Regionalization of health surveillance: a performance evaluation proposal in a health region in Brazil

Abstract Objectives: To evaluate the performance of the regionalization of the Vigilância em Saúde (VS) (Health Surveillance) in a region in Sao Paulo State. Methods: a quantitative cross-sectional study was carried out at the V Diretoria Regional de Saúde da Secretaria de Saúde do Estado de São Paulo (V Board of the Regional Health Secretary of São Paulo State Health Department). A structured questionnaire was developed from the three dimensions of the research (Policy, Structure and Organization). The escore médio (EM) (average score) was used as the central tendency and for each dimension and attributes, the synthetic indices were constructed. Three cutoff points for assessing the performance were assigned: values equal to or below 4.99 were considered unsatisfactory; between 5.00 and 6.99, intermediaries; and equal to or above 7.00, satisfactory. Results: The performance of the regionalization of the VS was considered satisfactory, with emphasis on the 'Policy' (EM 8.51) and 'Organization' (EM 8.18) dimensions. The ‘Structure’ obtained intermediate performance (EM 6.78). The proposed methodology demonstrated to be appropriate to evaluate the performance of the regionalization of VS, because its strengths and weaknesses were allowed to be identified. Conclusions: despite of the regionalization is an ongoing process, it is necessary for the establishment of a political project that will take up effectively as a strategy for the reorganization of the healthcare in Brazil.

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ORTHOPEDIC INJURIES IN MEN'S PROFESSIONAL SOCCER IN BRAZIL: PROSPECTIVE COMPARISON OF TWO CONSECUTIVE SEASONS 2017/2016

Acta Ortopédica Brasileira ◽

10.1590/1413-785220182605194940 ◽

2018 ◽

Vol 26 (5) ◽

pp. 338-341 ◽

Cited By ~ 1

Author(s):

Eduardo Ramalho de Moraes ◽

Gustavo Gonçalves Arliani ◽

Paulo Henrique Schmidt Lara ◽

Eli Henrique Rodrigues da Silva ◽

Jorge Roberto Pagura ◽

...

Keyword(s):

Cross Sectional Study ◽

Sao Paulo ◽

Lower Limbs ◽

São Paulo ◽

Level Of Evidence ◽

Cross Sectional ◽

Paulo State ◽

Professional Soccer ◽

Prospective Comparison ◽

São Paulo State

ABSTRACT Purpose: The purpose is to compare the incidence and characteristics of injuries sustained in two consecutive seasons of the São Paulo State Football Championship. Methods: Prospective study performed using an electronic form previously developed by the Medical Committee of the São Paulo State Football Federation, sent to the physicians responsible for the tournament's series A1 and A2 teams, after each round. Results: 17.63 injuries sustained per 1000 hours of matches in the A1 series and 14.91 injuries sustained per 1000 hours of matches in the A2 series. Incidence of injuries per 1000 hours of matches decreased from 24.16 to 17.63 in the A1 series (p<0.037) and from 19.10 to 14.01 in the A2 series (p<0.064). External defenders suffered most injuries, while muscular injuries were most common and lower limbs, the most affected areas. Most injuries occurred between 30 and 45 minutes of the match and only 11.9% of the injuries required surgery. Conclusions: Prevalence and frequency of injuries decreased between seasons. Most injuries were sustained in the lower limbs; strains were the most common injuries, followed by strains and contusions; MRIs were the most frequently requested exams and most injuries were classified as moderate (8-28 days). Level of evidence III, Cross-Sectional Study.

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NUTRITIONAL CONDITION OF CHILDREN WHO BENEFIT FROM THE “BOLSA FAMÍLIA” PROGRAMME IN A CITY OF NORTHWESTERN SÃO PAULO STATE, BRAZIL

Journal of Human Growth and Development ◽

10.7322/jhgd.106003 ◽

2015 ◽

Vol 25 (3) ◽

pp. 313 ◽

Cited By ~ 2

Author(s):

Fabiana Pelegrin Cogo Dos Santos ◽

Fabiana Cristina Frigieri De Vitta ◽

Marta Helena Souza De Conti ◽

Sara Nader Marta ◽

Márcia Aparecida Nuevo Gatti ◽

...

Keyword(s):

Risk Groups ◽

Sao Paulo ◽

Child Growth ◽

Nutritional Condition ◽

São Paulo ◽

Chi Square ◽

Cross Sectional ◽

Global Database ◽

Paulo State ◽

São Paulo State

Introdution: The direct income transfer programmes such as “BolsaFamília” have the important function of making it possible for aspects of life to receive the necessary care and importance in order to improve the quality of life. One of the aspects concerns food and healthy nutrition. Objective: The objective was to assess the nutritional condition of children under five years old whose families are benefited by the programme”BolsaFamília” in a city of northwestern São Paulo state, Brazil. Methods: A cross-sectional and retrospective study was carried out using the medical records of 284 children under the age of five, from which socio-demographic, weight and height data were collected. In order to diagnose children’s nutritional condition,the indicators weight/age, height/age and weight/height were used, from the cutoffpoint z-score, recommended by the WHO Global Database on Child Growth and Malnutrition. Descriptive statistics and the Chi-square test were used to analyse data, assessing the association of indicators, gender and age. Results: 8.8% of the children have deficits concerning height/age and 4.2% have deficits concerning weight/age; 8.1% and 7.4% are overweight concerning weight/age and weight/height; 4.6 % of the children under 2 years oldhave higher weight than the expected for their age and also for their height, and 7.8% of the children have low height for their age. The prevalence of weight deficit and excess in children observed in this study were similar to those found in other regions of Brazil. Conclusion: The maintenance of the nutritional surveillance system is extremely important in order to detect risk groups and help plan effective measures to prevent and correct nutritional problems.

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Social and racial inequalities in COVID-19 risk of hospitalisation and death across Sao Paulo state, Brazil

10.1101/2020.12.09.20246207 ◽

2020 ◽

Author(s):

Sabrina L. Li ◽

Rafael H. M. Pereira ◽

Carlos A. Prete ◽

Alexander E. Zarebski ◽

Lucas Emanuel ◽

...

Keyword(s):

Low Income ◽

Respiratory Infections ◽

Cross Sectional Study ◽

Sao Paulo ◽

Mobile Phone Data ◽

São Paulo ◽

Cross Sectional ◽

Paulo State ◽

Disadvantaged Population ◽

São Paulo State

Background: Little evidence exists on the differential health effects of COVID-19 on disadvantaged population groups. Here we characterise the differential risk of hospitalisation and death in Sao Paulo state, Brazil and show how vulnerability to COVID-19 is shaped by socioeconomic inequalities. Methods: We conducted a cross-sectional study using hospitalised severe acute respiratory infections (SARI) notified from March to August 2020, in the Sistema de Monitoramento Inteligente de Sao Paulo (SIMI-SP) database. We examined the risk of hospitalisation and death by race and socioeconomic status using multiple datasets for individual-level and spatio-temporal analyses. We explained these inequalities according to differences in daily mobility from mobile phone data, teleworking behaviour, and comorbidities. Findings: Throughout the study period, patients living in the 40% poorest areas were more likely to die when compared to patients living in the 5% wealthiest areas (OR: 1.60, 95% CI: 1.48 - 1.74) and were more likely to be hospitalised between April and July, 2020 (OR: 1.08, 95% CI: 1.04 - 1.12). Black and Pardo individuals were more likely to be hospitalised when compared to White individuals (OR: 1.37, 95% CI: 1.32 - 1.41; OR: 1.23, 95% CI: 1.21 - 1.25, respectively), and were more likely to die (OR: 1.14, 95% CI: 1.07 - 1.21; 1.09, 95% CI: 1.05 - 1.13, respectively). Interpretation: Low-income and Black and Pardo communities are more likely to die with COVID-19. This is associated with differential access to healthcare, adherence to social distancing, and the higher prevalence of comorbidities.

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Trends in the use of psychoactive substances by truck drivers in São Paulo State, Brazil: A time-series cross sectional roadside survey (2009–2016)

Traffic Injury Prevention ◽

10.1080/15389588.2018.1552786 ◽

2019 ◽

Vol 20 (2) ◽

pp. 122-127 ◽

Cited By ~ 5

Author(s):

Vilma Leyton ◽

Henrique Silva Bombana ◽

Juliana Gallottini Magalhães ◽

Helena Nascimento Panizza ◽

Daniele Mayumi Sinagawa ◽

...

Keyword(s):

Time Series ◽

Sao Paulo ◽

Truck Drivers ◽

São Paulo ◽

Psychoactive Substances ◽

Cross Sectional ◽

Paulo State ◽

Roadside Survey ◽

São Paulo State

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Two hundred days of COVID-19 in São Paulo State, Brazil

Epidemiology and Infection ◽

10.1017/s0950268820002927 ◽

2020 ◽

Vol 148 ◽

Author(s):

Gabriel Berg de Almeida ◽

Micheli Pronunciate ◽

Rejane Maria Tommasini Grotto ◽

Edmur Azevedo Pugliesi ◽

Raul Borges Guimarães ◽

...

Keyword(s):

Reproduction Number ◽

Health Department ◽

Sao Paulo ◽

Distance Measures ◽

São Paulo ◽

Health Security ◽

Slowing Down ◽

Paulo State ◽

São Paulo State ◽

The One

Abstract Two hundred days after the first confirmed case of COVID-19 in Brazil, the epidemic has rapidly spread in metropolitan areas and advanced throughout the countryside. We followed the temporal epidemic pattern at São Paulo State, the most populous of the country, the first to have a confirmed case of COVID-19, and the one with the most significant number of cases until now. We analysed the number of new cases per day in each regional health department and calculated the effective reproduction number (Rt) over time. Social distance measures, along with improvement in testing and isolating positive cases, general population mask-wearing and standard health security protocols for essential and non-essential activities, were adopted and impacted on slowing down epidemic velocity but were insufficient to stop transmission.

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Crossing Birth and Mortality Data as a Clue for Prevalence of Congenital Diaphragmatic Hernia in Sao Paulo State: A Cross Sectional Study

SSRN Electronic Journal ◽

10.2139/ssrn.3967072 ◽

2021 ◽

Author(s):

Victoria Oliveira Maia ◽

Eduardo Pavarino ◽

Leandro Tonderys Guidio ◽

João Paulo Dias de Souza ◽

Augusto Frederico Schmidt ◽

...

Keyword(s):

Congenital Diaphragmatic Hernia ◽

Diaphragmatic Hernia ◽

Cross Sectional Study ◽

Sao Paulo ◽

Mortality Data ◽

São Paulo ◽

Sectional Study ◽

Cross Sectional ◽

Paulo State ◽

São Paulo State

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Violence against teachers of public elementary II schools

ARCHIVES OF HEALTH INVESTIGATION ◽

10.21270/archi.v5i3.1322 ◽

2016 ◽

Vol 5 (3) ◽

Author(s):

Cléa Adas Saliba Garbin ◽

Tânia Adas Saliba Rovida ◽

Adriana Alves Costa ◽

Artênio José Isper Garbin

Keyword(s):

Public Schools ◽

Qualitative Study ◽

School Setting ◽

Exposure To Violence ◽

Sao Paulo ◽

Verbal Abuse ◽

São Paulo ◽

Cross Sectional ◽

Paulo State ◽

São Paulo State

The aim of was to determine the prevalence of cases of violence against teachers, in public schools in a city in São Paulo State. This is a cross-sectional, analytical, quantitative and qualitative study. Being a total of 148 teachers and consenting answered a questionnaire. Of these, 109 agreed to participate, 43% reported having experienced some form of violence at school and of the affirmative cases, 85% said that verbal abuse is more common. It is concluded that violence is present in the school setting, due to various factors that leads to an inversion of values, which generates disrespect against teachers.Descriptors: Exposure to Violence; Education, Primary and Secondary; Adolescent.

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Outbreaks of Healthcare-Associated Infections in Sao Paulo State, Brazil: Results From a Statewide Monitoring System

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.947 ◽

2020 ◽

Vol 41 (S1) ◽

pp. s338-s338

Author(s):

Heloisa de Jesus Marçal ◽

Geraldine Madalosso ◽

Denise Assis ◽

Maria Clara Padoveze

Keyword(s):

Health Department ◽

Multidrug Resistant ◽

Sao Paulo ◽

Healthcare Associated Infections ◽

São Paulo ◽

State Health ◽

Paulo State ◽

Health Authorities ◽

São Paulo State ◽

Healthcare Associated

Background: Outbreaks of healthcare-associated infections (HAI) are relevant causes of morbidity and mortality. Healthcare-authorities should monitor them to allow prompt interventions, identify tendencies along the time, and develop large scale strategies to avoid new cases and clusters. According to the Brazilian legislation, any outbreak should be reported to health authorities. Sao Paulo State Health Department (Brazil) has a system in place since 2011 to monitor HAI outbreaks. This study aims at describing the 3.5 last year’s results of surveillance system for monitoring HAI outbreaks. Methods:Study design: Quantitative descriptive study. Source of information: Database from HAI outbreak reports, Division of Hospital Infection at Sao Paulo State Health Department. Reports were filled out online by professionals from healthcare settings or regional health authorities according to predefined criteria. Interventions were put in place by the health authorities based on the analysis of each situation in a timely manner. Variables analyzed: Number of reports, local, infection site, type of care unit, causative microorganisms, number of cases, and number of deaths. Results: The number of reports have been stable for 3 years: 2016 (n = 34, 34.7%), 2017 (n = 28, 28.6%), 2018 (n = 25, 25.5%) and the first semester of 2019 (n = 11, 11.2%). These reports encompassed 712 confirmed cases and 123 deaths. The reports were mainly about infection outbreaks; 6 reports were about colonization of multidrug-resistant microorganisms. The bloodstream was the most frequent infection site in the HAI outbreak reports (n = 37, 37.7%), followed by respiratory tract (n = 25, 25.5%), urinary tract (n = 10, 10.2%), and surgical wound (n = 9, 9.2%). HAI outbreaks happened more frequently in intensive care units, including neonatal, pediatric, and adult ICUs (n = 38, 38.8%), followed by clinical and general wards (n = 20, 20.4%), hemodialysis (n = 6, 6.1%), and surgical wards (n = 5, 5.1%). Among reported outbreaks, 62.2% occurred in the capital and the metropolitan region of São Paulo. Microorganisms causing the HAI outbreaks reports were mainly carbapenem resistant, both Klebsiella pneumoniae (n = 28, 28.5%) and Acinetobacter baumannii (n = 12, 12.2%), but carbapenem-susceptible Pseudomonas aeruginosa (n = 7, 7.1%) was also reported. Conclusions: HAI outbreaks reported to health authorities in Sao Paulo may represent only a minute percentage of the total outbreaks, most of which are still not being reported, despite the normative. However, the available data emphasize the importance of developing strategies for intensive care units and hemodialysis units that focus on reducing bloodstream infections caused by multidrug-resistant gram-negative organisms.Funding: NoneDisclosures: None

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Factors Associated to the Decision to Terminate or not an Unwanted Pregnancy among a Sample of Civil Servant in São Paulo State, Brazil.

Journal of Public Health International ◽

10.14302/issn.2641-4538.jphi-18-2545 ◽

2019 ◽

Vol 1 (3) ◽

pp. 1-9

Author(s):

Silvana Ferreira Bento ◽

Karla Simônia de Pádua ◽

Graciana Alves Duarte ◽

...

Keyword(s):

Higher Education ◽

Unwanted Pregnancy ◽

Cross Sectional Study ◽

Sao Paulo ◽

São Paulo ◽

Barrier Method ◽

Cross Sectional ◽

Paulo State ◽

Unwanted Pregnancies ◽

São Paulo State

This is a cross sectional study of a sample of civil servants from the interior of São Paulo state, carried out with the purpose of evaluating the occurrence of unwanted pregnancies, the proportion which were terminated, the reason given for having or not having an abortion and which factors were associated to the decision whether or not to terminate an unwanted pregnancy. Just over one fifth declared to have experienced an unwanted pregnancy and over half of them were aborted. The reasons to abort concentrate on interferance with their life expectancy: “to continue studying or working” “being single”, “too young to get married” and “to become a father or mother”. Also important were fear of parents and rejection by the respondents'partner. Among those who did not terminate the unwanted pregnancy religion acted as a barrier among almost one third and the legal barrier for almost one fourth. Not having a permanent partner, being in use of behavioral or barrier method of contraception and higher education were associated with higher incidence of abortion of the unwanted pregnancy, but in multiple regression, only higher education remain significantly associated. Our results showed that once the unwanted pregnancy occur, more than half of them will be aborted, confirming the need to concentrate the efforts in reducing unwanted pregnancies if we want to prevent abortion.

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Prenatal and puerperal care and indicators of severity: a study about the information available on pregnant women’s card

Revista Brasileira de Saúde Materno Infantil ◽

10.1590/1806-93042019000400014 ◽

2019 ◽

Vol 19 (4) ◽

pp. 983-989

Author(s):

Ivelise Araújo de Souza ◽

Mário Ivo Serinolli ◽

Márcia Cristina Zago Novaretti

Keyword(s):

Prenatal Care ◽

Sao Paulo ◽

São Paulo ◽

Cross Sectional ◽

Paulo State ◽

Eastern Zone ◽

São Paulo State ◽

Adequate Prenatal Care ◽

The City ◽

Discharge Summaries

Abstract Objectives: to identify and to discuss the frequency of the prenatal and puerperal care of pregnant women from the eastern zone of São Paulo city, São Paulo State, Brazil, categorizing it according to the Kessner Index modified in 1993 by Takeda. We used the data avai-lable on the card of pregnant woman and the discharge summaries, correlating the results with the indicators of severity in childbirth. Methods: this is a descriptive, cross-sectional quantitative study based on the analysis of the variables of the pregnant woman's card and the diagnoses identified in the discharge summaries. Data were collected through a field survey conducted in the Eastern zone of the city of São Paulo city, São Paulo State, Brazil. A statistical analysis was used to identify asso-ciations between the categorization and the severity indicators listed in the discharge summaries. Results: it was observed that prenatal care in the Eastern zone of São Paulo city, São Paulo State, Brazil was classified as intermediate (56.9%) in the majority of women. Regarding this categorization with the severity indicators, there is a higher incidence of risks for inappropriate categorization (8.89%) when compared to the appropriate (1.67%) and the intermediate (4.44%) ones. Conclusions: it was possible to conclude that the more adequate prenatal care, the lower the chances of unfavorable outcomes and incidence of risks.

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