Ofidismo no Tocantins: análise ecológica de determinantes e áreas de risco, 2007-2015

Objective. To investigate the epidemiological profile affected by snakebite, their determinants and risk areas, in the state of Tocantins. Methods. Ecological study with data from the Notifiable Disease Information System, from 2007 to 2015. Linear regression of tests and Mann-Whitney and Kruskal-Wallis tests were used. Results. 7,764 snakebite were reported (incidence: 62.1/100,000 inhab.; lethality: 0.5%). The variables associated with snakebite were demographic density (Coeff.=1.36, 95%CI 0.72;1.99), agricultural work (Coeff.=0.02, 95%CI 0.01;0.03), Index of Municipal Human Development (Coeff.=2.99 – 95%CI 0.60;5.38), cassava cultivated area (Coeff.=8.49 – 95%CI 1.66;15.32), indigenous population (Coeff.=0,02 – 95%CI 0.00; 0.04), proportion of the illiterate population (Coeff.=4.70 – 95%CI 0.61;8.79) and employed (Coeff.=3.00 – 95%CI 0.93;5,06), which explained 64.48% of the variation. The high-risk areas were Amor Perfect, Cantão, Cerrado Tocantins Araguaia and Middle North Araguaia health regions. Conclusion. Municipal socioeconomic and demographic aspects associated with snakebites.Objetivo. Investigar o perfil dos casos de acidentes ofídicos, seus determinantes e áreas de risco no estado do Tocantins. Métodos. Estudo ecológico, com dados do Sistema de Informação de Agravo de Notificação do período 2007-2015. Empregou-se regressão linear múltipla e os testes Mann-Whitney e Kruskal-Wallis. Resultados. Foram notificados 7.764 acidentes ofídicos (incidência de 62,1/100 mil habitantes; letalidade de 0,5%). As variáveis associadas ao ofidismo foram densidade demográfica (Coef.=1,36 – IC95%0,72;1,99), trabalho agropecuário (Coef.=0,02 – IC95%0,01;0,03), índice de desenvolvimento humano municipal (Coef.=2,99 – IC95%0,60;5,38), área cultivada de mandioca (Coef.=8,49 – IC95%1,66;15,32), população indígena (Coef.=0,02 – IC95%0,00;0,04), proporção de população analfabeta (Coef.=4,70 – IC95%0,61;8,79) e população empregada (Coef.=3,00 – IC95%0,93;5,06), que explicaram 64,48% da variação. As áreas de alto risco foram as regiões de saúde Amor Perfeito, Cantão, Cerrado Tocantins Araguaia e Médio Norte Araguaia. Conclusão. Aspectos socioeconômicos e demográficos municipais associaram-se ao ofidismo

Completude das notificações dos acidentes por animais peçonhentos no Sistema de Informação de Agravos de Notificação: estudo descritivo, Brasil, 2007-2019

Objective: To describe the completeness of notifications of accidents by venomous animals in the Information System for Notifiable Diseases-Sinan, in Brazil and regions, from 2007 to 2019. Methods: Essential and non-mandatory fields for snakebite notifications were analyzed, araneism and scorpionism, considering the completeness categories Excellent (≤5.0% incompleteness), Good (5.0% to 10.0%), Regular (10.0% to 20.0%), Bad (20,0% and ≤50.0%) and Very bad (>50.0%). Proportional change in completeness between 2007 and 2019 was estimated. Results: 1,871,462 notifications were investigated. The fields “local manifestations”, “systemic”, case classification, case evolution and zone of occurrence presented excellent or good completeness. Schooling and race/color showed regular or poor completeness. Occupancy was predominantly poorly or very poorly filled. Zone, case evolution and education showed a proportional worsening in completeness in most regions (VP<0). Conclusion: There is improvement and completeness in most fields, although socioeconomic and occupational fields demand more attentionObjetivo: Describir la completitud de las notificaciones de envenenamiento por serpientes, arañas y escorpiones en el Sistema de Información de Enfermedades de Declaración-Sinan, en Brasil y regiones, de 2007 a 2019. Métodos: Se analizaron campos esenciales y no obligatorios para las notificaciones, considerando las categorías de completitud Excelente (≤5,0% de incompletitud), Buena (5,0% a 10,0%), Regular (10,0% a 20,0%), Mala (20,0% y ≤50,0%) y Muy mala (>50,0%). Se estimó el cambio proporcional en la completitud entre 2007-2019. Resultados: Se investigaron 1.871.462 notificaciones. Los campos manifestaciones locales y sistémicas, zona de ocurrencia, clasificación y evolución de casos presentaron excelente/buena completitud. Escolaridad y raza/color mostraron regular o mala integridad. Ocupación fue predominantemente mala/muy mala completitud. Zona, evolución y escolaridad mostraron empeoramiento proporcional en la completitud en la mayoría de las regiones (VP<0). Conclusión: Hay mejoría y completitud en la mayoría de los campos, aunque los campos socioeconómico y ocupacional demandan atención.Objetivo: descrever a completude das notificações de acidentes causados por animais peçonhentos no Sistema de Informação de Agravos de Notificação, no Brasil e macrorregiões, em 2007-2019. Métodos: analisou-se a completude de campos de preenchimento essenciais e não obrigatórios das notificações de ofidismo, araneísmo e escorpionismo, utilizando-se a classificação de “Excelente” (≤ 5,0% de incompletude), “Bom” (5,0% a 10,0%), “Regular” (10,0% a 20,0%), “Ruim” (20,0% e ≤ 50,0%) e “Muito ruim” (> 50,0%); estimou-se a variação proporcional (VP) da completude. Resultados: foram investigadas 1.871.462 notificações; os campos “manifestações locais”, “sistêmicas”, “classificação do caso”, “evolução do caso” e “zona de ocorrência” apresentaram completude excelente ou boa; “escolaridade” e “raça/cor da pele”, completude regular ou ruim; ocupação, completude ruim ou muito ruim; “zona”, “evolução do caso” e “escolaridade” apresentaram piora proporcional na completude, na maioria das regiões (VP < 0). Conclusão: Melhorou a completude na maioria dos campos, exceto socioeconômicos e ocupacionais, que demandam maior atenção

Associação ecológica entre fatores socioeconômicos, ocupacionais e de saneamento e a ocorrência de escorpionismo no Brasil, 2007-2019

Objective: To analyze the ecological association between socioeconomic, occupational, and sanitation characteristics and scorpionism in Brazil. Methods: Ecological study with data on scorpion accidents reported in the Notifiable Diseases Information System (2007-2019). Negative binomial regression was used to estimate ratios of incidence rates (RTI) and confidence intervals (95%CI). Results: In the period, 1,079,333 scorpion accidents occurred, with accumulated incidence 41.5/100,000 in habitants. In the adjusted analysis, there was an association with the municipal percentage of: women (IRR=1.65 – 95%CI 1.18;2.30) and men (IRR=0.90 – 95%CI 0.88;0.91) in civil construction, women (IRR=1.21 – 95%CI 1.18;1.25) and men(IRR=0.73 – 95%CI 0.69;0.77) in domestic service, women (IRR=1.03 – 95%CI 1.02;1.04) and men (IRR=0.93 – 95%CI 0.92;0.93) in agriculture, households with garbage collection (IRR=0.99 – 95%CI 0.98;0.99) and garbage in surroundings(IRR=1.02 – 95%CI 1.01;1.02), expectation of years of study (IRR=0.88 – 95%CI 0.83;0.92), and unemployment rate (IRR=1.07 – 95%CI 1.05;1.09). Conclusion: Scorpionism was associated with precarious infrastructure/sanitation, job offer, education and female occupation.Objetivo: Analisar associação ecológica entre características socioeconômicas, ocupacionais e de infraestrutura/saneamento com escorpionismo no Brasil. Métodos: Estudo ecológico, com dados dos acidentes escorpiônicos notificados no Sistema deInformação de Agravos de Notificação (2007-2019). Empregou-se regressão binomial negativa para estimar razões de taxas de incidência (RTI) e intervalos de confiança(IC95%). Resultados: No período, ocorreram 1.079.333 acidentes, com incidênciaacumulada de 41,5/100 mil habitantes. Na análise ajustada, houve associação com percentual municipal de mulheres (RTI=1,65 – IC95% 1,18;2,30) e homens (RTI=0,90 –IC95% 0,88;0,91) na construção civil, mulheres (RTI=1,21 – IC95% 1,18;1,25) e homens(RTI=0,73 – IC95% 0,69;0,77) no serviço doméstico, mulheres (RTI=1,03 – IC95% 1,02;1,04) e homens (RTI=0,93 – IC95% 0,92;0,93) na agropecuária, domicílios com lixo coletado (RTI=0,99 – IC95% 0,98;0,99) e lixo no entorno (RTI=1,02 – IC95% 1,01;1,02),2 expectativa de anos de estudo (RTI=0,88 – IC95% 0,83;0,92) e taxa de desocupação (RTI=1,07 – IC95% 1,05;1,09). Conclusão: O escorpionismo associou-se a precária infraestrutura/saneamento, oferta de emprego, educação e ocupação feminina

Speech, Language and Hearing services in Primary Health Care in Brazil: an analysis of provision and an estimate of shortage, 2005-2015

ABSTRACT Objective: to investigate the evolution and estimate the shortage of Speech, Language and Hearing professionals in Primary Health Care between 2005 and 2015. Methods: a mixed ecological study using data from the National Registry of Health Facilities and the Primary Health Care Information System. A descriptive analysis regarding the evolution of the number of professionals working in Primary Health Care over this period, in Brazilian states and regions, was conducted. The ratio of professionals per 100,000 inhabitants for the years 2005, 2010 and 2015, and the shortages in 2015, were estimated. Results: in 2005, there were 1,717 professionals working in Primary Health Care, that is, one per 100,000 inhabitants. In 2015, there were 4,124, increasing to 2.1/100,000. In 2015, the shortage in supply was 55.1%, varying widely across the states. Conclusion: the shortage in supply is equivalent to an absence of Speech, Language and Hearing service coverage within Primary Health Care for more than half of the Brazilian population. It is worth noting that a conservative parameter was adopted to conduct this estimate. The results suggest a process of consolidation for the inclusion of Speech, Language and Hearing professionals within Primary Health Care, however, still characterized by insufficient and unequal supply across the nation