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The scope of this paper is to analyze the implementation of the Directly Observed Treatment Short-Course (DOTS) strategy in the control of tuberculosis, from the standpoint of the coordinators of the Tuberculosis Control Program (TCP) in six priority municipalities in the state of Paraíba, Brazil. Semi-structured interviews were conducted with seven TCP coordinators. Five municipalities proved to be DOTS success points achieving a 90% cure rate. Among the DOTS weak points in the political dimension, the following aspects were identified: lack of continuity of the TCP coordinator position; lack of preparedness of the local team; precarious technical-administration structure and insufficiency of the laboratory network. In the operational dimension, the search for respiratory symptoms by the Family Health Teams is still low. Changes of an epidemiological, operational and political nature have been incorporated, though the implementation and guarantee of the sustainability of DOTS in the State depends on the way the health services are organized and on the manager's political commitment to support the strategy.

We detected an outbreak of American cutaneous leishmaniasis in the Jequitinhonha River Valley, Minas Gerais, Brazil. Clinical and epidemiological aspects were studied for a period of two years. Data include results of physical examinations, Montenegro skin test and serology. In total 72 of the 299 individuals evaluated presented active lesions. Only one case out of these 72 patients showed the mucosal form of the disease. The precarious sanitary conditions, low educational level and low income found in the population studied demonstrated that, as with the other parasitic diseases, cutaneous leishmaniasis occurs with greater frequency in needy populations. A canine serological survey detected 20.3% (30/148) of dogs reactive to the Leishmania antigen. Lutzomyia intermedia was the predominant phlebotomine species and the majority of the specimens (84.9%) were captured in the peridomicile. Four samples from human and three from canine cases were isolated and characterised by PCR and isoenzymes as being Leishmania (Viannia) braziliensis. The peridomiciliary nature of the disease is discussed.

This work aims at continuing the contribution of Brazilian nursing in the elaboration of ICNPâ, which is being constructed by the coordination of ICN. It has two main objectives which are: 1) the definition of the terms identified in the CIPESC project and classified in the axis focus of nursing practice of the Nursing Phenomena Classification of ICNPâ-Beta Version; 2) the validation of these definitions within a group of judges composed of professionals who were previously involved in the execution of the CIPESC project, or who were teachers or nurse assistants in the area of community health nursing. The process was carried out in two phases, considering that the definitions that had a 0.80 rate of Agreement (RA) within the group of judges were validated. Ninety-nine definitions of the terms were validated: 26 attained a RA equal to 1.00; 56 attained a RA between 0.90-0.99 and, 17 attained a RA between 0.80 an 0.89. The definition of one term was not validated.