No abstract

BackgroundBrazil is among the 30 countries with high-burden of tuberculosis worldwide, and Manaus is the capital with the highest tuberculosis incidence. The accelerated economic and population growth in Manaus in the last 30 years has strengthened the process of social stratification that may result in population groups that are less favored in terms of healthcare and are vulnerable to infection and illness due to tuberculosis. This study aimed to characterize inequalities associated with tuberculosis incidence in relation to the socioeconomic and demographic characteristics of the resident population of Manaus and to identify their determinants from 2007 to 2016.MethodsAn ecological study was conducted using the data from the Diseases Notification Information System. Tuberculosis incidence rates by population characteristics (gender, ethnicity, and socioeconomic level) were calculated for each year, studied, and represented in equiplot charts. To measure the disparity of tuberculosis incidence in the resident population in Manaus, the Gini index of tuberculosis in each neighborhood was calculated based on the incidence rates of the census sectors. A thematic map was constructed to represent the spatial distribution of tuberculosis incidence inequality. Linear regression models were used to identify the relationship between the tuberculosis incidence inequality and its social determinants.ResultsFrom 2007 to 2016, there was an increase in the tuberculosis incidence in Manaus, together with an increase in incident inequality among genders, ethnic groups, and socioeconomic level. The incidence of tuberculosis inequality was associated with the inequalities of its possible determinants (Gini of the proportion of male population, Gini of the proportion of indigenous population, Gini of the proportion of illiteracy, Gini of income, Gini of the proportion of households connected to the water network, and Gini of the mean number of bathrooms per inhabitant), the per capita income, and the proportion of cases with laboratory confirmation.ConclusionsDisparities in tuberculosis incidence in the resident population in neighborhoods can be explained by the sociodemographic and economic heterogeneity. Our findings recommend that public policies and tuberculosis control strategies consider differences in the determinants of tuberculosis inequality for the development of specific actions for each population group.

Success in tuberculosis control depends on the implementation of steps that reduce social inequities, allowing the diagnosis and effective treatment of the disease. Little is known about the conditions affecting antituberculosis treatment non-adherence in areas of great social and economic heterogeneity, such as the municipality of Rio de Janeiro. This study aimed to describe and identify the social determinants of antituberculosis treatment non-adherence in the municipality of Rio de Janeiro between 2008 and 2012. An ecological study was conducted with the districts of Rio de Janeiro as the units of analysis. Analyzes using Poisson regression models allowed us to identify the association between dropout from antituberculosis treatment and the human development index and social development index. The final model showed that economic conditions, infrastructure, and the tuberculosis control quality of surveillance were associated with treatment non-adherence. This study demonstrated that the scenarios of socio-environmental precariousness found in the districts of Rio de Janeiro were able to identify populations with an increased risk of default treatment from antituberculosis.

No abstract

| Background: Disability retirement, an outcome of permanent incapacity for work, represents 14.5% of pensions granted by the Brazilian National Social Security Institute. However, there are no data available for civil servants. Objective: To describe the epidemiological profile of disability retirement among employees of Oswaldo Cruz Foundation (FIOCRUZ) in the period from 2012 to 2016. Methods: Cross-sectional study in which we analyzed the following variables: age, sex, total working time, years of work at FIOCRUZ, position and reason for retirement as per ICD-10 codes. The significance level was set to p=0.05 and all the data are presented with 95% confidence interval. Results: The prevalence of disability retirement in the analyzed period was 113/10,000 employees. Employees granted disability retirement benefits worked about 9 years less. Odds for disability were higher for technicians (prevalence ratio-PR=6.83) and technical assistants (PR=7.67). Mental and behavioral disorders were the main reason for disability retirement (38.71%). Conclusion: Noncommunicable diseases are the main cause of disability retirement. We call the attention to the need to revise the legislation that establishes mandatory retirement after 24 months of sick leave. An interdisciplinary occupational health surveillance approach is necessary to obtain accurate knowledge of the actual situation in workplaces and of the impacts of work processes.

RESUMO Este artigo visou analisar a ocorrência de diarreia aguda em crianças menores de 5 anos assistidas pela Estratégia Saúde da Família de Ilha de Guaratiba, e as condições habitacionais e de saneamento da localidade. Foi realizado um estudo epidemiológico transversal. A análise das variáveis foi feita por meio de regressão logística simples e múltipla. As variáveis que apresentaram associação com a diarreia foram: (a) criança de idade <2,5 anos; frequentar creche/escola e renda familiar <um salário mínimo; (b) presença de filtro de água e tratamento domiciliar da água; (c) presença de inundações, esgoto a céu aberto, transbordamento de fossa e lixo a céu aberto. No modelo de regressão logística, foram considerados dois cenários epidemiológicos, com e sem inundações. No primeiro cenário, as variáveis que mantiveram associação estatisticamente significante com o desfecho foram: tratamento domiciliar da água, esgoto a céu aberto e presença de inundações. No segundo cenário, encontrou-se evidência de associação também da variável frequência a creche/escola. Portanto, este artigo ressalta a importância de políticas públicas, programas e ações com vistas à ampliação do saneamento básico, ao planejamento de ações de saúde pública e à garantia do acesso à educação infantil.

No abstract

COMUNICAÇÃO BREVERESUMO | O absenteísmo por doença no serviço público federal é uma temática de pouca visibilidade. Este é um estudo ecológico de série temporal com objetivo de analisar a taxa de licença para tratamento de saúde entre os servidores da FIOCRUZ no quadriênio 2012-2015. A taxa do quadriênio foi de 45,30 (DP=6,50). Não se identificou variação significativa das taxas entre os anos estudados (p=0,144). Enfatiza-se a necessidade de dados de forma estruturada para construção de indicadores para o conhecimento da realidade de saúde desses trabalhadores, visando à proposição de medidas de proteção e promoção da saúde do trabalhador. Palavras-chave | absenteísmo; setor público; recursos humanos; saúde do trabalhador.ABSTRACT | Sickness absenteeism within the federal public service setting is not a quite visible subject. The present ecological time-series study sought to analyze the rate of treatment leaves among FIOCRUZ employees from 2012 to 2015. The 4-year rate was 45.30 (SD=6.50). There was no significant change in the rates along the investigated period (p=0.144). We stress the need for structured data to develop indicators representing the actual health conditions of these workers aiming at suggesting measures to protect and promote the workers' health.