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Chagas disease (CD), caused by the protozoan Trypanosoma cruzi (T. cruzi), is a neglected disease endemic to some Latin American countries, including Brazil. Soon after infection, individuals develop an acute phase, which in most cases is asymptomatic and may go undetected. However, when CD is detected early, notification in the Notifiable Diseases Information System (SINAN), is mandatory. This study aimed to evaluate the information registered in the SINAN database and to determine the epidemiological profile of acute CD in Northeast Brazil, an endemic region, from 2001 to 2021. According to this survey, 1,444 cases of acute CD were reported in the Northeastern region of Brazil during this period. During the first six years, referred to as period 1, 90.24% of the notifications were registered, while the number of notifications significantly decreased in the subsequent years, referred to as period 2. Most individuals diagnosed with acute CD were Afro-Brazilian adults. All known routes of infection by the parasite were reported. Vector-borne transmission was predominant during period 1 (73.29%) and oral transmission during period 2 (58.87%). All nine states in Northeast Brazil reported cases in both periods. A higher incidence of disease was reported in Rio Grande do Norte (RN) during period 1, and in Maranhão (MA) during period 2. Our results show that CD remains a significant public health challenge.

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The emergence of the COVID-19 pandemic reinforced the central role of the One Health (OH) approach, as a multisectoral and multidisciplinary perspective, to tackle health threats at the human-animal-environment interface. This study assessed Brazilian preparedness and response to COVID-19 and zoonoses with a focus on the OH approach and equity dimensions. We conducted an environmental scan using a protocol developed as part of a multi-country study. The article selection process resulted in 45 documents: 79 files and 112 references on OH; 41 files and 81 references on equity. The OH and equity aspects are poorly represented in the official documents regarding the COVID-19 response, either at the federal and state levels. Brazil has a governance infrastructure that allows for the response to infectious diseases, including zoonoses, as well as the fight against antimicrobial resistance through the OH approach. However, the response to the pandemic did not fully utilize the resources of the Brazilian state, due to the lack of central coordination and articulation among the sectors involved. Brazil is considered an area of high risk for emergence of zoonoses mainly due to climate change, large-scale deforestation and urbanization, high wildlife biodiversity, wide dry frontier, and poor control of wild animals' traffic. Therefore, encouraging existing mechanisms for collaboration across sectors and disciplines, with the inclusion of vulnerable populations, is required for making a multisectoral OH approach successful in the country.

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As doenças de notificação obrigatória em bovinos podem gerar impactos sociais e econômicos significativos na cadeia pecuária brasileira, além de consequências negativas no mercado internacional devido a embargos sanitários. Para auxiliar no entendimento de como um sistema de vigilância epidemiológica com mais recursos pode gerar mais credibilidade para o país, foram realizadas análises de correlação entre a notificação de doenças e a estrutura veterinária disponível nos Órgãos Executores de Sanidade Agropecuária (OESAs), a partir dos dados contidos no Sistema Nacional de Informação Zoossanitária (SIZ), entre os anos de 2017 e 2019. Com base nos dados do serviço veterinário, foram produzidos o Índice de Estrutura Física Oficial (IEFO) e o Índice de Recursos Humanos do Serviço Oficial (IRHSO). Foi realizada análise de correlação entre a notificação de doenças de bovinos com a capacidade de estrutura física e recursos humanos de vigilância epidemiológica disponíveis no Serviço Veterinário brasileiro. Os estados AP, RR e SC foram os que mais notificaram brucelose e tuberculose no período e estão entre os melhores índices de estrutura e recursos humanos do país. A análise dos índices mostrou que a raiva não possui correlação significativa com estrutura e recursos humanos do serviço, entretanto, brucelose e tuberculose possuem correlação positiva com estrutura veterinária oficial disponível para a vigilância em bovinos. Portanto, melhorias na estrutura podem refletir no incremento dos índices de notificação das doenças de bovinos, assim como na qualidade de suas informações.

Notifiable diseases in cattle can generate significant social and economic impacts on the Brazilian livestock chain, in addition to impacts on the international market due to sanitary embargoes. To help understand how an epidemiological surveillance system with more resources can generate more credibility for the country, correlation analyzes were carried out between the notification of diseases and the veterinary structure available in the Executing Bodies of Agricultural Health (OESAs), based on the data contained in the National System of Zoosanitary Information (SIZ), between the years 2017 to 2019. Based on public data from the veterinary service, the Official Physical Structure Index (IEFO) and the Official Service Human Resources Index (IRHSO) were produced. Correlation analysis was performed between the notification of bovine diseases with the capacity of physical structure and human resources for epidemiological surveillance available in the Brazilian Veterinary Service. AP, RR and SC were the states that most notified brucellosis and tuberculosis in the period and are among the best indices of structure and human resources in the country. The analysis of correlation indices showed that the rabies disease does not have a significant correlation with the structure and the human resources of the service, however, brucellosis and tuberculosis does have a positive correlation with the official veterinary structure available for surveillance in cattle. Therefore, Improvements in the structure can reflect in the increase of the notification rates, as well as in the quality of its information.

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O fenômeno da violência é multicausal, complexo e possui relação com determinantes sociais e econômicos, sendo indiscutível o impacto da violência sobre a saúde das crianças e adolescentes. Objetivo: analisar as notificações de violência interpessoal e autoprovocada em crianças e adolescentes registradas no Sistema de Informação de Agravos de Notificação (SINAN) de Caxias do Sul, de 2015 a 2020, tendo em vista a qualidade do preenchimento da ficha de notificação e o perfil das notificações de violência. Metodologia: foi realizado estudo quantitativo, observacional, do tipo descritivo e ecológico o qual utilizou como fonte o banco de dados do SINAN (notificações de violência interpessoal e autoprovocada em crianças e adolescentes de 0 a 19 anos do município de Caxias do Sul/RS), no período de 2015 a 2020 fornecido pelo Centro Estadual de Vigilância em Saúde (CEVS) do Rio Grande do Sul (RS). O projeto possui a aprovação do Comitê de Ética em Pesquisa. Resultados: foram registradas no período 5.675 notificações de violência interpessoal e autoprovocada na faixa etária de 0 a 19 anos em Caxias do Sul. Perfil das notificações: 95% de residentes de Caxias do Sul; o nível secundário realizou maior proporção de notificações; 61,4% na faixa etária de 0 a 9 anos, o que difere do padrão nacional e estadual; 57,60% do sexo feminino; 80% de pessoas autodeclaradas como raça/cor branca, 11,5% parda e 4,2% preta; 64,20% dos casos ocorreram nas residências; 14,40% foram lesões autoprovocadas, com aumento de 279% em 2019 se comparado a 2015; quanto ao tipo de violência, 59,07% negligência/abandono, 11,54% violência sexual e 11,40% violência física; aumento de 14% no número de notificações de 2019 para 2020. Avaliação da completude: 76,71% boa, 9,5% excelente, 6,85% regular, 4,11% ruim e 2,74% muito ruim. Considerações: identificou-se a necessidade de melhorar a qualidade do preenchimento dos campos motivação da violência, suspeita de uso de álcool por parte do provável autor da violência, identidade de gênero, ocorreu outras vezes, ciclo de vida do provável autor da violência, escolaridade, situação conjugal, orientação sexual, deficiência ou transtorno e local da ocorrência. Apresenta-se a proposição de estratégias para melhorar a notificação de violência interpessoal e autoprovocada em crianças e adolescentes quanti e qualitativamente, com o intuito de promover o aprimoramento da vigilância em Saúde na Atenção Primária. Além de estratégias de identificação, monitoramento e atendimento dos casos suspeitos e/ou confirmados de violência interpessoal e autoprovocada através de atividades intersetoriais.

The phenomenon of violence is multicausal, complex and related to social and economic determinants, and the impact of violence on the health of children and adolescents is indisputable. Objective: to analyze the notifications of interpersonal and self-inflicted violence in children and adolescents registered in the Information System of Notifiable Diseases (SINAN) of Caxias do Sul, from 2015 to 2020, in view of the quality of filling out the notification form and the profile of reports of violence. Methodology: a quantitative, observational, descriptive and ecological study was carried out, using the SINAN database as a source (notifications of interpersonal and self-inflicted violence in children and adolescents aged 0 to 19 years in the city of Caxias do Sul/RS) , in the period from 2015 to 2020 provided by the State Center for Health Surveillance (CEVS) of Rio Grande do Sul (RS). The project has the approval of the Research Ethics Committee. Results: 5.675 reports of interpersonal and self-inflicted violence were recorded in the age group from 0 to 19 years in Caxias do Sul. Profile of notifications: 95% of residents of Caxias do Sul; the secondary level had a higher proportion of notifications; 61.4% in the age group from 0 to 9 years old, which differs from the national and state standard; 57.60% female; 80% of people self-declared as white, 11.5% brown and 4.2% black; 64.20% of the cases occurred in homes; 14.40% were self-inflicted, with an increase of 279% in 2019 compared to 2015; regarding the type of violence, 59.07% neglect/abandonment, 11.54% sexual violence and 11.40% physical violence; 14% increase in the number of notifications from 2019 to 2020. Completeness rating: 76.71% good, 9.5% excellent, 6.85% regular, 4.11% bad and 2.74% very bad. Considerations: it was identified the need to improve the quality of filling in the fields motivation of violence, suspicion of alcohol use by the probable perpetrator of the violence, gender identity, occurred at other times, life cycle of the probable perpetrator of the violence, education, situation marital status, sexual orientation, disability or disorder and place of occurrence. Strategies are proposed to improve the reporting of interpersonal and self-inflicted violence in children and adolescents quantitatively and qualitatively, with the aim of promoting the improvement of health surveillance in Primary Care. In addition to strategies for identifying, monitoring and treating suspected and/or confirmed cases of interpersonal and self-inflicted violence through intersectoral activities.

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Objetivou-se detectar aglomerados espaciais e espaço-temporais de tuberculose em município do nordeste brasileiro prioritário para o controle da doença. Trata-se de um estudo ecológico, no qual foram considerados os casos novos de tuberculose ocorridos em Imperatriz (MA), entre 2009 e 2018, coletados juntos ao Sistema de Informação de Agravos de Notificação. Utilizou-se da técnica de estatística de varredura para a detecção dos aglomerados espaciais e espaço-temporais dos casos. Foram identificados três aglomerados espaciais de alto risco relativo (RR): aglomerado 1 (RR=2,10), aglomerado 2 (RR= 2,20) e aglomerado 3 (RR=2,70). A análise espaço-temporal evidenciou dois aglomerados de alto risco relativo, o aglomerado 1 (RR=2,80) que ocorreu entre 01/01/2009 a 31/12/2013 e o aglomerado 2 (RR= 3,40) com ocorrência entre 01/01/2009 a 31/12/2010. Tais achados apontam para a necessidade da elaboração de estratégias para o combate e controle nas áreas de risco, considerando as evidentes desigualdades socioespaciais presentes no município sob investigação.

The objective was to detect spatial and spatiotemporal clusters of tuberculosis in a municipality in northeastern Brazil that is a priority for disease control. This is an ecological study, in which new cases of tuberculosis that occurred in Imperatriz (MA), between 2009 and 2018, were collected from the Notifiable Diseases Information System. Scanning statistics was used to detect the spatial and spatiotemporal clusters of the cases. Three spatial clusters of high relative risk (RR) were identified: cluster 1 (RR = 2.10), cluster 2 (RR = 2.20) and cluster 3 (RR = 2.70). The spatiotemporal analysis showed two spatiotemporal clusters of high relative risk, cluster 1 (RR = 2.80) that occurred between 01/01/2009 and 12/31/2013 and cluster 2 (RR = 3.40) occurring between 01/01/2009 and 12/31/2010. Such findings point to the need to elaborate procedures for combating and controlling risk areas, considering the evident socio-spatial inequalities present in the municipality under investigation.

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Background: Immunization in pregnant women is essential to help controlling and avoiding preventable diseases. Aim: Analyzing some factors associated with non-vaccination against tetanus in pregnant women who gave birth in maternity hospitals in Belo Horizonte City, Minas Gerais State, Brazil. Methods: Cross-sectional study carried out with database deriving from the research titled "Born in Belo Horizonte: Survey on childbirth", which was developed in public and private hospitals. Sample was calculated by taking into consideration the total number of births recorded in each investigated maternity hospital - the final sample comprised 481 mothers. Descriptive population statistics were used for data analysis purposes, whereas Poisson regression model was used to estimate factors associated with non-vaccination against tetanus during pregnancy. Results: The prevalence of puerperal women subjected to at least 2 doses of tetanus vaccine reached 59.2%. Adjusted analyses have shown that not living with a partner has increased by 1.58 times the prevalence of women who did not take tetanus vaccine, on average; that the prevalence of women who were not vaccinated has decreased by 0.65 times after each prenatal consultation, on average; that prenatal consultations with nurses have reduced by 0.52 times the prevalence of women who did not take the tetanus vaccine, on average. Conclusion: Almost half of puerperal women were not vaccinated against tetanus during pregnancy. It is essential identifying specific groups to help implementing and expanding preventive actions, such as immunization for pregnant women. Despite advances in public health policies, authorities still face challenges to expand vaccination coverage in the investigated state, as well as to strengthen the national immunization program to help increasing tetanus vaccination rates among pregnant women.

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Abstract Objectives: to assess the epidemiological profile of congenital and syphilis during pregnancy in residents of São José do Rio Preto in São Paulo State. Methods: ecological study of the epidemiological profile of patients with congenital and gestational syphilis, based on the Sistema de Informação de Agravos de Notificação (Information System for Notifiable Diseases) from 2007 to 2016. Results: there were 396 cases of syphilis reported in pregnant women and 290 of congenital syphilis. In 2016, the rate of detecting syphilis in pregnant women was 13.2 cases/1,000 live births, while congenital syphilis the incidence rate was 6.5 cases/1,000 live births. For gestational syphilis, 54% of the diagnosis was performed in 2nd or 3rd trimester and 85% were reported at the primary care. Adequate treatment for pregnant women occurred in 96% of the notifications with 52% of partners treated. In congenital syphilis, 82% of the mothers underwent prenatal care. However, 94% of the pregnant women were treated inadequately while 82% of the partners did not receive any treatment. Conclusions: there has been an increase in the number of cases of gestational syphilis in pregnant women and a decrease in the cases of congenital syphilis from 2014. These results showed that the goal of 0.5 case/1,000 live births proposed by World Health Organization is still far from being achieved in this city.

Resumo Objetivos: conhecer o perfil epidemiológico da sífilis congênita e em gestantes nos residentes de São José do Rio Preto/SP. Métodos: estudo ecológico do perfil epidemiológico dos pacientes com sífilis congênita e gestacional, a partir de dados coletados no Sistema de Informação de Agravos de Notificação entre 2007 e 2016. Resultados: foram notificados 396 casos de sífilis em gestantes e 290 de sífilis congênita. Em 2016, a taxa de detecção da sífilis em gestantes foi 13,2 casos/1.000 nascidos vivos, enquanto a sífilis congênita, a taxa de incidência foi 6,5 casos/1.000 nascidos vivos. Para sífilis gestacional, 54% do diagnóstico foram realizados no 2° ou 3° trimestre e 85% notificadas na atenção primária. O tratamento adequado das gestantes ocorreu em 97% das notificações, com 52% dos parceiros tratados. Na sífilis congênita, 82% das mães realizaram o pré-natal, entretanto, 94% das gestantes foram tratadas inadequadamente e 82% dos parceiros não realizaram o tratamento. Conclusões: foi observado o aumento no número de casos de sífilis em gestantes e uma queda dos casos de sífilis congênita a partir de 2014. Com esses resultados, é notório que a meta de 0,5 caso/1.000 nascidos vivos proposta pela Organização Mundial da Saúde ainda está distante de ser alcançada no município.

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Abstract INTRODUCTION: This paper analyzed sociodemographic and epidemiological data of individuals with syphilis as well as the compulsory reporting of the disease, for being a reemerging disease in Brazil. METHODS: General information and sociodemographic, epidemiological, clinical, and laboratory data were verified in compulsory reporting. RESULTS: From 2010 to 2016, 157 reporting forms were explored. Acquired and gestational syphilis occurred predominantly in those 20 to 29 years of age and those who did not complete secondary education. Compulsory reporting forms were not complete. CONCLUSIONS: The number of syphilis cases has varied over the years in the city. Incomplete compulsory reporting was noted.

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This document looks at health trends and statistics in Jamaica. This issue focuses on data collected in the September 2016 to August 2017 quarter along with annual comparisons. Data, utilization of the health sector complaints for the period January to December 2017

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This quarterly report integrates a special feature on surgeries in public hospitals and presents comparative data for January to March 2016 and 2017. It also looks at utilization data for health facilities and health centres, notifiable diseases and health sector complaints for the period.

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This document looks at health trends and statistics in Jamaica. This issue focuses on data collected in the October to December 2016 quarter along with annual comparisons. Data, utilization of the health services and complaints to the Ministry are included.

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Resumo Objetivo: este estudo analisa os elementos que influenciam a subnotificação do agravo LER/DORT no Sistema de Informação de Agravos de Notificação (Sinan) a partir da percepção dos profissionais que atuam na Rede de Serviços Sentinela em Saúde do Trabalhador na cidade de Palmas (TO). Método: pesquisa de natureza qualitativa, realizada com 21 profissionais de saúde que atendem pacientes com possíveis diagnósticos de LER/DORT ou que realizam a notificação desse agravo nas unidades sentinelas em saúde do trabalhador. Os dados foram coletados entre setembro e novembro de 2011 por meio de entrevistas semiestruturadas e analisados a partir da análise de conteúdo de Bardin. Resultados: entre os principais fatores relacionados à subnotificação das LER/DORT em Palmas, destacaram-se nos relatos dos participantes as dúvidas apresentadas pelos profissionais na identificação do agravo, as indefinições e desconhecimento do papel de cada profissional na identificação e notificação do agravo, a insuficiência do trabalho em equipe e a desvalorização da notificação por parte de alguns profissionais, associada ao desconhecimento da finalidade desses dados. Conclusões: essa situação assinala para a necessidade de qualificação dos profissionais em um processo de formação continuada, de modo a fomentar o trabalho em equipe que incorpore tanto discussões sobre as LER/DORT quanto em relação à importância da notificação no banco de dados do Sistema Único de Saúde (SUS).

Abstract Objective: to analyze the elements that influence underreporting of repetitive strain injuries/work-related musculoskeletal disorders (RSI/WMSDs) at the Brazilian notifiable diseases information system (SINAN), from the perspective of the healthcare workers from the Occupational Health Sentinel Service Network. Method: qualitative research with 21 healthcare workers who looked after patients with possible diagnosis of RSI/WMSD or who notified these diseases at the sentinel units in the city of Palmas (TO), Brazil. Data were collected from September to November 2011 through semi-structured interviews and analysed using Bardin's content analysis. Results: Among the main factors related to RSI/WMSDs underreporting in Palmas, the following are emphasized by the participants: the professionals' hesitation in identifying the injury; the lack of definition or knowledge regarding the role of each professional in identifying and reporting the injury; the insufficient team work; the way some healthcare workers undervalue notifications coupled with their unfamiliarity regarding the data purpose. Conclusions: this situation points towards the need for continuously training healthcare workers in a way to foster teamwork that includes discussions on both RSI/WMSDs and the importance of notifying them to the Brazilian Unified Health System (SUS) database.

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Este trabalho teve como objeto a exploração das potencialidades do Sistema de Informações Hospitalares - SIH/SUS na vigilância epidemiológica e monitoramento de doenças de notificação compulsória. Os Estados e Regiões do Brasil constituíram a área de estudo, sendo os dados, coletados do SIH/SUS, relativos a internações por doenças de notificação compulsória, do período de 1984 a 1998, e provenientes do Centro Nacional de Epidemiologia-CENEPI, de 1980 a 1997. As patologias foram agregadas quanto à necessidade de internação e quanto à distribuição por Estados e Regiões do país. Os resultados da classificação dos Estados segundo as quatro maiores freqüências absolutas de internações e notificações e a comparação entre a notificação e número de internações de acordo com a necessidade de internamento da patologia, mostraram uma grande coerência entre os dados do CENEPI e do SIH. Concluiu-se que o SIH/SUS tem uma grande agilidade na obtenção dos dados e uma boa capacidade para o monitoramento das patologias analisadas, podendo assim ser uma importante fonte complementar para vigilância das doenças de notificação compulsória.

The objective of this paper was to explore the potentialities of the Hospital Information System - SIH/SUS for epidemiologic surveillance and monitoring of Notifiable Diseases. The states and regions of Brazil constituted the study area. Data relative to hospital admittances for Notifiable Diseases, during the period from 1984 to 1998, was obtained from the SIH/SUS and data from the National Center of Epidemiology - CENEPI, during the period from 1980 to 1997. Data bases were linked by pathologies, hospital admittances and by place of occurrence - distributed for states and regions of the country. The results of the classification of the states according to the four larger absolute frequencies of admittances and reports and the comparison between the reports and the number of admittances according to the need of admittances for the pathologies, showed a high level of coherence between CENEPI and SIH data. It was concluded that SIH/SUS has a great agility in obtaining the data and shows a good capacity for monitoring the analyzed pathologies, being an important complementary source of information for surveillance of Notifiable Diseases.

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Analisaram-se as doenças de notificaçäo compulsória (DNC) cuja característica é a tranmissäo de pessoa a pessoa: AIDS, meningite(meingocócica, tuberculosa), tuberculose pulmonar, hanseníase, síifilis congênita e hepatites(A e B). As fontes de dados foram: Sistemas de Internaçöes Hospitalares (SIH/-SUS) (internaçöes) e Centro Nacional de Epidemiologia-CENEPI (notificaçöes) analisadas por regiöes e estados. Observou-se coerência entre os dados do CENEPI e SIH para Aids, com um sobre-internamento provavelmente mais por reinternaçöes que por subnotificaçöes. A sífilis congênita apresentou razäo de internaçäo maior que 1 no período analisado, havendo mudança em 1997. Os dados de tuberculose pulmonar e hanseníase foram analisados mais detalhadamente, tendo-se observado o total de pacientes cronificados. A exclusäo definiu os casos novos. Destacou-se o peso da prática de dispensarizaçäo no país. As meningites apresentaram resultados diferentes, conforme sua etiologia: meningite menigocócica com comportamento semelhante para internaçäo e notificaçäo, a meningite tuberulosa apresentando internaçöes inferiores às notificaçöes sugerindo imprecisäo da informaçäo gerada. A análise das hepatites a partir do SIH/SUS apresentou dificuldades. Concluiu-se pela potencialidade do SIH/SUS como sistema complementar na Vigilância e Monitoramento das DNC de transmissäo entre pessoas, particularmente se adotadas as proposiçöes apontadas no estudo

Notifiable Diseases characterized by person-to-person transmission such as: Aids, meningitis (meningococcal, tuberculous), pulmonary tuberculosis, leprosy, congenital syphilis and hepatitis (A and B), were analyzed. Data from the Hospital Information System - SIH/SUS (admittances) and National Center of Epidemiology-CENEPI (case reports), were used as sources of information and were analyzed by regions and states. Coherence was observed between the data of CENEPI and SIH for AIDS, however, over-admittances were detected, probably due to re-admittances rather than underreporting. Congenital syphilis presented a ratio of admittances greater than one in the analyzed period, changing in 1997. Data for pulmonary tuberculosis and leprosy were analyzed in more detail, by determining the total number of admittances of chronical patients. Their exclusion, defined new cases. It was detached the weight of the practices of hospital for chronic patients in the country. For meningitis, different results were obtained, according to the etiology: Similar patterns for admittances and reporting were observed for meningococcal meningitis while discordant results were detected for tuberculous meningitis, wich showed inferior number of admittances compared to cases reports, suggesting imprecision of the generated information. Difficulties for the analysis of hepatitis using data from SIH/SUS were identified. SIH/SUS has potenciality as a complementary source for surveillance and monitoring of notifiable person-to-person transmitted diseases, particularly if the proposed suggestions pointed out in the study are considered.

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