Public Hospital In Recife Research Articles

Newborn hearing screening: An outpatient model

The purpose of this study was to assess the feasibility of implementing an outpatient model of a newborn hearing screening program with a particular focus on determining how compliance with the follow-up appointment related to specific socio-economic and demographic factors associated with the mother. Mothers who delivered their babies in public hospitals in Recife, northeast Brazil, were invited to participate in a two-step program. In Step 1 they were interviewed with regard to specific socio-economic and demographic factors, and then scheduled for a hearing screening test for their baby 1 month after discharge. In Step 2, the baby's hearing was screened using transient otoacoustic emissions. A total of 1035 mothers consented to participate in Step 1, but only 149 returned to participate in Step 2 (14.3%). Analysis of the socio-economic and demographic factors indicated that mothers who did not comply with the scheduled newborn hearing screening (NHS) test generally had less than a high school education and came from primarily lower income families who lived in rural areas outside of Recife. The results of this study highlight some socio-economic and demographic factors of the population of northeast Brazil that contribute to a low compliance rate for an outpatient model of a newborn hearing screening program. Possible solutions to the low compliance rate are considered.

Triagem auditiva: perfil socioeconômico de mãe

OBJETIVO: descrever as características socioeconômicas e demográficas das mães cujos filhos participaram da triagem auditiva neonatal. MÉTODOS: o estudo foi desenvolvido em maternidades públicas da cidade do Recife, por meio de entrevistas realizadas com as parturientes. Após a entrevista, as mães foram convidadas a comparecer às clínicas-escola de Fonoaudiologia da Universidade Católica de Pernambuco e da Faculdade Integrada do Recife, para realizar avaliação auditiva em seus filhos. RESULTADOS: participaram do estudo 1.021 mães, sendo observado que: a idade destas variou de 13 a 50 anos, com maioria (69,5%) entre 20 e 35 anos; 59,4% são casadas ou têm união consensual; 39,1% são solteiras e a maior parte (34,1%) possui primeiro grau incompleto e 3,4%, o 3°grau. Quanto ao fator renda pessoal, a maioria (72,8%) apresenta inferior a um salário mínimo; 90,3% possuem bens, sendo que 83,6% televisão, 56,7% casa própria e 40,7% telefone e, como atividade, identificou-se (63,7%) como sendo dona de casa. CONCLUSÃO: as características socioeconômicas e demográficas das mães participantes da triagem auditiva neonatal foram marcadas por mulheres adultas jovens, que possuem marido ou parceiros, baixa escolaridade e renda familiar, possuem acesso à televisão e não possuem trabalho fora de casa. Tais resultados representam uma importante base diagnóstica para as necessárias ações de gestão, assistência e ensino na área de saúde materno-infantil. Portanto, a partir dos achados pode-se melhor fundamentar programas direcionados para as mães com as características socioeconômicas e demográficas identificadas. Entretanto, para se atingir todas as mães, o estudo também forneceu indícios de grupos minoritários que merecem, certamente, novas pesquisas seqüenciais.

Molecular typing of Klebsiella pneumoniae isolates from public hospitals in Recife, Brazil

Thirty nosocomial isolates of Klebsiella pneumoniae, collected from three public hospitals in Recife, Brazil, between 1999 and 2000, were analysed in order to determine their epidemiological relatedness and genetic characteristics. The isolates were characterised by biotyping, antibiotyping, protein analysis, plasmid profile and random amplified polymorphic DNA (RAPD). The majority of the clinical isolates were resistant to multiple antibiotics, in particular to beta-lactams, and 30% were found to be ESBLs producers. RAPD proved to be the most effective technique in discriminating unrelated K. pneumoniae isolates. It was confirmed by the highly genetic similarity found among related isolates from an hospital outbreak. We conclude that K. pneumoniae infections in Recife has been caused by a variety of bacterial genotypes. This is the first report that revealed the subtypes of K. pneumoniae in Brazil by plasmid analysis and RAPD.

Determinants of impaired growth among hospitalized children: a case-control study.

Protein energy malnutrition constitutes a public health problem, especially in less affluent countries. The identification of amenable predictive risk factors is of major importance for policy makers to plan interventions to reduce infant malnutrition. To identify risk factors for protein energy malnutrition among hospitalized low-income children aged 6 to 24 months. Case-control study. Two public hospitals in Recife, Brazil. The cases were 124 infants with length-for-age below the 10th percentile of the National Center for Health Statistics curve and the controls were 241 infants with length-for-age equal to or above the 10th percentile who were recruited in the same infirmary. Cases and controls were compared in relation to a variety of sociodemographic, environmental and reproductive factors, and their healthcare, previous feeding practice and morbidity. Logistic regression analysis was used to investigate the net effect of risk factors on infant malnutrition, after adjusting for potential confounding variables. The mother's age, possession of a TV set, type of water supply, family size and location of the home were significantly associated with child malnutrition in the bivariate analysis. However, these associations lost their significance after adjusting for other explanatory variables in the hierarchical logistic regression analysis. This analysis showed that low birth weight contributed the largest risk for impaired growth. Increased risks of infant malnutrition were also significantly associated with households that had no toilet facilities or refrigerator, high parity for the mother, no breastfeeding of the infant, inadequate vaccination coverage and previous hospitalization for diarrhea and pneumonia. The literature shows that chronic malnutrition, as assessed by low length-for-age indexes, is often related to low income. However, this was not the case in this study, in which other variables had greater impact on child growth. In view of the multiple causes of malnutrition, the interrelationship among its determinants should be taken into account when adopting strategies for its reduction and prevention.