Water safety : water potability of hospital in Minas Gerais, Brazil.

A Portaria 2.914/11 do Minist?rio da Sa?de do Brasil disp?e dos procedimentos e par?metros de controle e vigil?ncia da qualidade de ?gua para consumo humano e potabilidade. Neste sentido, faz-se necess?rio o monitoramento da qualidade das ?guas de unidades de atendimento hospitalar, devido ?s caracter?sticas de fragilidade de seus usu?rios. O presente trabalho visou analisar a qualidade da ?gua de abastecimento de um hospital geral de porte m?dio da regi?o central do estado de Minas Gerais, Brasil. Para isso, foram realizadas campanhas de coleta entre os meses de setembro de 2014 e novembro de 2016, em pontos amostrais variados, conforme determina??o da vigil?ncia sanit?ria. Os par?metros analisados foram Cloreto, Cloro Residual, Condutividade, Dureza Total, Nitrog?nio de Nitrito e de Nitrato, pH, Turbidez, Coliformes Totais, Coliformes Termotolerantes, Escherichia coli e contagem de Bact?rias Heterotr?ficas. Os resultados das amostras analisadas mostraram-se dentro dos limites estabelecidos pela portaria em rela??o aos par?metros f?sico- qu?micos, com exce??o de cloro residual e condutividade, que apresentaram respectivamente 32,5% e 10,1% das amostras fora dos padr?es. Observou-se a ocorr?ncia de Coliformes Termotolerantes em novembro de 2015, o qual foi rapidamente contornado pela adi??o de cloro nos reservat?rios. Percebe-se, desta forma, a import?ncia e pertin?ncia da continuidade do programa de monitoramento da ?gua de abastecimento do referido hospital.The Decree 2,914/11 of the Ministry of Health of Brazil has the procedures and parameters of control and surveillance of water quality for human consumption and potability. In this Ordinance all the procedures and parameters of control and monitoring of drinking water are described. In this sense, it is necessary to monitor the quality of the water in hospital care units, due to the fragility characteristics of its users. The present study aimed to analyse the quality of the water supply of a medium-sized general hospital in the central region of the state of Minas Gerais, Brazil. In order to do that, collection campaigns were carried out between September 2014 and November 2016, at various sampling points, as determined by the sanitary surveillance. The analyzed parameters were Chloride, Residual Chlorine, Conductivity, Total Hardness, Nitrogen of Nitrite and Nitrate, pH, Turbidity, Total Coliforms, Thermotolerant Coliforms, Escherichia coli and Heterotrophic Bacterial count. The results of the analyzed samples were within the parameters established by the ordinance regarding to the physical-chemical parameters, except for residual chlorine and conductivity, which presented 32.5% and 10.1% respectively, of samples out of the established. It was observed the occurrence of thermotolerant coliforms in November 2015, which was quickly overcome by the addition of chlorine in the reservoirs. According to the results was noticed the importance of the continuity of the water supply monitoring program of the cited hospital

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially