ObjectiveTo identify, in national and international journals, the studies conducted in Brazil related to breast feeding and reducing cases of diarrhea in children under 2 years of age, featuring health interventions more used.MethodsDescriptive study, based on an integrative review of literature from PubMed and LILACS data published between January 1992 and August 2011. The keywords “breastfeeding AND diarrhea” was searched in Portuguese, English and Spanish in PubMed and LILACS. The guiding question was: “What was knowledge produced about breast feeding and prevention of diarrhea in children under 2 years between 1992 and 2011 in studies conducted in Brazil?”ResultsWe selected 11 studies that showed the importance of breast feeding in the prevention and protection against diarrhea in children under 6 months, especially among children in exclusive breastfeeding.ConclusionPublic health policies should be directed to the context of each locality, in order to reduce the problems that involve the early weaning.

BackgroundDiarrhea is a waterborne disease that affects children, especially those under 5 years of age. The objective of this study was to identify the spatial patterns of distribution of diarrheal disease in under 5-year-old children in the State of Tocantins, Brazil, from 2008 to 2013.MethodsGeoprocessing tools were used to carry out an epidemiological study, to prepare thematic maps in the TerraView 4.2.2 software based on secondary data. General indicators of the disease, presence of spatial dependence through the Global Moran’s Index (I) and the Spatial Association Index (LISA) were described.ResultsThere were 3,015 cases of under 5-year-old children hospitalized for diarrhea, with an average annual rate (AAR) of 4.10/1,000 inhabitants (inhab.). Among the main characteristics were: increasing rates in under 1-year-old children (6.16 to 9.66/1,000 inhabitants); children aged 1 to 4 full years (63%); males (55%); 8 deaths of under one-year-old children (75%); county of Araguaína (67%); incidence in the county of Nazaré (63.97/1,000 inhab.); prevalence and incidence in the Araguaína microregion (45%, AAR 9.38/1,000 inhab.). The presence of a cluster with spatial autocorrelation was found in the Araguaína microregion, which was statistically significant (I = 0.11, p-value < 0.03), with priority of intervention (Moran Map).ConclusionsThere was an increase in the number of hospitalizations for diarrhea in under 5–year-old children in the state of Tocantins. The spatial analysis identified clusters of priority areas for measures of maintenance and control of diarrheal diseases.

This study's objectives were to identify the prevalence of breastfeeding in children younger than 12 months of age enrolled in the Family Health Strategy and identify cases of reported acute diarrhea, associating them with breastfeeding categories and factors that interfere in the practice of breastfeeding. This descriptive and cross-sectional study, based on statistical analysis, was conducted with 854 children living in a municipality in Northeastern Brazil. The prevalence of exclusive breastfeeding among children under six months of age was 32%. Exclusively breastfed children under the age of six months were less likely to experience diarrhea compared to mixed-breastfeeding children. Children using pacifiers, bottles or consuming water were less likely to be breastfed, while those consuming porridge were more likely to experience diarrhea. Strategies to promote, protect and support breastfeeding require continuous improvement, especially in regard to factors leading to early weaning, in order to achieve better indicators and improve prevention of acute diarrhea and promote child health. DESCRIPTORS:Child. Breastfeeding. Acute diarrhea. ALEITAMENTO MATERNO E DIARREIA AGUDA ENTRE CRIANÇASCADASTRADAS NA ESTRATÉGIA SAÚDE DA FAMÍLIA RESUMO: Os objetivos foram identificar a prevalência do aleitamento materno em crianças menores de 12 meses cadastradas na Estratégia Saúde da Família, e identificar os casos de diarreia aguda notificados associando aos tipos de aleitamento materno e aos fatores que interferem nessa prática. Estudo descritivo, transversal, realizado nos domicílios com 854 crianças, em município do Nordeste brasileiro, com análise estatística dos dados. A prevalência do aleitamento materno exclusivo entre menores de seis meses foi de 32%. Crianças menores de seis meses amamentadas exclusivamente tiveram menos chance de apresentar diarreia do que as em aleitamento misto. As que usaram chupeta, mamadeira e água tiveram menos chance de serem amamentadas. As que usaram mingau tiveram mais chance de ter diarreia. Estratégias de promoção, proteção e apoio ao aleitamento materno necessitam contínuo aprimoramento, especialmente nos fatores do desmame precoce, buscando melhores indicadores e maior impacto na prevenção contra diarreia aguda e promoção da saúde infantil. DESCRITORES:Criança. Aleitamento Materno. Diarreia aguda. AMAMANTAMIENTO MATERNO Y DIARREA AGUDA ENTRE NIÑOS REGISTRADOS EN LA ESTRATEGIA SALUD DE LA FAMILIA RESUMEN:Los objetivos fueron identificar la prevalencia del amamantamiento materno en menores de 12 meses registrados en la Estrategia Salud de la Familia, identificando los casos de diarrea aguda notificados asociándolos a los tipos de amamantamiento y a factores que interfieren esta práctica. Estudio descriptivo, transversal, realizado en domicilios con 854 niños, en municipio del Nordeste brasileño, con análisis estadístico de datos. La prevalencia del amamantamiento materno exclusivo entre menores de seis meses fue 32%. Niños menores de seis meses amamantados exclusivamente tuvi...

Background. Leprosy is an infectious disease that can lead to physical disabilities and stigmatization. It remains an important public health problem, especially in Brazil. Objective. To analyse sociodemographic and clinical factors associated with multibacillary leprosy in a hyperendemic region of the disease in northeastern Brazil. Method. This is a retrospective observational study with secondary data acquired from 2012 to 2015, from a group of leprosy cases reported in a reference outpatient clinic for the treatment and followup of leprosy in the city of Imperatriz, Maranhao, in northeastern Brazil. Results. From 905 new cases of leprosy studied, 656 (72.5%) were classified as multibacillary leprosy and 249 (27.5%) as paucibacillary leprosy. We observed that men were more likely to present 5 to 15 skin lesions (OR: 1.32; 95% CI: 1.18-1.49; p <0.0001) and >15 skin lesions (OR: 1.26; 95% CI: 1.09 -1.45; p = 0.005) and a lower chance of having <5 skin lesions (OR: 0.67; 95% CI: 0.59-0.76; p <0.0001). Women were more likely to have no affected nerves compared to men (OR: 1.46; 95% CI: 1.20-1.77; p <0.0001). The age range of 16 to 60 years showed a greater chance of having <5 skin lesions (OR: 1.01; 95% CI: 1.007-1.20; p = 0.03) and a lower chance of having 5 to 15 skin lesions (OR: 1.12, 95% CI: 1.03-1.23; p= 0.008) and a lower chance of being a grade I disability ( CI= 0.73-0.94; p=0.83) and II (OR: 0.82; 95% CI: 0.77-0.98; p=000.1). Conclusion. Cases of multibacillary leprosy were associated with male gender, low educational level, and clinical variables such as number of skin lesions and grade I or II disability.

Resumo Este estudo objetivou descrever a prevalência da hanseníase e verificar os fatores associados às formas clínicas multibacilares em cenário da Estratégia Saúde da Família, prioritário para o controle e a vigilância da doença no nordeste brasileiro. Trata-se de estudo transversal, que utilizou dados do Sistema de Informação de Agravos de Notificação relativos aos casos de hanseníase notificados em Imperatriz, Maranhão, entre 2008 e 2017. Determinaram-se as prevalências a cada ano e para o período. Para associar as variáveis e as formas clínicas multibacilares, utilizaram-se modelos de regressão de Poisson, com nível de significância de 5%. Dos 2.476 casos de hanseníase analisados, a maioria referiu-se às formas clínicas multibacilares. A prevalência variou entre 15,6 e 7,8/10 mil habitantes, encontrando-se níveis alto e muito alto de endemicidade. As variáveis sexo masculino, faixas etárias entre 30 e 59 anos e ≥60 anos, escolaridade <8 anos, grau 2 de incapacidade física, episódio reacional tipos 1 e 2 e zona de residência urbana apresentaram associações significativas (p≤0,05) com as formas clínicas multibacilares. Tais achados podem servir de base para elaboração e implementação de medidas de controle e vigilância da hanseníase, direcionando as ações para os grupos mais vulneráveis e tornando-se mais efetivas.

Introdução: Bancos de leite humano são responsáveis pela promoção do aleitamento materno, coleta, processamento e controle de qualidade do leite distribuído, apresentando ainda função importante no contexto da saúde pública, no âmbito da promoção à saúde infantil, como estratégia de segurança alimentar e nutricional. Objetivo: Identificar os fatores que contribuem para a doação de leite materno, as vantagens e as dificuldades percebidas pelas doadoras, além de conhecer o seu perfil sociodemográfico. Casuística e Métodos: Estudo descritivo, transversal, quantitativo, realizado com 50 doadoras de um hospital da Região Nordeste do Brasil, credenciado na iniciativa Hospital Amigo da Criança, entre janeiro e março de 2014. Foi realizada uma entrevista individual no domicílio da doadora para preenchimento de formulário estruturado, que continha questões de caracterização pessoal, conhecimento sobre banco de leite humano e doação de leite, e motivos e desvantagens para a doação. Resultados: Os fatores que contribuíram para a doação de leite materno foram o fato de a mulher ser primípara (54,0%), ter recebido orientação sobre aleitamento materno (78,0%) e sobre o banco de leite humano (68,0%), e ter recebido apoio para doação (80,0%). Dentre as vantagens apontadas pelas entrevistadas para doação do leite materno, 90% acreditavam que beneficiaria a saúde da criança receptora, enquanto que o fato de machucar as mamas (28%) foi apontado como principal desvantagem para este ato. Quanto ao perfil das doadoras, a idade variou de menos de 19 (26,0%) anos e mais de 35 (8%), 46,0% eram casadas, 56,0% eram donas de casa, 48,0% tinham Ensino Médio e 42,0% tinham renda familiar de até um salário mínimo. Conclusão: Os inúmeros benefícios para a saúde do bebê, o amor e a solidariedade foram fatores contribuintes para a doação do leite materno. A doação é uma experiência positiva, e o apoio familiar é fator facilitador à prática da doação.

RESUMO: O objetivo deste estudo foi identificar a prevalência de aleitamento materno exclusivo entre profissionais de saúde em hospital credenciado como Amigo da Criança e as variáveis de risco para a não adesão ao aleitamento materno exclusivo. Estudo transversal realizado entre janeiro e junho de 2014, com EXCLUSIVE BREASTFEEDING PRACTICES AMONG HEALTH PROFESSIONALS OF A BABY FRIENDLY ACCREDITED HOSPITALABSTRACT: The present study aimed to identify the prevalence of exclusive breastfeeding among health professionals of a baby friendly accredited hospital and the risk variables for non-adherence to exclusive breastfeeding. Cross-sectional study carried out between January and June 2014, with 53 health professionals who had babies at the time they were working at a hospital in the state of Maranhão. Data was collected with the use of a structured questionnaire. Of these, 15 (2.83%) sustained exclusive breastfeeding for the first six months of their infants' lives. Breastfeeding was facilitated by the following factors: rooming-in facilities (n = 45/84.9%), support to breastfeeding provided by health professionals, friends or relatives (n = 43/81.1%). In turn, breastfeeding was complicated by the following factors: nipple trauma (n = 22/41.5%), pain (n = 20/37.7%), mastitis (n = 11/20.7%), formula milk, babies were given water (n = six /11.3%) and teas (n = four/7.5%). The fact that the lactating women performed their activities at a Baby Friendly Accredited Hospital did not have a positive influence on the duration of exclusive breastfeeding. DESCRIPTORS: Breastfeeding; prevalence; Health staff; Cross-sectional studies; Hospitals. El objetivo del estudio fue identificar la prevalencia de lactancia materna exclusiva entre profesionales de salud en hospital caracterizado como Amigo del Niño, y variables de riesgo de no adhesión a la lactancia materna exclusiva. Estudio transversal realizado entre enero y junio de 2014, con 53 profesionales de salud que tuvieron hijos mientras trabajaban en hospital del interior de Maranhão. Datos recolectados mediante instrumento estructurado. Practicaron lactancia materna exclusiva, hasta el sexto mes, 15 (28,3%) profesionales. Facilitaron la lactancia el alojamiento conjunto (n=45/ 84,9%), apoyo para amamantar de profesionales de salud, amigos o familiares (n=43/ 81,1%). Dificultaron la lactancia materna fisuras del pezón (n=22/ 41,5%), dolor (n=20/ 37,7%), mastitis (n=11/ 20,7%), ingesta de leches industrializadas (n=9 /17%), agua (n=6/ 11,3%) y tés (n=4/ 7,5%). El hecho de tratarse de profesionales trabajadoras en hospital "Amigo del Niño" no influyó positivamente en el tiempo de lactancia materna exclusiva.

Coinfection with human visceral leishmaniasis (HVL) and human immunodeficiency virus (HIV) has become an emerging public health problem in several parts of the world, with high morbidity and mortality rates. A systematic review was carried out in the literature available in PubMed, Scielo and Lilacs related to HVL associated with HIV coinfection, seeking to analyze epidemiological, clinical and laboratory aspects. Of the 265 articles found, 15 articles were included in the qualitative analysis, which referred to the results of HVL treatment in patients coinfected with HIV. In the published articles between 2007 and 2015, 1171 cases of HVL/HIV coinfection were identified, 86% males, average age 34 years, liposomal amphotericin B was the most commonly used drug, cure rates 68 and 20% relapses and 19% deaths, five different countries, bone marrow was used in 10/15 manuscripts. HVL/HIV coinfection is a major challenge for public health, mainly due to the difficulty in establishing an accurate diagnosis, low response to treatment with high relapse rates and evolution to death. In addition, these two pathogens act concomitantly for the depletion of the immune system, contributing to worsening the clinical picture of these diseases, which requires effective surveillance and epidemiological control measures.