This cross-sectional study investigated the epidemiological profile of pregnant women with positive VDRL in Fortaleza, Ceará State, Brazil, in 2008. The study verified the proportion of pregnant women with syphilis that was classified as treated incorrectly according to Brazilian Ministry of Health guidelines, and assessed the reasons for inadequate treatment. Fifty-eight women who had given birth at five public maternity hospitals were interviewed consecutively following delivery. Data were also recovered from medical files and pregnancy cards. Sociodemographic and obstetric data and information related to the diagnosis and treatment of syphilis in both pregnant women and their partners were analyzed. Only three (5.2%; 95%CI: 1.8%-14.1%) pregnant women had received adequate treatment. The main reason for inadequate treatment was lack of partner treatment (88% of cases; 95%CI: 76.2%-94.4%). Medical care as currently provided does not guarantee the control of gestational syphilis in this sample.
PURPOSES:To analyze the sociodemographic and behavioral profile of sex partners, the proportion of those inadequately treated as well as to verify how many of them were inadequately treated and why some were not treated. METHODS: Quantitative study with data collected from May to October, 2008 at five public maternities in Fortaleza, Ceará. A survey was carried out with parturients who were hospitalized with syphilis and had a stable sex partner. We analyzed sociodemographic variables and those related to communication, diagnosis and treatment of sex partners. The data were entered into the Statistical Package for the Social Sciences and were analyzed using frequency distributions, measures of central tendency and dispersion. RESULTS: The study included 56 pregnant women. Most sexual partners were young adults aged on average 29 years, 50% of them had studied for less than seven years, 82.1 worked and 46.4% had a family income of less than a minimum wage. Of all the partners, 92.9% were the child's father and 69.6% lived with the women. Fifty percent and 12% were alcohol and drug users, respectively. Most partners (75.0%) were told about the diagnosis by the women, and in 78.6% of cases they were aware of the VDRL result before or during the prenatal period. However, 25.0% of the women did not communicate the result to their partners for the following reasons: not knowing the importance of the partner's treatment (50.0%), not being together after the diagnosis (42.9%) and having a quarrel (7.1%). Of the partners who were informed about the result before or during the prenatal period, 56.0% were treated and six (42.8%) were considered to have been
Cad. Saúde Pública, Rio de Janeiro, 32(9):e00118215, set, 2016Avaliação da cascata de cuidado na prevenção da transmissão vertical do HIV no Brasil Evaluation of the cascade of care in prevention of mother-to-child HIV transmission in Brazil Evaluación de la cascada de cuidado en la prevención de la transmisión vertical del VIH en Brasil
Identificar as experiências de gestantes e puérperas portadoras do HIV com a quimioprofilaxia para prevenção da transmissão vertical. Estudo de abordagem qualitativa desenvolvido nos meses de março e abril de 2006 em uma maternidade de referência de Fortaleza-Ceará. Os sujeitos foram gestantes e puérperas HIV positivas em acompanhamento pré-natal e no alojamento conjunto. A coleta de dados deu-se através de entrevista e a análise em três categorias: a revelação do diagnóstico aos familiares, o aconselhamento e a vivência das recomendações para a profilaxia da transmissão vertical. Constatou-se que essas mulheres enfrentaram situações de conflitos e sentimentos negativos diante da vida e a importância do acompanhamento emocional por equipe multiprofissional capacitada, atenta as demandas subjetivas.
ABSTRACT:The aim of this study was to investigate the knowledge of family health strategy professionals regarding the prevention and control of the vertical transmission of syphilis. This cross-sectional study was carried out in Fortaleza, Ceará, Brazil, from August to October 2009. A questionnaire was used, with its correct answers being in line with the recommendations of the Ministry of Health. Univariate analysis was carried out, with frequency distribution, mean and standard deviation. A total of 269 professionals participated, 44.7% had 6 to 10 years of experience in the FHS, and 60% of the questions regarding their knowledge were answered correctly: 75.8% were aware of the request period of the Venereal Disease Research Laboratory (VDRL) test; 78.1% of the alternative drug for the treatment for pregnant women allergic to penicillin, 55.1% of the request period for VDRL for cure and control, and 50.2% of the conduct with a sexual partner. It was concluded that healthcare professionals are unaware of the appropriate actions for the prevention and control of congenital syphilis. KEYWORDS:Syphilis. Congenital syphilis. Pregnant women. Family health strategy. Knowledge. CONHECIMENTO DOS PROFISSIONAIS DE SAÚDE ACERCA DA TRANSMISSÃO VERTICAL DA SÍFILIS EM FORTALEZA-CE, BRASILRESUMO: Objetivou-se verificar o conhecimento de profissionais da Estratégia Saúde da Família sobre ações de prevenção e controle da transmissão vertical da sífilis. Estudo transversal, em Fortaleza-CE, Brasil, de agosto a outubro de 2009. Utilizou-se questionário autoaplicado, considerando respostas corretas aquelas consoante às recomendações do Ministério da Saúde. Utilizou-se análise univariada, com distribuições de frequências, médias e desvios padrão. Participaram 269 profissionais, 44,7% com seis a dez anos de atuação na saúde da família; 60% das perguntas foram respondidas corretamente sobre o conhecimento destes da seguinte forma: 75,8% conheciam o período de solicitação do exame Venereal Disease Research Laboratory; 78,1%, a droga alternativa para tratamento da gestante alérgica à penicilina; 55,1% a periodicidade de solicitação do VDRL para controle de cura; e 50,2%, a conduta diante do parceiro sexual. Os profissionais de saúde pesquisados não detinham conhecimento adequado acerca das ações preventivas e do controle da sífilis congênita.PALAVRAS CHAVE: Sífilis. Sífilis congênita. Gestantes. Saúde da família. Conhecimento. CONOCIMIENTOS DE LOS PROFESIONALES DE SALUD SOBRE LA TRANSMISIÓN VERTICAL DE LA SÍFILIS EN FORTALEZA-CE, BRASILRESUMEN: El objetivo fue verificar el conocimiento de profesionales de la Estrategia de Salud de la Familia, con relación a las acciones de prevención y control de la transmisión de la sífilis. Estudio transversal, en Fortaleza-CE, Brasil, realizado de agosto a octubre/2009. Se utilizó cuestionario autoaplicado, se consideró como respuestas aquellas que eran consonantes con las recomendaciones del Ministerio de Salud. Se utilizó el análisis univariado, con distribuciones de frecuencias, medias y desviaci...
Introduction: The Brazilian society is still facing difficulties in dealing with the question of infant mortality control. Among the control mechanisms, the child's health handbook (CHH) is an indispensable tool for child development assistance in line with the current demands and changes promoted since 2005 by the Ministry of health. Objective: To analyze the national literature concerning the use of the CHH and the quality of its completeness. Materials and Methods: This was an integrative review using the BIREME virtual library and the databases LILACS, SciELO and BDENF. Among the articles published between 2005 to 2012, seven met the eligibility criteria and were selected to compose the sample. Results: There was a predominance of cross-sectional studies. Nursing and medicine were the professional categories which mostly published in this field. The studies were consensual on professional unpreparedness, lack of family orientation and unsatisfactory fulfillment of the CHH, as the main findings in their results. Conclusion: The CHH instrument has been underused, particularly due to the profile of assisting health professionals, which makes it indispensable to improve their training. Moreover, the design and development of specific strategies to further identify the barriers faced by health professionals and families on the use of the CHH is necessary.
In Brazil, the inclusion of minorities and the most vulnerable members of the population in the health service is still a challenge for health planners. This study analyzed the perception of men who have sex with men (MSM) treated in health units with the onset of a sexually transmitted disease (STD). It consists of qualitative research involving 21 MSM, contacted in a non-governmental organization (NGO) and in the Testing and Counseling Center (TCC) in Fortaleza, Ceará, Brazil. The data were collected during two periods: from February until May 2007 and from September until October 2008 by using focused interview, and were organized by subject matter according to the content analysis technique of Bardin. The references to the theoretical concepts of the symbolic violence by Bourdieu and stigma by Goffman were the foundation for the analysis. The results indicate that MSM experienced situations of symbolic violence and avoided seeking primary health care service fearing prejudice and being stigmatized. Even when they sought these services, they tended to demonstrate masculine behavior in order to not be indentified as to their sexual orientation. We concluded that MSM feel excluded and discriminated against in the primary health care service. More studies related to this subject matter are needed to help implement health care policies facilitating the inclusion of and to welcome this group of the population into the general health care service.
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