Epidemiology of Disappearing Plasmodium vivax Malaria: A Case Study in Rural Amazonia

Background: New frontier settlements across the Amazon Basin pose a major challenge for malaria elimination in Brazil. Here we describe the epidemiology of malaria during the early phases of occupation of farming settlements in Remansinho area, Brazilian Amazonia. We examine the relative contribution of low-density and asymptomatic parasitemias to the overall Plasmodium vivax burden over a period of declining transmission and discuss potential hurdles for malaria elimination in Remansinho and similar settings. Methods: Eight community-wide cross-sectional surveys, involving 584 subjects, were carried out in Remansinho over 3 years and complemented by active and passive surveillance of febrile illnesses between the surveys. We used quantitative PCR to detect low-density asexual parasitemias and gametocytemias missed by conventional microscopy. Mixed-effects multiple logistic regression models were used to characterize independent risk factors for P. vivax infection and disease. Principal Findings/Conclusions P. vivax prevalence decreased from 23.8% (March–April 2010) to 3.0% (April–May 2013), with no P. falciparum infections diagnosed after March–April 2011. Although migrants from malaria-free areas were at increased risk of malaria, their odds of having P. vivax infection and disease decreased by 2–3% with each year of residence in Amazonia. Several findings indicate that low-density and asymptomatic P. vivax parasitemias may complicate residual malaria elimination in Remansinho: (a) the proportion of subpatent infections (i.e. missed by microscopy) increased from 43.8% to 73.1% as P. vivax transmission declined; (b) most (56.6%) P. vivax infections were asymptomatic and 32.8% of them were both subpatent and asymptomatic; (c) asymptomatic parasite carriers accounted for 54.4% of the total P. vivax biomass in the host population; (d) over 90% subpatent and asymptomatic P. vivax had PCR-detectable gametocytemias; and (e) few (17.0%) asymptomatic and subpatent P. vivax infections that were left untreated progressed to clinical disease over 6 weeks of follow-up and became detectable by routine malaria surveillance

Estudo comparativo da atuação do enfermeiro no controle de dengue e febre chikungunya

Resumo O objetivo deste estudo foi analisar a atuação dos enfermeiros das Estratégias de Saúde da Família no controle de dengue e febre chikungunya nos municípios de Parnamirim e Santa Cruz/RN. Trata-se de um estudo exploratório, descritivo, com abordagem qualitativa de tratamento e análise de dados. A coleta foi realizada entre novembro e dezembro de 2015 por meio de uma entrevista gravada, voltada às questões que abordam a ação da enfermagem e sua equipe no controle de dengue e febre chikungunya no campo de atuação da ESF. Utilizou-se como método de observação dos dados a análise de conteúdo de Bardin. Após análise, houve criação de duas categorias - educação em saúde e campanhas pontuais. Na primeira, os entrevistados informaram realizar palestras educativas, mas não explicam a metodologia usada e nem a participação popular, como também a articulação com o setor de endemias da cidade para fortalecer a discussão. Na segunda, algumas ações são assistencialistas de caráter campanhista/higienista, realizadas pelos enfermeiros dos municípios em campanhas de “higienização” e “limpeza”, as quais se mostram bastante presentes nas falas dos entrevistados. Há uma forte presença desse modelo enraizada tanto nas ações quanto na realização de atividades educativas, usando como metodologia a palestra. Além disso, há necessidade de se realizar mais estudos que aprofundem o tema abordado, a julgar por uma amostra pequena, especialmente no município de Parnamirim

New national curricula guidelines that support the use of interprofessional education in Brazilian context : an analysis of key documents

The National Curricular Guidelines (NCGs) are important documents for understanding the history of academic health professions education in Brazil. Key policies within the NCGs have helped to re-orient health professions education and have stimulated curricular changes, including active learning methodologies, more integrated teaching-service environments and, more recently, have introduced interprofessional education (IPE) in both undergraduate and postgraduate sectors. This paper presents the findings of a study that examined the NCGs for nursing, dentistry and medicine courses as juridical foundations for adopting strategies that promote IPE across higher education institutions in Brazil. We employed a comparative and exploratory documentary analysis to understand the role of IPE or collaborative practices in NCGs for the three largest professions in Brazil. Following a thematic analysis of these texts, four key themes emerged: faculty development; competencies for teamwork; curricular structure; and learning metrics. Key findings related to each of these themes are presented and discussed in relation to the wider interprofessional literature. The paper goes on to argue that the statements contained in the NCGs about adoption of IPE and collaborative practices will have an important influence in shaping the future of health professions education in Brazil

Open innovation in public management: analysis of the Brazilian action plan for Open Government Partnership

Este estudo objetivou analisar o Plano de Ação brasileiro para o Governo Aberto, baseado na teoria da inovação aberta na gestão pública. Utilizou-se de uma pesquisa documental, com vistas a aprofundar o conhecimento do fenômeno em questão. O documento foi escolhido intencionalmente, por ser exemplo basilar das políticas públicas relacionadas à inovação aberta brasileira. Os resultados mostram que os compromissos firmados pelo governo brasileiro estão consoantes com o processo de inovação aberta pública. As ações previstas no Plano estão especificamente relacionadas a transparência, abertura de dados e preparação do corpo estatal para o processo aberto de inovação. _________________________________________________________________________________________ RESUMEN: Este estudio tuvo como objetivo analizar el Plan de Acción de Brasil para el Gobierno Abierto con base en la teoría de la innovación abierta en la gestión pública. Se utilizó una investigación documental, con el fin de profundizar el conocimiento en el fenómeno en cuestión. El documento fue elegido intencionadamente porque es fundamental para las políticas públicas relacionadas con la innovación abierta brasileña. Los resultados muestran que los compromisos asumidos por el gobierno brasileño son compatibles con el proceso de innovación abierta pública. En concreto, las acciones contenidas en el plan están relacionados con la transparencia, los datos abiertos y preparación de la estructura de gobierno para el proceso abierto de innovación. _________________________________________________________________________________________ ABSTRACT: This study aims to analyze the Brazilian action plan for Open Government, based on the theory of open innovation in public management. Documentary research was used, in order to deepen of the knowledge the phenomenon being discussed . The document was intentionally chosen because it is essential for public policies related to Brazilian open innovation The results show that the commitments made by the Brazilian government are compatible with the public open innovation process. The actions in the Plan are related specifically to transparency, open data and preparation of the governance body for the open innovation process