RESUMO
OBJECTIVE: This article aims to analyse the evolution of 40 Sustainable Development Goals' (SDGs) health-related indicators in Brazil and Ecuador from 1990 to 2019. STUDY DESIGN: Epidemiological study of long-term trends in 40 SDGs' health-related indicators for Brazil and Ecuador from 1990 to 2019, using estimates from the Global Burden of Disease Study. METHODS: Forty SDGs' health-related indicators and an index from 1990 to 2017 for Brazil and Ecuador, and their projections up to 2030 were extracted from the Institute for Health Metrics and Evaluation's Global Burden of Disease website and analysed. The percent annual change (PC) between 1990 and 2019 was calculated for both countries. RESULTS: Both countries have made progress on child stunting (Brazil: PC = -38%; Ecuador: PC = -43%) and child wasting prevalences (Brazil: PC = -42%; Ecuador: PC = -41%), percent of vaccine coverage (Brazil: PC = +215%; Ecuador: PC = +175%), under-5 (Brazil: PC = -75%; Ecuador: PC = -60%) and neonatal mortality rates (Brazil: PC = -69%; Ecuador: PC = -51%), health worker density per 1000 population (Brazil: PC = +153%; Ecuador: PC = +175%), reduction of neglected diseases prevalences (Brazil: PC = -40%; Ecuador: PC = -58%), tuberculosis (Brazil: PC = -27%; Ecuador: PC = -55%) and malaria incidences (Brazil: PC = -97%; Ecuador: PC = -100%), water, sanitation and hygiene mortality rates (Brazil and Ecuador: PC = -89%). However, both countries did not show sufficient improvement in maternal mortality ratio to meet SDGs targets (Brazil: PC = -37%; Ecuador: PC = -40%). Worsening of indicators were found for violence, such as non-intimate partner violence for both countries (Brazil: PC = +26%; Ecuador: PC = +18%) and suicide mortality rate for Ecuador (PC = +66%), child overweight indicator for Brazil (PC = -67%), disaster mortality rates (Brazil: PC = +100%; Ecuador: PC = +325%) and alcohol consumption (Brazil: PC = +46%; Ecuador: PC = +35%). CONCLUSIONS: Significant improvements are necessary in both countries requiring the strengthening of health and other policies, particularly concerning the prevention and management of violence and alcohol consumption, and preparedness for dealing with environmental disasters.
Assuntos
Desenvolvimento Sustentável , Equador/epidemiologia , Humanos , Brasil/epidemiologia , Lactente , Pré-Escolar , Indicadores Básicos de Saúde , Recém-Nascido , Mortalidade Infantil/tendências , Transtornos do Crescimento/epidemiologia , Transtornos do Crescimento/prevenção & controle , CriançaRESUMO
Transwomen are a high-risk population for HIV/AIDS worldwide. However, many transwomen do not test for HIV. This study aimed to identify factors associated with resistance to HIV testing among transwomen in Fortaleza/CE. A cross-sectional study was conducted between August and December 2008 with a sample of 304 transwomen recruited through respondent-driven sampling. Data analysis utilized Respondent-Driven Sampling Analysis Tool and SPSS 11.0. Univariate, bivariate, and multivariate analyses examined risk factors associated with resistance to HIV testing. Less than 18 years of age (OR = 4.221; CI = 2.419-7.364), sexual debut before 10 years of age (OR = 6.760; CI = 2.996-15.256), using illegal drugs during sex (OR = 2.384; CI = 1.310-4.339), experience of discrimination (OR = 3.962; CI = 1.540-10.195) and a belief that the test results were not confidential (OR = 3.763; CI = 2.118-6.688) are independently associated with resistance to testing. Intersectoral and targeted strategies aimed at encouraging the adoption of safer sexual behaviors and testing for HIV among transwomen are required.
Assuntos
Sorodiagnóstico da AIDS/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde , Comportamento Sexual/psicologia , Pessoas Transgênero/psicologia , Transexualidade , Adolescente , Adulto , Brasil/epidemiologia , Preservativos/estatística & dados numéricos , Estudos Transversais , Discriminação Psicológica , Feminino , Infecções por HIV/epidemiologia , Humanos , Masculino , Análise Multivariada , Fatores de Risco , Trabalho Sexual , Estigma Social , Sexo sem Proteção , Adulto JovemRESUMO
A quantificação do bacilo realizada pelo exame baciloscópico e histopatológico apresenta sensibilidade limitada. Portanto, o emprego de uso de técnicas moleculares permite o diagnóstico direto do material clínico com elevada especificidade e sensibilidade. A PCR em tempo real (qPCR) é um ensaio sensível e específico que permite a quantificação do número de bacilos a partir de diversas amostras, além de poder ser utilizada no diagnóstico diferencial de muitos patógenos. Pacientes multibacilares hansenianos liberam o bacilo Mycobacterium leprae através da secreção nasal, sendo a coleta deste realizada por procedimento não invasivo. Até o momento, nenhum estudo avaliou a sensibilidade e especificidade da qPCR para o diagnóstico da hanseníase utilizando amostras de secreção nasal.
RESUMO
A quantificação do bacilo realizada pelo exame baciloscópico e histopatológico apresenta sensibilidade limitada. Portanto, o emprego de uso de técnicas moleculares permite o diagnóstico direto do material clínico com elevada especificidade e sensibilidade. A PCR em tempo real (qPCR) é um ensaio sensível e específico que permite a quantificação do número de bacilos a partir de diversas amostras, além de poder ser utilizada no diagnóstico diferencial de muitos patógenos. Pacientes multibacilares hansenianos liberam o bacilo Mycobacterium leprae através da secreção nasal, sendo a coleta deste realizada por procedimento não invasivo. Até o momento, nenhum estudo avaliou a sensibilidade e especificidade da qPCR para o diagnóstico da hanseníase utilizando amostras de secreção nasal.
RESUMO
Tubal sterilization is the most common contraceptive method used by Brazilian HIV-positive women. This cross sectional study describes the main reasons why HIV-positive women decide to be sterilized and identifies factors associated with choosing sterilization in HIV-positive women in Ceará, northeast Brazil. Data from 229 non-sterilized women, 80 women sterilized before HIV diagnosis and 48 women sterilized after diagnosis were analysed. Of the women sterilized after HIV diagnosis, 96% had the procedure done in the postpartum, during a caesarean section. No desire for more children was the most common appointed reason to be sterilized (39.6%), followed by medical recommendation because of HIV (31.3%). Seventy-nine women (28.5%) had a child after HIV diagnosis. Of those, 46 (58.2%) were sterilized in the postpartum. Factors associated with sterilization for HIV-positive women were: having a child after diagnosis (AOR: 120.9; 95%CI: 27.8-525.4) and having at least three children (AOR: 2.8; 95%CI: 1.1-7.1). It is recommended that non-coercive counselling should be provided so that HIV-positive women can make informed decisions on their reproductive options.
Assuntos
Infecções por HIV/psicologia , Direitos Sexuais e Reprodutivos , Esterilização Tubária/psicologia , Adolescente , Adulto , Brasil , Aconselhamento , Estudos Transversais , Tomada de Decisões , Feminino , Infecções por HIV/prevenção & controle , Infecções por HIV/transmissão , Humanos , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , GravidezRESUMO
The lymphangioma is a rare disease, more frequently reported in children and just occasionally in the adult patient. The lymphangioma is considered a benign neoplasm of embryonic origin of the lymphatic vessels. Its habitual location is in the cervical and axillary area; it is rarely found in the abdominal cavity and exceptionally in the retroperitonio. In this latter location, the lesion habitually is asymptomatic. The clinical diagnosis of the retroperitoneal cystic lymphangioma is not often due to its rarity and the absence of clinical expression. The size of the lesion is more important than its location to the symptomatology development. The findings of the abdominal ultrasonography and computerized tomography of the abdomen usually show a cystic lesion and its location. The treatment is surgical and it consists of the resection of the cyst or group of cysts once the liquid accumulation in its interior may be responsible for the development of some important complications of this disease. The cure is obtained when the lesion is completely resected also with the resection of eventual adhesive structures. The relapse may take place when the resection is incomplete. A case of retroperitoneal lymphangioma in a female adult patient as incidental finding of abdominal ultra-sonography is described. It is discussed the clinical picture, the radiologic diagnosis, the treatment and the prognostic of this unusual disease.
Assuntos
Linfangioma Cístico/diagnóstico , Neoplasias Retroperitoneais/diagnóstico , Feminino , Humanos , Linfangioma Cístico/cirurgia , Pessoa de Meia-Idade , Neoplasias Retroperitoneais/cirurgiaRESUMO
Estudo sobre assistência perinatal destinado a examinar os padröes de utilizaçäo dos serviços de atençäo à saúde de que dispöem as mulheres pertencentes a distintos grupos sociais e expostas a diferentes riscos da gestaçäo. Discute alguns resultados do estudo epidemiológico realizado em Pelotas em 1982, que permitiram investigar os fatores determinantes dos padröes de utilizaçäo dos serviços de atençäo à saúde, especialmente sobre a prática de cesáreas