RESUMO
BACKGROUND: Dengue is increasing in its global presence with an estimated 4 billion people at-risk of infection in at least 128 countries. Despite the promising results of EcoHealth and community mobilization approaches to Aedes reduction, more evidence of their efficacy on reducing dengue risk is needed. The principal research question is to determine if interventions based upon community mobilization reduce the risk of dengue virus infection among children 3 to 9 years old compared to usual dengue control practice in Fortaleza, Brazil. METHODS: The present study will follow a pragmatic cluster randomized controlled trial (cRCT) design with randomization at the census tract level with equal allocation to the two arms. In each arm, there will be 34 clusters of 86 children between 3 to 9 years old for an expected total of 5848 children enrolled in the study, assuming a risk reduction of 29.5% based upon findings from a previous multi-site cRCT. The primary outcomes are rates of anti-dengue Immunoglobulin G (IgG) seroconversion and adult female Aedes density. The intervention is based upon a participatory health research approach, Socializing Evidence for Participatory Action (SEPA), where the research evidence is used to foster community engagement and ownership of the health issue and solution. Following allocation, intervention communities will develop and implement their own solutions that will likely include a wide variety of collective events and media approaches. Data collection activities over a period of 3 years include household visits for blood collection, household surveys, and entomological surveys; and qualitative activities including focus groups, in-depth interviews, and document analysis to evaluate the process, acceptability, fidelity, and sustainability of the intervention. Study participants will be aware of their assignment and all research staff will be blinded although the intervention assignment will likely be revealed to field staff through interaction with participants. DISCUSSION: The results of our study will provide evidence on community mobilization as an intervention for dengue control. We anticipate that if community mobilization is effective in Fortaleza, the results of this study will help develop evidence-based vector control programs in Brazil, and also in other countries struggling with Aedes-transmitted diseases. TRIAL REGISTRATION: ISRCTN66131315, registration date: 1 October 2018.
Assuntos
Aedes/virologia , Participação da Comunidade , Dengue/prevenção & controle , Controle de Mosquitos/organização & administração , Mosquitos Vetores/virologia , Adulto , Animais , Brasil , Criança , Pré-Escolar , Cidades , Pesquisa Participativa Baseada na Comunidade/métodos , Pesquisa Participativa Baseada na Comunidade/organização & administração , Dengue/transmissão , Dengue/virologia , Feminino , Educação em Saúde/métodos , Educação em Saúde/organização & administração , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Controle de Mosquitos/métodos , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
El síndrome de Sjögren es una enfermedad autoinmune. Afecta las glándulas que producen secreciones y humedad. Para esta investigación la revisión bibliográfica se realizó en bases de datos de Infomed, SciELO Regional, Clinical Key y PubMed; con el objetivo de actualizar los signos y síntomas orales, y el manejo estomatológico, en pacientes con síndrome de Sjögren. Los principales síntomas orales son: ardor y dolor de origen mucoso, disgeusia, dificultad en la fonación, formación del bolo alimenticio, masticación y deglución. Entre los signos orales se encuentran: pérdida del brillo, palidez y adelgazamiento de las mucosas, inflamación y candidiasis oral. El tratamiento estomatológico se realiza en tres fases: inicial, paliativa y preventiva, restauradora y rehabilitadora, y mantenimiento. Es importante conocer y diagnosticar los signos y síntomas orales del paciente con síndrome de Sjögren, pues estos requieren un manejo estomatológico especial.
Sjögren syndrome is an autoimmune disease. It attacks the secretions and humidity glands. For bibliographical databases reviewing, we used Infomed, SciELO Regional, Clinical Key and PubMed. In order to upgrade knowledge about oral signs and symptoms, dentistry`s management and treatment of Sjögren syndrome patients. Burning mucous and pain, dysgeusia, phonation, alimentary bolus formation, chewing and swallowing difficulties, are the main syntoms. Paleness, mucous membranes brilliance and weight loss, oral inflammation and candidiasis are most common signs. The dentistry`s management of patients with this syndrome, divides in three phases: start-up, palliative and preventive, restoring and rehabilitative, and maintenance. It is important to know and to diagnose signs and symptoms of the patient with a special dentistry`s management.