during the COVID-19 pandemic

Objectives: We assessed whether combining (pooling) four individual's samples and testing with Xpert Ultra has the same accuracy as testing samples individually as a more efficient testing method. Methods: We conducted a cross-sectional study of individuals with presumptive tuberculosis attending primary health care or general hospital facilities in Alagoas, Brazil. The sputum samples of four consecutive individuals were pooled and the pool and individual samples were tested with Xpert Ultra. The agreement of the tests was compared using kappa statistics. We estimated the sensitivity and specificity of pooling using the individual test as the reference standard and potential cartridge savings. Results: A total of 396 participants were tested. A total of 95 (24.0%) individual samples were Mycobacterium tuberculosis (MTB)-positive, 300 (75.8%) “MTB not detected”, including 20 “MTB trace”, and one reported an error. A total of 99 pools of four samples were tested, of which 62 (62.6%) had MTB detected and 37 (37.4%) MTB not detected, including six (6.1%) with MTB trace. The agreement between individual and pooled testing was 96.0%. Pooling had a sensitivity of 95.0% (95% confidence interval 86.9-99%), specificity of 97.1% (95% confidence interval 85.1-99.9%), and kappa of 0.913. The method saved 12.4% of cartridge costs. Conclusion: The pooled testing of specimens had a high level of agreement with individual testing. The pooling of samples for testing improves the efficiency of testing, potentially enabling the screening and testing of larger numbers of individuals more cost-effectively