Desafios da Vigilância Sanitária nos Eventos de Massa

O presente número da revista Visa em Debate vem a público em momento especial para a sociedade brasileira. Durante os meses de agosto e setembro, o país é sede dos Jogos Olímpicos e Paralímpicos Rio 2016. Trata-se do maior evento esportivo mundial, que conta com milhares de atletas de mais de 200 países e milhões de espectadores presentes nas arenas do Rio de Janeiro e nas outras cinco capitais em que ocorrem jogos

the SANAR program, 2011-2014

BACKGROUND: Brazil is an endemic country for schistosomiasis in the Latin American and Caribbean countries. Pernambuco is a higher-endemic Brazilian state among the 19 states reporting the disease in the country; schistosomiasis affects 102 (55%) of its 185 municipalities. Our objective was to evaluate the effectiveness of the treatment cycles of the SANAR Program (Plan to Reduce and Eliminate Neglected Diseases) in Pernambuco State in Northeast Brazil. METHODS: A cross-sectional population-based study was conducted in 2014 via a household survey in 117 hyperendemic locations in the state of Pernambuco. We compared the schistosomiasis prevalence rates in hyperendemic locations, aggregated by geographical region, before and after the intervention. The dependent variable was a positive stool test result by the Kato-Katz method, and the main exposure variable was the number of treatment cycles (one/two). The covariables were the regions of the state and socioenvironmental, socioeconomic, demographic and behavioral characteristics. RESULTS: In all, 12,969 individuals were interviewed, 8932 of whom had stool tests. Of these, 4969 (55.6%) underwent two cycles of collective treatment. Changes in the environmental conditions since 2011 were minimal. Comparison before (2011) and after (2014) treatment showed an average schistosomiasis prevalence of 18.6%, decreasing to 4.1% and 2.0% in locations with one and two treatment cycles, respectively. In 2014, the highest schistosomiasis prevalence was found in the forest area (2.8%), while the lowest was found in the northern region (1.2%) of the state. The adjusted analysis showed a lower occurrence of schistosomiasis in individuals living in areas with two treatment cycles than in individuals from areas with just one cycle (PR 0.65, 95% CI: 0.47-0.89). CONCLUSIONS: The political decision made in Pernambuco to implement the SANAR Program in 2011 greatly impacted the burden of schistosomiasis. This program was effective in reducing the occurrence of schistosomiasis in hyperendemic areas in Pernambuco, with a stronger response in areas with two cycles of collective treatment.publishersversionpublishe

Consumo de bebidas alcoólicas e direção de veículos, balanço da lei seca, Brasil 2007 a 2013

O estudo analisa a tendência da frequência de adultos que dirigem alcoolizados, nas capitais brasileiras, após aprovação das leis que proíbem uso de álcool e direção. Foram utilizados dados do sistema de Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico (Vigitel), entre 2007 e 2013. A frequência de adultos que dirigiram após o consumo abusivo foi reduzida em 45,0% no período (2,0% em 2007 a 1,1% em 2013). Reduções significativas foram verificadas nos anos imediatamente após a publicação das leis que proíbem o uso do álcool e direção entre 2007 e 2008 (-0,5%) e entre 2012 e 2013 (-0,5%). As melhorias apontadas em relação a dirigir alcoolizado mostram mudança dos hábitos da população brasileira.The study analyzes the trend in frequency of adults who drive under the influence of alcohol in major Brazilian cities after the passing of laws, which prohibit drunk driving. Data from the Surveillance System for Risk and Protective Factors for Chronic Diseases by Telephone Survey (VIGITEL) between 2007 and 2013 were analyzed. The frequency of adults who drove after abusive alcohol consumption was reduced by 45.0% during this period (2.0% in 2007 to 1.1% in 2013). Between 2007 and 2008 (-0.5%) and between 2012 and 2013 (-0.5%), significant reductions were observed in the years immediately after the publication of these laws that prohibit drunk driving. These improvements towards the control of drunk driving show a change in the Brazilian population’s lifestyle

Sources for obtaining drugs for hypertension in Brazil : results from the National Health Survey, 2013

Objetivo: analisar as diferenças sociodemográficas dos indivíduos adultos hipertensos, em relação às fontes de obtenção de medicamentos para tratar hipertensão arterial no Brasil. Métodos: análise secundária dos dados oriundos da Pesquisa Nacional de Saúde, 2013; os desfechos considerados nas análises foram representados pelas fontes de obtenção de medicamentos para tratar a hipertensão arterial. Resultados: foram entrevistados 10.017 indivíduos. A grande maioria dos hipertensos em uso de medicamentos (74,0%) utiliza uma fonte única de obtenção de medicamentos 7,3% (IC95% 6,4 - 8,4) referiu obter todos os medicamentos por meio dos planos de saúde privados; 22,7% (IC95% 21,0 - 24,4) em farmácias do sistema público de saúde; 21,8% (IC95% 20,2 - 23,4) no Programa Farmácia Popular do Brasil; e 29,5% (IC95% 27,7 - 31,4) exclusivamente pelas farmácias comerciais. A obtenção no sistema público de saúde como fonte única diminuiu com o avanço da idade, apresentou-se menor nas pessoas de cor da pele branca, diminuiu fortemente com o aumento da escolaridade e evidenciou-se menor entre os residentes na região Norte do país; no Programa Farmácia Popular do Brasil, a fonte única de obtenção também foi menor para as pessoas com maior escolaridade. A obtenção nas farmácias comerciais esteve associada positivamente com um perfil do sexo masculino, de maior escolaridade, de idade mais elevada, tendo declarado cor da pele branca. A ocorrência de mais de uma fonte de obtenção mostrou-se associada positivamente ao aumento da idade e inversamente ao aumento da escolaridade. Conclusões: os resultados possibilitaram identificar diferentes estratégias para obtenção de medicamentos usados no tratamento da hipertensão, de modo a explicar como são obtidos os medicamentos no país e qual o impacto das políticas públicas nesse setor.Objective: to analyze the sociodemographic differences among adults with hypertension regarding the sources for obtaining drugs for hypertension treatment in Brazil. Methods: this is a secondary analysis of data from the National Health Survey 2013; the outcomes considered for the analysis were the sources for obtaining drugs for treating high blood pressure. Results: the great majority (74%) of patients with hypertension taking drugs use a single source for obtaining them, 7.3% (95%CI 6.4 - 8.4) reported getting all the drugs through private health plans, 22.7% (95%CI 21.0 - 24.4) by pharmacies of the public health system, 21.8% (95%CI 20.2 - 23.4) by the Popular Pharmacy Program, and about one-third (29.5%; 95%CI 27.7 - 31.4) exclusively by commercial pharmacies. Having the public health system as the single source for obtaining the drugs was found to decrease with age, was lower in white people, decreased strongly with increase in education, and was lower for residents in the North region. Exclusive obtainment through the Popular Pharmacy Program was lower for people with higher education. Obtainment in commercial pharmacies was positively associated with being male, with higher education level, being older, and having white skin color. Obtainment using more than one source was positively associated with increasing age and inversely associated with higher education levels. Conclusions: the results allowed the identification of a trajectory of patients in obtaining drugs for the treatment of hypertension, aiming at explaining how the drugs are obtained and the impact of public policies in this sector in the country

Risk of symptomatic dengue for foreign visitors to the 2014 FIFA World Cup in Brazil

Brazil will host the FIFA World Cup T, the biggest single-event competition in the world, from June 12-July 13 2014 in 12 cities. This event will draw an estimated 600,000 international visitors. Brazil is endemic for dengue. Hence, attendees of the 2014 event are theoretically at risk for dengue. We calculated the risk of dengue acquisition to non-immune international travellers to Brazil, depending on the football match schedules, considering locations and dates of such matches for June and July 2014. We estimated the average per-capita risk and expected number of dengue cases for each host-city and each game schedule chosen based on reported dengue cases to the Brazilian Ministry of Health for the period between 2010-2013. On the average, the expected number of cases among the 600,000 foreigner tourists during the World Cup is 33, varying from 3-59. Such risk estimates will not only benefit individual travellers for adequate pre-travel preparations, but also provide valuable information for public health professionals and policy makers worldwide. Furthermore, estimates of dengue cases in international travellers during the World Cup can help to anticipate the theoretical risk for exportation of dengue into currently non-infected areas.FNS-SVSMSConselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)LIM01-HCFMUSPFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)DengueTools/Seventh Framework Programme of the European CommunityUniv São Paulo, Fac Med, Hosp Clin LIM01, São Paulo, BrazilUniv São Paulo, Fac Med Vet, São Paulo, BrazilUniv São Paulo, Nucleo Anal Interdisciplinares Polit Publ & Estra, São Paulo, BrazilLondon Sch Hyg & Trop Med, London WC1, EnglandNanyang Univ, Lee Kong Chian Sch Med, Singapore, SingaporeFlorida Int Univ, Ctr Internet Augmented Res & Assesssment, Miami, FL 33199 USAMinist Saude, Brasilia, DF, BrazilFiocruz MS, Programa Comp Cient, Rio de Janeiro, RJ, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, Hosp São Paulo, São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, Hosp São Paulo, São Paulo, BrazilMS: 27835/2012DengueTools/Seventh Framework Programme of the European Community: 282589Web of Scienc

Importance of animal/human health interface

This study analyzed the importance of zoonoses and communicable diseases common to man and animals as potential Public Health Emergencies of Internationa

Accidents and violence in childhood: survey evidence of emergency care for external causes - Brazil, 2009

Compreender as características e a magnitude das causas externas (acidentes e violência) em crianças de 0 a 9 anos de idade torna-se cada vez mais importante em Saúde Pública. O objetivo do presente artigo foi analisar os atendimentos de emergência por causas externas em crianças. Utilizaram-se dados do Sistema de Vigilância de Violências e Acidentes em Serviços Sentinelas de Urgência e Emergência (Inquérito VIVA), realizado em 74 serviços de urgência do Distrito Federal e 23 capitais no ano 2009. Analisaram-se dados de 7.123 crianças: 6.897 (96,7%) vítimas de acidentes e 226 (3,3%) de violência. Em comparação às vítimas de violência, os atendimentos por acidentes foram mais frequentes entre crianças de 2 a 5 anos, de pele branca e ocorridos no domicílio (p < 0,05). Dentre os acidentes, as quedas e queimaduras predominaram no grupo de 0 a 1 ano, enquanto os acidentes de transporte foram mais frequentes no grupo de 6 a 9 anos (p < 0,001). Quanto às violências, atendimentos por negligência e agressão física predominaram, respectivamente, nos grupos extremos de faixa etária, sendo um familiar identificado como agressor (p < 0,001). Informações sobre ocorrência de causas externas em crianças podem apoiar políticas de promoção da saúde, além de orientar profissionais de saúde, educadores e famílias na prevenção destas causas.Understanding the characteristics and magnitude of accidents and violence due to external causes in children from 0 to 9 years of age is becoming ever more important in Public Health. The scope of this paper was to analyze emergency care for accidents due to external causes in children. The Sentinel Urgency and Emergency Services of the Violence and Accident Vigilance System (VIVA Survey), performed in 74 urgency services in the Federal District and 23 State capitals in 2009 was used. Data of 7,123 children were analyzed: 6,897 (96.7%) victims of accidents and 226 (3.3%) of violence. In comparison with victims of violence, the visits for accidents were more frequent among white children from 2 to 5 years old occurring in the home (p &lt; 0.05). Among the accidents, falls and burns predominated in the 0 to 1group, while traffic accidents were most frequent in the 6 to 9-year-old age group (p < 0.001). With respect to violence, the visits for neglect and physical assault predominated, respectively, in extreme age groups, with someone in the family being the perpetrator (p < 0.001). Information on the occurrence of external causes in children may support health promotion policies, besides guiding health professionals, teachers and families in the prevention of such causes

Planejamento estratégico em vigilância sanitária: aplicação do Balanced Scorecard (BSC)

This article main objective is to present the method, framework and guidelines applied by the Brazilian Health Regulatory Agency (Anvisa) Strategic Planning, for the period 2016-2019. In order to provide information about the concepts that are used in the project, there is a section that shows Strategic Planning and Balanced Scorecard theoretical frameworks, with an emphasis on how these concepts are applied to Public Management. Then, the authors show how these frameworks were implemented by Anvisa. This article focuses on the Strategy Map review and, in this regard, it compares the previous Strategy Map and the current one. In this comparison, there is a discussion about its elaboration and validation methods, as well as about the guidelines for its preparation.Este artigo objetiva apresentar o método e a estrutura do ciclo de Planejamento Estratégico (PE) para o período de 2016 a 2019 na Agência Nacional de Vigilância Sanitária (Anvisa). Para isso, utilizou-se o referencial teórico sobre PE, apresentando, especificamente, a metodologia Balanced Scorecard (BSC), com destaque para o emprego desses conceitos na Gestão Pública. A partir disso, é apresentado como a metodologia BSC foi aplicada na Anvisa, na forma de um estudo de caso, com ênfase no método utilizado para a construção do PE, bem como nas diretrizes para sua elaboração. Discute-se ainda a revisão do Mapa Estratégico da Agência, com análise comparativa entre os mapas anteriormente vigente e o atual, descrevendo-se as etapas de construção e validação dos diferentes elementos do Mapa. Conclui-se que o método de Planejamento apontado é aplicável à Gestão Pública, de tal forma que é possível desenhar a estratégia e priorizar os objetivos, com vistas a alcançar resultados e melhorar o desempenho da instituição pública