OBJECTIVE: To analyze the obstacles and challenges faced by managers and coordination professionals in their practices in municipal coordinating centers. METHODS: An exploratory descriptive study with a qualitative focus, applied in 40 managers and coordination professionals, from September 2017 to November 2018, with semi-structured interviews, resulting in two categories of analysis: limiting factors and factors that facilitate the management and operationalization of the Brazilian Unified Health System (SUS) coordinating sector. RESULTS: Analyzing the statements, we found evidence of the following limiting factors: failure in the criteria of referral, unavailability of beds, high demand, systemic difficulties in relation to the coordinating system, procedures of difficult scheduling and execution, increased repressed demand for elective procedures and difficulties in the flow of information between primary care and coordination. In the category of facilitating factors, the most significant possibilities were: expansion of the capability to know the user’s reality, improvement in primary care and increase in health financial resources, health training and education and restructuring, in addition to reorganizing internal coordinating procedures. CONCLUSION: The limiting factors of coordination show the need to promote actions that offer all SUS users full access to health services.

Objective To evaluate the secondary attack rate (SAR) in children and adolescents, contacts of essential activities workers who were infected by SARS‐CoV‐2; and to describe associated clinical and epidemiological data. Methods A cross‐sectional study conducted in children and adolescents aged 5 to 19 years of age, that were household contacts of parents and other relatives who were infected by SARS‐CoV‐2 in the city of Goiânia, Central Brazil, from March to October 2020. Sociodemographic and clinical data were collected from all participants. Nasopharyngeal and oropharyngeal swabs were collected and tested for SARS‐CoV‐2 RNA using real‐time reverse transcription polymerase chain reaction (RT‐PCR). Factors associated with SARS‐CoV‐2 infection and SAR were analyzed using Poisson regression. Results A total of 267 children and adolescents were investigated. The prevalence of SARS‐CoV‐2 RNA by the real‐time RT‐PCR test and/or the presence of COVID‐19 associated symptoms (anosmia/ageusia and flu syndrome) was 25.1% (95.0% Confidence Interval [95.0% CI] = 20.3‐30.6). More than half (55.1%) of the participants had sygns and symptoms. The most prevalent signs and symptoms in positive individuals were nasal congestion (62.7%), headache (55.2%), cough (50.8%), myalgia (47.8%), runny nose (47.8%), and anosmia (47.8%). The Poisson model showed that the following signs or symptoms were associated with SARS‐CoV‐2 infection: fever, nasal congestion, decreased appetite, nausea, anosmia, and ageusia. Families that had more than one infected adult, in addition to the index case, presented greater transmissibility to children and adolescents. Conclusions Our results contribute to the hypothesis that children and adolescents are not important sources of transmission of SARS‐CoV‐2 in the home environment during a period of social distancing and school closure; even though they are susceptible to infection in the household (around ¼ of our study population).

Objetivou-se analisar a acessibilidade aos serviços de saúde na Atenção Básica no estado de Goiás. Estudo descritivo de corte transversal com base nos dados secundários proveniente do Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica. A amostra do estudo foi constituída por profissionais de saúde das 1.216 UBS. Verificou-se que, a sala de acolhimento está ausente em 68,5% das unidades de saúde, o que prejudica, consideravelmente, os profissionais na tomada de decisão imediata. A ausência de consultórios clínicos em 2% dos locais dificulta a acessibilidade aos serviços de saúde na Atenção Básica em Goiás. Com relação ao horário e turno de funcionamento, verificou-se que 86% das unidades atendem cinco dias na semana em turnos de oito horas, não favorecendo a acessibilidade do usuário. Com este estudo constata-se a deficiência da acessibilidade aos serviços de saúde e a necessidade de maiores investimentos no fortalecimento da Atenção Básica.

the results point to the need for educational activities in the context of where the adolescents live, including school, community and family environments, to support and to minimize their vulnerability.

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