Temporal trend and spatial analysis of the HIV epidemic in young men who have sex with men in the second largest Brazilian Amazonian province

After 40 years of its starting, the HIV epidemic in Brazilian Amazon region remains on an increasing trend. The young men who have sex with men (MSM) have been the most impacted by the HIV in the last decade. However, much more than attributing the risk behavior to HIV uniquely to the individual, behaviors are shaped by social determinants of health (SDH). Despite the problem, there is a scarcity of studies evaluating the impact of SDH on HIV among young MSM and none of them were done in the Northern of Brazil. Therefore, the main goal of this study was to analyse the HIV epidemic among Brazilian Amazonian young MSM using temporal trends and spatial analysis. We conducted an ecological study using reported cases of HIV/AIDS in young MSM living in Pará, the second larger Brazilian Amazonian province, between 2007 and 2018. Data were obtained from the Information System for Notifiable Diseases. For the temporal analysis, we employed a Seasonal and Trend decomposition using Loess Forecasting model (STLF), which is a hybrid time-series forecast model, that combines the Autoregressive-Integrated Moving Average (ARIMA) forecasting model with the Seasonal-Trend by Loess (STL) decomposition method. For the spatial analysis, Moran’s spatial autocorrelation, spatial scan, and spatial regression techniques were used

Perfil epidemiológico das infecções relacionada a assistência à saúde em unidade de terapia intensiva adulto em hospital referência materno-infantil do Pará

Background and objectives: Healthcare-related infections are a worldwide public health problem that affects people, services, and national health systems. This study aims to know the epidemiological profile of health care-related infections in an adult intensive care unit in a public hospital in Belém-PA, in 2016. Methods: This is a descriptive, cross-sectional study. In a retrospective and quantitative approach, the variables gender, age group, topography, microorganism were studied, based on a database containing information related to healthcare-related infections of an intensive care unit in the city of Belém, Pará. Results: Infections related to health care in the intensive care unit occurred in most cases in male, elderly and coming from Belém. They are from the bloodstream, mainly with the use of central venous catheter, by the bacterium A. Baumannii. Conclusion: The study presented evidence on health care-related infections that may assist in the reflection on the adoption of prevention and control measures to ensure patient safety.Justificación y objetivos: las infecciones relacionadas con la atención médica son un problema mundial de salud pública que afecta a las personas, los servicios y los sistemas nacionales de salud. Este estudio tiene como objetivo conocer el perfil epidemiológico de las infecciones relacionadas con la atención médica en una unidad de cuidados intensivos para adultos en un hospital público de Belém-PA, en 2016. Métodos: Este es un estudio descriptivo, de corte transversal. En un enfoque retrospectivo y cuantitativo, se estudiaron las variables género, grupo de edad, topografía, microorganismo, en base a una base de datos que contiene información relacionada con infecciones relacionadas con la atención médica de una unidad de cuidados intensivos en la ciudad de Belém, Pará. Resultados: las infecciones relacionadas con la atención médica en la unidad de cuidados intensivos ocurrieron en la mayoría de los casos en hombres, ancianos y provenientes de Belém. Provienen del torrente sanguíneo, principalmente con el uso del catéter venoso central, por la bacteria A. Baumannii. Conclusión: El estudio presentó evidencia sobre infecciones relacionadas con la atención médica que pueden ayudar a reflexionar sobre la adopción de medidas de prevención y control para garantizar la seguridad del paciente.Justificativa e objetivos: As infecções relacionadas a assistência à saúde são um problema de saúde pública mundial, que afeta as pessoas, serviços e sistemas nacionais de saúde. Este estudo tem como objetivo conhecer o perfil epidemiológico das infecções relacionada a assistência à saúde em unidade de terapia intensiva adulto em um hospital público em Belém-PA, no ano de 2016. Métodos: Trata-se de uma pesquisa descritiva, do tipo transversal, retrospectiva e abordagem quantitativa, foram estudadas as variáveis sexo, faixa etária, topografia, microrganismo, realizada a partir do levantamento de um banco de dados contendo informações referentes as infecções relacionadas a assistência à saúde de uma unidade de terapia intensiva da cidade de Belém, Pará. Resultados: As infecções relacionada a assistência à saúde em unidade de terapia intensiva ocorreu na maioria dos casos em pessoas do sexo masculino, idosas e procedentes de Belém. São da corrente sanguínea, principalmente com o uso de cateter venoso central, pela bactéria A. baumannii. Conclusão: O estudo apresentou evidências sobre as infecções relacionadas a assistência à saúde que podem auxiliar na reflexão de adoção de medidas de prevenção e controle para garantir a segurança do paciente

ANÁLISIS DE LA ETAPA DE GARANTÍA DE PREPARACIÓN DEL TEAM BASED LEARNING EN LA ENSEÑANZA DE ENFERMERÍA

Objetivo: analizar la etapa de garantía de preparación del Team-Based Learning a través del desempeño de los estudiantes de Enfermería en el Individual Readiness Assurance Test – iRAT y Team Readiness Assurance Test – tRAT. Método: estudio descriptivo con enfoque cuantitativo. Veintiséis estudiantes en el quinto semestre de una universidad del Norte de Brasil. La recopilación de datos se realizó en octubre y noviembre de 2018 con cuestionarios aplicados en cinco unidades. El análisis fue descriptivo, por cuestionario, pregunta, equipo y alumno. Resultados: el desempeño en equipo fue superior, pero no en todas las unidades. Hay cuestiones en las que los estudiantes, individualmente y en equipo, presentaron dificultades, sugiriendo variables que intervienen de origen pedagógico. Conclusión: el análisispor el desempeño de los estudiantes sugiere fallos en la garantía de preparación. El estudio contribuye indicando las posibles variables pedagógicas que pueden influir en el éxito de esta etapa del Team-Based Learning.Objetivo: analisar a etapa de garantia de preparo do Team-Based Learning por meio do desempenho de estudantes de Enfermagem no Individual Readiness Assurance Test – iRAT e Team Readiness Assurance Test – tRAT.Método: estudo descritivo de abordagem quantitativa. Participaram 26 estudantes do quinto semestre de uma faculdade do Norte do Brasil. A coleta de dados ocorreu nos meses de outubro e novembro de 2018 com questionários aplicados em cinco unidades. A análise foi descritiva, por questionário, questão, equipe e aluno.Resultados: o desempenho em equipe foi superior, porém não em todas as unidades. Há questões em que os estudantes individualmente e em equipe apresentaram dificuldades, sugerindo variáveis intervenientes de origem pedagógica.Conclusão: a análise por desempenho dos estudantes sugere falhas na garantia de preparo. O estudo contribui ao indicar possíveis variáveis pedagógicas que podem influenciar no sucesso desta etapa do Team-Based Learning.Objective: to analyze the readiness assurance step of the Team-Based Learning through the performance of Nursing students in the Individual Readiness Assurance Test – iRAT and Team Readiness Assurance Test – tRAT.Method: descriptive study of quantitative nature. Twenty-six fifth semester students of a university of northern Brazil participated. Data collection took place in October and November 2018 with questionnaires applied in five units. The analysis was descriptive, by questionnaire, question, team and student.Results: the team performance was superior, but not in all units. There are issues where students individually and in teams presented difficulties, suggesting intervening variables of pedagogical origin.Conclusion: the analysis by performance of students suggests failures in the readiness assurance. The study contributes by indicating possible pedagogical variables that can influence the success of this step of the Team-Based Learning

Spatial scenery of congenital syphilis in Brazil between 2007 and 2018: An ecological study

Objective: To analysis the epidemiological scenery of the congenital syphilis (CS) in Brazil employing spatial analysis techniques. Design: Ecological study. Settings: This study was conducted in Brazil Sample: A total of 151 601 CS cases notified to the Diseases and Notification Information System from 2007 to 2018 from children aged 0–23 months and born from mothers living in Brazil were included in this study. Primary outcome measures: The CS incidence rates were calculated by triad (2007–2010, 2011–2014 and 2015–2018) for all Brazilian municipalities following the Boxcox transformation to remove the discrepant values. The transformed rates were analysed through the spatial autocorrelation of Moran, Kernel density estimative and spatial scan. Results: From 2007 to 2018, the CS incidence rates increased in all Brazilian regions. The CS spread towards the interior of Brazil, and a higher expansion was noticed between 2015 and 2018. The municipalities that were greatly affected by the CS were those having a high migration of people, such as the ones bordering other countries and the touristic cities. Recife, Campo Grande, Rio de Janeiro, Porto Alegre and Manaus were the capitals with the greatest spatial and spatiotemporal risk. Conclusion: This study provides assistance to health authorities to fight CS in Brazil. More investment is necessary in prenatal care quality focusing on pregnant women and their partners to guarantee their full access to preventive resources against sexually transmitted infections

AIDS-related mortality in Pará Province, Brazilian Amazon region: Spatial and temporal analysis.

Despite considerable therapeutic advances in the care of people living with human immunodeficiency virus (HIV) and with the acquired immunodeficiency syndrome (AIDS) and an overall reduction of 47% in the AIDS mortality rate in the last decade, the AIDS-mortality rates remains high. The social determinants of health (SDH) have a direct influence on the dynamics of this phenomenon. However, changes in SDH caused by the implemented policies against HIV have been poorly investigated. Moreover, the Brazilian rainforest has had the highest and continuously increasing AIDS mortality rate in Brazil since the 1980s. In this study, AIDS mortality in a province of the Brazilian rainforest was examined by using temporal and spatial analyses.MethodsIn this ecological study, data from 2007 to 2018 were extracted from the Mortality Information System provided by the State Department of Public Health of Pará. For the temporal analysis, the integrated autoregressive model of moving average (ARIMA) and locally weighted polynomial regression (STLF) were used to forecast AIDS mortality from 2019 to 2022. For the spatial analysis, spatial autocorrelation and geographically weighted regression (GWR) analyses were employed.ResultsThe samples consisted of 6,498 notifications for AIDS-related deaths. From 2007 to 2013, the AIDS mortality rates showed an upward trend, followed by a stabilization until 2018 and an upward forecasted trend from 2019 to 2022. High mortality rates and high-high clusters were found in economic pole municipalities. Furthermore, AIDS mortality risk was directly associated with per capita income and demographic density, except in the southwestern region of Pará, which exhibited an inverse association with population density.ConclusionAlthough the policies against HIV may have contributed to the stabilization of AIDS mortality rates from 2013 in Pará, the upward forecasted trend until 2022 raises an alert and concern to health authorities to provide reinforcement of the policies. The geographic variability of AIDS mortality promoted by SDH provides subsidies to health authorities to implement SDH-focused strategies for AIDS mortality reduction

Human immunodeficiency virus epidemic scenery among brazilian women: a spatial analysis study

Abstract Background Approximately 37.7 million people worldwide are infected with human immunodeficiency virus (HIV). Although HIV detection among women, they still representing 53% of population living with the virus. Spatial analysis techniques are powerful tools for combating HIV allowing the association of the phenomenon with socioeconomic and political factors. Therefore, the main goal of this study was to spatially analyze HIV prevalence among Brazilian women from 2007 to 2020. Methods ecological study was conducted using secondary databases of the Notifiable Diseases Information System (SINAN) for HIV and Acquired Immunodeficiency Syndrom (AIDS) in Brazilian women 15 years old and over. Age-adjusted HIV/AIDS incidence rates were analyzed using spatial distribution, autocorrelation, and spatiotemporal risk analysis techniques. Results During the study period, 119,890 cases of HIV/AIDS were reported among Brazilian women. The southeastern region had a higher age-adjusted HIV/AIDS incidence than other Brazilian regions. Hotspot HIV/AIDS incidence rates decreased in all Brazil. Piauí, Paraná, and Minas Gerais were the only states with an increased number of cold spots. Previous spatiotemporal risk zones were observed in the states of São Paulo, Rio Grande do Sul, and Rio de Janeiro. Belém was a risk zone with a later spatiotemporal risk. Conclusions The efficiency of public policies fighting HIV has not been uniform among municipalities, although HIV/AIDS cases have decreased among Brazilian women. The social determinants of health in each municipality should be considered when local health authorities implement policies. Women empowerment should be promoted, and access to preventive, diagnostic, and treatment healthcare places should be expanded and guaranteed

Comparison of OLS and GWR models for the impact of SDH on the AIDS mortality rate in Pará between 2007 and 2018.

Comparison of OLS and GWR models for the impact of SDH on the AIDS mortality rate in Pará between 2007 and 2018.</p

HIV epidemic among Brazilian women who have sex with women: An ecological study

The influences of public policies fighting HIV among women who have sex with women is scarcely studied. This study aimed to analyse the time series of human immunodeficiency virus (HIV) epidemic, between 2007 and 2020, among Brazilian women who have sex with women, in order to evaluate the eect of Brazilian policies for fighting HIV in this subpopulation compared to women who have sex with men (WSM). This ecological study employed HIV and acquired immunodeficiency syndrome (AIDS) new cases among women who have sex strictly with women (WSW), women who have sex with men and women (WSMW), and WSM reported to the Sistema de Informação de Agravos de Notificação from 2007 to 2020. Crude Brazilian and regional annual age-adjusted HIV/AIDS population-level incidence rates were calculated for WSW, WSMW and WSM. The rates were then analyzed using the Joinpoint regression model. A total of 102,890, 757, and 1,699 notifications of WSW, WSMW, and WSM living with HIV/AIDS were reported during the study period, respectively. South Brazilian region had the greatest HIV/AIDS incidence rates among WSM and bisexual women while the North region had the greatest incidence among WSW. In the WSM population, the temporal trends showed at least one stable or an increasing trend period from 2007 to 2013 or 2014, followed by one decreasing trend in all Brazilian regions. While among the WSMW most of the regions had a stable trend period from 2007 to 2020, in WSW group most of the trends had only one decreasing period. The decreasing trends were faster in WSM than in WSW. These results suggest a low efficiency of Brazilian policies for fighting HIV among WSW and WSMW and show the necessity of implementing new policies specific to this populatio

Prevalence and Vulnerability Factors Associated with HIV and Syphilis in Older People from Subnormal Agglomerate, Brazilian Amazon

Background: This study aimed to estimate the prevalence of HIV and syphilis and associated factors among elderly people from subnormal agglomerations in a city in the Brazilian Amazon. Methods: An observational, cross-sectional study was carried out in a subnormal agglomerate from the Brazilian Amazon. Data collection was conducted from August 2021 to February 2022, using a structured questionnaire. Whole blood samples were collected to perform a rapid test for HIV and syphilis. People aged 50 and over were included in the study, and the sample consisted of 213 participants. The odds ratio was calculated by multiple logistic regression. Results: A total of 203 participants with a mean age of 63.5 years were considered (95% CI: 62.4; 64.6; standard deviation: 8.1; minimum age: 50 years and maximum age: 94 years). The prevalence of either HIV or syphilis was 16.4% (35/213; 95% CI: 0.11; 0.21); syphilis was 15.5% (33/213) and HIV was 1.40% (3/213). One coinfection (0.46%; 1/213) was registered. In the final multiple logistic regression, the elderly with an education level of illiterate/elementary were two times more likely to have a positive rapid test result for HIV or syphilis. Conclusions: Testing for HIV and syphilis identified that STI represented a burden on populations affected by socioeconomic inequality