Epidemiological characterization of congenital syphilis in a health region of the northern zone in the state of Ceará, Brazil

The study sought to investigate the epidemiological profile of congenital syphilis in a health region in the State of Ceará, in the period from 2015 to 2019. This is a descriptive epidemiological study, with a quantitative approach, with secondary data collected through the Health System. Information on Notifiable Diseases and Live Birth Information System. There were a total of 248 cases: 65 cases in 2015, 50 in 2016, 45 in 2017, 51 in 2018 and 37 in 2019. The incidence of congenital syphilis was: 8.1 (2015), 6.1 (2016), 5.1 (2017), 5.3 (2018) and 3.9 (2019). In 62.9% of cases from all the years, women were between 20 and 34 years old and in 45.5% of cases they had less than eight years of educational instruction. 57.2% never had a miscarriage, 63.3% had vaginal deliveries and 59.2% had full-term deliveries. Most women received prenatal care (95.9%). In 49.5% of cases, the diagnosis of maternal syphilis occurred during prenatal care. Only 67 (27%) of the pregnant women were treated properly and only 52 (29%) had their partners treated. The study shows a flaw in prenatal care with low effectiveness of the prevention actions, determining factors in the control of congenital syphilis.

Fatores associados ao óbito em casos confirmados de COVID-19 no estado do Rio de Janeiro

Background COVID-19 can occur asymptomatically, as influenza-like illness, or as more severe forms, which characterize severe acute respiratory syndrome (SARS). Its mortality rate is higher in individuals over 80 years of age and in people with comorbidities, so these constitute the risk group for severe forms of the disease. We analyzed the factors associated with death in confirmed cases of COVID-19 in the state of Rio de Janeiro. This cross-sectional study evaluated the association between individual demographic, clinical, and epidemiological variables and the outcome (death) using data from the Unified Health System information systems. Methods We used the extreme boosting gradient (XGBoost) model to analyze the data, which uses decision trees weighted by the estimation difficulty. To evaluate the relevance of each independent variable, we used the SHapley Additive exPlanations (SHAP) metric. From the probabilities generated by the XGBoost model, we transformed the data to the logarithm of odds to estimate the odds ratio for each independent variable. Results This study showed that older individuals of black race/skin color with heart disease or diabetes who had dyspnea or fever were more likely to die. Conclusions The early identification of patients who may progress to a more severe form of the disease can help improve the clinical management of patients with COVID-19 and is thus essential to reduce the lethality of the disease.

Participatory practice with queer refugees in Germany

Evidence shows that queer refugees in Germany neither have equal access to the health system, information, HIV-Testing and treatment, nor are they involved in HIV-Prevention. The community-based participatory health approach provides a valuable tool for building capacity and enabling queer refugees to create knowledge and develop appropriate prevention tools for their communities. “Your health, your rights” (2017-2018) is a 2-year community-based participatory health project, which aims to improve the involvement of queer refugees in HIV-Prevention, as well as to create appropriate prevention media in collaborative way. It is conducted by the National AIDS Organization in collaboration with partners from different immigrant organisations, queer refugees and AIDS service organisations - all based in Berlin. The components of the project include a multilingual participatory need assessment workshop, a series of capacity-building methodological workshops, a community-led art-based project and a participatory evaluation. 12 queer refuges choose to take part in the project and have been supported to document their lived experiences using community and concept mapping. Key topics and needs connected to sexual health have been jointly identified. Based on these results and in the framework of an art-based workshop participants created a design of multilingual website for queer refugees which delivers helpful information in appropriate way (www.queerrefugeeswelcome.de). The involvement of queer refugees in HIV-Prevention is possible, if it is enabled. The usage of participatory visual methods has opened up ways of participation of even highly traumatised refugees who otherwise are not able to verbally express their thoughts and enabled the communication between participants who don’t share the same language. Key messages The resources of queer refugees are identified and mobilised and community building processes are supported. The participants improved their competencies (empowerment). Service providers are able to tailor their services better to the needs of queer refugees.

Change and Continuity in Konkomba Medical Culture: A Historical Perspective of an Indigenous People in Northern Ghana

Medicine (n-nyork) has been one of meaning laden words faced by scholars. This subject has attracted much attention from scholars, but the social aspect of health tied to people’s medical culture has been neglected. The paper examines the reasons and the context within which the medical culture of the Konkomba ensured social equilibrium and well-being. It further examines key medicines and healers that constituted the corpus of the Konkomba health system. Information was sourced from oral interviews, archival and secondary sources. The work focuses on the historiography of indigenous medicine in Ghana, in particular, and Africa in general. In conclusion, it analyses the impact of the Western understanding of medicine indicating that n-nyork (medicine) and ngbanpuan (health) were more holistic within the Konkomba conceptualisation. In that sense, the adoption and non-adaptation of the western view of health has led to more undesirable health situation in the twentieth century. That notwithstanding, the medical culture of the Konkomba still constitute an integral aspect of their medication.

INTERNAÇÕES POR ABORTO ESPONTÂNEO: UM RETRATO DE SUA OCORRÊNCIA EM FORTALEZA

Objetivo: o estudo teve como objetivo caracterizar as internações por aborto espontâneo no município de Fortaleza, Ceará, no período de 2010 a 2014. Metodologia: estudo descritivo exploratório, com dados obtidos por meio do Departamento de Informática do Sistema Único de Saúde. Resultados: os dados mostram que foram registradas 14.203 internações por abortamentos espontâneos, sendo 2010 o ano de maior incidência. Observou-se ainda que a maioria dos atendimentos concentrou-se no sistema público de saúde e a maior parte deles em caráter de urgência. Conclusões: os dados permitem afirmar a urgência do acesso da população à educação sexual nas escolas.Descritores: Aborto espontâneo, Saúde Reprodutiva, Epidemiologia.HOSPITALIZATION FROM MISCARRIAGES:A PORTRAIT OF ITS OCCURRENCE IN FORTALEZA.Objective: The study aimed to characterize hospitalizations from miscarriage in Fortaleza , Ceará, in the period 2010-2014. Methodology : A descriptive exploratory study , with data obtained from the Department of Health System Information . results: the data shows that 14,203 admissions were recorded from miscarriages, and 2010 being the year of highest incidence . It was also observed that most of the visits focused in the public health system and most of them on an urgent basis . Conclusions: The data allows us to state the urgency of sex education in schools for the population.Descriptors: Abortion Spontaneous, Reproductive health, Epidemiology.HOSPITALIZACIÓN POR ABORTO ESPONTÁNEO : UN RETRATO DE SU APARICIÓN EN FORTALEZA.Objetivo: El objetivo del estudio fue caracterizar las hospitalizaciones por aborto involuntario en Fortaleza , Ceará , en el período 2010-2014.Metodología: Un estudio exploratorio descriptivo, con datos obtenidos del Departamento de Información del Sistema de Salud . resultados : los datos muestran que 14,203 admisiones fueron registrados por abortos espontáneos , y 2010 , el año de mayor incidencia. También se observó que la mayoría de las visitas se centraron en el sistema de salud pública y la mayoría de ellos con carácter de urgencia . Conclusiones: Los datos permiten afirmar la urgencia de acceso de la población a la educación sexual en las escuelas.Descriptores: Aborto Espontáneo, Salud Reproductiva, Epidemiología.

Analysis of the correlation between different forms of access to water and cases of gastroenteritis hospitalization in the territory of Médio Piranhas, Paraíba State, Brazil

Drinking water has a direct influence on people's well-being, since this resource can transmit various diseases. This research proposes the diagnosis of access to water in the territory of Médio Piranhas, located in semiarid portion of Paraíba State, Brazil. The premise is based on the number of gastroenteritis hospitalization accounted for the Department of Health System Information. The authors selected the municipalities and collected secondary data from the Brazilian Institute of Geography and Statistics. The paper became evident the relationship between the form of access to water and the cases of gastroenteritis hospitalization. The results indicated that 71,75% of residences in the territory receive a water supply service. It was also observed 2.725 cases of gastroenteritis hospitalizations between 2010 and 2015, which provided a correlation of approximately 39%, showing that more investments in infrastructure need to be made in order to improve the health and well-being of the population, and consequently reduce the chain of transmission of water-related diseases. Análise da correlação entre diferentes formas de acesso à água e os casos de internações por gastroenterite no território do Médio Piranhas-PBResumo: A água de consumo exerce influência direta no bem-estar da população, uma vez que este recurso pode ser um veículo transmissor de diversas enfermidades. Esta pesquisa propõe o diagnóstico do acesso à água no território do Médio Piranhas, localizado no semiárido paraibano. A premissa encontra fundamento no grande número de internações por gastroenterite contabilizado pelo Departamento de Informática do Sistema Único de Saúde. Foram selecionados os municípios e coletados dados secundários do Instituto Brasileiro de Geografia e Estatística. O trabalho tornou notória a relação existente entre a forma de acesso à água e os casos de internação pela enfermidade adotada. Os resultados indicaram que 71,75% dos domicílios do território constam com uma cobertura por um sistema de tratamento e abastecimento de água. Foram contabilizados 2725 casos de internações por gastroenterite no período de 2010 a 2015, o que forneceu uma correlação de aproximadamente 39%, evidenciando que mais investimentos em infraestrutura precisam ser feitos, visando melhorar a saúde e bem-estar da população, além de, consequentemente, reduzir a cadeia de transmissão das doenças de veiculação hídrica.

Health Literacy: What Is It and Why Is It Important to Measure?

This report summarizes the proceedings of the first Outcome Measures in Rheumatology Clinical Trials (OMERACT) Health Literacy Special Interest Group workshop at the OMERACT 10 conference. Health literacy refers to an individual’s capacity to seek, understand, and use health information. Discussion centered on the relevance of health literacy to the rheumatology field; whether measures of health literacy were important in the context of clinical trials and routine care; and, if so, whether disease-specific measures were required. A nominal group process involving 27 workshop participants, comprising a patient group (n = 12) and a healthcare professional and researcher group (n = 15), confirmed that health literacy encompasses a broad range of concepts and skills that existing scales do not measure. It identified the importance and relevance of patient abilities and characteristics, but also health professional factors and broader contextual factors. Sixteen themes were identified: access to information; cognitive capacity; disease; expression/communication; finances; health professionals; health system; information; literacy/numeracy; management skills; medication; patient approach; dealing with problems; psychological characteristics; social supports; and time. Each of these was divided further into subthemes of one or more of the following: knowledge, attitude, attribute, relationship, skill, action, or context. There were virtually no musculoskeletal-specific statements, suggesting that a generic health literacy tool in rheumatology is justified. The detailed concepts across themes provided new and systematic insight into what needs to be done to improve health literacy and consequently reduce health inequalities. These data will be used to derive a more comprehensive measure of health literacy.