2 nd Brazilian Consensus on Chagas Disease, 2015

Abstract Chagas disease is a neglected chronic condition with a high burden of morbidity and mortality. It has considerable psychological, social, and economic impacts. The disease represents a significant public health issue in Brazil, with different regional patterns. This document presents the evidence that resulted in the Brazilian Consensus on Chagas Disease. The objective was to review and standardize strategies for diagnosis, treatment, prevention, and control of Chagas disease in the country, based on the available scientific evidence. The consensus is based on the articulation and strategic contribution of renowned Brazilian experts with knowledge and experience on various aspects of the disease. It is the result of a close collaboration between the Brazilian Society of Tropical Medicine and the Ministry of Health. It is hoped that this document will strengthen the development of integrated actions against Chagas disease in the country, focusing on epidemiology, management, comprehensive care (including families and communities), communication, information, education, and research

Evolução da migração de partos para Aracaju, Sergipe, Brasil, 1970-1996 Shift in demand for childbirth services from rural Sergipe State to the capital city, Aracaju, Brazil, 1970-1996

O objetivo deste estudo é descrever a evolução da migração de partos do interior do Estado de Sergipe para a capital (Aracaju), no período compreendido entre 1970 e 1996. Para tanto utilizou-se a informação "município de residência da mãe" cujo parto ocorreu nas maternidades de Aracaju, nos anos de 1970, 1976, 1986 e 1996. Ao se estudar as proporções de mães não residentes em Aracaju, verificaram-se diferenças significativas, sendo que o período com maiores percentuais de migração ocorreu entre 1976 e 1986. A migração foi estimulada pela melhoria das rodovias que dão acesso à capital (a partir de 1970) e pelo incentivo político com fins eleitoreiros (clientelismo). Assim, a melhoria na estrutura hospitalar do interior não impediu o aumento da migração para a capital. Em Sergipe, no período em estudo, houve um crescimento de 134,6% do número de partos ocorridos na capital, provenientes de outras localidades. Além disso, observa-se intensidades de variação diferenciadas, quando se analisa o fenômeno por regiões, tendo em vista a melhoria das condições de acessibilidade. Faz-se necessária a regionalização e hierarquização da assistência ao parto e ao recém-nascido, para que se possa dar um atendimento adequado às gestantes e aos seus filhos.<br>This study analyzes trends in the migration of childbirth from rural areas of Sergipe State, Brazil, to the capital city, Aracaju, from 1970 to 1996. Data on "mother's place of residence" were obtained from mothers whose children were born in maternity hospitals in Aracaju in 1970, 1976, 1986, and 1996. Significant differences occurred in the proportion of mothers who resided outside of Aracaju but came there to give birth, especially from 1976 to 1986. This shift was stimulated by improvement of State highways and the granting of personal political favors in exchange for votes. Changes in the State hospital structure did not appear to have influenced the childbirth shift to Aracaju. There was a 134.6% increase in deliveries occurring in the State capital. There were also different trends among the various regions of the State, with some regional health districts displaying a downward trend in the number of deliveries from 1986 to 1996. It is urgent that more regional and hierarchical support be provided for childbirth and neonatal care in order to ensure quality assistance for pregnant women and their infants