A imunização é reconhecida como uma das intervenções mais bem-sucedidas e custo-efetivas, resultando na erradicação e no controle de diversas doenças em todo o mundo. Todavia, uma preocupante redução na cobertura vacinal tem sido observada no Brasil, trazendo o recrudescimento de algumas doenças até então superadas. Dessa forma, no intuito de realizar um diagnóstico situacional que pondere as diferentes regiões do país e a tendência temporal de cobertura vacinal, o presente estudo teve o objetivo de evidenciar áreas com queda da cobertura vacinal de BCG, poliomielite e tríplice viral no Brasil por meio de um estudo ecológico que coletou informações acerca do número crianças de até um ano de idade imunizadas para essas três vacinas, no período entre 2006 e 2016, por município brasileiro. Os dados foram adquiridos por meio do Departamento de Informática do SUS. Foi realizada uma varredura espacial, analisando as variações espaciais nas tendências temporais de cobertura vacinal. Foi observada uma tendência de redução no número de imunizações no Brasil, com quedas de 0,9%, 1,3% e 2,7% ao ano para BCG, poliomielite e tríplice viral, respectivamente. Ademais, aglomerados significativos com tendências temporais de redução da cobertura vacinal foram verificados em todas as cinco regiões brasileiras. O estudo evidencia uma importante redução na cobertura vacinal nos últimos anos, constatando heterogeneidades consideráveis entre os municípios. Dessa forma, uma atenção singular e planejamento estratégico condizente com as características de cada localidade são necessários para o controle tanto da redução de cobertura vacinal como do reaparecimento de doenças no Brasil.

Background The COVID-19 pandemic brought social, economic, and health impacts, requiring fast adaptation of health systems. Although information and communication technologies were essential for achieving this objective, the extent to which health systems incorporated this technology is unknown. Objective The aim of this study was to map the use of digital health strategies in primary health care worldwide and their impact on quality of care during the COVID-19 pandemic. Methods We performed a scoping review based on the Joanna Briggs Institute manual and guided by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) Extension for Scoping Reviews. A systematic and comprehensive three-step search was performed in June and July 2021 in multidisciplinary health science databases and the gray literature. Data extraction and eligibility were performed by two authors independently and interpreted using thematic analysis. Results A total of 44 studies were included and six thematic groups were identified: characterization and geographic distribution of studies; nomenclatures of digital strategies adopted; types of information and communication technologies; characteristics of digital strategies in primary health care; impacts on quality of care; and benefits, limitations, and challenges of digital strategies in primary health care. The impacts on organization of quality of care were investigated by the majority of studies, demonstrating the strengthening of (1) continuity of care; (2) economic, social, geographical, time, and cultural accessibility; (3) coordination of care; (4) access; (5) integrality of care; (6) optimization of appointment time; (7) and efficiency. Negative impacts were also observed in the same dimensions, such as reduced access to services and increased inequity and unequal use of services offered, digital exclusion of part of the population, lack of planning for defining the role of professionals, disarticulation of actions with real needs of the population, fragile articulation between remote and face-to-face modalities, and unpreparedness of professionals to meet demands using digital technologies. Conclusions The results showed the positive and negative impacts of remote strategies on quality of care in primary care and the inability to take advantage of the potential of technologies. This may demonstrate differences in the organization of fast and urgent implementation of digital strategies in primary health care worldwide. Primary health care must strengthen its response capacity, expand the use of information and communication technologies, and manage challenges using scientific evidence since digital health is important and must be integrated into public service.

BackgroundSexual desire is one of the domains of sexual function with multiple dimensions, which commonly affects men and women around the world. Classically, its assessment has been applied through self-report tools; however, an issue is related to the evidence level of these questionnaires and their validity. Therefore, a systematic review addressing the available questionnaires is really relevant, since it will be able to show their psychometric properties and evidence levels.MethodA systematic review was carried out in the PubMed, EMBASE, PsycINFO, Science Direct, and Web of Science databases. The search strategy was developed according to the following research question and combination of descriptors and keywords, including original studies with no limit of publication date and in Portuguese, English, and Spanish. Two reviewers carried out the selection of articles by abstracts and full texts as well as the analysis of the studies independently. The methodological quality of the instruments was evaluated by the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) checklist.ResultsThe search resulted in 1203 articles, of which 15 were included in the review. It identified 10 instruments originally developed in the English language. Unsatisfactory results on methodological quality were evidenced in cultural adaptation studies with no description of the steps of the processes and inadequacy of techniques and parameters of adequacy for models. The Principal Component Analysis with Varimax rotation predominated in the studies.ConclusionsThe limitation of the techniques applied in the validation process of the reviewed instruments was evident. A limitation was observed in the number of adaptations conducted and contexts to which the instruments were applied, making it impossible to reach a better understanding of the functioning of instruments. In future studies, the use of robust techniques can ensure the quality of the psychometric properties and the accuracy and stability of instruments. A detailed description of procedures and results in validation studies may facilitate the selection and use of instruments in the academic and/or clinical settings.Systematic review registrationPROSPERO CRD42018085706.Electronic supplementary materialThe online version of this article (10.1186/s12874-018-0570-2) contains supplementary material, which is available to authorized users.

Objectives: to analyze the impact of social protection programs on adults diagnosed with Tuberculosis. Methods: systematic review conducted by PRISMA, with registration PROSPERO CRD42019130884. The studies were identified in the VHL, PubMed, Scielo, CINAHL and Scopus databases, using the descriptors “Social Protection” and “Tuberculosis”, in combination with keywords combined with Boolean operators AND and OR. Observational and interventional studies published until October 23, 2019, in Portuguese, English and Spanish, were included. Results: social protection programs improve the treatment of tuberculosis, cure rates, adherence to treatment, the provision of services for the control of TB and reduce poverty. Conclusions: social protection programs have a positive impact on the treatment and control of people diagnosed with Tuberculosis.

The present study aimed to investigate the epidemiological situation of leprosy (Hansen’s Disease), in a hyperendemic metropolis in the Central-West region of Brazil. We studied trends over eleven years, both in the detection of the disease and in disabilities, analyzing disparities and/or differences regarding gender and age. This is an ecological time series study conducted in Cuiabá, capital of the state of Mato Grosso. The population consisted of patients diagnosed with leprosy between the years 2008 and 2018. The time series of leprosy cases was used, stratifying it according to gender (male and female), disability grade (G0D, G1D, G2D, and not evaluated) and age. The calendar adjustment technique was applied. For modeling the trends, the Seasonal-Trend decomposition procedure based on Loess (STL) was used. We identified 9.739 diagnosed cases, in which 58.37% were male and 87.55% aged between 15 and 59 years. Regarding detection according to gender, there was a decrease among women and an increase in men. The study shows an increasing trend in disabilities in both genders, which may be related to the delay in diagnosis. There was also an increasing number of cases that were not assessed for disability at the time of diagnosis, which denotes the quality of the services.

IntroductionTelemedicine gained strength in primary healthcare (PHC) during the COVID-19 pandemic. Thus, there is a need to know its scope, technologies used and impacts on people’s health. This study will map telemedicine use in PHC around the world and its impacts on quality of care in the context of the COVID-19 pandemic.MethodsThis is a scoping review protocol developed according to Arksey and O'Malley and Levac et al, based on the Joanna Briggs Institute manual, and guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). The records will be mapped in the following multidisciplinary health sciences databases: Virtual Health Library, PubMed, Scopus, Web of Science, CINAHL and Embase. Searches will also be conducted on Google Scholar, preprint repositories and specific COVID-19 databases (grey literature). Quantitative data will be analysed using descriptive statistics, while thematic analysis will be performed for qualitative data. Preliminary findings will be presented to stakeholders to identify missing studies and develop effective dissemination strategies.Ethics and disseminationResults will be disseminated through publication in an open access scientific journal, scientific events, and academic and community newspapers. Ethical approval was obtained due to stakeholder consultation, but will not involve the direct participation of patients. Link to the protocol record in the Open Science Framework (OSF) (osf.io/q94en).

ObjectiveThis study determined the prevalence and factors associated with sexual dysfunction in breastfeeding women.DesignCross-sectional analytical study.SettingPopulation-based study of individuals living in the northeast region of São Paulo state, Brazil.ParticipantsFrom May to August 2017, 372 women aged ≥18 years were selected who gave exclusive, predominant or complementary breast feeding up to 23 months postpartum, and who did not have contraindications for the resumption of intercourse. Pregnant women, those diagnosed with mental health problems, users of medications that affect sexual function (antihypertensives, antidepressants or antipsychotics) and women unable to read or understand the instructions for the study were excluded.Primary and secondary outcome measuresThe breastfeeding women completed the Female Sexual Function Index, the EUROHIS-QOL 8-item index and a questionnaire to collect participants’ sociodemographic, clinical and interpersonal data. A bivariate analysis was performed, and variables with p values<0.20 were analysed by multivariate logistic regression.ResultsSexual dysfunction was present in 58.3% of the study population. Factors significantly associated with female sexual dysfunction (FSD) included placing a low importance on sexual intercourse (adjusted OR [AOR]=2.49, 95% CI=1.22 to 5.09), limited communication with the partner (AOR=2.64, 95% CI=1.43 to 4.86), decreased frequency of sexual intercourse (AOR=2.17, 95% CI=1.30 to 3.61) and low quality of life (AOR=2.23, 95% CI=1.33 to 3.74).ConclusionsThe prevalence of FSD appears with a great magnitude in breastfeeding women. The risk factors for sexual dysfunction are biopsychosocial and these findings may lead to improved counselling for prenatal and postnatal care.

Resumo OBJETIVO Analisar a perspectiva da criança sobre a própria condição de saúde, suas experiências relacionadas ao atendimento ambulatorial hospitalar e ao uso de fantoches como estratégia lúdica para a coleta de dados. MÉTODO Estudo qualitativo, incluiu 16 crianças diagnosticadas com doenças crônicas, recrutadas em um ambulatório pediátrico do interior paulista. Os dados foram coletados em outubro de 2016 mediante entrevista semiestruturada e utilizou-se o fantoche como recurso facilitador na comunicação. As entrevistas foram analisadas por meio da análise temática indutiva. RESULTADOS Foram construídos quatro temas: “criança em seguimento ambulatorial: o que elas sabem?”; “emoções que perpassam o seguimento ambulatorial”; “o ambulatório dos meus sonhos”; e “a utilização dos fantoches e o universo lúdico da entrevista”. CONSIDERAÇÕES FINAIS Foi possível identificar o motivo e os principais sentimentos vivenciados durante o atendimento ambulatorial, assim como as preferências das crianças acerca dos aspectos físicos e estruturais do ambulatório.