Abstract. Environmental changes have a strong influence on the emergence and/or reemergence of infectious diseases. The city of Salvador, Brazil -currently the focus of a housing boom linked to massive deforestation-is an example in point as the destruction of the remaining areas of the Atlantic Forest around the city has led to an increased risk for Chagas disease. Human domiciles have been invaded by the triatomine vectors of Trypansoma cruzi, the flagellate protozoan causing Chagas disease, a problem of particular concern in urban/suburban areas of the city such as the Patamares sector in the north-east, where numbers of both the vector and human cases of the disease have increased lately. To control and prevent further deterioration of the situation, the control programme for Chagas disease, developed by the Bahia Center for Zoonosis Control, has divided the area into a grid of designated surveillance units (ZIs) that are subjected to vector examination. In six out of 98 of these ZIs, 988 triatomes were collected and georeferenced during the 3-year period between 2006 and 2009. The hottest months, that are also generally the driest, showed the highest numbers of triatomines with Triatoma tibiamaculata being the predominant species (98.3%) with Panstrongylus geniculatus present only occasionally (0.6%). Fifty-four percent of all triatomines captured were found inside the homes, and 48.6% out of 479 individuals in the affected ZIs selected for analysis tested positive for T. cruzi infection. The study presented here is a pioneering initiative to map the spatial distribution of triatomines based on geographical information systems with the additional aim of contributing to an expanded knowledge-base about T. cruzi and its vectors in urban areas and raise public health awareness of the risks involved.

To understand the occurrence of the Congenital Zika Syndrome (CZS), the living conditions of pregnant individuals must be considered in order to identify factors and areas of risk. An intersectional approach provides an understanding of the vulnerabilities to which Black women are subjected. To that end, we present an overview of the spatio-temporal distribution of confirmed cases of microcephaly associated with CZS during the 2015-2016 period in Salvador, Bahia, Brazil based on a survey of Black and Caucasian, pregnant women seen through the intersectional lens of race and class. To consider the confirmed cases of microcephaly and other neurological anomalies associated with CZS, a Living Condition Index (LCI) was utilized to rate the socio-environmental vulnerability of pregnant women. There was less information in the notification records with regard to Black, pregnant women resulting in fewer examinations. Twelve, highrisk areas for Black, pregnant women were identified but only two for Caucasian women. CZS cases referred to Black, pregnant women were found to be concentrated in census sectors with a low (31.6%) and very low (34.5%) LCI, while those referred to Caucasian, pregnant women were concentrated in areas with a high (35.6%) and intermediate (29.4%) LCI. The study concludes that inequities in health expose different population groups to different forms of illnesses, and institutional racism solidifies scenarios of exclusion. In this sense, Black women experiences manifest directly in their health. Confrontation with arboviruses requires the implementation of inter-institutional policies aimed at overcoming discriminatory practices of exposure.

INTRODUÇÃO: A morte de jovens negros é o principal resultado da violência urbana. Quando esses jovens morrem deixam os seus familiares, principalmente as mães negras, em um contexto de sofrimento causado por essa perda. Nesse contexto, as mulheres negras desenvolvem formas de enfrentamento para lidar com a dor. OBJETIVO: Analisar formas de enfrentamento de mulheres negras diante do assassinato de seus filhos na capital baiana. MÉTODO: Trata-se de uma pesquisa qualitativa, do tipo documental, realizada em sites que publicaram relatos dessas mulheres entre 2014 a 2019.  Os dados foram analisados a partir da análise de conteúdo, com fundamento em Minayo. Para a realização da pesquisa, fez-se o uso de documentos públicos e de acesso livre. RESULTADOS: Foram mapeados oito relatos de mães negras, sendo sete oriundos de jornais online e um em blog. Seus relatos revelam muito sofrimento psíquico, e desvelam contextos marcados por racismo, violências e violação de direitos. Nesse cenário emergiram algumas formas de enfrentamentos como a religiosidade, a busca por justiça e a percepção das mães negras diante do racismo. CONSIDERAÇÕES:  Foi possível conhecer a caminhada dessas mulheres que foram atravessadas pela violência e que a partir disso construíram formas de enfrentamento e cuidado. Os resultados apontam para maior necessidade de pesquisas que investiguem mais sobre esse sofrimento e seus desdobramentos na saúde mental dessas mães.

This study analyzes how the National Policy on Comprehensive Health of the Black Population (PNSIPN) has been implemented in three municipalities in the state of Bahia, Brazil. This qualitative study is part of an ongoing action research, in which semi-structured interviews were performed with 27 professionals from family health, primary health care, and health district headquarters. Content analysis presented four categories: primary health care (PHC); Black health; health care in diversity; and PNSIPN. Health professionals showed a superficial understanding of PHC, despite recognizing it as a gateway. A specific health care for the Black population was considered irrelevant, on the grounds that everyone is equal. Diversity was linked to the LGBTQIA+ population and life cycles, but not to ethnicity or skin color. All municipalities lacked knowledge about the PNSIPN and the practical means to implement it in their daily work. Its absence in the services’ planning and work processes shows an urgent need for permanent education in health so that managers and professional can appropriate the principle of equity.

Resumo Este artigo analisa como a Política Nacional de Saúde Integral da População Negra (PNSIPN) tem sido implementada na atenção à saúde em três municípios do Estado da Bahia, Brasil. Trata-se de um estudo qualitativo que faz parte da primeira etapa de uma pesquisa-ação, na qual foram realizadas entrevistas semiestruturadas com 27 profissionais de unidades de Saúde da Família, Atenção Básica e Sede do Distrito Sanitário. Após análise de conteúdo, emergiram quatro categorias: Atenção Primária à Saúde (APS); Saúde da População Negra; Atenção à saúde na diversidade; e PNSIPN. Como resultado, os profissionais apresentaram entendimento superficial sobre a APS, apesar de a reconhecerem como porta de entrada. A relevância de uma atenção à saúde específica para a população negra foi desconsiderada, sob o argumento de que todos são iguais. A diversidade racial não foi reconhecida dentro do cotidiano, sendo o termo atrelado à diversidade LGBTQIA+ e aos ciclos de vida. O dado comum nos municípios foi o desconhecimento da PNSIPN e dos meios práticos para inseri-la no cotidiano do trabalho. A ausência da política para essa população no processo de planejamento e trabalho dos serviços revela a urgência da educação permanente em saúde para a apropriação do princípio de equidade pelas gestoras e profissionais.