Epidemiologia e Servicos de Saude最新文献

Objective: To develop a matrix with potential interfaces between the principles and recommendations of the Brazilian dietary guidelines and food and nutrition care actions developed in the mother and child hospital environment.

Methods: A theoretical-conceptual study that included: reading and extracting excerpts from the Dietary Guidelines for the Brazilian Population and the Dietary Guidelines for Brazilian Children Under 2 Years of Age; mapping, through on-site observation of the care spaces of a maternal and child hospital (inpatient units, outpatient units, human milk bank, lactation room, hospital food and nutrition unit and self-service restaurant/canteen/cafeteria for patient companions); identification and systematization of potential interfaces between food and nutrition care actions in the selected spaces and the principles and recommendations of the Dietary Guidelines; preparation of preliminary versions of the matrix and its assessment by panels of experts; preparation of the final version of the matrix.

Results: The matrix is ​​composed of two sections: one, referring to the Brazilian Population Guidelines and the other, to the Child Guidelines. Different opportunities for materializing the Dietary Guidelines were identified in the matrix, including food and nutrition education in different spaces, creation of menus aligned with the Dietary Guidelines for patients and workers, reorganization of spaces to promote commensality and restriction clauses on ultra-processed foods in food and nutrition units.

Conclusion: The matrix presents necessary interfaces for the implementation of the Dietary Guidelines in the hospital context, highlighting their potential to support the promotion of adequate and healthy eating, as well as to qualify food and nutrition care in this space.

Objective: To evaluate quality of acute respiratory infection reporting in Brazil, 2009-2021, and to analyze association with contextual factors, the COVID-19 pandemic and death as the clinical outcome.

Methods: Cross-sectional study of quality of completeness and timeliness of reporting held on the Influenza Epidemiological Surveillance System, via OpenDATASUS, based on Centers for Disease Control and Prevention guidelines. Pearson's chi-square test was applied to compare sociodemographic and geographic factors, Bayesian structural time series were used to measure the impact of the COVID-19 pandemic and logistic regression was used to analyze association with the clinical outcome, using odds ratios (OR) and 95% confidence intervals (95% CI).

Results: Among the 3,401,881 reports, 53.6% had high completeness, ranging from 71.3% in the South to 37.3% in the Northeast. The surveillance stages with least timeliness were case identification (13.0%), sample collection (28.2%) and data entry (43.5%). During the COVID-19 pandemic, completeness reduced by 34.8%, mainly among sociodemographic (35.9%) and signs and symptoms (28.5%) variables. Completeness of signs and symptoms variables (OR 0.56; 95%CI 0.55; 0.56) and hospital care variables (OR 0.91; 95%CI 0.90; 0.92), as well as timely communication (OR 0.72; 95%CI 0.71; 0.72), sample collection (OR 0.90; 95%CI 0.89; 0.90) and data entry (OR 0.91; 95%CI 0.90; 0.92), was associated with lower odds of death.

Conclusion: This study demonstrated that completeness and timeliness of acute respiratory infection epidemiological surveillance actions has regional inequalities, with effects on filling out records during the COVID-19 pandemic and associations with clinical outcomes.