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Background: Chikungunya is an arbovirus, transmitted by Aedes mosquitoes, which emerged in the Americas in 2013 and spread rapidly to almost every country on this continent. In Brazil, where the first cases were detected in 2014, it currently has reached all regions of this country and more than 900,000 cases were reported. The clinical spectrum of chikungunya ranges from an acute self-limiting form to disabling chronic forms. The purpose of this study was to estimate the seroprevalence of chikungunya infection in a large Brazilian city and investigate the association between viral circulation and living condition. Methodology/principal findings: We conducted a population-based ecological study in selected Sentinel Areas (SA) through household interviews and a serologic survey in 2016/2017. The sample was of 1,981 individuals randomly selected. The CHIKV seroprevalence was 22.1% (17.1 IgG, 2.3 IgM, and 1.4 IgG and IgM) and varied between SA from 2.0% to 70.5%. The seroprevalence was significantly lower in SA with high living conditions compared to SA with low living condition. There was a positive association between CHIKV seroprevalence and population density (r = 0.2389; p = 0.02033). Conclusions/significance: The seroprevalence in this city was 2.6 times lower than the 57% observed in a study conducted in the epicentre of the CHIKV epidemic of this same urban centre. So, the herd immunity in this general population, after four years of circulation of this agent is relatively low. It indicates that CHIKV transmission may persist in that city, either in endemic form or in the form of a new epidemic, because the vector infestation is persistent. Besides, the significantly lower seroprevalences in SA of higher Living Condition suggest that beyond the surveillance of the disease, vector control and specific actions of basic sanitation, the reduction of the incidence of this infection also depends on the improvement of the general living conditions of the population. Author summary: Chikungunya is a disease caused by viruses transmitted by Aedes mosquitoes. It stands out because it can produce chronic cases and disabling forms. This survey was conducted in a large city in Brazil, involving 1,981 people living in different living conditions/LC, distributed in 30 urban areas. Interviews and blood collection were performed to know the seroprevalence of chikungunya virus (CHIKV). The global seroprevalence was 22.1%, ranged from 2.0 to 70.5%. The areas where the highest and lowest seroprevalence were of low LC, but population density was different among them, which was related to seroprevalence. The mosquito index was not associated with the seroprevalence. Our results showed that lower seroprevalence than another survey conducted in the epicentre of the epidemic of this same city. So, a considerable proportion of the population of Feira de Santana is susceptible to the CHIKV. Possibly the virus will continue to circulate and manifest itself as endemic or epidemic, as long as LC remain favourable to the reproduction of the transmitting vector of CHIKV. [ABSTRACT FROM AUTHOR]

Objective: This study investigated whether the presence of care workers who completed a specialization course on family health was associated with improved care and maternal and child health indicators in municipalities in the state of Mato Grosso do Sul, Brazil. Methods: Negative binomial regression models with fixed effects were used for the 79 municipalities in the state of Mato Grosso do Sul, with repeated observations for the period 2009–2015. For our reference, the parameter "number of professionals who completed the course" calculated the proportion of professionals who completed the course, and was divided by the total number of primary health care professionals in the municipality to create a ratio. The cutoff points used represented tertile distribution: T3: high (0.35–1.00), T2: intermediate (0.02–0.33) and T1: low (0.00–0.01); to avoid biased results, the analysis was also performed for the years prior to the beginning of the course in question (2009 and 2010). Results: During the study period, enrollment of pregnant women, exclusive breastfeeding for children under 4 months, and up-to-date vaccinations in children younger than 1 year to 23 months increased (high to intermediate categories) in municipalities where professionals who completed the specialization course worked. Growth in the intermediate ratio was also observed in indicators related to cervical cancer screening and new diagnoses of congenital syphilis in infants under one year of age. Conclusions: The presence of care workers who completed a specialization course on family health was seen to be associated with improved care and indicators for maternal and child health in municipalities in the state of Mato Grosso do Sul, Brazil. These findings reaffirm the importance and effectiveness of policies on training and continuing education for the Brazilian Unified Health System. [ABSTRACT FROM AUTHOR]

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Objective: this study aimed to analyze the interaction of gender in the association between decision time for seeking healthcare services and the sociodemographic and clinical variables. Method: this exploratory, cross-sectional study was performed with 100 individuals interviewed in hospitals in Salvador, Bahia. The chi-square test or Fisher's exact test and the robust linear regression model were used in the analysis. A statistical significance of 5% was adopted. Results: men and women presented long decision times. The decision time was less for smokers and those with constant and/or severe pain. There was an interaction between gender and smoking and between gender and pain radiating to the neck or jaw for the decision time outcome. Conclusion: decision times were long and were influenced by clinical and gender variables. The study provides support for nursing care practices focused on the specificity of these factors and of the genders aiming to reduce the decision time. [ABSTRACT FROM AUTHOR]

Objective: To assess the effectiveness of remote monitoring in the knowledge of overweight women., Method: Randomized clinical trial with 101 women, randomly assigned to the control group (CG=50) and to the intervention group (IG=51). The IG received educational intervention over the telephone, during three months and routine follow-up in the service, while the CG only received conventional follow-up. The knowledge was assessed by a specific questionnaire. Data were analyzed by the Robust Linear Regression Model, adopting a statistical significance of 5%., Results: In the intragroup assessment, an increase in the correct answers with a statistically significant difference was observed only for the IG in the domains: "Concept and causes of overweight," "Complications of overweight" and "Eating habits." In the intergroup comparison, an increase in the average knowledge was verified in the same domains for the IG (p≤0.005)., Conclusion: nursing telemonitoring contributed positively to the improvement of women's knowledge.

Introduction:: This study compares the clinical and epidemiological features of patients with TB, with and without DM., Methods: New cases of active pulmonary TB that occurred in Salvador, Bahia, Brazil between 2008 and 2010 were included. DM was diagnosed by based on diagnostic criteria established by the American Diabetes Association., Result: S: Of the 323 cases of TB, 44 (13.6%) were diabetic . Patients with TB and DM were older (44.7%), with a high level of education (34.%); had slow wound healing (23.4%) and fatigue (61.7%)., Conclusions: Clinical symptoms differed between patients with TB, with and without DM.

The prevalence of asthma is high in urban areas of many Latin-American countries where societies show high levels of inequality and different levels of development. This study aimed to examine the relationship between asthma symptoms prevalence in adolescents living in Latin American urban centers and socioeconomic and environmental determinants measured at the ecological level. Asthma prevalence symptoms were obtained from the International Study of Asthma and Allergies in Childhood (ISAAC) phase III. A hierarchical conceptual framework was defined and the explanatory variables were organized in three levels: distal, intermediate, proximal. Linear regression models weighed by sample size were undertaken between asthma prevalence and the selected variables. Asthma prevalence was positively associated with Gini index, water supply and homicide rate, and inversely associated with the Human Development Index, crowding and adequate sanitation. This study provides evidence of the potential influence of poverty and social inequalities on current wheezing in adolescents in a complex social context like Latin America.

Objective: This study aimed at assessing the association between factors such as age, sex, skin color, occupation, educational level, marital status, place of residence, and tobacco and alcohol consumptions and oral cancer in individuals in a city in the northeast of Brazil between 2002 and 2012., Methods: This is a case-control study. The case group consisted of 127 people attended at the Oral Injury Reference Center with histopathological diagnosis of oral squamous cell carcinoma. The control group consisted of 254 individuals treated at the same center. The study considered two controls for each case. The cases and controls were adjusted according to sex and age. Univariate and bivariate analyses were performed (Pearson χ2-test) to verify the correlation between the dependent variable (oral cancer) and the independent variables; odds ratio (OR) and the confidence interval of 95% (95%CI) were calculated. Finally, in the multivariate analysis, it was used as the hierarchical model with logistic regression to explain the interrelationships between the independent variables and oral cancer., Results: Consumption of more than 20 cigarettes per day [OR = 6.64; 95%CI 2.07 - 21.32; p ≤ 0.001], an excessive alcohol consumption [OR = 3.25; 95%CI 1.03 - 10.22; p ≤ 0.044], and the synergistic consumption of tobacco and alcohol [OR = 9.65; 95%CI 1.57 - 59.08; p ≤ 0.014] are the most important risk factors for oral cancer., Conclusion: It was concluded that tobacco and alcohol consumptions are the most important factors for the development of oral cancer. Sociodemographic factors were not associated with this neoplasm after adjusting for smoking and drinking.

Analyze cognitive and emotional variables between genders in terms of the decision time (DT) to seek care when experiencing symptoms of myocardial infarction. One hundred adults were interviewed at two hospitals in Salvador-BA. The analysis used percentage means, the chi-square test, and a robust linear regression model. Most participants were male, with a mean age of 58.78 years and a low socioeconomic status. The geometrical mean of the sample was 1.1h (0.9h for men, and 1.4h for women). A shorter decision time was found for those who considered their symptoms to be severe, and a longer decision time for those who expected symptoms to improve and took something to feel better, with statistically significant associations. An interaction was observed between gender and the following variables: waiting for symptoms to improve (p=0.014), concealing symptoms (p=0.016) and asking for help (p=0.050), thus an association was observed between the variables of interest and DT. The decision times were long and were affected by cognitive, emotional and gender variables. Nursing care may promote early assistance.

Respiratory diseases are the leading cause of hospitalizations in Brazil (excluding hospital admissions related to childbirth, pregnancy, and postpartum). To analyze the trend and seasonality of hospitalizations for respiratory diseases in Salvador, Bahia State, Brazil, 1998-2009, a time trend study was performed using simple linear regression. Hospitalization rates for all respiratory diseases and specifically for asthma, chronic obstructive pulmonary disease (COPD), and pneumonia were calculated by year and age group. Hospitalizations for all respiratory diseases decreased by 45.6% (β = -2.2; p < 0.001); those due to asthma showed the largest decline (annual average 1.2/10,000), pneumonia showed the largest reduction until 2002, subsequently tending to stabilize, and COPD remained unchanged. The under-5-year age group showed the largest decline in hospitalizations for all respiratory diseases. There was no seasonality in hospitalizations for COPD. There was a reduction in the burden of hospitalizations due to respiratory diseases in Salvador, mainly due to the drop in asthma and pneumonia in children < 5 years. However, the city still has hospitalization rates for respiratory diseases that are higher than in other large Brazilian cities.

Unlabelled: The influence of oral infections, especially periodontal disease, on systemic diseases has been extensively discussed in the literature. Because periodontal disease is a persistent infection, it promotes an inflammatory response. C-reactive protein is a marker for inflammatory reactions that is frequently studied, since elevated levels of this protein are related to coronary events., Objective: The aim of this study was to investigate the effect of periodontal therapy on reducing the serum levels of C-reactive protein, by means of a systematic review of the literature and meta-analysis., Material and Methods: A systematic review of the English-language literature was conducted in the PUBMED-MEDLINE database, using the key words "periodontal disease", "C-reactive protein", "periodontal therapy" and "periodontal treatment", in accordance with the terms for Medical Subject Headings (MeSH), to evaluate the effect of periodontal therapy on C-reactive protein levels. A qualitative analysis of studies of randomized clinical trial design was performed using CONSORT, with subsequent meta-analysis., Results: The literature search initially retrieved 46 potentially relevant studies available in the databases. From these, in accordance with the inclusion criteria, only 11 were selected, of which only 4 fulfilled the criteria of randomized clinical trial design. According to CONSORT, the studies evaluated generally presented good quality with regard to the criteria analyzed. Through meta-analysis, the reduction in mean levels of C-reactive protein (-0.231; p=0.000) after introducing periodontal treatment was estimated. The result was statistically significant, without evidence of heterogeneity between the studies (p=0.311)., Conclusions: The findings indicated that non-surgical periodontal treatment had a positive effect with regard to reduction of the serum levels of C-reactive protein.