Sistema Regional de Información
en línea para Revistas Científicas de América Latina,
el Caribe, España y Portugal

Introduction: Dengue is an endemic infectious disease in tropical and subtropical regions. Knowing the factors associated with dengue cases is necessary to organize the health care system and ensure preventive measures and proper clinical management. Objective: To analyze the factors associated with dengue virus infection in cases reported to the health surveillance system. Methods: This is a cross-sectional study of secondary data on suspected dengue cases reported to the Information System on Diseases of Compulsory Declaration. The sample included individuals with a report of suspected dengue made between January 1, 2016, and December 31, 2020, who lived in São Mateus (Espírito Santo). We calculated the relative and absolute frequencies of the variables and used Poisson regression with robust variance to estimate the prevalence ratio (PR) and 95% confidence intervals (95%CI). Results: A total of 4,547 suspected dengue cases were reported, of which 2,438 (53.8%) were confirmed, 844 (27.7%) were confirmed by laboratory criteria, nine presented warning signs, three had severe dengue, 35 required hospitalization, and four died from dengue. The prevalence of dengue was higher in the age group ≥60 years (PR=1.28; 95%CI 1.14–1.45), individuals with five to eight years of schooling (PR=1.47; 95%CI 1.19–1.81), with positive tourniquet test (PR=1.40; 95%CI 1.22–1.60), and diabetes mellitus (PR=4.19; 95%CI 1.91–9.20). Conclusions: Dengue was more prevalent among individuals aged 60 years and older, with five to eight years of schooling, diabetes mellitus, positive tourniquet test, and leukopenia. These groups are more likely to develop severe dengue, requiring efforts from health care and surveillance services for their clinical management.

Introduction: The Programa Telessaúde (Telehealth Program) performs its role in health care, especially in area that do not offer specialized structure or medical care in Brazil. In Pará, this center provides assistance to 144 cities in the state. Objective: Outline the profile of the teleassistance carried out in the state of Pará. Methods: The study design was a retrospective, quantitative, observational analysis of the program’s database. The source consulted was the Telessaúde-Pará platform with the consultations carried out between 2018 and 2019. Results: It was found that, in this period, 208 teleconsultations were carried out. Medical Doctors were the professionals who most frequently requested the assistance. The specialists who responded to requests most frequently were Family Physicians, Neurologists, and Dermatologists. The most frequent questions were related to pharmacological treatment and diagnosis. The use of teleconsultation prevented referrals in 76.9% of cases. Among the professionals who use the platform, over 90% declare being satisfied with the service. Conclusions: The data demonstrate the importance of the program in assisting the resolvability of Primary Health Care, even though there is still little adherence to it and underutilization by users.

Introduction: Skin cancer is the most prevalent cancer in Brazil, especially in the South region. Despite its high prevalence, it is a potentially preventable comorbidity with sun protection measures. Objective: To analyze photoprotection habits in patients in primary care. Methods: This was a cross-sectional study, with a quantitative approach and analytical-descriptive purposes, with a sample of 374 patients over 18 years old, selected from a primary health unit in the South region of Brazil. As instruments, the Sun Exposure Protection Index questionnaire and a sociodemographic questionnaire formulated for this study were used. Results: It was found that a large portion of patients are at high risk in relation to sun exposure. Nearly half do not use sunscreen, and most do not use physical barrier methods to protect themselves from the sun. The risk resulting from sun exposure was higher in men (p=0.007), in people with darker skin tone (p=0.033) and in individuals with less education (p=0.037). The propensity to improve photoprotection habits was lower in people with darker skin (p=0.010) and in individuals with less education (p=0.019). In general, it was found that the greater the risk of the individual, the worse the propensity to reduce it with photoprotection measures (p<0.001). Conclusions: A large portion of patients are at high risk in relation to sun exposure. It is up to health professionals to promote awareness of the risks of inadvertent exposure to the sun and guide healthy behaviors in photoprotection.

Problem: Changes in the Brazilian morbidity and mortality profile have highlighted the importance of genetic diseases, but epidemiological data are still limited. Since 2014, the National Policy for Comprehensive Care of People with Rare Diseases aims to foster comprehensive care in The Brazilian Unified Health System (Sistema Único de Saúde – SUS). However, primary care professionals are not yet sufficiently trained to deal with genetic and rare diseases. The objective of the study was to present the experience gained by a Family and Community Medicine resident in a reference service in genetic and rare diseases. Methods: This is an experience report of an elective internship developed during eight weeks at the Medical Genetics Service at Hospital Universitário Professor Edgard Santos of Universidade Federal da Bahia (HUPES-UFBA). The internship consisted of rotations in outpatient clinics, laboratory, infirmary, and participation in theoretical classes. Results: Residents had contact with genetics knowledge and tools that are useful to their practice as a family physician, assisting in the care of people with genetic and rare diseases. They also identified how primary health care tools and principles enhance care in Medical Genetics. Conclusion: The experience gave the residents a better understanding of their role within the line of care for rare diseases, reinforcing the primary care professionals’ responsibility for comprehensive care.

Problem: Primary Health Care required several adaptations to ensure access to health due to the new coronavirus (COVID-19) pandemic. To maintain the community informed at the beginning of the pandemic, a group of health professional residents of the Costa e Silva Health Center in Porto Alegre, Brazil, organized a radio program broadcasted via WhatsApp called “Stay at Home.” This article aims to reflect on the creation of the program and its developments. Methods: This is an experience report of a radio created based on the field diary of those involved and the experience and reflections about it. Results: The “Stay at Home” Program is an expanded form of radio that is not limited to Hertzian broadcasting, but rather to a community radio broadcasting initiative in its social, participatory, and cultural essence. The team’s voices suggest security for the community as a space for micropolitics and empowerment of autonomy in response to misinformation. Conclusions: The “Stay at Home” Program worked as a form of access to health, popular education, law, resistance, memory, and art. 

Routine vaccination/immunization is intrinsic to the Primary Health Care practice throughout Brazil. For the past few years, the country has faced issues such as the fall and heterogeneity of vaccination uptake rates, motivated by different causes, one of which is vaccine hesitancy. This perspective article intends to offer Primary Health Care professionals another look at the phenomenon of vaccine hesitancy, with multiple and context-specific lenses, which allow them to approach the theme and understand it in its complexity.

Introduction: In January 2020, SARS-CoV-2 virus was isolated in China as the cause of COVID-19 disease, later on disseminating globally as a pandemic. Primary health care (PHC) plays a crucial role in the global response to this threat, as it is one of the entrances for the public health system in Brazil, acting in coordenating health care as well, playing a crucial role in a prompt response to epidemics and outrbreaks. In this scenario, health care professionals working in PHC are potentially exposed to mental suffering, especially in a pandemic setting. Objective: To analyze the level of adverse mental health outcomes among health care professionals working ia a PHC setting, as well as possible relations between mental suffering and working during the COVID-19 pandemic. Methods: We conducted an epidemiological, cross-sectional, quantitative and exploratory study, in which an online survey was applied, investigating sociodemographic and occupational data, as well as assessing adverse mental health outcomes using the Kessler Psychological Distress Scale (K10), followed by statistical analysis of the data. Results: High risk for adverse mental health outcomes was found in 48.6% of respondents, with a mean of 66.8±21.7% of negative symptoms being related do COVID-19 pandemic. In addition, in the 30 days prior to the moment when each participant answered the “survey”, 73.4% (corresponding to 72.5% of nurses and 73.9% of doctors) reported a higher frequency than usual in the occurrence of feelings, investigated on the K10 scale. The average percentage of these feelings attributed to insecurities/uncertainties/fears related to the COVID-19 pandemic was 66.8% (with a standard deviation of ±21.7%). Almost all respondents (99.1%) considered it possible to transmit the infection to family members or close people. Thirty-seven of participants (33.94% of the study population) declared that they had used an anxiolytic or antidepressant in the 30 days before the survey was completed, prescribed by an assistant physician with whom they performed follow-up (19 participants), or by self-medication (18 participants). The cause of mental suffering was the possibility of transmitting COVID-19 to relatives. The was an association between high risk for adverse mental health outcomes and participants’ perception (total and doctors) of available personal protective equipment, while no other statistically significant associatoin was found. Conclusions: In a scenario of constant fear and potential risk of COVID-19 infection in this group of professionals, mental suffering in this group hovers as a permanent threat. It is important to adopt strategies to improve mental well-being of health care professionals working in a PHC setting, and also to carry out further studies on the subject.

Introduction: Primary Health Care is responsible for coordinating care and providing continuous care for the population under its responsibility. Due to its proximity and connection with the community and knowledge of the territory’s main problems, the Family Health Strategy presents greater problem-solving capacity of health demands, thus reducing the burden on medium- and high-complexity services. To assess whether Primary Health Care has performed its role with effectiveness and quality, instruments capable of verifying this situation in a simple and concise way are necessary. One of them is the Hospitalizations due to Ambulatory Care Sensitive Conditions. Objective: To analyze the reasons for hospitalization due to ambulatory care sensitive conditions in Gramado, state of Rio Grande do Sul – Brazil, from 2015 to 2021. Methods: Ecological time series study, with a quantitative approach and descriptive characteristic. Data were collected from the Hospital Information System from SUS and the Brazilian List of Ambulatory Care Sensitive Conditions package program was used in the R program, which converts the data of all hospitalizations by municipality of reference through the Inpatient Hospital Authorization. For data analysis, the research was divided into two axes: clinical-epidemiological and demographic aspects. The causes of hospitalizations due to ambulatory care sensitive conditions were based on the list of the Brazilian Ministry of Health. Results: Hospitalizations due to ambulatory care sensitive conditions accounted for 22% (14,083) of the total number of hospitalizations in the city of Gramado. There were more hospitalizations of women (54.1%) compared with men (45.9%). The three main groups with the highest percentage of hospitalization due to ambulatory care sensitive conditions were pulmonary diseases (18.4%), followed by heart failure (17.6%), and kidney and urinary tract infection (14.7%). The age group with the highest prevalence was users aged 60 years or older (57.6%), followed by those aged 20 to 59 years (30.7%), and 0 to 4 years (6.7%). Conclusions: The results of the behavior of hospitalizations in Gramado in the analyzed years point to a reduction in their proportion in relation to the total number of hospitalizations in the city, but when evaluating the standardized rates by sex and city population, these rates are stable throughout the assessed years

Introduction: Family planning within the scope of primary health care comprises an essential set of actions capable of guaranteeing the right to reproductive health for patients of the Brazilian Unified Health System. However, several obstacles prevent its full implementation, causing many citizens not to access this service. Objective: To analyze the role of family planning in the construction of parenting from the perspective of users of primary health care services in Fortaleza (state of Ceará, Brazil). Methods: Cross-sectional mixed methods study with concurrent data triangulation, according to Creswell and Clack. For the quantitative phase, 60 parents were selected to respond to a structured questionnaire, of whom 12 participated in the qualitative phase through semi-structured interviews. Results: Regarding the responses to the questionnaire, most participants had their first child between the ages of 17 and 20 years, currently have two children, and remain with the same partner as when they had their first child. The interviews showed lack of knowledge of family planning, attributed to the scarcity of assistance, lack of acceptance by healthcare professionals, inefficiency of policies, and lack of interest on the part of the population. The triangulation of methods showed complementation and corroboration between quantitative and qualitative data. Data integration enabled us to observe an appeal to the population’s co-responsibility in relation to family planning and the need for more training and awareness of the topic among healthcare professionals. Conclusions: It is necessary to advance the family planning approach in the context of primary health care, in such a way that it can become an actual place of care, exchange, and development of effective and affective parenting.

Problem: The National Curriculum Guidelines for Medicine Courses advocate the health network as the main locus of academic training, which allows the integration of teaching into the Unified Health System (SUS). To meet this prerogative, new teaching-learning strategies should be adopted by educational institutions in collaboration with the health system. Methods: Reports of the experience of Family and Community Medicine professors and residents concerning the development of activities of internship teaching in an initial course in postgraduate medicine. The interaction of the professor and residents with the medical students was carried out in an online format because of the SARS-CoV-2 pandemic. Results: Development of teaching activities in the health network, with practical experiences of the principles of the Unified Health System and primary health care. Conclusions: Pooling of knowledge of undergraduates and resident physicians at the university united the learning needs and promoted a creative and reflective interaction between young physicians and those entering the medical course. An initiative that was relevant for the initiation in teaching of resident physicians and for the initial learning of undergraduates.