Palavras-chave: Sífilis; Sífilis Congênita; Gestantes; Estratégia Saúde da Família; Estudos Ecológicos

Objective: To analyze temporal trend and spatial distribution of syphilis in pregnancy and congenital syphilis in Goiás State, Brazil, between 2007 and 2017. Methods: This was an ecological time series and spatial distribution study with data obtained from the Notifiable Health Conditions Information System. Prais-Winsten Regression was used to analyze indicator trends by health macro-region. Descriptive spatial analysis was performed to verify case distribution in three different years in the period. Results: Between 2007 and 2017, 7,679 cases of syphilis in pregnancy and 1,554 congenital syphilis cases were reported. A rising trend was found in the rates of syphilis in pregnancy (annual percent change [APC] = 18.0 – 95% confidence interval [95%CI] 15.3;20.8) as well as in congenital syphilis rates (APC=16.8 – 95%CI 20.1;33.8); and a 326% increase in the number of municipalities with a congenital syphilis incidence rate >0.5/1,000 live births. Conclusion: Growth in syphilis in pregnancy and congenital syphilis detection rates was identified, as was growth in the number of municipalities reporting cases.

Background: More than 5 years after the Zika virus (ZIKV) epidemic, Zika infection remains a major concern in regions with high Aedes infestation. The objectives of this study were (i) to identify clusters of ZIKV infection and microcephaly, and/or central nervous system (CNS) alterations associated with congenital infection during the epidemic peak in 2016 and subsequently, in 2017 and 2018; (ii) to measure the non-spatial correlation between ZIKV infection and microcephaly and/or CNS alterations associated with congenital infection; and (iii) to analyse the sociodemographic/economic, health, and environmental determinants associated with the incidence of ZIKV in a region of high infestation by Aedes aegypti in the Central-West Region of Brazil. Methods: This ecological study analysed 246 municipalities in the state of Goiás (6.9 million inhabitants). The data were obtained from the Information System for Notifiable Diseases (ZIKV cases) and the Public Health Event Registry (microcephaly and/or CNS alterations associated with congenital infection). Incidence rates and prevalence of ZIKA infection were smoothed by an empirical Bayesian estimator (LEbayes), producing the local empirical Bayesian rate (LEBR). In the spatial analysis, ZIKV infection and microcephaly cases were georeferenced by the municipality of residence for 2016 and grouped for 2017 and 2018. Global Moran's I and the Hot Spot Analysis tool (Getis-Ord Gi* statistics) were used to analyse the spatial autocorrelation and clusters of ZIKV infection and microcephaly, respectively. A generalised linear model from the Poisson family was used to assess the association between ecological determinants and the smoothing incidence rate of ZIKV infection. Results: A total of 9892 cases of acute ZIKV infection and 121 cases of microcephaly were confirmed. The mean LEBR of the ZIKV infection in the 246 municipalities was 22.3 cases/100,000 inhabitants in 2016, and 10.3 cases/100,000 inhabitants in 2017 and 2018. The LEBR of the prevalence rate of microcephaly and/or CNS alterations associated with congenital infection was 7 cases/10,000 live births in 2016 and 2 cases/10,000 live births during 2017–2018. Hotspots of ZIKV infection and microcephaly cases were identified in the capital and neighbouring municipalities in 2016, with new clusters in the following years. In a multiple regression Poisson analysis, ZIKV infection was associated with higher population density, the incidence of dengue, Aedes larvae infestation index, and average rainfall. The important determinant of ZIKV infection incidence reduction was the increase in households attended by endemic disease control agents. Conclusions: Our analyses were able to capture, in a more granular way, aspects that make it possible to inform public managers of the sentinel areas identified in the post-epidemic hotspots.

Resumo Objetivo: Analisar a tendência dos indicadores da hanseníase em Goiás no período de 2001 a 2017. Métodos: Foi realizado estudo ecológico de séries temporais. Indicadores de morbidade e operacionais da hanseníase foram calculados a partir de dados do Sistema de Informação de Agravos de Notificação (Sinan). Utilizou-se regressão de Prais-Winsten para análise de tendência. Resultados: Verificou-se tendência decrescente na taxa de detecção na população geral (variação percentual anual [VPA] = -6,8 – IC95% -8,2;-5,4) e em menores de 15 anos de idade (VPA = -7,2 – IC95% -8,5;-5,9); e tendência crescente na proporção de grau 2 de incapacidade física (VPA = 3,7 – IC95% 2,0;5,3) e na proporção de incapacidade física examinada (VPA = 0,6 – IC95% 0,3;0,8); as proporções de cura e de contatos examinados mostraram-se estáveis. Conclusão: As taxas de detecção diminuíram, enquanto as proporções de grau 2 de incapacidade física e de incapacidade física examinada cresceram.

OBJECTIVE: To investigate the epidemiology of tobacco use and nicotine dependence in a sample of truck drivers in Brazil. METHODS: Between 2015 and 2016, a cross-sectional study was conducted on 624 truck drivers who operate on the BR-050 highway in Brazil. Participants were interviewed about sociodemographic data, occupational characteristics, mental health, behavioral data, and tobacco use. Then, the Fagerstrom Test for Nicotine Dependence (FTND) was used to verify nicotine dependence in smoking truck drivers. Logistic regression and linear regression were also used to verify factors associated with tobacco use in the previous 30 days and nicotine dependence scores, respectively. RESULTS: The prevalence of tobacco use among truck drivers was 21.1% (n = 132; 95%CI: 18.1–24.5). Of the total number of smokers who responded to the FTND (n = 118; 89.4%), most had high/very high nicotinic dependence (68.6%; 95%CI: 59.8–76.3). Tobacco use was associated with absence of religion (adjusted odds ratio [AOR]: 2.60; 95%CI: 1.35–5.01), employment relationship of the contract (AOR = 1.98; 95%CI: 1.26–3.13); > 12 hours daily working time (AOR = 1.80; 95%CI: 1.09–2.98) and alcohol use in the previous 30 days (AOR = 2.92; 95%CI: 1.86–4.57). Irregular physical activity was associated with higher scores of nicotine dependence (β = 1.87; 95%CI: 0.55–3.19). CONCLUSION: The results showed a high prevalence of tobacco use and high/very high nicotine dependence among the truck drivers.

Objetivo: investigar a qualidade de vida de estudantes do curso técnico em enfermagem e os desafios associados à formação profissional. Método: trata-se de um estudo quantitativo, descritivo, observacional, transversal e analítico, com discentes de uma instituição federal de ensino. Coletaram-se os dados utilizando o questionário WHOQOL-breve e o formulário com variáveis complementares. Empregaram-se, na análise bivariada, o teste t de student e a correlação de Pearson. Realizou-se a análise de regressão linear múltipla para verificar os fatores associados aos escores de qualidade de vida (p<0,05). Resultados: compôs-se o estudo por 165 discentes. Evidenciou-se, no domínio social, melhor avaliação média e a pior avaliação foi o domínio meio ambiente. Encontraram-se discentes com vontade de desistir do curso com escore médio de qualidade de vida menor em todos os domínios, sendo que aqueles que relataram dificuldade de se manter no curso por razões financeiras tiveram escores menores nos domínios físico (p=0,024) e ambiental (p<0,001). Conclusão: aferiu-se a pior qualidade de vida entre discentes com fragilidades nas redes de apoio social e financeira, o que pode impactar o rendimento escolar e o risco de evasão. Descritores: Qualidade de Vida; Estudantes de Enfermagem; Avaliação em Saúde; Educação; Enfermagem; Estudantes de Ciências da Saúde.AbstractObjective: to investigate the quality of life of nursing technical students and the challenges associated with vocational training. Method: this is a quantitative, descriptive, observational, cross-sectional and analytical study with students from a federal educational institution. Data was collected using the WHOQOL-brief questionnaire and the form with complementary variables. In the bivariate analysis, the Student's t test and Pearson's correlation were used. Multiple linear regression analysis was performed to verify factors associated with quality of life scores (p <0.05). Results: the study was composed by 165 students. In the social domain, the best average rating was evidenced and the worst one was the environment domain. Students were willing to drop out of the course with a lower average quality of life score in all domains, and those who reported difficulty in maintaining the course for financial reasons had lower scores in the physical (p = 0.024) and environmental domains. (p <0.001). Conclusion: the worst quality of life was assessed among students with weaknesses in social and financial support networks, which may impact school performance and the risk of dropout. Descriptors: Quality of Life; Students, Nursing; Health Evaluation; Education; Nursing, Students, Health Occupations. ResumenObjetivo: investigar la calidad de vida de los estudiantes técnicos de enfermería y los desafíos asociados con la formación profesional. Método: este es un estudio cuantitativo, descriptivo, observacional, transversal y analítico con estudiantes de una institución educativa federal. Los datos fueron recolectados utilizando el cuestionario breve WHOQOL y el formulario con variables complementarias. En el análisis bivariado, se utilizaron la prueba t de Student y la correlación de Pearson. Se realizó un análisis de regresión lineal múltiple para verificar los factores asociados con los puntajes de calidad de vida (p <0.05). Resultados: el estudio estuvo compuesto por 165 estudiantes. En el dominio social, se evidenció la mejor calificación promedio y la peor fue el dominio del medio ambiente. Los estudiantes estaban dispuestos a abandonar el curso con un puntaje promedio de calidad de vida más bajo en todos los dominios, y aquellos que informaron dificultades para mantener el curso por razones financieras tuvieron puntajes más bajos en el dominio físico (p = 0.024) y ambiental (p <0,001). Conclusión: se evaluó la peor calidad de vida entre los estudiantes con debilidades en las redes de apoyo social y financiero, lo que puede afectar el rendimiento escolar y el riesgo de abandono escolar. Descriptores: Calidad de Vida; Estudiantes de Enfermería; Evaluación en Salud; Educación; Enfermería; Estudiantes del Área de la Salud.