BackgroundAn interferon-γ release assay, QuantiFERON-TB (QFT) test, has been introduced an alternative test for the diagnosis of latent Mycobacterium tuberculosis infection (LTBI). Here, we compared the performance of QFT with tuberculin skin test (TST) measured at two different cut-off points among primary health care work (HCW) in Brazil.MethodsA cross-sectional study was carried out among HCWs in four Brazilian cities with a known history of high incidence of TB. Results of the QFT were compared to TST results based on both ≥5 mm and ≥10 mm as cut-off points.ResultsWe enrolled 632 HCWs. When the cut-off value of ≥10 mm was used, agreement between QFT and TST was 69% (k = 0.31), and when the cut-off of ≥5 mm was chosen, the agreement was 57% (k = 0.22). We investigated possible factors of discordance of TST vs QFT. Compared to the TST−/QFT− group, risk factors for discordance in the TST+/QFT− group with TST cut-off of ≥5 mm included age between 41–45 years [OR = 2.70; CI 95%: 1.32–5.51] and 46–64 years [OR = 2.04; CI 95%: 1.05–3.93], BCG scar [OR = 2.72; CI 95%: 1.40–5.25], and having worked only in primary health care [OR = 2.30; CI 95%: 1.09–4.86]. On the other hand, for the cut-off of ≥10 mm, BCG scar [OR = 2.26; CI 95%: 1.03–4.91], being a household contact of a TB patient [OR = 1.72; CI 95%: 1.01–2.92] and having had a previous TST [OR = 1.66; CI 95%: 1.05–2.62], were significantly associated with the TST+/QFT− group. No statistically significant associations were found among the TST−/QFT+ discordant group with either TST cut-off value.ConclusionsAlthough we identified BCG vaccination to contribute to the discordance at both TST cut-off measures, the current Brazilian recommendation for the initiation of LTBI treatment, based on information gathered from medical history, TST, chest radiograph and physical examination, should not be changed.
We report an ongoing measles outbreak in Manaus, Amazonas state, Brazil. As at 3 November 2018, 1,631 cases were confirmed corresponding to an incidence of 75.3 per 100,000 inhabitants; all five sanitary districts presented confirmed cases. Reintroduction of measles virus in Manaus is likely related to the current outbreak in Venezuela and due to recent decline in measles vaccine coverage. Given the current scenario, prevention and control measures should target individuals aged 15–29 years.
Objective: To assess the degree of implementation of the Directly Observed Treatment, Short-course -DOTS for tuberculosis (TB) in a large city. Method: Assessment of the implementation of the logic model, whose new cases of infectious pulmonary TB were recruited from specialized clinics and followed-up in basic health units. The judgment matrix covering the five components of the DOTS strategy were used. Results: The result of the logic model indicates DOTS was partially implemented. In external, organizational and implementation contexts, the DOTS strategy was partially implemented; and, the effectiveness was not implemented. Conclusion: The partial implementation of the DOTS strategy in the city of Manaus did not reflect in TB control compliance, leading to low effectiveness of the program. descriPtOrs Tuberculosis; Directly Observed Therapy; Health Evaluation; Program Evaluation; Public Health Nursing.Evaluation of the implementation of the directly observed treatment strategy for tuberculosis in a large city Avaliação da implantação da estratégia de tratamento diretamente observado para tuberculose em um município de grande porte Evaluación de la implantación de la estrategia de tratamiento directamente observado para tuberculosis en un municipio de gran porte Evaluation of the implementation of the directly observed treatment strategy for tuberculosis in a large city
Resumo Este artigo tem por objetivo determinar a prevalência e os fatores associados à infecção latente pelo Mycobacterium tuberculosis entre agentes comunitários de saúde (ACS), usando dois pontos de corte da prova tuberculínica 5mm e 10mm. Trata-se de estudo transversal, com dados coletados sobre sexo, idade, cicatriz de BCG, prova tuberculínica (PT) anterior, tempo que trabalha na profissão de ACS, atuar em unidade básica de saúde (UBS), ter tido contato intradomiciliar com tuberculose (TB), usar álcool, ser fumante e apresentar comorbidades. Para controle de variáveis de confusão e estimativa da medida de efeito (OR), foi empregada a regressão logística. Aplicou-se PT, com leitura após 48-72 horas. As prevalências foram de 57,88% e 37,3%, respectivamente, para 5mm e 10mm. Manteve-se associada à positividade para o ponto de corte de 10mm a condição de trabalhar em UBS com Programa de Controle de Tuberculose (PCT) implementado e já ter tido contato intradomiciliar com TB. Já para o ponto de corte de 5mm, trabalhar em UBS com PCT e implementado. São necessárias ações de conscientização nos municípios e fortalecimento das ações de educação permanente sobre a temática.
Este artículo presenta en cuatro apartados el resultado de una investigación realizada en la Argentina sobre las Empresas Recuperadas por sus Trabajadores. En el primer es establecido el referencial teórico; en el segundo se analiza la relación entre las relaciones sociales de producción y la subjetividad; en el tercero, la relación entre las relaciones sociales de producción y el derecho; y en el cuarto, la incidencia de lo jurídico sobre lo político y lo económico.
Submetido em: 28/11/2020Aceito em: 15/12/2020
Há uma abundante produçãodiscursiva sobre os movimentossociais e deles mesmos, tanto namídia tradicional como na internet, além davelha forma de comunicação dosmovimentos populares: o panfleto. Essaprodução discursiva abrange uma variadagama de temas: reivindicação, processosmobilizatórios, informações gerais, análisesde conjuntura e histórica, etc.
Este artigo, dividido em duas seções, na primeira, analisa-se o conceito de liberdade jurídica como efeito do processo histórico de abstração do produtor direto (separação entre vontade e potência), na segunda, examina dedutivamente a possibilidade de desenvolver um conceito de liberdade concreta com base nas indicações de Marx sobre a possibilidade histórica do comunismo.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.