Secretaria de Estado da Saude de Sao Paulo

São Paulo de Olivença, Brazil

Secretaria de Estado da Saude de Sao Paulo

São Paulo de Olivença, Brazil
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Kezh N.H.P.,Secretaria de Estado da Saude de Sao Paulo | Bogus C.M.,University of Sao Paulo | Martins C.L.,University of Sao Paulo
Saude e Sociedade | Year: 2016

The Municipal Council of Health is a collegiate body of social participation in the field of public health policies. Representative and deliberative council is made up of users, workers and managers in the health sector at the municipal level. This article aims to describe and analyze the participation of health workers segment in the Municipal Health Council of Guarulhos, São Paulo, Brazil. The approach was qualitative and the data were collected through documentary analysis observation of Council meetings and semi-structured interviews. As a result, it was found that members of the city council do not identify clearly the representatives of the segment of workers and unaware of the role of this segment and have an expectation of the scientific-technical role to be played by them. In the municipality of Guarulhos, the worker segment makes up with the segment managers a group called “health promoters”. It was observed that this contributed to the dilution of its role, highlighting the barriers and obstacles to the effective participation of civil society in decisions relating to local health policies. Distortions in representation of the segments that compose the council contribute to accentuate the barriers and obstacles to the effective participation of civil society in decisions about local health policies. © 2016, UNIV SAOPAULO. All rights reserved.

Patel M.M.,Centers for Disease Control and Prevention | Lopez-Collada V.R.,National Center for Child and Adolescent Health | Bulhoes M.M.,Centers for Disease Control and Prevention | De Oliveira L.H.,Pan American Health Organization | And 37 more authors.
New England Journal of Medicine | Year: 2011

Background: Because postlicensure surveillance determined that a previous rotavirus vaccine, RotaShield, caused intussusception in 1 of every 10,000 recipients, we assessed the association of the new monovalent rotavirus vaccine (RV1) with intussusception after routine immunization of infants in Mexico and Brazil. Methods: We used case-series and case-control methods to assess the association between RV1 and intussusception. Infants with intussusception were identified through active surveillance at 69 hospitals (16 in Mexico and 53 in Brazil), and age-matched infants from the same neighborhood were enrolled as controls. Vaccination dates were verified by a review of vaccination cards or clinic records. Results: We enrolled 615 case patients (285 in Mexico and 330 in Brazil) and 2050 controls. An increased risk of intussusception 1 to 7 days after the first dose of RV1 was identified among infants in Mexico with the use of both the case-series method (incidence ratio, 5.3; 95% confidence interval [CI], 3.0 to 9.3) and the case-control method (odds ratio, 5.8; 95% CI, 2.6 to 13.0). No significant risk was found after the first dose among infants in Brazil, but an increased risk, albeit smaller than that seen after the first dose in Mexico - an increase by a factor of 1.9 to 2.6 - was seen 1 to 7 days after the second dose. A combined annual excess of 96 cases of intussusception in Mexico (approximately 1 per 51,000 infants) and in Brazil (approximately 1 per 68,000 infants) and of 5 deaths due to intussusception was attributable to RV1. However, RV1 prevented approximately 80,000 hospitalizations and 1300 deaths from diarrhea each year in these two countries. Conclusions: RV1 was associated with a short-term risk of intussusception in approximately 1 of every 51,000 to 68,000 vaccinated infants. The absolute number of deaths and hospitalizations averted because of vaccination far exceeded the number of intussusception cases that may have been associated with vaccination. (Funded in part by the GAVI Alliance and the U.S. Department of Health and Human Services.) Copyright © 2011 Massachusetts Medical Society.

PubMed | Epidemic Intelligence Service, Secretaria de Estado da Saude de Sao Paulo, Field Epidemiology Training Program Sao Paulo State EPISUS SP and Centers for Diseases Control and Prevention
Type: Journal Article | Journal: Jornal de pediatria | Year: 2016

Intussusception surveillance was initiated after the nationwide introduction of live attenuated monovalent rotavirus vaccine (RV1). The objective is to assess the epidemiology of intussusception and compare the number of cases before and after the introduction of rotavirus vaccine.Cases of intussusception occurring between March 2006 and January 2008 were identified through a prospective enhanced passive surveillance system established in sentinel state hospitals. Retrospective review of medical records was used to identify cases, which occurred in sentinel hospitals between January 2001 and February 2006.From 2001 to 2008, 331 intussusception cases were identified, 59.5% were male, with peak incidence among those 18-24 weeks of age. Overall <10% of cases were among infants 6-14 weeks of age (when the first dose of RV1 is administered). The most frequently observed signs or symptoms of intussusception included vomiting (89.4%), bloody stool (75.5%), and abdominal distention (71.8%). A majority (92.1%) of the case-patients required surgery for treatment; 31.8% of those who underwent surgery required bowel resection, and 13 (3.9%) died. Among the 21 hospitals that reported cases throughout the entire surveillance period (2001-2008), the number of intussusception events during 2007 (n=26) and 2008 (n=19) was not greater than the average annual number (n=31, range 24-42) during baseline years 2001-2005.Although this analysis did not identify an increase in intussusception cases during the two years after RV1 introduction, these results support the need for special epidemiologic methods to assess the potential link between rotavirus vaccine and this very rare adverse event.

Francisco P.M.S.B.,University of Campinas | de Azevedo Barros M.B.,University of Campinas | Segri N.J.,University of Sao Paulo | Cesar C.L.G.,University of Sao Paulo | Alves M.C.G.P.,Secretaria de Estado da Saude de Sao Paulo
Cadernos de Saude Publica | Year: 2011

The study assesses differences in socio-demographic, lifestyle, and health-related characteristics among adults with and without residential telephone lines using data from a health survey in Campinas, São Paulo State, Brazil, (2008-2009), through a population-based cross-sectional survey that included 2,637 adults (18 years and older). Descriptive statistics, chi-square tests, prevalence, and 95% confidence intervals were used in the analysis. Estimates were also made of the bias associated with non-coverage of the population without telephones before and after adjusting for post-stratification. The impact of bias on the confidence intervals was assessed by the bias ratio. Some 76% of respondents owned residential telephone lines. Except for marital status, differences were observed in socio-demographic data according to ownership of residential telephones. After post-stratification adjustment, there was a decrease in bias estimates for variables associated with ownership of telephone lines. However, except for osteoporosis, post-stratification adjustment was insufficient to correct the non-coverage bias.

Mendes T.A.B.,University of Sao Paulo | Goldbaum M.,University of Sao Paulo | Segri N.J.,University of Sao Paulo | de Azevedo Barros M.B.,University of Campinas | And 3 more authors.
Cadernos de Saude Publica | Year: 2011

This study analyzes factors associated with diabetes prevalence according to demographic and socioeconomic variables, health status, and lifestyle among 872 elderly living in the city of São Paulo, Brazil, in addition to health services utilization and control measures and practices. Reported diabetes prevalence among the elderly was 17.9%, a higher rate than in the adult population. The highest diabetes rates in elderly individuals were associated with: bad or very bad self-rated health, never having consumed alcohol or having stopped drinking, widowhood, and at least one hospitalization in the previous 12 months, independently of age. Among the elderly, 69.9% routinely sought out health services due to their diabetes, and 96.1% received treatment at the services they turned to. There is a lack of information, knowledge, and use of control measures for diabetes among the elderly. Health policies focusing on professional training and family orientation are needed to promote lifestyle changes among the elderly.

Francisco P.M.S.B.,University of Campinas | Belon A.P.,University of Campinas | Barros M.B.A.,University of Campinas | Carandina L.,São Paulo State University | And 3 more authors.
Cadernos de Saude Publica | Year: 2010

The aim of the study was to assess the prevalence of self-reported diabetes in the elderly, identifying associated factors, knowledge, and practices related to treatment options. This was a cross-sectional population-based study with stratified clustered two-stage sampling in six municipalities in the State of São Paulo, Brazil. Among the 1,949 elderly, 15.4% presented self-reported diabetes. Body mass index and exercising were statistically associated with diabetes. There was a significant difference between diabetics and non-diabetics in terms of self-rated health, hospitalization, self-reported illness in the previous two weeks, and report of the following diseases: hypertension, anemia, chronic kidney disease, and heart disease. In terms of per capita family income, there was no difference in regular medical visits, participation in discussion groups, and control practices. The findings show the need for behavior changes to prevent and control diabetes and its complications. Educational interventions are needed to expand the coverage of diabetes care.

Zaitune M.P.A.,University of Campinas | Barros M.B.A.,University of Campinas | Cesar C.L.G.,University of Sao Paulo | Carandina L.,São Paulo State University | And 2 more authors.
Cadernos de Saude Publica | Year: 2010

The purpose of this study was to measure the prevalence of global and leisure-time physical activity and associated factors in the elderly. This was a population-based cross-sectional study covering a multiple-stage sample of 1,950 subjects 60 years or older living in areas of São Paulo State, Brazil. Prevalence of global physical activity (assessed through the short version of the International Physical Activity Questionnaire - IPAQ) was 73.9%, and prevalence of leisure-time physical activity was 28.4%. The results highlight the differences between factors associated with global and leisure-time physical activities. The social groups most prone to overall sedentary lifestyle and especially to lack of leisure-time physical activity should be the main targets of health policies aimed at promoting healthier lifestyles.

Amorim V.M.S.L.,University of Campinas | de Barros M.B.A.,University of Campinas | Cesar C.L.G.,University of Sao Paulo | Goldbaum M.,University of Sao Paulo | And 2 more authors.
Cadernos de Saude Publica | Year: 2011

The aim of this study was to analyze the prevalence of prostrate cancer screening among men aged 50 years or older based on socioeconomic, demographic, and health-related behavioral variables and the presence of morbidity. A population- based cross-sectional study was performed. The following factors were associated with failure to undergo screening: age under 70 years; less than eight years of schooling; per capita household income less than one-half the minimum wage; not having diabetes; lack of visual impairment; and lack of visit to the dentist in the previous year. The Brazilian public healthcare system accounted for 41% of the reported prostate cancer screening tests. According to the present study, despite controversy over the effectiveness of digital rectal examination and prostrate-specific antigen for detecting prostate cancer, a significant portion of the male population has been undergoing these tests, the access to which displays significant socioeconomic inequalities.

Opromolla P.A.,Secretaria de Estado da Saude de Sao Paulo | Laurenti R.,University of Sao Paulo
Revista de Saude Publica | Year: 2011

Leprosy is an infectious contagious disease known since Biblical times. Global effort for disease control reveals intricate convergences of national history and of medical, governmental, and international policies. The study describes the history of Hansen's disease and control actions undertaken in the state of São Paulo starting in the 19th century and its connection with the development of public health in that state, by means of a bibliographic and documental analysis.

More than 20 years after the creation of Sistema Único de Saúde (SUS - Brazil's National Health System) and after a long period of improvements in primary health care (PHC) in the State of São Paulo, Brazil, one of the most important tasks is to evaluate their processes and their health outcomes. The aim of this study is to analyze the profile of indicators related to PHC in the State of São Paulo during the last decade (2000 to 2009). Fourteen indicators related to PHC structure, SUS performance and to health conditions were selected. These indicators were analyzed considering the entire State of São Paulo and by groups of municipalities defined by their population (small: less than 20 thousand inhabitants; medium: between 20 and 100 thousand inhabitants; large: more than 100 thousand inhabitants) and by their wealth (low; high). Almost all the 14 selected indicators improved along the period. The PHC structure-related indicators had a global improvement, and the groups of small municipalities showed better levels along the entire period. The SUS performance-related indicators showed differences among groups of municipalities. The group of large municipalities obtained lower hospitalization rates in conditions preventable by PHC. Nevertheless, this same group had the lowest rates of pap smear tests. The group of small and high wealth municipalities presented better trends in health condition indicators. The group of large municipalities presented the highest rates of mortality caused by cervical cancer and cardiovascular disease. In conclusion, there is a clear improvement in PHC in terms of structure, health care performance and health conditions.

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