Basic Healthcare Centers Research Articles

Knowledge, Attitudes and Practices of Mothers on Neonatal Danger Signs

Neonatal mortality is still a public health problem. The objective of our study was to evaluate the knowledge, attitude and practices of mothers in the Fianarantsoa Level 2 Basic Health-care Centers, face to neonatal danger signs.

Assessment of Geographical Distribution of Emerging Zoonotic Toxoplasma gondii Infection in Women Patients Using Geographical Information System (GIS) in Various Regions of Khyber Pakhtunkhwa (KP) Province, Pakistan.

Toxoplasmosis is a zoonotic parasitic disease caused by T. gondii, an obligate intracellular apcomplexan zoonotic parasite that is geographically worldwide in distribution. The parasite infects humans and all warm-blooded animals and is highly prevalent in various geographical regions of the world, including Pakistan. The current study addressee prevalence of Toxoplasma infection in women in various geographical regions, mapping of endemic division and t district of Khyber Pakhtunkhwa province through geographical information system (GIS) in order to locate endemic regions, monitor seasonal and annual increase in prevalence of infection in women patients. Setting: Tertiary hospitals and basic health care centers located in 7 divisions and 24 districts of Khyber Pakhtunkhwa (KP) province of Pakistan. During the current study, 3586 women patients from 7 divisions and 24 districts were clinically examined and screened for prevalence of T. gondii infection. Participants were screened for Toxoplasma infection using ICT and latex agglutination test (LAT) as initial screening assay, while iELISA (IgM, IgG) was used as confirmatory assay. Mapping of the studied region was developed by using ArcGIS 10.5. Spatial analyst tools were applied by using Kriging/Co-kriging techniques, followed by IDW (Inverse Distance Weight) techniques. Overall prevalence of T. gondii infection was found in 881 (24.56%) patients. A significant (<0.05) variation was found in prevalence of infection in different divisions and districts of the province. Prevalence of infection was significantly (<0.05) high 129 (30.07%) in Kohat Division, followed by 177 (29.06%), 80 (27.87%), 287 (26.72%), 81 (21.21%), 47 (21.07%), and 80 (13.71%) cases in Hazara Division, D.I Khan Division, Malakand Division, Mardan Division, Bannu Division, and Peshawar Division. Among various districts, a significant variation (<0.05) was found in prevalence of infection. Prevalence of infection was significantly (<0.05) high 49 (44.95%) in district Karak, while low (16 (10.81%) in district Nowshera. No significant (>0.05) seasonal and annual variation was found in prevalence of Toxoplasma infection. LAT, ICT and ELISA assays were evaluated for prevalence of infection, which significantly (<0.05) detected T. gondii antibodies. LAT, ICT and ELISA assays significantly (<0.05) detected infection, while no significant (>0.05) difference was found between positivity of LAT and ICT assays. A significant difference (<0.05) was found in positivity of Toxoplasma-specific (IgM), (IgG) and (IgM, IgG) immunoglobulin by ICT and ELISA assay. The current study provides comprehensive information about geographical distribution, seasonal and annual variation of Toxoplasmosis infection in various regions of Khyber Pakhtunkhwa province of Pakistan. Infection of T. gondii in women shows an alarming situation of disease transmission from infected animals in the studied region, which is not only a serious and potential threat for adverse pregnancy outcomes, but also cause socioeconomic burden and challenges for various public and animal health organizations in Pakistan and across the country.

Effectiveness of an instructional program on mothers knowledge toward child vaccines at primary health care centers in AlـNajaf City

Objective(s): The objective of this article is to identify the effectiveness of an instructional program toward mothers' knowledge of child vaccines as well as find the relationship between mothers' knowledge of child vaccines and their demographic data. Methodology: A quasi-experimental study is conducted for the period of October 4th, 2021 to April 19th, 2022. A nonprobability "purposive" sample of (60) mothers (30) for the control group and (30) for the study group was used in the study. Six basic health care centers in the Iraqi city of Al-Najaf were chosen for the sampling. The data is collected using a self-report questionnaire with two parts: the first part deals with the mothers' demographic information and previous history, and the second portion deals with the mothers' knowledge of child vaccines. Results: According to the findings, there is a significantly difference in mothers' knowledge about child immunizations between the study group's post-test knowledge score Except for the educational and occupational status, where there is a statistically significant association. In the control group, there is no significant relationship between mothers' knowledge and demographic characteristics such as age, education, or socio-economic status.

Factors related to treatment adherence among hypertensive patients: A cross-sectional study in primary healthcare centers in Taif city.

Antihypertensive medications must be taken as prescribed since noncompliance can result in the lack of hypertension (HTN) control. The aim of this study was to determine the factors that influence adherence to treatment by HTN patients in Taif city. A cross-sectional study was undertaken in basic healthcare centers in Taif city, Saudi Arabia. A simple random sampling method was used to select participants from primary healthcare centers. Data was obtained on patients' demographic characteristics, smoking habits, anti-HTN drugs and treatment characteristics, barriers to medication compliance, systolic and diastolic blood pressure (BP), anthropometric measurements, and family history of HTN and diabetes mellitus (DM). We used the 4-item Morisky Medication Adherence Scale (MMAS-4™) as a valid questionnaire to assess medication adherence. Data were analyzed using SPSS. Qualitative data was presented as numbers and percentages, and Chi-squared test was applied to test the relationship between qualitative variables. For quantitative data, mean and standard deviation was calculated. Multiple logistic regression analysis were performed to determine correlates of treatment adherence, and results were presented as Odds Ratio (OR) and 95% confidence interval (CI) for OR. Of the 549 patients included, 36.8% did not have a regular check of their BP at home and the majority had a family history of HTN and diabetes. About 86% patients showed a high level of adherence. Income ≥5000 SAR, age ≥60 years, female gender, who were being married, having ≤10 family members, being unemployed, and never having smoked were associated with high adherence level. The most important factor that affected MMAS scores was the regular BP checks at home. When patients attend routine follow-up clinics, it is critical to strengthen reminder mechanisms and provide regular counseling.

Theoretical-logical model and judgment matrix of the effectiveness of the Expanded Family Health and Basic Healthcare Centers

Primary health care requires work processes guided by collaborative inter-professional action to respond to health care needs. The Expanded Family Health and Basic Healthcare Center (NASF-AB) acts as an important device to expand the possibilities of care in this scenario. This study aims to describe the process of constructing a theoretical-logical model and judgment matrix to evaluate the effectiveness of the NASF-AB. Evaluative study, with a descriptive-qualitative approach using documentary research, in which 11 documents regulating the work process of NASF-AB were selected to support the theoretical-logical model. For the elaboration of the judgment matrix to evaluate the effectiveness of NASF-AB, we considered the fundamental concepts and expected competencies, with the definition of indicators and criteria for a staggered evaluation, which allows classifying the NASF-AB as effective, potentially effective, low effectiveness, and non-effective. Both the structuring of the model and the application of the matrix and its graphic expression are instruments that support the ideal functioning of the NASF-AB, being able to guide decision-making in the management and work process, in the care and pedagogical dimensions. The products of this investigation constitute theoretical and methodological devices to support the evaluation of the effectiveness of NASF-AB and to identify the weaknesses and potencies of its performance.

Primary care health actions to homeless people during covid-19:an experience report

ObjectiveExperience report by professionals from Basic Health Care Centers working with homeless people during COVID-19 pandemic.MethodsDescriptive and reflexive study by professionals and Nursing professors and academics.Results and discussionProfessionals experience challenges when facing the pandemic considering the life conditions and misinformation of homeless people about COVID-19.Brazil's Unified Public Health System needs to take some measures to promote social distancing, access to toilets, mask and food distribution. Meetings with health teams and clinic on the street teams were held to organize care according to local reality, infrastructure, and users' flow. In a similar vein, intra and intersectoral articulations for joint actions on the street were articulated to provide access to health care and social assistance, and to accommodate and care for those presenting respiratory symptoms till improvement of the condition. Reorganizing actions is a dynamic process because each epidemiological stage demands new strategies as the pandemic advances or recedes. Attendance at Basic Health Care Centers was defined as priority:suspected COVID-19 cases and people with mental suffering or chronic disease.These people were identified to have face-to-face consultations or teleconsultations. In this sense, therapeutic interruption and worsening of conditions were avoided. Some management challenges are listed:information dynamics, the need to publicize, to qualify professionals and to articulate the network;care with the health team, keep away professionals from the group of risk and COVID-19 confirmed cases;training demands, input assurance, and agendas;electronic means to share information and to keep collegiate management.ConclusionsTo face COVID-19 and to work with homeless people it becomes fundamental to share challenges and caring strategies to minimize impacts.Health professionals perform to sensitize users according to their life experiences and singularities.Key messages The caring process is built through dialog and reflection.It is of utmost importance to make the population aware of the COVID-19 prevention.

Syndromic surveillance of female sexually transmitted infections in primary care: a descriptive study in Monastir, Tunisia, 2007\u25002017

BackgroundSexually Transmitted Infections (STIs) are a public health problem, especially for reproductive-age women. The aim of this study was to determine the incidence and trend of STIs during 11 years in Tunisia (2007–17).MethodsWe conducted a descriptive study including all women with curable STIs (chlamydia, gonorrhea, syphilis and trichomoniasis) diagnosed with the syndromic approach in all basic health care centers of the Governorate of Monastir (Tunisia) from 2007 to 2017. Syndromes included, Pelvic Pain (PP), Vaginal Discharge (VD) and Genital Ulceration (GU).ResultsWe analyzed 40,388 episodes of curable STIs with a crude incidence rate and age standardized incidence rate of 1393 (95% Confidence Interval (CI); 1348–1438) / 100,000 Person Year (PY) and 1328 (95%CI; 1284–1372) /100,000 PY respectively. The incidence rate showed a positive trend over 11 years for all age groups and syndromes. VD was the most common syndrome with a crude incidence rate of 1170/100,000 PY. For all syndromes, women aged 20 to 39 were the most affected age group (p < 0.001).ConclusionIn conclusion, the incidence rate of STIs episodes among women diagnosed with the syndromic approach was high, consistent with the global evidence. Focusing on reviewing STIs surveillance system in low and middle-income countries could allow the achievement of the ending of STIs epidemics by 2030.

Characteristics and performance of professionals of the Expanded Family Health and Basic Healthcare Centers.

To analyze the characteristics and performance of the teams of the Expanded Family Health and Basic Healthcare Centers (Nasf-AB) of Santa Catarina state. A multicenter study implementing mixed methods, a sample of 149 municipalities (50.5% of the state) and 359 professionals through applying a survey and collective interviews with five teams of 43 professionals. Quantitative data were analyzed using descriptive statistics, and qualitative data were subjected to thematic analysis. There were 11 professions integrated to the Centers with a predominance of psychologists (27%), physiotherapists (18%) and nutritionists (18%). The professionals were mostly women (88%) aged between 30 and 39 years (50.4%), with their performance involving shared care, collective activities of their professional core, group activities and individual care to users. Professionals participate in the intermediation, regulation or evaluation of referrals from Primary Care to other points of the Network. The interviews revealed a set of actions of technical care and technical-pedagogical support and specialized actions. Despite operational difficulties, the Expanded Family Healthcare Centers have been supporting Family Healthcare teams, strengthening Primary Care.

BEST PRACTICES IN NURSING AND THEIR INTERFACE WITH THE EXPANDED FAMILY HEALTH AND BASIC HEALTHCARE CENTERS

ABSTRACT Objective: to know and reflect on the best practices in nursing and their interface with the Expanded Family Health and Basic Healthcare Centers (NASF-AB). Method: this is a participatory research based on Paulo Freire’s methodological framework and developed from thematic investigation, coding, decoding, and critical unveiling. The information was produced and analyzed in four Culture Circles, with an average of five nurses and duration of two hours each, between April and June 2018. The investigation revealed four generating themes, unveiled during the meetings. In this study, the theme “best nursing practices that favor relations with NASF-AB” will be discussed. Results: nurses acknowledge communication as a tool that promotes best practices in nursing. It was possible to deepen the dialogue and knowledge about NASF-AB’s work process and the role of nursing. Nurses act as a link between the support team and the Family Health team, a skill resulting from their training focused on management, having leadership and dialogue as resources for conflict resolution. Conclusion: the present study contributed to improve nurses’ thinking and acting in relation to the proposed theme. The reflections made during Culture Circles boosted transformative attitudes in the practice settings. Nurse approximation with NASF-AB favors autonomy and collaborative practices (understood as best practices), encouraging interprofessional and solve-problem actions within Basic Care.

Nurses' knowledge, attitudes and practices regarding breast cancer screening in the Sousse region of Tunisia: a cross-sectional descriptive study.

The aim of our study is to describe the knowledge, attitudes, and practices of nurses about breast cancer screening in the region of Sousse, in Tunisia. This is a transversal descriptive study with a quantitative approach which was carried out during 2015-2016 and concerns nurses working in the different basic healthcare centers (BHC), (Tunisian health centers providing basic preventive and curative care). They were selected by simple random chance sampling (n=160) using as a basis a selfadministered questionnaire written through the analysis of literature. Our sample concerns 153 nurses. Only 46.40% had a KAP (knowledge, attitudes, and practices) score above or equal to 16. This score is related to the different characteristics of the participants. It is important to highlight those practicing nurses (those working in the basic healthcare centers) should receive training in advising patients in the practice of breast self-examination so that they can educate and tell women attending BHC

Criança com varicela: conhecimento e práticas de profissionais da educação infantil e da saúde

Trata-se de pesquisa descritiva, quantitativa e transversal, para analisar o conhecimento acerca da varicela entre profissionais das áreas da educação infantil e da saúde, antes da participação em oficinas de educação em saúde. Os dados foram coletados por meio de questionários autoaplicados e processados no programa Epi Info®, considerando-se para análise estatística nível de significância de 5%. Participaram 92 profissionais de oito Centros de Educação Infantil e duas Unidades de Saúde da Família de Londrina (PR). Mais de 52,0% dos profissionais da saúde e 74,0% da educação desconheciam a doença. Para 76,0% dos profissionais da educação e 38,1% dos da saúde a varicela não apresenta complicações, e a etiologia viral reportada foi de 75,0% e 50,0%, respectivamente. A varicela ainda é uma doença prevenível, pouco conhecida entre ambas as categorias profissionais, que emerge para a adequada assistência e redução da transmissibilidade mediante programas de educação em saúde, além da imunização.

Trichomonas vaginalis / AWARENESS OF TRICHOMONIASIS IN WOMEN ATTENDED BY THE HEALTH SERVICE OF BAGÉ, RS, BRAZIL

This study aimed to measure the level of awareness of Trichomonas vaginalis / trichomoniasis and other sexually transmitted diseases (STDs), in 300 women from 19 municipalities in the southwest region of Rio Grande do Sul, Brazil, who sought the gynecology sector of the Basic Healthcare Centers in the Municipality of Bage from January to June 2013. The data were collected through a semi-structured questionnaire, and the results were tabulated and organized using Excel® 2010 software. Only 5.7% of the participants said they were aware of T. vaginalis / trichomoniasis and had a little information on HIV and Aids in reference to other STDs. Schooling alone was significant (p = 0.0135), as women who had a high school diploma or higher education were 6.6 times more likely to be aware of T. vaginalis. There is, therefore, a need to devise better educational campaigns, addressing this and other STDs, such as trichomoniasis, given the lack of knowledge about this parasite, its high frequency and possible escalation

Respiratory disease and climatic seasonality in children under 15 years old in a town in the Brazilian Amazon

To analyze the climatic seasonality of primary care visits for respiratory disease (RD) in children less than 15 years old. This was a descriptive, epidemiological study based on data from the municipal records of primary care events from basic healthcare centers for the period 2004-2005, for the municipality of Tangará da Serra (MT), Brazil. Population estimates were obtained from the Brazilian Institute of Geography and Statistics (Instituto Brasileiro de Geografia e Estatística, IGBE), and data on temperature and relative humidity of the air, from the National Meteorology Institute (Instituto Nacional de Meteorologia, INMET). Mean rates of primary care visits for RD were calculated according to sex, age group and anatomic location of complaint. The ratio of dry season to rainy season visits was calculated according to anatomic location of the RD. Data were analyzed using Epi-Info 3.2, testing differences between proportions using the chi-square test to a significance level of 5%. Male children had an almost 50% greater (37.3/25.0) rate of primary care visits for diseases of the lower respiratory tract than did females. The rates of primary care visits due to RD in children under 15 years of age varied as age increased, varying from 457.7 per thousand of children less than 1 year of age to 133.5 per thousand in the 10 to 14 years-of-age group. During the dry season there were an average of 21% (4,148/5,231) fewer visits for RD (p = 0.000). Peaks in numbers of visits were observed during the months of March and August, being more accentuated in March, which is the wet season in the region. Primary care visits for RD, especially those due to upper airway diseases, are related to the rainy season in this municipality.

Aspectos contemplados na consulta de enfermagem ao paciente com hipertensão atendido no Programa Saúde da Família

Objetivou-se, neste estudo, averiguar os aspectos contemplados na consulta de enfermagem ao portador de hipertensão arterial (HA). É um estudo descritivo, desenvolvido em três unidades de saúde de Fortaleza. Os sujeitos foram 13 enfermeiros. A coleta de dados ocorreu por observação de três consultas de cada enfermeiro e, posteriormente, de uma entrevista com este profissional. Foi observado que, durante a anamnese, houve identificação do tratamento prévio, da ingestão de substâncias hipertensoras e da existência de fatores de risco associados. No exame físico, constatou-se a ocorrência de inspeções da aparência do paciente e verificações da pressão arterial e peso. As categorias identificadas foram: nuances do papel do enfermeiro na atenção básica; tratamento da HA e dificuldades cotidianas das pessoas com esta enfermidade. Concluímos que muitos aspectos não vêm sendo abordados durante a consulta de enfermagem, o que pode acarretar um atendimento deficiente das pessoas acompanhadas pelo programa de HA em tais unidades de saúde.

Doença respiratória e sazonalidade climática em menores de 15 anos em um município da Amazônia brasileira

OBJETIVO: Analisar a sazonalidade climática dos atendimentos ambulatoriais por doença respiratória (DR) em menores de 15 anos. MÉTODOS: Estudo epidemiológico descritivo, realizado com dados dos Registros de Ocorrências Ambulatoriais das unidades básicas de saúde referentes ao período 2004-2005, do município de Tangará da Serra (MT). As estimativas populacionais foram obtidas do Instituto Brasileiro de Geografia e Estatística (IBGE), e os dados de umidade relativa do ar e temperatura, do Instituto Nacional de Meteorologia (INMET). Foram construídas taxas médias de atendimento ambulatorial por DR segundo sexo, faixa etária e localização anatômica. Calculou-se a razão seca/chuva dos atendimentos de acordo com a localização anatômica da DR. Utilizou-se o Epi-Info 3.2 para análise dos dados, com as diferenças de proporção testadas através do teste do qui-quadrado, ao nível de significância de 5%. RESULTADOS: Indivíduos do sexo masculino tiveram taxa quase 50% maior (37,3/25,0) de atendimentos ambulatoriais por doenças das vias aéreas inferiores que os do sexo feminino. As taxas de atendimentos ambulatoriais por DR em menores de 15 anos apresentaram variação com o aumento da idade, passando de 457,7‰ nos menores de 1 ano de idade para 133,5‰ no grupo de 10 a 14 anos. Os atendimentos por DR foram em média 21% menos freqüentes(4.148/5.231) no período seco (p = 0,000). Observou-se picos de atendimento nos meses de março e agosto, mais acentuados em março, período chuvoso na região. CONCLUSÃO: Os atendimentos ambulatoriais por DR, especialmente por doenças das vias aéreas superiores, estão relacionados ao período chuvoso no município.

Fatores de risco para a soropositividade do ML Flow em pacientes com hanseníase

The early diagnosis of leprosy, its correct classification and the risk factors related to seropositivity have become important for patient treatment and disease control, especially where the responsibility for treatment has been transferred to basic health care centers. This descriptive, exploratory study using logistic regression was undertaken to evaluate the association between the variables of sex, age, mode of detection, number of skin lesions and affected nerves, disability grade and bacilloscopy with the results of the ML Flow serological test in 1,072 new leprosy cases in 13 municipalities in Minas Gerais State. Seropositivity (50.7%) was statistically associated with patients 15 years-old or over (OR:2.6) and those with more than five skin lesions (OR:7.5), more than one affected nerve (OR:2.4) and a positive bacilloscopic index (OR:5.5 for 0<BI<2 and OR:191.2 for BI>or=2), thus contributing to the appropriate classification and treatment of patients.