Background Following the emergence of the COVID-19 pandemic, the number of infected Brazilian people has increased dramatically since February 2020, with Brazil being amongst the countries with the highest number of cases and deaths. Brazilian vaccination began in January 2021, aimed at priority groups. This study analysed the spatial and temporal evolution of vaccination in Brazil between the 3rd and 21st epidemiological weeks (EW) of 2021. Methods Spatial and temporal analyses were performed comprising 19 EW. Cases were structured into priority groups—elderly population (EP); healthcare workers (HW); indigenous and quilombola populations (I/Q), dose, vaccine (CoronaVac or AstraZeneca), and place of vaccination. A sweep test was performed to identify vaccination rate clusters. Vaccination rates (VR) were calculated according to a spatial window for each Health Region, indicating clusters above/below expected VR. Based on the discrete Poisson probability model, spatial analysis was performed to detect high/low VR clusters, which were converted into Kernel maps. Points were generated from SaTScan analyses associated with Health Region centroids. Temporal analysis of VR was carried out to identify significant trends, and results were converted into temporal cluster graphs. P-value ≤ 0.05 was adopted. Results Southeast region concentrated most of the vaccines of EP and HW, followed by the Northeast. The latter region had the largest contingent of I/Q vaccinated. In all priority age groups and all regions, a higher percentage of complete CoronaVac vaccination schedules were observed compared with AstraZeneca. The temporal analysis identified high VR clusters of CoronaVac first and second dose in the early weeks, except for the EP; of AstraZeneca first dose, only for HW in the early weeks, and for EP and I/Q in the final weeks; of AstraZeneca second dose for all priority groups in the final weeks. I/Q populations had the lowest general VR. The spatial profile of VR indicated significant regional cluster differences between the priority groups. Conclusion This study highlights the importance of establishing vaccination priority groups, considering the asymmetries that a pandemic can trigger, notably in vast geographic areas, to contemplate the main objective of vaccination: to prevent casualties.

A partir das recomendações sobre experiências que aproximam a formação em saúde da realidade de populações em situação de vulnerabilidade, apresenta-se um relato de experiência, na perspectiva de um trabalhador residente em saúde, sobre a vivência de estágio no Território Indígena Xukuru do Ororubá (Pernambuco/Brasil). Emergiram reflexões sobre as condições de vida e saúde do povo indígena, o processo pedagógico de estágio e repercussões na formação e no fazer profissional, além das fragilidades relacionadas à cobertura e longitudinalidade do cuidado em saúde bucal. Por meio de intervenções com a perspectiva de autonomia dos sujeitos, foi possível aprimorar o olhar sociopolítico à questão indígena. Aponta-se a potencialidade da proposta, que estimula o confronto entre saberes profissionais instituídos e a realidade objetiva das comunidades, buscando superar o modelo colonial de cuidado, ampliando a perspectiva de atuação do profissional em formação para o Sistema Único de Saúde (SUS).

Este trabalho expõe o processo de construção e os percursos históricos da Organização Mundial da Saúde (OMS), desde sua origem até o atual cenário político e epidemiológico, destacando seu papel no enfrentamento à Covid-19. Foi utilizada, como referencial metodológico, a revisão narrativa, através de busca de literatura em bases de dados diversas, sem restrição quanto à data de publicação. Inicialmente, foram identificados os elementos e processos que subsidiaram a criação da agência. Em seguida, para exemplificação, foram descritas as condutas da OMS diante da epidemia do HIV/Aids, considerada uma das mais importantes da história. Os conflitos políticos, econômicos e institucionais da organização são abordados na perspectiva das condutas adotadas na pandemia do novo coronavírus, classificado como Emergência de Saúde Pública de Importância Internacional (Espii). Além do escopo internacional, destacam-se as intervenções da agência no Brasil e o posicionamento do atual governo brasileiro frente à atuação da OMS na pandemia. Em síntese, vislumbra-se um cenário incerto quanto às decisões políticas que virão a ser adotadas pela agência, levando em conta o desafio de enfrentar a crise sanitária em meio a político econômicas.

Background The latest national oral health survey showed a high prevalence of the need for dental prostheses between the Brazilian elderly. To classify this need, normative (clinical) and subjective (self-reported) criteria must be considered since patients' self-perception takes into account social and functional issues that arise with oral health problems. Few studies investigate the agreement between these criteria, as well as its determinants. Thus, this study aimed to investigate the accuracy of the need for the use of total dental prosthesis and factors associated with the agreement between criteria. Methods Cross-sectional study, carried out in three municipalities in the Metropolitan Region of Recife, with a random sample of 816 elderly people from 65 to 74 years old. The dependent variable was the accuracy, calculated by the agreement between the self-reported and the normative need for a total dental prosthesis, and the independents were assembled in three blocks (socioeconomic/demographic, access to oral health services and self-perceived oral health). Hierarchical logistic models were conducted for total upper prosthesis (TUP) and total lower prosthesis (TLP). Results The self-perception of the need for prosthetic use presented an accuracy of 75.9% (95% CI = 72.8-78.7%) for TUP and 78.6% (95% CI = 75.6-81.3%) for TLP. In the multiple analysis, the accuracy for TUP and TLP needs holds an association with the variables: family income, age and time since the last dental appointment. Conclusions In conclusion, the self-perception of need for dental prosthesis demonstrates potential applicability for the elderly, presenting notable accuracy values. It suggests that studies based on patients' self-reports should be stimulated, aiming for the evaluation and validation of self-reported criteria in different contexts and cultures. Furthermore, the identification of accuracy associated factors can help to build more meaningful questions to be used in future surveys. Key messages The use of the self-reported need for total dental prosthesis may be feasible when considering lower cost, reduced time of execution and ease of use in population epidemiological surveys. Application of self-reporting as an epidemiological tool for planning and monitoring oral health services, incorporating it in the form of indicators for oral health surveillance.

Background Primary oral health care services are responsible for performing collective actions, in order to prevent diseases and promote health through education. Brazilian indigenous populations, especially from the Northeast Region, suffer from insufficient access to oral health services. From this perspective, this study aims to verify the performance of oral health collective actions indicators in the territory of the Xukuru do Ororubá indigenous ethnic group (Pesqueira, Brazil) in 2018. Methods An observational and ecological study. Secondary data for 2018 were extracted from the Indigenous Health Care Information System, part of the Brazilian Unified Health System (SUS). Performance of collective oral procedures conducted by the oral health teams in the Xukuru territory was analyzed through indicators applied for the evaluation of oral health actions and services related to primary care. Results There was an average monthly coverage of the collective supervised toothbrushing (CST) of 47.8% for the entire Xukuru territory. The average monthly coverage of the collective topical fluoride application (CTFA) was 2.8%. There was an annual average of 6.2 collective dental procedures (CDP) per capita. Conclusions Less than half of the population participated in CST actions. CTFA proved to be almost nonexistent, with poor coverage for the general territory population. The annual average of CDP was satisfactory which may, in general terms, demonstrate greater concern with preventive measures. However, it appears that such average gains strength due to the volume of health education actions, which is part of the indicator sum. Analyzing the low coverage of CST and CTFA in isolation, a reality of low access to fluoride in this indigenous population can be seen. Results points to the need for greater provision of collective actions in the indigenous territory studied, aiming at strengthening the prevention of diseases and/or aggravations of oral health, in all life cycles. Key messages Measurement of the performance of oral health teams regarding the collective oral health actions in the territory of the Xukuru do Ororubá ethnic group. Analysis of the indigenous oral health stored data quality, aiming to offer support for system management decision making and to the services organization improvement.