Factores asociados con el consumo de tabaco entre adolescentes de escuela pública

Objetivo Estimar la prevalencia de consumo de tabaco y su asociación con las variables sociodemográficas, iniciación sexual y vivencia de violencia doméstica en adolescentes escolares de la red pública de enseñanza de Guanambi, Bahía, Brasil. Método Estudio transversal, llevado a cabo con adolescentes. Los datos fueron recogidos mediante entrevistas guiadas por un instrumento estructurado y analizados conforme a la estadística descriptiva e inferencial, con regresión logística múltiple. Resultados Participaron en el estudio 370 adolescentes. La prevalencia de consumo de tabaco fue del 17,6% y hubo asociación estadísticamente significativa con las variables: edad mayor que 15 años (RP = 5,63 e IC = 95%: 1,33 – 23,85), sexo masculino (RP = 2,53 e IC = 95%: 1,47 – 4,37), no proferir religión (RP = 1,93 e IC = 95%: 0,99 – 3,75), trabajar (RP = 2,17 e IC = 95%: 1,25 – 3,74), inicio de las actividades sexuales (RP = 10,64 e IC= 95%: 5,31 – 21,33) y vivencia de violencia doméstica (RP = 3,61 e IC = 95%: 2,07 – 3,28). Conclusión La prevalencia del consumo de tabaco y las variables asociadas señalan la necesidad de estrategias de intervención en los grupos de adolescentes más vulnerables, con involucración familiar y auxilio de los profesionales de la educación y salud, en especial los enfermeros que actúan en la atención primaria.Objetivo Estimar a prevalência de consumo de cigarro e sua associação com as variáveis sociodemográficas, iniciação sexual e vivência de violência doméstica em adolescentes escolares da rede pública de ensino de Guanambi, Bahia, Brasil. Método Estudo transversal, realizado com adolescentes. Os dados foram coletados por meio de entrevistas guiadas por um instrumento estruturado, e analisados conforme estatística descritiva e inferencial, com regressão logística múltipla. Resultados Participaram do estudo 370 adolescentes. A prevalência de consumo de cigarro foi de 17,6% e houve associação estatisticamente significante com as variáveis: idade maior que 15 anos (RP = 5,63 e IC = 95%: 1,33 – 23,85), sexo masculino (RP = 2,53 e IC = 95%: 1,47 – 4,37), não proferir religião (RP = 1,93 e IC = 95%: 0,99 – 3,75), trabalhar (RP = 2,17 e IC = 95%: 1,25 – 3,74), início das atividades sexuais (RP = 10,64 e IC= 95%: 5,31 – 21,33) e vivência de violência doméstica (RP = 3,61 e IC = 95%: 2,07 – 3,28). Conclusão A prevalência do consumo de cigarro e as variáveis associadas apontam para a necessidade de estratégias de intervenção nos grupos de adolescentes mais vulneráveis, com envolvimento familiar e auxílio dos profissionais da educação e saúde, em especial os enfermeiros que atuam na atenção primária.Objective Estimating the prevalence of cigarette smoking and its association with sociodemographic variables, sexual initiation and experience with domestic violence among adolescents from public schools in Guanambi, Bahia, Brazil. Method A crosssectional study carried out with adolescents. Data were collected through interviews guided by a structured instrument, and analyzed according to descriptive and inferential statistics with multiple logistic regression. Results A total of 370 adolescents participated in the study. The prevalence of cigarette smoking was 17.6% and a statistically significant association was observed between the variables: age over 15 years (PR = 5.63 and 95% CI: 1.33 – 23.85), males (PR = 2.53 and 95% CI: 1.47 – 4.37), no reported religion (PR = 1.93 and 95% CI: 0.99 – 3.75), working (PR = 2.17 and 95% CI: 1.25 – 3.74), onset of sexual activity (PR = 10.64 and CI= 95%: 5.31 – 21.33) and experience of domestic violence (PR = 3.61 and 95% CI: 2.07 – 3.28). Conclusion The prevalence of cigarette smoking and the associated variables point to the need for intervention strategies among more vulnerable groups of adolescents, encompassing family involvement and assistance from teachers and health professionals, in particular nurses working in Primary Care

História Natural da leptospirose urbana: estudo longitudinal prospectivo em uma comunidade de alto risco durante epidemias urbanas em Salvador - Bahia

Submitted by Repositório Arca ([email protected]) on 2019-07-08T17:27:35Z No. of bitstreams: 1 license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5)Approved for entry into archive by Ana Maria Fiscina Sampaio ([email protected]) on 2019-07-09T16:53:03Z (GMT) No. of bitstreams: 2 Ridalva Dias Martins Historia natural 2006.pdf: 10006807 bytes, checksum: b7c3982d1a51706568c03a06ff95eda0 (MD5) license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5)Made available in DSpace on 2019-07-09T16:53:03Z (GMT). No. of bitstreams: 2 Ridalva Dias Martins Historia natural 2006.pdf: 10006807 bytes, checksum: b7c3982d1a51706568c03a06ff95eda0 (MD5) license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) Previous issue date: 2006FAPEX, NIH e CNPq.Universidade Federal da Bahia. Faculdade de Medicina. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil.A leptospirose, considerada a antropozoonose mais difundida no mundo, é uma doença febril aguda de início súbito causada por espiroquetas do gênero Leptospira. A infecção por Leptospira patogênica produz uma diversidade de sintomas clínicos que podem variar desde uma forma assintomática ou sub-clínica até a doença de Weil que acomete aproximadamente 10 por cento dos casos clínicos e pode levar ao óbito. A leptospirose em Salvador é responsável por epidemias anuais acometendo predominantemente indivíduos residentes em comunidades desprovidas de infra-estrutura sanitária. Para traçarmos medidas efetivas de saúde pública, torna-se necessário entender a história natural da leptospirose urbana, a razão entre casos graves e infecção, os fatores de risco para aquisição da doença. Determinar a taxa de infecção por Leptospira em uma sub-coorte de indivíduos residentes em uma comunidade de alto risco; Calcular a razão entre os casos graves de leptospirose e os indivíduos com infecções assintomáticas ou sub-clínicas; Identificar fatores de risco para aquisição de infecção por Leptospira. Uma coorte prospectiva de 9.862 indivíduos foi estabelecida no bairro periférico de pau da lima, Salvador-Bahia e uma sub-coorte de 2.003 indivíduos selecionados randomicamente foi acompanhada anualmente. Destes indivíduos foram coletados dados epidemiológicos e uma amostra de sangue para avaliação sorológica. Para cálculo da taxa de infecção este último termo foi definido como soro conversão ou aumento de quatro vezes o título recíproco na microaglutinação entre amostras pareadas. Foi identificada uma taxa de infecção de 49,0 por 1.000 pessoas/anos de seguimento nesta sub-coorte e razões doença grave:infecção de 1:516 na coorte e 1:598 para a ZI Pau da Lima; fatores de risco estatisticamente significantes foram: gênero masculino (RR 1,98; IC 95 por cento 1,19 - 3,29); faixa etária de 25-34 (2,35; 1,12 - 4,94), não ser alfabetizado (2,45; 1,45 - 4,15), passado clínico de leptospirose (5,16; 1,26 - 21,1 1), contato com lama no peridomicílio (1,95;1,18 - 3,22), contato com lama na rua (2,14; 1,28 - 3,58), contato com lixo no peridomicílio (1,92; 1,13 - 3,26), contato com lixo na rua (2,33; 1,41 - 3,85), contato com alagamento no peridomicílio (2,07; 1,25 - 3,45), contato com alagamento na rua (2,40; 1,38 - 4,16), alagamento da rua (2,40; 1,38 - 4,16), residir em local sujeito a alagamento (1,67; 1,05 - 4,78), contato com esgoto no peridomicílio (2,02;1,22 - 3,36), contato com esgoto na rua (2,95;1,78 - 4,91), desentupir esgoto da rua (2,26;1,35 - 3,77), residir a até 10m de esgotos abertos (1,89; 1,09 - 3,27), possuir gato em casa (2,52; 1,49 - 4,28). Nas análises multivariadas utilizando o modelo de Cox com e sem efeitos aleatórios no domicílio, foram fatores de risco independentes: sexo masculino (2, I 2; 1,25 - 3,60), faixas etárias de quinze a vinte e quatro (2,74; 1,22 - 6,16) e vinte e cinco a trinta e quatro (4,24; 1,88 - 9,52) ambas em relação aos indivíduos de cinco a quatorze anos, ão ser alfabetizado (2,92; 1,65 - 5,17), contato com alagamento na rua (2,14; 1,20¬. 3,82), criar gato no domicílio (2,51; 1,46 - 4,32). Foi identificada uma alta taxa de infecção na população, destacando-se as faixas etárias de 15 a 34 anos e o sexo masculino com maior número de indivíduos infectados (59 por cento), nenhum fator de risco ocupacional foi identificado, reforçando a hipótese de transmissão peridomiciliar de nossos estudos anteriores. Baseados nestes dados poderemos implementar e avaliar intervenções de saúde pública nesta comunidade de alto risco para infecção.Leptospirosis, considered to be the most widespread antropozoonose in the world, is an acute febrile illness that begins suddenly, caused by spirochetes o f the genus Leptospira. Leptospira infection produces a wide range of clinical presentation that can vary from an asymptomatic or sub-clinical form to W eil's disease which causes approximately 10% of the clinical cases and can lead to death. Leptospirosis in Salvador is responsible for annual epidemics predominantly affecting individuals that are resident in communities with poor sanitary infrastructure. To identify public health measures for prevention, it is necessary to understand the natural history of urban leptospirosis, the relationship between severe cases and infection, the risk factors for acquiring the illness. OBJECTIVES: 1- To determine the leptospiral infection rate in a sub-cohort of resident individuals in a high risk community; 2- To calculate the relationship between the severe cases and the asymptomatic or subclinical infected individuals and 3- To identify the risk factors for acquiring leptospiral infection. METHODS: a cohort of 9.862 individuals was established in Pau da Lima, Salvador-Bahia and one sub-cohort of 2.003 randomly selected individuals was followed during one year. We collected epidemiologic data from these individuals and a blood sample for sorologic evaluation. Infection was defined as seroconversion or a four fold rise in reciprocal titters as determined in the microaglutination test. RESULTS: We identified an infection rate of 49,0 per 1.000 people/years of follow-up and a proportions severe disease:infection o f 1:516 in the cohort and 1:598 in Pau da Lima; statistically significant risk factors were: masculine gender (RR 1,98; IC 95% 1,19 - 3,29); age range from 25-34 (2,35; 1,12 - 4,94), lacky literacy (2,45; 1,45 - 4,15), severe leptospirosis in the past (5,16; 1,26 - 21,11), peridomiciliar contact with mud (1,95;1,I8 - 3,22), contact with mud in street (2,14; 1,28 - 3,58), peridomiciliar contact with garbage (1,92; 1,13’- 3,26), contact with garbage in street (2,33; 1,41 - 3,85), peridomiciliar contact with waste water (2,07; 1,25 - 3,45), contact with waste water in street (2,40; 1,38 - 4,16), waste water in the street (2,40; 1,38 ~ 4,16), residence in flooding area (1,67; 1,05 - 4,78), peridomiciliar contact with sewer (2,02;1,22 - 3,36), contact with sewer in the street (2,95;1,78 - 4,91), to remove blocking sewers in the street (2,26;1,35 - 3,77), residence 10m from an open sewer (1,89; 1,09 - 3,27), presence of a cat in the house (2,52; 1,49 - 4,28). In the multivaried analyses using the Cox model with and without intra-domiciliary aleatory effects, the independent risk factors were: masculine sex (2,12; 1,25 - 3,60), age range from 15 to 24 (2,74; 1,22 - 6,16) and 25 to 34 (4,24; 1,88 - 9,52) both compared to age range from 5 to 14, lacky literacy (2,92; 1,65 - 5,17), contact with waste water in street (2,14; 1,20 - 3,82), presence of a cat in the house (2,51; 1,46 - 4,32). CONCLUSIONS: We identified a high infection rate in the population, especially in males aged from 15 to 34 years were the largest number of infected individuals (59%), no occupational risk was identified, strengthening the hypothesis of peridomiciliar transmission from our previous studies. Based on these findings we can implement and e avaliate public health measures in this high risk community

Performance of resident nurses in obstetrics on childbirth care

Abstract Objectives: to describe good practices on childbirth care and obstetric interventions performed by resident nurses in obstetrics during the obstetric childbirth risk at a public maternity hospital in Salvador. Methods: a descriptive cross-sectional study with a quantitative approach, based on the of 102 parturients, between February and April 2016. The data collection was performed through the collection of information on clinical files for analysis by using descriptive statistics with absolute and relative frequencies for the evaluated categorical variables. Results: it was observed that 100.0% of the women used some kind of non-pharmacological method for pain relief, although the method of choice was to take a hot bath; 99.0% of the women drank liquids; 94.0% had the presence of a companion of free choice; 99.0% walked during labor; 100.0% had the freedom to choose a position during childbirth. It is noteworthy that no woman in this study was submitted to episiotomy, and more than 70.0% were not submitted to any obstetric intervention. Conclusions: the Programa de Residência em Enfermagem (Residency Nursing Program) an important point in the childbirth humanization process is directly associated to the increase in the normal childbirth rates, the highest use on good practices in childbirth care, and the reduction on obstetric interventions

Suicide attempts in Brazil, 1998–2014: an ecological study

Abstract Background Attempted suicide is the main predictor of suicide constituting a major public health issue worldwide. It is estimated that for every completed suicide, 10 to 20 suicide attempts occur. Important part of the occurrences of suicide attempts in Brazil are registered in the hospital information system for coverage of more than 70 % allows to evaluate the extent of this problem in the country. The scope of this article is to analyse hospitalizations resulting from suicide attempts at public hospitals or services contracted out by the public health system (SUS) in Brazil from 1998 to 2014. Methods This is an ecological study of secondary morbidity data obtained from the Hospital Information System. The overall rate of suicide attempts per 100 000 (105) individuals and rates stratified by age group and sex were calculated. To measure trends, simple linear regression coefficients were calculated. The hospital mortality rate was calculated per 100 individuals. Results The overall rate of hospitalization decreased from 1998 to 2014. The young and adult age groups had the highest hospitalization rates. Men were admitted more and the elderly had higher hospital mortality rates. The main cause of hospitalization was poisoning, accounting for 70.4 % of hospitalizations. Among the people who used poisoning by non-medical drugs as the method of attempted suicide, 58 178 (69.6 %) were men and 49 585 people who are poisoned by medical drugs (60.1 %) were women. Conclusions Although hospitalization rates for attempted suicide have declined in Brazil, it remains a serious public health problem. Because a suicide attempt is the main predictor of suicide, studies to identify those most vulnerable to attempted suicide will help in the development of prevention strategies for mental health

Seizures as a Complication of Congenital Zika Syndrome in Early Infancy

Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2018-08-07T14:08:53Z No. of bitstreams: 1 Oliveira-Filho J Seizures as a Complication of Congenital Zika.pdf: 82677 bytes, checksum: e67ebd92b967354def5e0e51f9e225c4 (MD5)Approved for entry into archive by Ana Maria Fiscina Sampaio ([email protected]) on 2018-08-07T15:44:32Z (GMT) No. of bitstreams: 1 Oliveira-Filho J Seizures as a Complication of Congenital Zika.pdf: 82677 bytes, checksum: e67ebd92b967354def5e0e51f9e225c4 (MD5)Made available in DSpace on 2018-08-07T15:44:32Z (GMT). No. of bitstreams: 1 Oliveira-Filho J Seizures as a Complication of Congenital Zika.pdf: 82677 bytes, checksum: e67ebd92b967354def5e0e51f9e225c4 (MD5) Previous issue date: 2018NIH Grants RO1 NS064905, NIH R01 AI052473, U01 AI088752, and R25 TW009338, and the Oswaldo Cruz FoundationUniversidade Federal da Bahia. Faculdade de Medicina da Bahia. Postgraduate Program in Health Sciences. Salvador, BA, BrasilUniversidade Federal da Bahia. Faculdade de Medicina da Bahia. Instituto de Saúde Coletiva. Escola de Enfermagem. Salvador, BA, BrasilUniversidade Federal da Bahia. Faculdade de Medicina da Bahia. Instituto de Saúde Coletiva. Escola de Enfermagem. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, BrasilHospital Geral Roberto Santos. Secretaria Estadual da Saúde da Bahia. Salvador, BA, BrasilInstituto Evandro Chagas. Belem, PA, BrasilFundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil / Yale School of Public Health. Department of Epidemiology of Microbial Diseases. New Haven, ConnecticutFor The Salvador Zika Response TeamZika virus transmission in Brazil was linked to a large outbreak of microcephaly but less is known about longer term anthropometric and neurological outcomes. We studied a cohort of infants born between October 31, 2015, and January 9, 2016, in a state maternity hospital, followed up for 101 ± 28 days by home visits. Microcephaly (< 2 standard deviations, Intergrowth standard) occurred in 62 of 412 (15%) births. Congenital Zika syndrome (CZS) was diagnosed in 29 patients. Among CZS patients, we observed a significant gain in anthropometric measures (P < 0.001) but no significant gain in percentile for these measures. The main neurological outcome was epilepsy, occurring in 48% of infants at a rate of 15.6 cases per 100 patient-months, frequently requiring multiple anti-seizure medications. The cumulative fatality rate was 7.4% (95% confidence interval: 2.1-23.4%). Health-care professionals should be alerted on the high risk of epilepsy and death associated with CZS in early infancy and the need to actively screen for seizures and initiate timely treatment

Knowledge, attitudes, and practices related to Leptospirosis among urban slum residents in Brazil

Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2014-03-28T18:07:28Z No. of bitstreams: 1 Navegantes AW, Knowledge, atitudes, and pratices....pdf: 469736 bytes, checksum: 6a3c3d1fbf68162baf4150cee7c160dd (MD5)Made available in DSpace on 2014-03-28T18:07:28Z (GMT). No. of bitstreams: 1 Navegantes AW, Knowledge, atitudes, and pratices....pdf: 469736 bytes, checksum: 6a3c3d1fbf68162baf4150cee7c160dd (MD5) Previous issue date: 2012Fundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, BrasilUniversidade Federal da Bahia. Institute of Collective Health. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, BrasilYale School of Public Health. New HavenFundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, BrasilYale School of Public Health. New HavenFundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, BrasilLeptospirosis disproportionately affects residents of urban slums. To understand the knowledge, attitudes, and practices regarding leptospirosis, we conducted a cross-sectional study among residents of an urban slum community in Salvador, Brazil. Of the 257 residents who were interviewed, 225 (90%) were aware of leptospirosis and more than two-thirds of respondents correctly identified the modes of disease transmission and ways to reduce exposure. However, study participants who performed risk activities such as cleaning open sewers had limited access to protective clothing such as boots (33%) or gloves (35%). Almost all respondents performed at least one activity to prevent household rat infestation, which often included use of an illegal poison. Our findings support the need for interventions targeted at the individual and household levels to reduce risk of leptospirosis until large-scale structural interventions are available to residents of urban slum communities

Promotion of health, sustainability and social development of a vulnerable community

ABSTRACT Objective: to report the experience of research phases on promoting sustainable development based on social technologies with palm fiber artifacts in a vulnerable community. Method: this is an experience report that describes the phases of a multiprofessional project that sought sustainable development, and was conducted with inhabitants from a vulnerable community. Results: the actions were developed in four phases: exploratory, planning, implementation and evaluation. These phases encompassed a situational diagnosis, planning and performing health education workshops, training meetings, production of handcrafted window shutters with insulation and acoustic comfort. The most emphatic result was the possibility of a new source of income. Final Considerations: the project actions favored the individual and collective empowerment of the participants regarding their health, especially considering the recovery of self-esteem, valuation of traditional knowledge and a new source of income