Reorganization of secondary and tertiary health care levels: impact on the outcomes of oral cancer screening in the São Paulo State, Brazil

This study presents the strategies for prevention and early detection of oral cancer by means of screening in the elderly population of São Paulo, the richest and the most populous state of Brazil. This research was a retrospective longitudinal study based on the analysis of secondary data. The variables - number of participating cities, coverage of screening, and number of suspicious and confirmed cases of oral cancer - were divided into two periods: 2001-2004 and 2005-2008. Data were analyzed statistically by the chi-square test at 5% significance level. The implementation of a nationwide public oral health policy in 2004 and the reorganization of the secondary and tertiary health care were evaluated as mediator factors able to interfere in the achieved outcomes. From 2001 to 2008, 2,229,273 oral examinations were performed. There was an addition of 205 participating cities by the end of the studied period (p<0.0001). The coverage of oral cancer screening increased from 4.1% to 16% (p<0.0001). There was a decrease in the number of suspicious lesions (from 9% in 2005 to 5% in 2008) (p<0.0001) and in the rate of confirmed oral cancer cases per 100,000 examinations (from 20.89 in 2001 to 10.40 in 2008) (p<0.0001). After 8 years of screening, there was a decrease in the number of suspicious lesions and confirmed cases of oral cancer in the population. The reorganization of secondary and tertiary health care levels of oral care seems to have contributed to modify these numbers, having a positive impact on the outcomes of oral cancer screening in the São Paulo State.

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Oral Cancer Screening in Elderly in Sao Paulo State, Brazil (2001 to 2009)

Pesquisa Brasileira em Odontopediatria e Clínica Integrada ◽

10.4034/pboci.2017.171.34 ◽

2017 ◽

Vol 17 (1) ◽

pp. 1-10

Author(s):

FCA Carrer ◽

EM Cossato ◽

C Cazal ◽

GA Pucca Júnior ◽

DP Silva ◽

...

Keyword(s):

Cancer Screening ◽

Oral Cancer ◽

Sao Paulo ◽

São Paulo ◽

Paulo State ◽

Oral Cancer Screening ◽

São Paulo State

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Organization of cervical cancer screening in Campinas and surrounding region, São Paulo State, Brazil

Cadernos de Saúde Pública ◽

10.1590/s0102-311x2006000900022 ◽

2006 ◽

Vol 22 (9) ◽

pp. 1909-1914 ◽

Cited By ~ 9

Author(s):

Luiz Carlos Zeferino ◽

José A. Pinotti ◽

Jessé P. Neves Jorge ◽

Maria Cristina A. Westin ◽

Julia K. Tambascia ◽

...

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Screening Program ◽

Sao Paulo ◽

Necessary Condition ◽

São Paulo ◽

Paulo State ◽

Cervical Cancer Screening Program ◽

São Paulo State

Cervical cancer screening remains a challenge in developing countries due to a complex array of problems. This paper aimed to describe the experience with organization of cervical cancer screening in three districts of Campinas and the surrounding region in São Paulo State, Brazil, and to report the resulting data. The program was organized in a pyramid format, and the health care hierarchy was defined according to the complexity and total number of medical procedures. Screening has been extended currently to 88 municipalities, of which 51 are equipped with colposcopy and eight have facilities for treating advanced cervical cancer. The standardized incidence rate for cervical cancer in Campinas was 14.2/100,000 women per year in 1993-1995, and the standardized mortality rate per district ranged from 2.7 to 3.0 per 100,000 women in 1997-1998. This project has clearly shown that hierarchical and decentralized organization of health procedures is a necessary condition for achieving the goals of an effective cervical cancer screening program.

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Managers' perspective on continuous health education in a region of São Paulo State

Revista da Escola de Enfermagem da USP ◽

10.1590/s0080-623420150000400018 ◽

2015 ◽

Vol 49 (4) ◽

pp. 0665-0673 ◽

Cited By ~ 4

Author(s):

Silvana Martins Mishima ◽

Allan Correa Aiub ◽

Anna Francine Gonçalo Rigato ◽

Cinira Magali Fortuna ◽

Silvia Matumoto ◽

...

Keyword(s):

Primary Care ◽

Health Care ◽

Health Education ◽

Management Practices ◽

Sao Paulo ◽

São Paulo ◽

Structured Interviews ◽

Paulo State ◽

São Paulo State ◽

Municipal Health

OBJECTIVEAnalysing the concepts of Continuous Health Education - CHE (EPS - in Portuguese), operated by municipal managers and translated into official documents.METHODQualitative research with the use of official documents and semi-structured interviews with the Municipal Health Secretaries or Coordinators of Primary Health Care in the Northeast Region of São Paulo State, and thematic analysis of empirical material.RESULTSResults indicate difficulties in the municipalities problematizing their management practices, services and health care; EPS tools presented are insufficient and unsatisfactory for amending the array of problems raised and are still far from the routine of Primary Care services.CONCLUSIONDespite efforts to implement EPS actions for the strengthening of primary care, the process appears to be incipient.

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The Changing Landscape: Geospatial, Epidemiologic Characteristics and Infectious Diseases of Inmates Living in a Region with a High Number of Prisons, Brazil

10.1101/2020.01.10.20016998 ◽

2020 ◽

Author(s):

Charlene Troiani do Nascimento ◽

Danilo Zangirolami Pena ◽

Rogério Giuffrida ◽

Fernanda Nobre Bandeira Monteiro ◽

Francisco Assis da Silva ◽

...

Keyword(s):

Health Care ◽

Infectious Diseases ◽

Population Growth ◽

Statistical Significance ◽

Sao Paulo ◽

List Type ◽

São Paulo ◽

Paulo State ◽

São Paulo State ◽

Epidemiologic Characteristics

ABSTRACTObjectiveWe determined the geospatial and epidemiologic characteristics and prevalence of HIV, tuberculosis, viral hepatitis, syphilis, and co-infections in inmates in 28 prisons.DesignThis is a regional, observational, retrospective, and descriptive study conducted from November 2017 to October 2018.SettingPrisons are located in the western and northwestern regions of São Paulo state, Brazil.MethodsData were obtained through a standard questionnaire from inmates with a diagnosis of infectious diseases and co-infections (HIV, hepatitis B virus, hepatitis C virus, syphilis, and tuberculosis), treatment, and time of incarceration. Locations of prisons and highways were obtained from shape file databases. Data on inhabitants, population growth, and Human Development Index were obtained from public agencies. Maps were constructed using geographic information system.ResultsA total of 37,497 individuals were enrolled in the study and 741 (1.97%) were diagnosed. HIV was the most prevalent disease (0.68%), followed by tuberculosis (0.66%), syphilis (0.2%), HCV (0.2%), and HBV (0.04%). HIV-syphilis was the most prevalent co-infection (odds ratio, 63.7; 95% confidence interval: 41.4, 96.7). There was a statistical significance (P<0.001) for those with HIV acquiring co-infections. In 21 units, there was no relationship between the number of prisoners and the prevalence of infectious diseases.Mean age was 35.82 years (SD, 10.41 years) and 57.9% had been in prison previously. Strategically, most prisons were constructed beside radial highways. A higher than expected population growth was observed in 17 municipalities in which prisons were constructed (47.2%).ConclusionsThis is one of the biggest studies in Brazil, and the prevalence of infectious diseases among inmates was lower than countrywide. Therefore, improvements in health care are necessary, mainly in screening for infectious diseases. Construction of large prisons beside the radial highways changed the landscape and prevented migration of people from small to large cities.Strengths and limitations of this studyThe western and northwestern regions of São Paulo state have the highest number of prisons in Brazil and the risk of infectious diseases in prisoners is higher than that in the general population.Few studies have addressed this issue countrywide and for this reason, we determined the prevalence of HIV, HBV, HCV, syphilis, tuberculosis and co-infections as well as epidemiologic characteristics in 37,497 inmates of 28 prisons.The data were obtained through a questionnaire sent to each prison health care unit. Due to lack of commitment to complete the questionaire and as a retrospective study, some important data cannot be measured and therefore are limitations of this study.We used geospatial analytic techniques to understand the geographic strategy used for the location and construction of the prisons.Most prisons were constructed in small-sized cities. We used the number of inhabitants, population growth and human developing index to analyze their impact on preventing migration and development in the municipalities in which prisons were constructed.

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Mathematical model describing CoViD-19 in São Paulo State, Brazil – Evaluating isolation as control mechanism and forecasting epidemiological scenarios of release

10.1101/2020.04.29.20084830 ◽

2020 ◽

Author(s):

Hyun Mo Yang ◽

Luis Pedro Lombardi Junior ◽

Fabio Fernandes Morato Castro ◽

Ariana Campos Yang

Keyword(s):

Mathematical Model ◽

Health Care ◽

Control Mechanism ◽

Reproduction Number ◽

Sao Paulo ◽

Model Parameters ◽

São Paulo ◽

Paulo State ◽

São Paulo State ◽

The Basic Reproduction Number

AbstractWe formulated a mathematical model considering young (below 60 years old) and elder (above 60 years) subpopulations to describe the introduction and dissemination of new coronavirus epidemics in the São Paulo State, Brazil. From the data collected in São Paulo State, we estimated the model parameters and calculated the basic reproduction number as R0 = 6.828. Considering isolation as a control mechanism, we varied the releasing proportions of young and elder persons to assess their epidemiological impacts. The best scenarios were release of young persons, but maintaining elder persons isolated. To avoid the collapse of the health care system, the isolation must be at least 80%.

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