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At least 1,081 records · Page 60Linked to original sources
PubMedDate not supplied

[Canine heartworm on São Luís Island, Northeastern Brazil: a potential zoonosis].

A survey on the prevalence of canine heartworm was conducted in 1, 495 dogs from Maranhão Island, State of Maranhão, Northeastern Brazil, from 1991 to 1994, by testing for microfilariae in blood. Of the total, 1,358 (12.8% of which were infected) were dogs with no known history; they included 1,265 homeless animals (10.3% with microfilariae) and 93 kept by owners at the time the survey was conducted (37.8% of which were infected). Prevalence is high among dogs captured and/or living along the seashore. Examples of such high coastal prevalence rates were found in Olho d'Agua and Calhau (46% and 43%, respectively). The search for microfilariae in blood samples of 137 exclusively domiciliary dogs with a known history showed that 43% of these animals were infected, confirming transmission of heartworm on the island. This was the first survey formally published on canine dirofilariasis in Northeastern Brazil. Since D. immitis is infective to man and prevalence of the parasite is high, particularly along the coast of Maranhão Island, human cases of dirofilariasis may be expected. Local physicians should consider this parasite among the possible causes of solitary lesions in humans living in this area.

Animals↗
PubMedDate not supplied

[Time trends in death rates from homicides in the city of Sao Paulo, Brazil, 1979-1994].

To study homicide trends by gender and age, 1979-1994, São Paulo, Brazil, cubic polynomials were used to determine the best model for adjusting to time trends in homicide mortality rates by age and gender in the city of São Paulo, Brazil, 1979-1994. The model best adjusted to each group was selected considering the regression coefficient (Beta) , R2 value, residual analysis, and model's simplicity. The results show linear growth for total rates and rates by gender due to behavior of rates in the 20-29 and 30-39 year age groups. The reciprocal model adjusted best to rates for the 40-49 and 50-59 year age groups, while rates for adolescents followed the multiplicative model. There was no significant relationship between homicide rates and time for the remaining groups (under 10 and over 59 years). Rates for males were considerably higher in all age groups. The remarkably steady growth in homicide rates among adolescents and young adults is consistent with trends observed in other urban areas in developing and developed countries and denotes deteriorating living conditions and increased poverty.

Adolescent↗
PubMedDate not supplied

[Age at menarche among schoolgirls from a rural community in Southeast Brazil].

The purpose of this study was to determine the 3rd percentile (P3), 50th percentile (P50 = median age at menarche = MAM), and amplitude between the extremes (P97 and P3) of age at menarche among schoolgirls in the county of Barrinha, São Paulo, Brazil. Values were correlated with socioeconomic conditions such as social class, number of siblings, and father's employment status. This was a cross-sectional study based on the use of status quo adjusted by logit for calculation of percentiles. A questionnaire was applied to 1,602 schoolgirls aged 8 to 17 years (incomplete). MAM was 12 years (y) and 6 months (m), with a P97 of 10 y and 2 m and a P3 of 14 y and 10 m. Girls from lower-income families and those with unemployed fathers showed later MAM. No difference in MAM was observed with respect to number of siblings. Amplitude between P97 ad P3 was great in the overall sample. We conclude that Barrinha presented a MAM similar to and even lower than regional values for Brazil and for some developed countries. The study of the interval between extreme percentiles proved to be a better indicator of biological diversity and socioeconomic inequality than MAM alone.

Adolescent↗
PubMedDate not supplied

[Trends and spatial distribution of mortality from external causes in Salvador, Bahia State, Brazil].

Since 1980, external causes (ICD-9 E800-E999) have been ranked as the second leading causal group for mortality in Brazil, thus becoming a major public health problem. This study aimed to describe spatial distribution trends for violent deaths in the urban setting of Salvador, a city in Northeast Brazil, for the years 1988, 1991, and 1994. An ecological study was conducted, and mortality data were obtained from death certificates and the archives of the Institute for Forensic Medicine. There was an increase of 34.6% in the number of deaths from external causes between 1988 and 1994. The highest mortality rates were among men from 20 to 29 years of age (from 192.0 to 262.0/100,000) and those 65 years and over (from 188.7 to 258.1/100,000). Homicides were the leading cause of violent deaths in about 75.0% of neighborhoods. The authors discuss the need for comprehensive public policies and an interdisciplinary approach to elucidate the causes and deal with the problem of violence.

Adolescent↗
PubMedDate not supplied

[Morbidity among job applicants in the Metropolitan Region of Salvador, Bahia, Brazil].

This cross-sectional study evaluates the pre-employment health status of job applicants, based on prevalence estimates of abnormal laboratory test results, clinical diagnosis, and a physician-signed fit-for-work assessment, which is mandatory in Brazil. The study population was a random sample of 1,237 male workers selected from medical records (1988-1996) from an Occupational Medical Center located in Salvador, the capital of Bahia State, Brazil. The data were from a single pre-employment medical assessment for each individual. The most common diseases were intestinal parasites (51.7%), anemia (12.8%), and hypertension (12.7%). Drivers showed a high prevalence of overweight (38.2%) and hypertension (16.2%). In addition to work-related risks and diseases, occupational hygiene and safety programs need to address prevailing illnesses and risk factors, which in this population are typical of poor living conditions. Special attention should to be given to drivers, who are at increased risk of cardiovascular disease.

Adolescent↗
PubMedDate not supplied

[Electric power generation and transmission: the impact on indigenous peoples in Brazil].

This paper presents an overview of the effects of electric power generation and transmission on indigenous communities in Brazil. According to data from FUNAI (the Brazilian government's Board of Indian Affairs), there are 156 cases of direct impact, present or future, of the electric power sector on Indian settlements geographically distributed throughout Brazil, 65% of which are located in the Northern Region of the country. The principal complaints by indigenous communities relate to the direct effects of flooding following construction of hydroelectric dams, destruction of sacred sites like cemeteries, mosquito proliferation, and health-related hazards such as malaria and other infectious diseases, decrease in game for hunting, crowding out of farm land, and increased invasion of indigenous lands. Future perspectives include a scenario with further construction of hydroelectric dams, especially in the Amazon region, with possible similar effects on indigenous communities.

Brazil↗
PubMedDate not supplied

[Indigenous peoples' health and the implementation of Health Districts in Brazil: critical issues and proposals for a transdisciplinary dialogue].

Based on the authors' experience, this paper discusses a series of problems during the implementation of so-called Indigenous Health Districts (DSEI) in Brazil, related to organization of health services provision as viewed by both health professionals and anthropologists. The authors report on the Health District model's underlying concepts and present the different approaches used to implement the DSEI. The authors' experience refers to the Rio Negro area - in the northwestern Amazon, representing 10% of Brazil's total indigenous population - and the Brazilian Northeast, specifically the State of Pernambuco, with an indigenous population estimated at 20,000.

Brazil↗
PubMedDate not supplied

[Nursing practice and public health policy in Campinas, São Paulo, Brazil].

Redemocratization in the 1970s brought about changes in the public health system in Brazil. The Unified National Health System (SUS) was implemented in 1988, based on local and regional administrative systems. This was an important step that resulted in greater local control and the introduction of new technologies. This study focuses on the local health system in Campinas, a relatively affluent and technologically advanced region some 100km from the city of São Paulo in Southeast Brazil. Qualitative and quantitative methods were used to evaluate the work of 233 nurses in the local health system. The first nurse was hired in 1977, and now there are 53 nurses working in specific areas: 10 in the central health administration, 36 in district administrations, and the rest in local services. Nursing services are organized in six main areas: administration, coordination of human resources, education, information technology, health surveillance, and health administration. Nursing intervention may be found in various areas, but it generally focuses on medical consultations, and there is little emphasis on collective activities and health promotion. Local health objectives can only be achieved by creating new practices that promote collective health.

Brazil↗
PubMedDate not supplied

[Emergency contraception in Brazil: facilitators and barriers].

A multi-centered qualitative study was conducted in Brazil, Chile, and Mexico to assess the acceptability of emergency contraception both among potential users and possible providers, authorities, and opinion-makers, and to identify (according to participants' perceptions) factors facilitating or hindering the method's use and the most appropriate strategies to disseminate information and provide the method. Data were collected through semi-structured interviews, group interviews, and discussion groups, which were tape-recorded and transcribed. A thematic analysis of this material was conducted. Acceptability of emergency contraception was high among participants, who also felt that there were no barriers towards its acceptance by the population. Participants felt that the method's acceptability would be greater if it were included in reproductive health programs, emphasizing its prescription for emergency situations. Participants highlighted that strategic components in Brazil would be training of providers and inclusion of the method in family planning services.

Brazil↗
PubMedDate not supplied

The estimated magnitude of AIDS in Brazil: a delay correction applied to cases with lost dates.

The number of HIV-infected people is an important measure of the magnitude of the AIDS epidemic in Brazil and allows for comparison with epidemic patterns in other countries. This quantity can be estimated from the number of reported AIDS cases, which in turn needs to be corrected for the distribution of reporting delays and under-recording of cases. These distributions are unknown and must also be estimated from the recorded dates, which were missed to the Brazilian National AIDS registry. This paper estimates the number of AIDS cases diagnosed by inputting the lost information based on an estimate of the pattern in registration delay until 1996. We first fitted a non-stationary bivariate Poisson regression model to estimate the pattern in reporting delay. In the subsequent steps these models were applied to input new data, thus replacing the missing information, and to estimate the magnitude of the AIDS epidemic in the country. Model estimates ranged from 36,000 to 50,000 AIDS cases diagnosed in Brazil and still unreported. Therefore, the epidemic was 20 to 30% greater than known from the available information as of February 1999. To be useful to health policy-makers, the surveillance system based on officially reported AIDS cases must be continuously improved.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

[Retrieval and failure analysis of surgical implants in Brazil: the need for proper regulation].

This paper summarizes several cases of metallurgical failure analysis of surgical implants conducted at the Laboratory of Failure Analysis, Instituto de Pesquisas Tecnológicas (IPT), in Brazil. Failures with two stainless steel femoral compression plates, one stainless steel femoral nail plate, one Ti-6Al-4V alloy maxillary reconstruction plate, and five Nitinol wires were investigated. The results showed that the implants were not in accordance with ISO standards and presented evidence of corrosion-assisted fracture. Furthermore, some of the implants presented manufacturing/processing defects which also contributed to their premature failure. Implantation of materials that are not biocompatible may cause several types of adverse effects in the human body and lead to premature implant failure. A review of prevailing health legislation is needed in Brazil, along with the adoption of regulatory mechanisms to assure the quality of surgical implants on the market, providing for compulsory procedures in the reporting and investigation of surgical implants which have failed in service.

Biocompatible Materials↗
PubMedDate not supplied

[Health education for triatomine control in an area under epidemiological surveillance in Paraná State, Brazil].

This paper describes a health education project targeting a rural community and health professionals from counties undergoing epidemiological surveillance for Chagas disease vectors in the State of Paraná, Brazil. A group of technicians from the Brazilian National Health Foundation (FUNASA) was trained, together with teachers, workers, and students from the State University of Maringá, who prepared an instructions manual and drew up guidelines for reporting presence of triatomines or suspected cases of Trypanosoma cruziinfection. From June 1996 through February 2000, the activities reached 742 families, 2,300 schoolchildren, and 27 teachers from 18 elementary schools, and included a meeting between FUNASA members and 40 participants, 21 meetings in health centers, and provision of a set of preserved triatomine specimens for use in vector surveillance and identification. After three years of health education activities and insecticide treatment (cipermetrina 125 mg i.a./m2), there was a reduction of 80.6% in households infested with triatomines and increased awareness among rural residents and health workers. The authors discuss the need to train professionals committed to changing Brazil's prevailing health model.

Animals↗
PubMedDate not supplied

[Changes in child health indicators in a municipality with community health workers: the case of Itapirapuã Paulista, Vale do Ribeira, São Paulo State, Brazil].

Twelve community health workers (CHWs) were trained to offer basic health care for children under five years of age through household visits in Itapirapuã Paulista, a municipality in Vale do Ribeira, São Paulo State, Brazil. Their tasks included diagnosis, initial treatment, and management of diarrhea and acute respiratory diseases at the household level, growth monitoring, incentives to complete basic immunization, and counseling on infant food supplementation. An average of 409 (396-417) children were visited weekly by CHWs in their homes over the course of three years. In this period, the hospitalization rate dropped drastically, and the use of oral rehydration therapy during bouts of diarrhea increased greatly. However, prevalence of stunting and incidence of low birth weight did not change. Child health indicators (CHI) in this municipality were better than those in a municipality chosen as a control. CHWs may have contributed to improved local CHI, but the results should be interpreted with caution for two reasons: (1) CHI is improving in Brazil countrywide and (2) it is a small program implemented in an area with high morbidity and mortality rates and low availability of health services.

Brazil↗
PubMed2003

[Snake bite epidemiology in the last 100 years in Brazil: a review].

We review 30 studies on snake bites in Brazil, published from 1901 to 2000, and conclude that epidemiological analyses conducted in the last 100 years are based on the same variables already identified by Vital Brazil in his pioneering report, i.e., characteristics of the individuals prone to snake bites, the bites themselves, and treatment. The original epidemiological profile was also maintained over the years and indicates that such accidents are more frequent among male farm workers in the 15-49-year age bracket, affecting mainly the lower limbs, and caused by snakes from genus Bothrops.

Adolescent↗
PubMed2003

[Pap test coverage in the city of Pelotas, Rio Grande do Sul, Brazil].

In Brazil, the effectiveness of preventive public heath programs and actions is rarely evaluated. A cross-sectional study was thus performed in a population-based sample focused on several health characteristics of adults living in Pelotas, Rio Grande do Sul, Brazil. The study aimed to measure temporal trends in coverage of Pap smear testing in the city. The authors studied the factors associated with failure of women to submit to a Pap smear. An updated Pap smear was defined as one performed in the previous 3 years. The sample consisted of 1,122 women ages 20 to 69 years, 72.2% of whom had an updated Pap smear, 16.6% of whom were behind schedule for testing, and 11.2% of whom had never had a Pap smear. Risk factors for never having a test were low socioeconomic status and old age. Logistic regression showed an independent effect of social class, low family income, age, skin color, marital status, and no medical appointment in the previous year. However, the effect of chronic diseases disappeared in logistic regression. The authors compare the results of the study conducted in 1992 with the present. Pap smear coverage increased from 65.0% to 72.2% (1992 to 1999/2000) in the city, yet such figures had still not ensured the effectiveness of the program for uterine cervical cancer prevention.

Adult↗
PubMed2003

[The sociocultural basis for indigenous peoples' health advocacy: problems and issues in the Northern Region of Brazil].

This article discusses the sociocultural basis for indigenous peoples' health advocacy in Brazil. The discussion follows two main lines of reasoning: (1) advocacy or "social control" at the local level and the functioning of local or district-level health councils and (2) the interface between the relations among large indigenous peoples' organizations in the Northern Region of Brazil and the managers of public policies for indigenous peoples' health. The information was gathered through participatory observation in regional and national health meetings and follow-up on local and district-based health councils. The article demonstrates the reinforcement of the ethnic/political movement generated by the partnership with the Ministry of Health and the contradictions generated by measures affecting indigenous peoples' health.

Brazil↗
PubMed2003

Evaluation of informative materials on leishmaniasis distributed in Brazil: criteria and basis for the production and improvement of health education materials.

Based on categories related to structure, content, language, and illustrations, the present study provides an evaluation of the quality of educational materials on leishmaniasis available to health services in Brazil. The 18 publications evaluated consisted of four handbooks, four guided studies, four booklets, and six leaflets. Of the total publications assessed, nine were produced by the Brazilian National Health Foundation (FUNASA), five by State and Municipal Health Departments jointly with FUNASA, and one by the Pan-American Health Organization. The evaluations were also performed by three professionals: a physician specialized in leishmaniasis, a parasitologist, and an information/communications expert. The publications failed to specify key items such as target public, objective, and bibliography. The illustrations, especially in the booklets and leaflets, failed to clarify the text, portrayed biased concepts, and omitted credits and scale. According to this study, informative materials on leishmaniasis distributed in Brazil present major limitations which jeopardize the quality of information they contain.

Brazil↗
PubMed2003

[Social participation in health services: concepts of users and community leaders in two municipalities of Northeastern Brazil].

Social participation in management of the health care system at different levels of government is one of the key policies promoted by the Unified National Health System (SUS) in Brazil. As with any new policy, success hinges on several factors such as stakeholders' interests and opinions, which have not always been considered in the past. This paper analyzes the underlying concepts of two groups of stakeholders with respect to social participation in health and the potential influence of these concepts on the effectiveness of policy implementation. A case study of two municipalities in Northeast Brazil was conducted using a combination of qualitative and quantitative social science research methods. Health services users and community leaders were interviewed. Various concepts were found in which the participatory approach to health policies was only partially reflected. Likely influences on stakeholders' concepts of social participation in health are the evolution of the broader Brazilian social context and the traditional performance of health services. Particular attention should be paid to stakeholders' opinions and concepts if policy effectiveness is to be improved.

Adolescent↗