Delays in the diagnosis of tuberculosis in a town at the triple border of Brazil, Paraguay, and Argentina

Objective. To identify the factors linked to patients and health services in delays in the diagnosis of tuberculosis. Methods. Epidemiological study in Foz do Iguacu, Parana, Brazil, 2009. The Primary Care Assessment Tool, adapted for appraising tuberculosis treatment, was the instrument used. Descriptive statistics techniques were used, such as frequency distributions, central tendency and dispersion measurements (median and interquartile intervals), and odds ratios. Results. There were greater delays in seeking health services for those in the age group 60 years and older, for females, for patients with low levels of education, and for patients with poor knowledge of the disease. Clinical variables (being a new case and HIV infection) and behavioral variables (use of tobacco and alcohol consumption) were not linked with delays in diagnosis. The median time delays before diagnosis attributable to patients and to the health services were 30 days and 10 days, respectively. Emergency 24-hour medical services and primary health care services were not effective in identifying suspicious cases of tuberculosis and requesting tests to confirm the diagnosis, with a high percentage of referrals to the Tuberculosis Control Program clinic. Conclusions. Going to primary health care services for diagnosis increased the time before diagnosis of the disease was reached. The Tuberculosis Control Program clinic was more effective in diagnosis of tuberculosis, due to the training of the staff and to an organized process for receiving patients, including the availability of tests to support the diagnosis.

NUTRITIONAL BALANCE, ESSENTIAL OIL AND WOOD PRODUCTION FROM Corymbia citriodora Hill & Johnson WITH SEWAGE SLUDGE AND MINERAL FERTILIZER APPLICATIONS

The Corymbia citriodora is one of the most important forest species in Brazil and the reason is the diversity of its use, because it produces good quality wood and the leaves may be used for essential oil production. Although, there are not many studies about species and the handling effect in the nutritional balance. This study aimed to evaluate the biomass production and nutrient balance in the conventional production of essential oil and wood of Corymbia citriodora with sewage sludge application. The experiment design established was the randomized blocks, with four replicates and two treatments: 1 - fertilization with 10 tons ha(-1) (dry mass) of sewage sludge, supplemented with K and B, and 2 - mineral fertilization. It was evaluated the aerial biomass production, the nutrient export of the leaves, the essential oil and wood production at four years old. The trees that received application of sewage sludge produced 20 % more leaves biomass than the trees with mineral fertilization, resulting in larger oil production. Besides, the trees with sewage sludge application produced 14.2 tons ha(-1) yr(-1) of woody biomass that was 27 % higher than the treatment with mineral fertilization. For both treatments the N balance was negative, but treatment with sewage sludge application (-45 kg ha(-1)) was four times lower than the observed on mineral fertilization treatment (-185 kg ha(-1)). It may be concluded in this paper that the application of sewage sludge benefits the production of leaves biomass, essential oil and wood, besides result better nutritional balance of the Corymbia citriodora production system.

Mycetophilidae (Diptera: Bibionomorpha) type specimens in the Iziko South African Museum, Cape Town

FAPESP [2008/52324-6]

Social support, socioeconomic and clinical risk: comparison between to neighborhoods in a Brazilian upcountry town

The objective of this study was to compare the perceptions of two families living in two different neighborhoods (rated according to risk levels) regarding social support. A questionnaire was designed to assess social support according to the following dimensions: instrumental, emotional, religious, and support from friends, neighbors and family. The sample was comprised as follows: considering the 114 families living in neighborhood 1, 52 families were interviewed; and among the 162 families living in neighborhood 2, 60 families were interviewed. No significant difference was found related to instrumental, religious and emotional support, including the support from relatives among the families from both neighborhoods. The results disagree with the reviewed literature, which indicated a strong association between social support and families living at socioeconomic risk. In conclusion, social support is important for families, regardless of their risk stratification.