Resumo em Espanhol:

OBJETIVO: Probar las propiedades psicométricas de un instrumento de encuesta destinado a evaluar algunas variables históricas y de contexto que facilitan el comportamiento sexual de riesgo en una muestra de estudiantes de dos centros universitarios de México. MÉTODOS: Estudio transversal con una muestra compuesta por 1 346 estudiantes universitarios de México: 784 del Centro de Estudios Superiores del Estado de Sonora, Hermosillo, Sonora, (33,2% del total de la matrícula de ese centro) y 562 de la Universidad Nacional Autónoma de México, campus Tlalnepantla, Estado de México (23,5% del total de estudiantes de ese centro). El trabajo se realizó en octubre de 2006 en Hermosillo y entre los meses de enero y marzo de 2006 en Tlalnepantla. La encuesta contenía 11 preguntas sobre datos sociodemográficos, 7 sobre comportamientos sexuales de riesgo, 22 sobre motivos subyacentes, 8 sobre las situaciones sociales y 6 sobre el estado biológico previo a la relación. Se evaluó la capacidad de comprensión de las preguntas, la validez conceptual y la confiabilidad del instrumento. RESULTADOS: La versión definitiva del instrumento quedó constituida por 44 preguntas. En el análisis de confiabilidad se obtuvo un valor a de Cronbach global de 0,821, considerando todas las variables en su conjunto y agrupadas por factores. Se encontraron tres factores (motivos para no usar preservativos en la primera relación sexual y a lo largo de la vida, motivos del uso inconsistente de preservativos con parejas ocasionales y disposición hacia la primera relación sexual y hacia la relación con parejas ocasionales) que en su conjunto explicaron 38,36% de la varianza total. CONCLUSIÓN: Las propiedades psicométricas del instrumento de encuesta evaluado fueron satisfactorias. Los interesados en aplicar este instrumento deben familiarizarse con el modelo teórico que lo sustenta, ya que la interpretación de los resultados se basa en las definiciones de las diferentes variables históricas y de contexto contempladas y en su interacción.

Resumo em Inglês:

OBJECTIVES: To measure the psychometric attributes of a survey instrument designed to evaluate historical and context variables that lead to high-risk sexual behaviors among a sample of university students in Mexico. METHODS: Cross-sectional study of a sample of 1 346 university students in Mexico: 784 from the Sonora State Center for Higher Education in Hermosillo, Sonora, or 33.2% of its total enrollment; and 562 from the National Autonomous University of Mexico, at Tlalnepantla campus in Mexico State, or 23.5% of its total enrollment. The study took place in Hermosillo during the month of October 2006 and in Tlalnepantla from January to March 2006. The survey had 11 questions on sociodemographics, 7 on risky sexual behaviors, 22 on related motives, 8 on social context, and 6 on physical status prior to sexual relations. The survey was evaluated in terms of how well the questions were understood, its conceptual validity, and reliability. RESULTS: The final version of the survey instrument was composed of 44 questions. The reliability analysis produced an overall Cronbach a value of 0.821, taking into account all the variables combined and grouped by factor. Three factors were found that together accounted for 38.36% of the total variance: reasons for not using a condom in the first sexual relationship or throughout life, reasons for inconsistent use of a condom with a casual sex partner, and willingness to become sexually active and to engage in casual sex. CONCLUSIONS: The psychometric attributes of this survey instrument were found to be satisfactory. Those interested in using this instrument should become familiar with the theoretical model on which it is based, since understanding the results depends on properly defining the historical and context variables, and their interaction.

Resumo em Espanhol:

OBJETIVO: Analizar las actitudes relacionadas con la diabetes en los miembros del equipo de salud (MES) y las personas con diabetes en un país en desarrollo, Argentina. MÉTODOS: Se administró de forma aleatoria la tercera versión de la Escala de Actitudes en la Diabetes (DAS-3) a 252 MES (enfermeros, nutriólogos, médicos, podólogos y trabajadores sociales) y a 279 personas con diabetes mellitus tipos 1 ó 2 en varias provincias de Argentina en 2004. Los datos de 531 cuestionarios respondidos se evaluaron mediante análisis de varianza y covarianza, y las pruebas de la t y de la ji al cuadrado. RESULTADOS: Aunque pocas, las diferencias entre las actitudes de los MES y de las personas con diabetes fueron significativas. Los dos grupos mostraron solamente una ligera coincidencia en algunos aspectos del DAS-3, como "importancia de la diabetes tipo 2", "el valor de un riguroso control" y "el impacto psicosocial de la diabetes" y difirieron totalmente en cuanto a "la autonomía del paciente". No se encontraron diferencias significativas entre los pacientes con diabetes tipos 1 y 2 en cuanto a "importancia de la diabetes", sin embargo, en ambos grupos las personas que habían asistido a algún curso educativo sobre diabetes le asignaron una mayor puntuación a este aspecto (P < 0,01). CONCLUSIONES: La tendencia desfavorable encontrada en los participantes de este estudio, similar a la observada en otros países en desarrollo, puede haber contribuido a los insatisfactorios resultados del tratamiento en las personas con diabetes tipo 2. Cambiar estas actitudes mediante la educación puede ayudar a mejorar la calidad de la atención y de la vida de los diabéticos y a reducir los costos de esta enfermedad.

Resumo em Inglês:

OBJECTIVE: To test diabetes-related attitudes of health care team members (HCTMs) and people with diabetes in a developing country, in this case, Argentina. METHODS: The third version of the Diabetes Attitudes Scale (DAS-3) was randomly administered, in person, to 252 HCTMs (nurses, nutritionists, physicians, podiatrists, and social workers) and 279 people with type 1 or type 2 diabetes mellitus in several provinces of Argentina in 2004. Data from 531 completed questionnaires were included in the study. The data were statistically analyzed using analysis of variance, covariance, chi-square, and t-tests. RESULTS: Although few, the differences in attitudes of HCTMs and people with diabetes were significant. The two groups expressed only slight agreement on DAS-3 statements such as "seriousness of type 2 diabetes," "value of tight control," and "psychosocial impact of diabetes;" and disagreed completely on "patient autonomy." No significant differences were recorded between people with type 1 or type 2 diabetes regarding "seriousness of the disease," but from both groups, those individuals who had previously attended a diabetes education course assigned this statement a higher score (P < 0.01). CONCLUSIONS: The unfavorable trend among the participants, similar to that recorded in developed countries, would contribute to the poor treatment outcomes observed in people with type 2 diabetes. Changing these attitudes by means of education could contribute to improving the quality of care and of life for people with diabetes and to decreasing the cost of the disease.

Resumo em Português:

OBJETIVO: Investigar a utilização de serviços odontológicos e seus determinantes entre idosos brasileiros. MÉTODO: Foram incluídos os idosos participantes do inquérito de saúde bucal do Ministério da Saúde realizado em 2002 e 2003 que usaram algum serviço odontológico pelo menos uma vez na vida. Dentados e edentados foram comparados e analisados separadamente, utilizando regressão logística múltipla. RESULTADOS: Dos 5 009 participantes, 46,0% eram dentados e 54,0% edentados. A prevalência de uso de serviço odontológico no último ano foi 26,6 e 10,4%, respectivamente. Entre dentados, o uso foi maior entre aqueles com maior escolaridade, que percebiam sua mastigação como péssima/ruim e que relataram sensibilidade dolorosa; e menor entre os que não receberam informações sobre saúde bucal, que percebiam sua saúde bucal como ruim/péssima, que tinham menor renda per capita, que precisavam de prótese e já a usavam, que precisavam de prótese e não a usavam, que tinham problemas periodontais e maior número de dentes extraídos. Entre edentados, o uso foi maior entre aqueles com maior escolaridade e os que relataram sensibilidade dolorosa; e menor entre os idosos identificados como não-brancos e os que não receberam informações sobre saúde bucal. CONCLUSÃO: A saúde bucal dos idosos brasileiros é precária e o uso de serviços odontológicos foi menor entre os que mais necessitavam. Diferentes fatores estiveram associados ao uso entre dentados e edentados. Apenas a escolaridade, o acesso a informações sobre saúde bucal e a dor nos dentes ou gengiva nos últimos 3 meses foram comuns aos dois estratos. São necessários investimentos públicos em saúde bucal para reverter esse quadro.

Resumo em Inglês:

OBJECTIVE: To investigate the pattern of dental services use and its determinants among the elderly in Brazil. METHODS: The study included the elderly participating in the Ministry of Health of Brazil’s oral health survey carried out in 2002 and 2003 who had used dental services at least once in their lifetime. Dentulous and edentulous individuals were compared and analyzed separately using multiple logistic regression. RESULTS: Of 5 009 participants, 46.0% were dentulous and 54.0% edentulous. The prevalence of dental services use in the year right before the survey was 26.6% and 10.4%, respectively. Among dentulous participants, the utilization rate was higher in those with more years of schooling, those who perceived their chewing as poor/very poor, and those who reported feeling oral pain; and lower in those who did not have information on oral health, who perceived their oral health as poor/very poor, those with lower per capita income, those who required prostheses and used them, and who required prostheses and did not use them, those with periodontal problems, and with a higher number of extracted teeth. Among edentulous participants, the utilization rate was higher in those with more years of schooling and those reporting oral pain; and lower in non-whites and in those who did not have information on oral health. CONCLUSIONS: The oral health of the elderly in Brazil is deficient and the use of dental services was lower among those who needed them most. The factors associated with dental services utilization differ for dentulous and edentulous individuals. The only similarities are schooling, having information on oral health, and having experienced pain in the teeth and gums in the previous three months. Public investment in oral health is needed to turn around this scenario.

Resumo em Espanhol:

OBJETIVOS: Hacer una evaluación preliminar de un sistema autóctono para la detección de la infección asintomática por Chlamydia trachomatis mediante la reacción en cadena de la polimerasa (RCP), como alternativa a los costosos sistemas comerciales, y ofrecer datos demográficos muy necesarios relacionados con los indicadores de esta infección en el sistema de salud pública de Trinidad y Tobago. MÉTODOS: Se empleó un sistema autóctono y económico de RCP anidada con control interno de la amplificación para la detección de C. trachomatis y Neisseria gonorrhoeae en muestras de orina de 273 mujeres embarazadas asintomáticas, entre marzo y septiembre de 2004 en Trinidad y Tobago, Indias Occidentales. Se obtuvo la información demográfica de las participantes y se sometió a análisis estadístico. RESULTADOS: Se detectó C. trachomatis en 57/273 (21%) muestras, de las cuales 5 (2%) fueron también positivas para N. gonorrhoeae. La infección se correlacionó bien con algunos parámetros demográficos; la mayor incidencia de la infección por C. trachomatis se observó en las mujeres embarazadas solteras o de ascendencia africana. CONCLUSIONES: Debido al déficit de sistemas de diagnóstico comerciales en Trinidad, la RCP autóctona es una alternativa económica que puede emplearse para detectar la infección asintomática por C. trachomatis y obtener la información demográfica necesaria para que el sistema de salud pública implemente intervenciones.

Resumo em Inglês:

OBJECTIVES: To provide a preliminary assessment of in-house polymerase chain reaction (PCR) as an alternative to the more costly commercial test for detection of asymptomatic infection by Chlamydia trachomatis and to provide much needed demographic data on infection indicators within the Trinidad and Tobago public health care system. METHODS: An inexpensive in-house nested-PCR with an Internal Amplification Control was used to detect C. trachomatis and Neisseria gonorrhoeae in urine samples collected from 273 apparently healthy, pregnant women from March-September 2004 in Trinidad, West Indies. Demographic information on participants was collected and subjected to statistical analyses. RESULTS: C. trachomatis was detected in 57/273 (21%) samples, of which 5 (2%) were also positive for N. gonorrhoeae. Infection correlated well with certain demographic parameters, with the highest incidence of C. trachomatis infection found among pregnant women that were single or of African descent. CONCLUSIONS: Given the lack of commercial tests in Trinidad, in-house PCR is an inexpensive alternative that can be used to detect asymptomatic infections of C. trachomatis and to provide demographic information needed for interventions by the public health care system.

Resumo em Espanhol:

OBJETIVOS: Evaluar los conocimientos y actitudes hacia la donación de sangre voluntaria entre estudiantes, académicos y no académicos de la Universidad de Talca, Chile. MÉTODOS: Entre junio y julio de 2002, se aplicó una encuesta, previamente validada, a 487 personas de la comunidad universitaria, para indagar acerca de su percepción con respecto a algunos aspectos de la donación de sangre, tales como: conocimientos y motivaciones sobre la donación, y desmotivaciones y mitos asociados a la donación de sangre. Para el análisis de los datos se usaron estadígrafos descriptivos. RESULTADOS: De los encuestados sólo 14% habían donado sangre y correspondían mayoritariamente al grupo de académicos (43,3%). Los estudiantes fueron quienes, en mayor medida, manifestaron su intención de donar sangre en el futuro (88,1%). Al comparar la predisposición a donar sangre en el futuro entre hombres y mujeres, se obtuvieron porcentajes de 90% y 84,2% respectivamente; sin embargo, esta diferencia no fue estadísticamente significativa. Dentro de las desmotivaciones para donar sangre, 73,4% de los encuestados dijo desconfiar de la esterilidad del material empleado en la colección de sangre. CONCLUSIONES: La población universitaria es un grupo muy deseable para convertirlo en donantes voluntarios; una adecuada campaña de información y motivación podría transformar a 87,3% de las personas con intención de donar sangre, en donantes voluntarios reales.

Resumo em Inglês:

OBJECTIVES: To evaluate the knowledge and attitudes of students, professors, and other staff at the University of Talca, Chile, regarding voluntary blood donation. METHODS: From June to July 2002 a previously-validated survey was administered to 487 individuals in the university community. The survey sought to measure their understanding of blood donation, i.e., motivators and reasons for becoming a blood donor and the myths and fears that might deter blood donation. Descriptive statistics were used to analyze the data. RESULTS: Only 14% of survey participants had donated blood in the past, and most of these (43.3%) were professors or other academics. Of the participants who were planning to donate blood in the future, students were the majority (88.1%). When the males in the group that was planning to donate were compared to the females, the difference was not statistically significant (90.0% vs. 84.2%, respectively). Of the deterrents to blood donation, 73.4% said the collection instruments might not be sterile. CONCLUSIONS: The university population represents a pool of desirable donors; an informative and motivating campaign could successfully convert the 87.3% potential donors into actual volunteer blood donors.

Resumo em Português:

OBJETIVO: Identificar os padrões de consumo alimentar dos residentes da área urbana do Município de São Paulo, Brasil, e investigar a associação desses padrões com fatores de risco biológicos, sociodemográficos e comportamentais para doenças cardiovasculares (DCV). MÉTODO: Realizou-se um inquérito epidemiológico de delineamento transversal, com amostra probabilística de base populacional. Os 2 100 participantes de ambos os sexos tinham entre 15 e 59 anos. Em uma sub-amostra sistemática de 700 pessoas, aplicou-se um inquérito sociodemográfico, comportamental, clínico e alimentar. Obtiveram-se os padrões alimentares por análise fatorial a partir de um questionário de freqüência alimentar. As associações dos padrões alimentares com as variáveis sociodemográficas e comportamentais foram determinadas por meio de análise de covariância; e com os fatores biológicos, por regressão linear múltipla. RESULTADOS: Identificaram-se quatro padrões alimentares: "cafeteria" (açúcares simples e gorduras saturadas) associou-se com área de homogeneidade sociodemográfica e ambiental média, escolaridade média e superior e consumo de álcool. Associou-se ainda positivamente com a pressão sistólica (PAS), diastólica (PAD), índice de massa corporal (IMC) e relação cintura-quadril (RCQ) e negativamente com o HDL. O segundo padrão, "tradicional" (cereais, feijões e infusões), predominou entre mulheres e na idade superior a 50 anos; associou-se com consumo de álcool, renda superior e área de homogeneidade média. Associou-se de modo positivo com glicemia e IMC e de modo negativo com triglicérides e RCQ. O padrão "moderno" (baixos teores de gordura de açúcares simples; consumo de peixes), predominou entre os indivíduos de áreas de homogeneidade alta, com maior renda e escolaridade superior. Associou-se negativamente com PAD, colesterol total, glicemia e LDL. O padrão "aterogênico" (gorduras saturadas, adição de sal na comida depois de pronta e bebidas alcoólicas) predominou entre os homens. Associou-se com escolaridade fundamental, tabagismo, consumo de álcool e áreas de homogeneidade média e baixa. Associou-se de modo positivo com colesterol total, triglicérides, glicemia, IMC e RCQ. CONCLUSÕES: Os resultados apontam para tendências desfavoráveis do padrão alimentar na população estudada, visto que três dos quatro padrões de consumo identificados (cafeteria, tradicional e aterogênico) associaram-se de forma significativa com fatores de risco para DCV.

Resumo em Inglês:

OBJECTIVE: To identify the dietary patterns of individuals living in the urban area of São Paulo, Brazil, and to investigate the association between these patterns and biological, sociodemographic, and behavioral risk factors for cardiovascular disease (CVD). METHOD: A cross-sectional epidemiological survey was carried out with a population-based probabilistic sample. The 2 100 participants of both sexes were from 15 to 59 years of age. A sociodemographic, behavioral, clinical, and dietary survey was applied to a systematic subsample of 700 people. Dietary patterns were determined using factor analysis based on a food frequency questionnaire. Covariance analysis was used to determine the associations between dietary patterns and sociodemographic and behavioral variables, and multilinear regression to determine the association between dietary patterns and biological factors. RESULTS: Four patterns were identified: (1) the "cafeteria" pattern (simple sugars and saturated fat), associated with areas of medium sociodemographic and environmental homogeneity, high school and university-level schooling, and alcohol consumption; positively associated with systolic (SAP) and diastolic (DAP) arterial pressure, body mass index (BMI) and waist-to-hip ratio (WHR); and negatively associated with HDL. (2) The "traditional" pattern (including cereals, beans, and infusion beverages) was predominant among women and in the age group over 50 years;associated with alcohol consumption, higher income, and areas of medium homogeneity; positively associated with glucose levels and BMI; and negatively associated with triglycerides and WHR. (3) The "modern" pattern (low intake of fat and simple sugars; fish) was predominant among individuals from high homogeneity areas, with higher income and university schooling;negatively associated with DAP, total cholesterol, glucose levels, and LDL. (4) The "atherogenic" pattern (saturated fat, addition of salt to cooked foods and alcohol consumption) was predominant among males; associated with elementary schooling, smoking, alcohol consumption, and areas of medium and low homogeneity; and positively associated with total cholesterol, triglycerides, glucose levels, BMI, and WHR. CONCLUSIONS: The results indicate an unfavorable trend in the dietary patterns of this population, since three of the four patterns identified (cafeteria, traditional, and atherogenic) are significantly associated with risk factors for CVD.

Resumo em Espanhol:

OBJETIVOS: Este estudio tuvo dos propósitos: primero, determinar los conocimientos, las actitudes y las prácticas relacionados con el ácido fólico y las malformaciones congénitas en una muestra de conveniencia de mujeres hondureñas recién paridas; y segundo, identificar los patrones de consumo de alimentos en esta población y determinar los productos básicos de alto consumo para su posible fortificación con ácido fólico. MÉTODOS: Se seleccionaron las posibles participantes mediante un muestreo de conveniencia. Participaron 2 619 mujeres hondureñas que habían tenido un parto normal en alguno de los 16 hospitales públicos del país o de dos hospitales de la seguridad social que prestan servicios a la clase trabajadora hondureña. En un período de 10 meses se realizaron entrevistas personales directas, orales y exhaustivas en los propios hospitales antes del alta médica. El coordinador y el equipo de investigación supervisaron las entrevistas. RESULTADOS: La mayoría de las mujeres tenían entre 16 y 29 años de edad. Aproximadamente la mitad de las encuestadas (46,4%) habían oído sobre el ácido fólico y más de la tercera parte (37,6%) sabía que era una vitamina relacionada con la prevención de malformaciones congénitas. Las mujeres encuestadas atribuyeron estas malformaciones principalmente al consumo de drogas y alcohol (20,6%) y a la insuficiente ingesta de vitaminas (18,1%); no obstante, 23,0% relacionó las malformaciones con causas místicas, míticas o religiosas. En esta población no se consumen muchos alimentos ricos en folatos, excepto frijoles colorados, naranjas y jugos de frutas naturales. Los alimentos básicos más frecuentes que podrían fortificarse con ácido fólico fueron el arroz, las pastas y las harinas de trigo y de maíz. CONCLUSIONES: Los resultados de este estudio abren una posible vía para la fortificación de alimentos y, además, subrayan la necesidad de una mayor educación sobre la importancia del ácido fólico en la prevención de malformaciones del tubo neural en los fetos. Los resultados destacan la necesidad de ofrecer una educación sanitaria estandarizada a las mujeres hondureñas en edad reproductiva si se implementa de manera exitosa y sostenible el consumo de ácido fólico mediante la fortificación y suplementación de alimentos.

Resumo em Inglês:

OBJECTIVES: This study had two purposes: first, to determine the knowledge, attitudes, and practices related to folic acid and birth defects among a convenience sample of postpartum Honduran women; and second, to identify food consumption patterns in this population and determine high-consumption staples for potential folic acid fortification. METHODS: Convenience sampling methodology was used to recruit potential study participants. Participants for this study were 2 619 postpartum Honduran women who had had a normal, in-hospital delivery in one of 16 public hospitals located throughout the country or the two social security hospitals that provide services to the Honduran working class population. Over a 10-month period, in-depth, face-to-face oral interviews, supervised by the research coordinator and staff, were conducted in-hospital prior to discharge. RESULTS: The majority of the women were between 16 and 29 years of age. Approximately half of the respondents (46.4%) had heard of folic acid and over one-third (37.6%) knew that it was a vitamin related to preventing birth defects. Birth defects were most often attributed to drug and alcohol use (20.6%) and lack of vitamin intake (18.1%), but 23.0% related defects to mystical, mythical, or religious causes. Aside from red beans, oranges, and natural fruit juices, folate-rich foods are not widely consumed by this population. The highest consumption frequency of staple foods with the potential to be fortified with folic acid were rice, white flour, corn flour, and pasta. CONCLUSIONS: Results from this study provide potential avenues for food fortification, as well as underscore the need for further education about the role of folic acid in the prevention of neural tube defects. Results highlight that standardized health education for Honduran women of reproductive age is needed if folic acid consumption through fortification and supplementation is to be successful and sustainable.

Resumo em Espanhol:

Los autores realizaron una evaluación de los sistemas de salud mental en El Salvador, Guatemala y Nicaragua, por medio de un grupo de indicadores seleccionados. Para recopilar la información en los países se utilizó el Instrumento de Evaluación para Sistemas de Salud Mental de la Organización Mundial de la Salud (WHO-AIMS, por su sigla en inglés). Nicaragua, Guatemala y El Salvador tienen serias limitaciones en sus sistemas nacionales de salud mental, en especial en la atención primaria, así como una marcada insuficiencia de recursos humanos calificados. El presupuesto dedicado a la salud mental apenas representa 1% del presupuesto general de salud y los hospitales psiquiátricos situados en la capital de los países consumen más de 90% de los fondos de salud mental. Los limitados recursos (materiales y humanos) existentes se concentran en las respectivas capitales de los países. No se han formulado políticas ni legislaciones nacionales de salud mental. Sin embargo, las tres naciones cuentan con planes nacionales en ejecución. Asimismo, se ha avanzado en el diseño e implementación de programas de protección de la salud mental en situaciones de desastre. Es necesario establecer acuerdos con las procuradurías de los derechos humanos para incrementar la vigilancia y protección de los derechos humanos en las personas afectadas por enfermedades mentales. En los últimos años se han logrado impulsar algunas experiencias innovadoras que requieren ser generalizadas. La Organización Panamericana de la Salud (OPS/OMS) y el proyecto WHO-AIMS han contribuido al desarrollo de modelos comunitarios de servicios de salud mental. También se identificaron prioridades y se plantean recomendaciones para la acción.

Resumo em Inglês:

The authors evaluated the mental health systems of El Salvador, Guatemala, and Nicaragua, using a group of select indicators. The World Health Organization Assessment Instrument for Mental Health Systems (WHO-AIMS) was used to collect data from the nations. The national mental health systems of Nicaragua, Guatemala, and El Salvador have serious limitations, especially in primary care, and a marked lack of qualified human resources. Budget allocations for mental health care are barely 1% of the total health care budgets; and the psychiatric hospitals located in the national capitals consume at least 90% of those funds. The limited human and material resources available are concentrated in the respective country capital cities. National mental health policies and legislation have not been adopted; however, all three countries do have national plans in progress. Furthermore, all three have designed and implemented programs for mental health care in case of disaster. Agreements must be reached with offices for the defense of human rights to raise awareness and protection of rights for the mentally ill. In recent years, new experiences have been gained and these should be distributed more widely. The Pan American Health Organization (PAHO/WHO) and the WHO-AIMS project have contributed toward developing community models for mental health services. Lastly, priorities have been identified and action items recommended.

Resumo em Espanhol:

En Brasil se han notificado 4 243 049 casos de dengue entre 1981 y 2006, de ellos 5 817 casos de dengue hemorrágico/síndrome de choque por dengue (DH/SCD) y un total de 338 casos mortales. A pesar de que la enfermedad ha afectado a todas las regiones brasileñas, el mayor número de casos se ha notificado en las regiones nororiental y suroriental. Los virus del dengue (DENV) 1 y 4 se aislaron por primera vez en la región amazónica de Brasil en 1981 y 1982. La enfermedad se convirtió en un problema nacional de salud pública después de los brotes de DENV-1 y DENV-2 en el Estado de Río de Janeiro en 1986 y 1990, respectivamente. La introducción del DENV-3 en 2000, también en el Estado de Río de Janeiro, llevó a una grave epidemia con 288 245 casos notificados de dengue y 91 muertes. Las cepas del virus identificadas durante la epidemia de 2002 demostraron que el DENV-3 ha desplazado a los otros serotipos y se ha expandido a nuevas zonas, algo que merece una evaluación más profunda. En los pacientes con dengue de al menos tres regiones del país se han observado síntomas clínicos atípicos, entre ellos alteraciones del sistema nervioso central.

Resumo em Inglês:

A total of 4 243 049 dengue cases have been reported in Brazil between 1981 and 2006, including 5 817 cases of dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS) and a total of 338 fatal cases. Although all Brazilian regions have been affected, the Northeast and Southeast regions have registered the highest number of notifications. DENV-1 and DENV-4 were isolated for the first time in the Amazon region of Brazil in 1981 and 1982. The disease became a nationwide public health problem following outbreaks of DENV-1 and DENV-2 in the state of Rio de Janeiro in 1986 and 1990, respectively. The introduction of DENV-3 in 2000, also in the state of Rio de Janeiro, led to a severe epidemic with 288 245 reported dengue cases, including 91 deaths. Virus strains that were typed during the 2002 epidemic show that DENV-3 has displaced other dengue virus serotypes and entered new areas, a finding that warrants closer evaluation. Unusual clinical symptoms, including central nervous system involvement, have been observed in dengue patients in at least three regions of the country.