Despite the existing resources for adequate dengue patient care in the Brazilian healthcare system, the case-fatality rate for the disease is still high in the country. In order to identify factors associated with dengue-related death, this study evaluated quality of care according to the degree of implementation of specific measures, the technical and scientific quality of care, and access to health services in two municipalities (counties) in Northeast Brazil. An evaluative study of the implementation analysis type was performed, with death from dengue as the sentinel event for quality of care. To assess the degree of implementation and quality of care, the study scored the interview criteria and patient chart analysis; access was evaluated by thematic analysis. As for structure and process, the health services were found to be partially adequate (70%). No geographic or economic barriers were found to explain the occurrence of deaths. Technical and scientific quality failed to achieve adequate levels in the municipalities (46% and 30%) or in the specific services, and clinical management of dengue by the health services proved insufficient.

Resumo Objetiva-se analisar a prevalência e os fatores associados às Doenças Crônicas não Transmissíveis (DCNT), em adultos residentes numa área urbana de pobreza situada em Recife, Nordeste do Brasil. Trata-se de um estudo transversal, com amostra de 631 adultos de 20 a 59 anos. Analisaram-se possíveis associações das DCNT com fatores demográficos, socioeconômicos, comportamentais e relativos à saúde, por meio de Regressão de Poisson, considerando-se como estatisticamente significantes aqueles com valor de p < 0,05. A prevalência de DCNT foi de 56,7%, sendo maior no sexo masculino (60,8%), entre os adultos com 50-59 anos (80,5%), de menor classe econômica (57,7%) e menor nível de instrução (62%). O problema também predominou entre aqueles com IMC ≥ 25Kg/m2 (34,2%) e que referiram estado de saúde ruim (76,4%). No modelo multivariado hierarquizado, as variáveis estatisticamente significantes foram: escolaridade, IMC, percepção da própria saúde, sexo e faixa etária. Observou-se, neste estudo, uma elevada prevalência de pelo menos uma DCNT, bem como, associação estatisticamente significante entre DCNT e as variáveis: escolaridade, IMC, percepção da própria saúde, sexo e faixa etária. Estes resultados sugerem a necessidade de se intensificar as ações de promoção à saúde, em comunidades carentes, com vistas ao seu melhor controle.

An investigation into the ethno-epidemiological profile of the Pankararu indigenous group in the State of Pernambuco, Brazil, identified multiple intestinal parasites in nearly all members of the community. To detect possible environmental risk factors, we used the data base from a previous survey to test relations between daily living conditions (housing, sanitation, water supply and treatment, and garbage disposal) and the number of different parasite species found in the same household. The sample consisted of 84 families from the original sample of 112. Selection was based on the number of stool tests performed in the family. The mean number of parasite species was 5.0 per family, for a mean family size of 6.1 members. This number was greater for wattle-and-daub houses (mean 6.0 parasite species vs. 4.9 for brick houses; p < 0.03) and when water used in the household was not treated (mean 5.1 parasite species, vs. 4.5 for treated water; p < 0.05). Other household characteristics and hygienic habits did not significantly influence this number. We concluded that multiple intestinal parasitism in the Pernambuco Pankararu community is frequent, to the point of being the rule, and that it relates essentially to water source and treatment.

Introdução: A alta mortalidade por câncer de mama no Brasil está intimamente associada ao retardo na investigação das lesões suspeitas e na instituição oportuna da terapêutica. Objetivo: Investigar os aspectos relacionados ao atraso no diagnóstico e tratamento das pacientes com câncer de mama. Método: Estudo epidemiológico observacional, descritivo, de corte transversal. Foram inicialmente entrevistadas 54 pacientes admitidas para investigação no departamento de mastologia do Hospital de Câncer de Pernambuco; destas, 25 resultaram positivas para câncer de mama se constituindo no universo da pesquisa. Resultados: A faixa etária mais representada foi das pacientes entre 60 e 79 anos (48%). A maioria se apresentava em estádios avançados (72%) e após, pelo menos, três meses do início dos sintomas (64%). O diagnóstico foi confirmado em menos de 30 dias (88,9% dos casos); porém o início do tratamento excedeu os 60 dias em 56,6% dos casos. Conclusão: Demonstrou-se que, para a maior parte das pacientes, há atraso no estabelecimento do diagnóstico e início do tratamento. Este se distribui nos diversos níveis de atenção à saúde e possui aspectos relacionados tanto às usuárias, como aos profissionais e aos serviços de saúde.

This article deals with a public policy in education, Post Graduation in Collective Health, to identify forms of dialogue of this policy, with the public health policy, the SUS, starting in 1990. The main product of PGSC policy is the training of masters and doctors, essential for teaching and research in the field. Bibliographic review and analysis of CAPES documents and databases based the analysis. Education policy was consistent over time and core to social development, alongside health policy, without presenting formal points of intercession, and its impacts occur mainly through the formation of good and committed professionals, teachers and researchers. In PGSC, professional masters programs are more relevant, for a more direct link of postgraduate programs with the SUS, and the initiatives of the Ministry of Health to finance priorities in research for the Health System. Even ininitiatives that explicitly seek to approximate the knowledge produced by PG with praxis in the SUS, the mechanisms involved in translating or impacting scientific knowledge into concrete practice are complex and must be context specific andthematic.

BackgroundThe 2005 International Health Regulations (IHRs) established parameters for event assessments and notifications that may constitute public health emergencies of international concern. These requirements and parameters opened up space for the use of nonofficial mechanisms (such as websites, blogs, and social networks) and technological improvements of communication that can streamline the detection, monitoring, and response to health problems, and thus reduce damage caused by these problems. Specifically, the revised IHR created space for participatory surveillance to function, in addition to the traditional surveillance mechanisms of detection, monitoring, and response. Participatory surveillance is based on crowdsourcing methods that collect information from society and then return the collective knowledge gained from that information back to society. The spread of digital social networks and wiki-style knowledge platforms has created a very favorable environment for this model of production and social control of information.ObjectiveThe aim of this study was to describe the use of a participatory surveillance app, Healthy Cup, for the early detection of acute disease outbreaks during the Fédération Internationale de Football Association (FIFA) World Cup 2014. Our focus was on three specific syndromes (respiratory, diarrheal, and rash) related to six diseases that were considered important in a mass gathering context (influenza, measles, rubella, cholera, acute diarrhea, and dengue fever).MethodsFrom May 12 to July 13, 2014, users from anywhere in the world were able to download the Healthy Cup app and record their health condition, reporting whether they were good, very good, ill, or very ill. For users that reported being ill or very ill, a screen with a list of 10 symptoms was displayed. Participatory surveillance allows for the real-time identification of aggregates of symptoms that indicate possible cases of infectious diseases.ResultsFrom May 12 through July 13, 2014, there were 9434 downloads of the Healthy Cup app and 7155 (75.84%) registered users. Among the registered users, 4706 (4706/7155, 65.77%) were active users who posted a total of 47,879 times during the study period. The maximum number of users that signed up in one day occurred on May 30, 2014, the day that the app was officially launched by the Minister of Health during a press conference. During this event, the Minister of Health announced the special government program Health in the World Cup on national television media. On that date, 3633 logins were recorded, which accounted for more than half of all sign-ups across the entire duration of the study (50.78%, 3633/7155).ConclusionsParticipatory surveillance through community engagement is an innovative way to conduct epidemiological surveillance. Compared to traditional epidemiological surveillance, advantages include lower costs of data acquisition, timeliness of information collected and shared, platform scalability, and capacity for integration between the population being se...

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The current context of intense social, economic and political transformations has contributed to changes in the health profile of the population and generated discussions about the impact of these changes on the reorganization of society. At the present moment, the increase in non-communicable illnesses and diseases raises major concerns about the paradox of malnutrition and obesity. Based on an in-depth reading and interpretation of texts, documents and databases, this article discusses issues related to nutrition, considering the dimensions of shortages and excesses, the evolution of nutrition over time, and the connection with the new epidemiological trend. We begin with a conceptual characterization, the historical background and the anthropological connections with the guiding theme of the article. We then describe the prevalence, distribution and secular trend of malnutrition and obesity, as well as the temporal relationship with the new epidemiological trend in Brazil within a context of development and inequalities. Finally, we reflect on the issue of (mal)nutrition in post-modernity, the new interests at stake in the health-disease process, as well as international experiences and strategies of partnerships designed to overcome these problems. We conclude by discussing some current advances and challenges in relation to the complexity and speed of contemporary changes.