The objective of this study was to analyse the dynamics of spatial dispersion of the coronavirus disease 2019 (COVID-19) in Brazil by correlating them to socioeconomic indicators. This is an ecological study of COVID-19 cases and deaths between 26 February and 31 July 2020. All Brazilian counties were used as units of analysis. The incidence, mortality, Bayesian incidence and mortality rates, global and local Moran indices were calculated. A geographic weighted regression analysis was conducted to assess the relationship between incidence and mortality due to COVID-19 and socioeconomic indicators (independent variables). There were confirmed 2 662 485 cases of COVID-19 reported in Brazil from February to July 2020 with higher rates of incidence in the north and northeast. The Moran global index of incidence rate (0.50, P = 0.01) and mortality (0.45 with P = 0.01) indicate a positive spatial autocorrelation with high standards in the north, northeast and in the largest urban centres between cities in the southeast region. In the same period, there were 92 475 deaths from COVID-19, with higher mortality rates in the northern states of Brazil, mainly Amazonas, Pará and Amapá. The results show that there is a geospatial correlation of COVID-19 in large urban centres and regions with the lowest human development index in the country. In the geographic weighted regression, it was possible to identify that the percentage of people living in residences with density higher than 2 per dormitory, the municipality human development index (MHDI) and the social vulnerability index were the indicators that most contributed to explaining incidence, social development index and the municipality human development index contributed the most to the mortality model. We hope that the findings will contribute to reorienting public health responses to combat COVID-19 in Brazil, the new epicentre of the disease in South America, as well as in other countries that have similar epidemiological and health characteristics to those in Brazil.
Resumo A vulnerabilidade é um fator chave no enfrentamento da COVID-19 tendo em vista que pode influenciar no agravamento da doença. Desse modo, ela deve ser considerada no controle da COVID-19, prevenção e promoção da saúde. O objetivo deste artigo é analisar a distribuição espacial da incidência de casos de COVID-19 em uma metrópole brasileira e sua associação com indicadores de vulnerabilidade social. Estudo ecológico. Foi utilizada a análise de varredura espacial (scan) para identificar aglomerados de COVID-19. As variáveis para identificação da vulnerabilidade foram inseridas em um modelo de Regressão Espacial Geograficamente Ponderado (GWR) para identificar sua relação espacial com os casos de COVID-19. A incidência de COVID-19 em Fortaleza foi de 74,52/10 mil habitantes, com notificação de 3.554 casos, sendo pelo menos um caso registrado em cada bairro. A regressão espacial GWR mostrou relação negativa entre incidência de COVID-19 e densidade demográfica (β=-0,0002) e relação positiva entre incidência de COVID-19 e percentual de ocupados >18 anos trabalhadores autônomos (β=1,40), assim como, renda domiciliar per capita máxima do quinto mais pobre (β=0,04). A influência dos indicadores de vulnerabilidade sobre a incidência evidenciou áreas que podem ser alvo de políticas públicas a fim de impactar na incidência de COVID-19.
Objective: To validate the construct and measure the trustworthiness of a questionnaire aimed at assessing HIV/AIDS coping actions developed by health professionals in Primary Health Care. Method: A methodological study carried out with 397 primary health care professionals in two municipalities in the Northeast region of Brazil. The construct validity was developed by the exploratory and confirmatory factor analysis, and the reliability analyzed by the reliability and reproducibility. Results: The validation determined six factors retention that composed the six domains of the questionnaire. Internal consistency was 0.91 and quality of the confirmatory analysis adjustment was 0.998 for Goodness of Fit Index. The domains presented Kappa values between 0.833 and 0.997. Conclusions: The final questionnaire was composed of 18 items and presented feasibility of application, and potential to evaluate actions for HIV/AIDS control in Primary Health Care.
Objective: To validate the content of a questionnaire to assess the care provided by healthcare professionals to control the HIV/AIDS epidemic in primary care. Methods: A methodological study was conducted, based on the development of a questionnaire using an integrative review, and subsequent validation by experts, using a two-round Delphi technique. Data were analyzed by considering the level of consensus responses, associated with the Kappa index. The criteria for retaining the questions were: ≤ 75% agreement, and Kappa ≤ 0.41. Results: The first round eliminated 16 questions, five questions were revised according to vocabulary changes requested by experts, and criteria for topic coverage and clarity. In the second round, 31 questions were considered appropriate. Conclusion: This questionnaire, unpublished nationally or internationally, achieved acceptable content validity after a careful review of its questions. ResumoObjetivo: Validar o conteúdo de um questionário para a avaliação da atenção ofertada pelos profissionais de saúde para o controle da epidemia do HIV/Aids na atenção básica. Métodos: Estudo metodológico realizado a partir da construção de questionário por meio de uma revisão integrativa, com posterior validação por juízes, utilizando-se a técnica Delphi em duas rodadas. Os dados foram analisados tomando o nível de consenso das respostas, associado ao índice Kappa. Os critérios para a permanência das questões foram: porcentagem de concordância ≤ 75% e Kappa ≤ 0,41. Resultados: Na primeira rodada, 16 questões foram eliminadas, 05 questões sofreram mudanças para atender à solicitação dos especialistas quanto aos critérios de vocabulário, abrangência ao tema e clareza e Na segunda rodada, as 31 questões foram consideradas adequadas. Conclusão: O questionário, inédito tanto no âmbito nacional quanto no internacional, encontra-se validado em relação ao seu conteúdo, após cuidadosa revisão de suas questões.
Objective: To analyze the spatiotemporal pattern and factors related to infant mortality in Northeastern Brazil from 2008 to 2018. Method: Ecological study developed with infant deaths that occurred in the Northeast and reported in the Mortality Information System. Non-spatial and spatial regression models were used to identify indicators related to infant mortality. Results: The mortality rate showed a decreasing trend of 2.1% per year (95% CI: -2.7 - -1.6; p<0.001), with higher Bayesian coefficients concentrated in in municipalities in the interior of Piauí. The variables related to infant mortality were: Gini Index (β = 6.56; p=0.01), Municipal Human Development Index (β = -22.21; p 0.001), dependency ratio (β = 0.16; p <0.001), percentage of people in households without electricity (β = -0.12; p<0.001) and percentage of women aged 10 to 17 who had children (β=0.19; p=0.01). Conclusion: There was a decrease in infant mortality during the studied period and high Bayesian rates in the interior of Piauí.
O objetivo deste estudo foi analisar a utilização dos Sistemas de Informação em Saúde para a construção da sala de situação na Atenção Primária à Saúde. Trata-se de uma revisão integrativa realizada por meio de busca de artigos na íntegra, nas bases de dados BDENF, Lilacs, Medline, SciELO, PubMed e Cochrane. Foram analisados sete artigos, os quais foram apresentados em três categorias. Os sistemas de informação apoiam a sala de situação na coleta, no processamento e na divulgação de resultados, na análise e na comparação de indicadores, no planejamento, na gestão e na avaliação em saúde. Por fim, percebeu-se que os sistemas de informação contribuem para a construção da sala de situação subsidiando a atuação da gestão local na formação de indicadores de saúde e na implementação de ações.
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