Dynamic analysis of major public health emergency transmission considering the dual-layer coupling of community–resident complex networks

We construct a dual-layer coupled complex network of communities and residents to represent the interconnected risk transmission network between communities and the disease transmission network among residents. It characterizes the process of infectious disease transmission among residents between communities through the SE2IHR model considering two types of infectors. By depicting a more fine-grained social structure and combining further simulation experiments, the study validates the crucial role of various prevention and control measures implemented by communities as primary executors in controlling the epidemic. Research shows that the geographical boundaries of communities and the social interaction patterns of residents have a significant impact on the spread of the epidemic, where early detection, isolation and treatment strategies at community level are essential for controlling the spread of the epidemic. In addition, the study explores the collaborative governance model and institutional advantages of communities and residents in epidemic prevention and control.

Ancylostoma ceylanicum and other zoonotic canine hookworms:neglected public and animal health risks in the Asia-Pacific region

Zoonotic hookworm infections remain a significant public health problem,causing nearly 500 milion cases globally and approximately four million disability-adjusted life years lost annually.More than one-fth of these cases are attrib-uted to Ancylostoma ceylanicum,an emerging zoonotic health issue in the Asia-Pacific region.This review presents key research gaps regarding the epidemiology,diagnosis,control,prevention and elimination of A.ceylanicum and other canine zoonotic hookworms as neglected health threats.A.ceylanicum is the second most prevalent human hook-worm in the region;it is the most common hookworm among dogs and cats-reservoirs of zoonotic infections.Previous population genetic and phylogenetic analyses revealed that A.ceylanicum has three possible transmis-sion dynamics:zoonotic,animal-only,and human-only pathways.The actual burden of zoonotic ancylostomiasis in most endemic countries remains unknown due to the use of parasitological techniques(e.g.,Kato-Katz thick smear and floatation techniques)that have reduced diagnostic performance and do not allow accurate species identifica-tion in helminth surveys.The emergence of benzimidazole resistance in soil-transmitted helminths(STHs),includ-ing hookworms,is a concern due to the protracted implementation of mass drug administration(MDA).Resistance is conferred by single nucleotide polymorphisms(SNPs)that occur in theβ-tubulin isotype 1 gene.These mutations have been reported in drug-resistant A.caninum but have not been found in A.ceylanicum in the field.A.ceylanicum remains understudied in the Asia-Pacific region.The zoonotic nature of the parasite warrants investigation of its occur-rence in human and animal reservoir hosts to understand the dynamics of zoonotic transmission in different endemic foci.The detection of benzimidazole resistance-associated SNPs in zoonotic hookworms from Asia-Pacific countries has yet to be thoroughly explored.Considering the high level of hookworm endemicity in the region,the circulation of resistant isolates between humans and animals potentially presents a significant One Health threat that can under-mine current MDA and proposed animal deworming-based control efforts.

Linking Perceived Risk of Public Health Emergency to Psychological Distress among Chinese College Students: The Chain Mediation Role of Balanced Time Perspective and Negative Coping Styles

Background:With public health emergencies(PHE)worldwide increasing,the perceived risk of PHE has been one of the critical factors influencing college students’psychological distress.However,the mechanisms by which the perceived risk of PHE affects college students’psychological distress are not clear.The study’s purpose was to investigate the mediation roles of deviation from a balanced time perspective(DBTP)and negative coping styles between the perceived risk of PHE and psychological distress.Methods:A convenience sampling method was used to survey 1054 Chinese college students with self-reporting.Data was collected using the Public Risk Perception Scale(PRPS),the Zimbardo Time Perspective Inventory(ZTPI),the Simplified Coping Style Questionnaire(SCSQ),the PHE Anxiety Scale,and the Chinese version of the Patient Health Questionnaire(PHQ).The associations between the perceived risk of PHE,DBTP,negative coping styles,and psychological distress were clarified using the correlation analysis.Additionally,the mediating roles of DBTP and negative coping styles between the perceived risk of PHE and psychological distress were investigated using a structural equation model.Results:The findings revealed low to moderate correlations between the variables studied.Students’perceived risk of PHE was a positive predictor of their psychological distress(b=0.219,p<0.01).DBTP and negative coping styles played chain mediation roles between them with the effect being 0.009 and a 95%Boot CI of[0.003,0.023].This chain mediation model had an excellent fit index(χ^(2)/df=4.732,CFI=0.973,TLI=0.930,RMSEA=0.048,SRMR=0.047).Conclusion:These findings showed how the perceived risk of PHE affected college students’psychological distress.Specifically,these results suggested that improving students’mental ability to switch effectively among different time perspectives depending on task features and situational considerations and reducing their negative coping styles might be effective ways to promote their mental health.

Principle for the Installation of Accommodation for Sick guards in Public Health Establishments in Brazzaville in the Republic of Congo

The results of scientific studies of human social facts in the field of health show that the management of a patient should involve the patient’s entourage,whatever the status or size of the health establishment.In healthcare establishments in the Congo,the following are recognised as being responsible for medical care:specialist doctors,doctors,midwives,nurses and care assistants.The patient’s family and close friends are responsible for looking after the patient and financing care.The hospital infrastructure does not provide any space for the patient warden who accompany the patient during reception and hospitalisation.This makes Congolese hospitals inefficient for patient care.How can we integrate the function of the Sick guard and the assistance of the family,in order to reduce the mortality rate and repair the harm caused to patients requiring the presence of relatives during their stay in hospital,which is considered to be a dangerous place?This article examines the functional principles for configuring the space that patient warden would occupy in the patient care system.On the basis of a documentary analysis of sociological and architectural studies of existing facilities,this article proposes a typical accommodation model with the spaces needed to ensure the well-being and effectiveness of the patient warden with the patient.These are rooms with minimum space for 2 to 4 individual beds,equipped with toilets and showers.The accommodation has a dining area,kitchen and laundry facilities.In the future,this accommodation will become part of the hospital estate and may be occupied by orderlies and patient warden recruited by the hospital administration.

Identification and Optimisation of Cycling Life Circle in High Density Communities with Public Health Support: A Case Study of Tiantongyuan in Beijing

In recent years,the compact development of high-density cities has sparked ongoing interest in healthy urban environments and public well-being.This study examines the relationship between cycling behaviors and the built environment of streets in Tiantongyuan Community,a typical high-density area in Beijing,China.By observing street spaces and summarizing residents’travel modes and behaviors,the study evaluates the impact of street design on cycling habits.In order to reveal the riding behavior characteristics of residents in different time periods and different street spaces,tools such as track recording APPs and the Gopro Motion Camera are employed to collect street view pictures and riding track data comprehensively,analyzing the various travel purposes of residents in Tiantongyuan community and the riding OD activity tracks of the main entrances and exits of the community.Meanwhile,by conducting the questionnaire survey of residents’travel demands and OD data of Baidu,and utilizing geographic information system(GIS)for data visualization,this study further investigates the distribution characteristics of cycling hotspots,cycling paths and cycling space,accurately identifies the cycling life circle of this community based on the spatial and temporal scales,and further puts forward the optimization strategy of the cycling network.Some cycling-friendly street space optimization strategies are suggested to deeply analyze the mechanism of the built environment of street space in high-density communities on the cycling activities and health of urban residents,with a view to provide accurate data support for the renewal of street cycling space.

Greenway Non-mortorized System Planning from the Perspective of Public Health

The important role of greenway non-mortorized systems in urban sustainable development was summarized,pointing out their potential value in improving the ecological environment,promoting healthy living,and enhancing community connections.Based on the analysis on some cases of urban greenway construction in China,specific transformation models and strategies were proposed for greenway construction,which could integrate green spaces with non-mortorized system,so as to enhance the comprehensive efficiency of urban linear spaces.

Comprehensive Analysis of Cancer Incidence and Mortality Trends in Costa Rica: Implications for Public Health

This commentary delves into the evolving landscape of cancer incidence and mortality in Costa Rica, presenting a comprehensive analysis of the data. Key findings reveal a concerning upward trajectory in cancer incidence rates, placing Costa Rica at the forefront within Central America. While prostate cancer and breast cancer dominate, disparities emerge when scrutinizing gender-specific trends. Notably, stomach and cervical cancers show declines, potentially attributed to targeted interventions. However, colorectal and liver cancers witness mortality increases, necessitating strategic responses. Geographical disparities persist across provinces, highlighting the need for equitable healthcare access. In conclusion, this commentary underscores the urgency of addressing the burgeoning cancer burden in Costa Rica, calling for evidence-based interventions and collaborative efforts on a global scale.

REDISSE in Benin and Lessons Learned for the Management of Public Health Emergencies after Five Years of Implementation

Introduction: Benin was embarked on phase 3 of the REDISSE Benin project (Regional Disease Surveillance Systems Enhancement) which began in 2018. The objectives were in five key components namely, Surveillance and health information;Laboratory capacity building;Emergency preparedness and response;Human resources management for effective disease surveillance and epidemic preparedness;and Institutional Capacity Building, Project Management, Coordination and Advocacy. After five years of implementation, this study aimed at the documentation of lessons learned and best practices. Methods: A descriptive cross-sectional study. Apart from individual semi-structured interviews, a thematic workshops bringing together the project’s main stakeholders recruited on an exhaustive way by component to identify and validate lessons learned, good practices and propose improvement mechanisms to be taken into account by the sector. Criteria were set up and used to validate best practices and lessons learned. Results: A total 54 (Surveillance workshop), 47 (Preparedness & response workshop), 53 (Human Resources workshop), 26 (Laboratories workshop) participated to the thematic workshops, and five interviews. The good practices (33: 9 for animal health, 7 for human health and 17 crosscutting) and lessons learned (10: 3 for animal health and 7 for human health) have been identified and have been the subject, depending on the case, of proposals for improvement or conditions necessary for their maintenance. Discussion: The richness of a project lies not only in the immediate achievement of its results, but also and above all, in its usefulness for similar interventions, whether in the local, regional, national or international context. It is in this context that the REDISSE project has set out to make public the various lessons learned and best practices from the implementation of its activities over a period of some five consecutive years.

Assessment of public perspectives and barriers towards dengue preventive practices using the Health Belief Model in Puducherry,India:A cross-sectional study

Objective:To assess the perspectives and barriers towards dengue preventive practices among the residents of Puducherry,India.Methods:A cross-sectional survey was conducted in 300 households in Puducherry,using a population-proportionate(7:3)distribution from urban and rural areas by grid sampling.One adult interview per household was conducted and the participants were selected using a KISH grid.A semi-structured questionnaire based on the Health Belief Model(HBM)with additional questions on knowledge assessment was used.Knowledge was assessed based on the correctness of answers and the HBM scores were calculated on a 5-point Likert scale.Participants were categorized based on the median score under each domain.Logistic regression was used for adjusted analysis and models were built to predict the performances in each domain.Results:Four percent of the participants lacked basic knowledge regarding dengue transmission.While 208(69.3%)participants did not consider themselves at risk of contracting dengue within the next year,majority perceived dengue as a disease with low severity.Around 49.3%(148)were skeptical about the benefit of time and money spent on dengue prevention.Inadequate government efforts were stated as the major barrier(47.0%)and frequent reminders(142,47.3%)as the major cue to action.Age above 50 years(aOR 1.78,95%CI 1.04-3.06,P=0.037)and rural locality(aOR 2.68,95%CI 1.52-4.71,P=0.001)were found to be significantly associated with poor knowledge scores.Urban participants had a significantly higher chance to perceive low susceptibility as compared to the rural counterparts(aOR 1.74,95%CI 1.05-2.9,P=0.03).Participants with less than a high school education had low perceived benefits(aOR 2.46,95%CI 1.52-3.96,P<0.001)and low self-efficacy scores(aOR 2.66,95%CI 1.61-4.39,P<0.001).Conclusions:This study identifies key gaps in dengue prevention,including low perceived susceptibility,mild disease perception,limited knowledge of breeding sites,and overreliance on government efforts.Tailoring interventions to community needs,stratified to factors influencing the community perspectives can significantly improve dengue prevention efforts.

Building the Capacity of Health Professionals in Monitoring and Evaluation in a Public Health Institution: Experience of the National Institute of Public Health (NIPH) of Côte d’Ivoire

Background: In the context of the fight against HIV, a lack of skills in monitoring and evaluating the personnel in charge of activities has been identified at the national level. It was the subject of a priority axis of the national plan for monitoring and evaluating the fight against HIV (2006-2010) that was aimed at strengthening the capacities of actors in this area. To increase the critical mass of competent human resources in the short term, the National Institute of Public Health (NIPH) of Côte d’Ivoire organized monitoring and evaluation training sessions for healthcare professionals from 2011 to 2016. Methods: A single case study with multiple levels of analysis was carried out, combining a qualitative survey and a literature review. An evaluation was carried out six months after each training session. In addition, the results of the pre- and post-tests and of the daily and final evaluations that accompanied the various training sessions were used to provide further information. The qualitative data collected were analyzed using INVIVO 15 software. Results: Some 89 health professionals (69% men and 31% women) working at the national level (51% at the central level, including 58% in health programs) and in development partner agencies (37%) participated in this capacity building program. Most participants were senior health managers (56%), data managers (23%), and statisticians and computer scientists (10%). Almost all the trainings were financed by 16 technical and financial partners (85%), mainly the MEASURE Evaluation project (27%). Conclusion: M&E training, despite all its imperfections, has made it possible to identify M&E training needs at the national level and to increase the critical mass of national skills and to have some culture in M&E.

The Enforcement of Occupational Safety and Health Requirements in Public and Private Sectors in the Emirate of Abu Dhabi, the United Arab Emirates

Research Problem: In Abu Dhabi, limited implementation of OSH Regulations contributes to the general unawareness among employees and workers about occupational hazards and safety measures, resulting in slow responsiveness toward enforcement measures and a lack of self-regulatory approaches within companies. Purpose: The purpose of this study is to examine the implementation methods practised in Abu Dhabi with those in developed countries with established OSH regulatory bodies. Methodology: Qualitative and quantitative research methods were employed to gather primary research data. Workers from various industries in Abu Dhabi were sampled on purpose and asked to respond to questionnaires and interviews on OSH protocol awareness and implementation, and circumstances of workplace incidence. Results: The findings of this study showed that the enforcement of OSH requirements in UAE positively correlated to a reduction in the rate of work-related injury and improved business performance. The quantitative research data showed that the energy sector had the highest score (15) while the tourism sector had the lowest score (5.3) in occupational health systems and improvements in business efficiency and productivity. Implications: The outcomes of this study shed light on the importance of implementing OSH Guidelines for companies to empower their safety managers to fully enforce OSH requirements in their organisations. In conclusion, effective OSH enforcement requires cooperation between general workers and OSH managers and facilitation from business owners.

Development of Human Rights-Based Practices in Psychiatry from People Living with Mental Health Problems During Involuntary Hospitalization or Treatment - A Secondary Publication

This article presents the research protocol of an interpretative phenomenological study that aims to understand the lived experiences of coercion and human rights-based practices in psychiatry from the perspectives of people living with mental health problems during involuntary hospitalization or treatment.This qualitative study used an interpretative phenomenological analysis design.In-depth,one-on-one interviews along with a socio-demographic questionnaire were conducted with approximately 10 participants.Data analysis was followed by an iterative and hermeneutic emergence coding process.By centering human rights-based practices on the lived experiences of people living with mental health problems who encountered coercion,this study highlighted the contributing and limiting factors to the recognition of human rights in nursing practices.This study also promoted the development of nursing knowledge and practices that can significantly contribute to an individual’s recovery process.

Artificial Intelligence Based on Resilient Leadership in the Health Sector-A Secondary Publication

At present,it is impossible to deny the existence of artificial intelligence in various areas of social life,understood as the simulation of expert human intelligence from computer processes that involve learning,reasoning,and self-correction,its benefits to the medical field,in particular,are innumerable,but their incorporation into health systems has been gradual for many reasons.According to the above,this research analyzed artificial intelligence based on resilient leadership in the health sector,for which qualitative research was carried out with a documentary-bibliographic design with printed and electronic documentary sources with theoretical contributions fromÁvila,Mayer,and Quesada[1],Morgan[2],Villa[3],and Finol[4],among others.It is highlighted that resilient leadership has become a strategic factor in all organizations,since times of uncertainty and changes lead institutions to properly manage the incorporation of technologies specifically AI,achieving in this way that the centers and professionals in the field of health assume the needs of the contexts and the innovations of the same.It is concluded that resilient leadership will allow artificial intelligence in the health sector to generate higher levels of learning and adaptability to the transformations that are necessary,whose resistance would make its application difficult and in the long run it will leave behind professionals who refuse to assume the contributions of these innovative techniques in medical practice.

Weighing in on monkeypox against the criteria of public health emergency

The monkeypox,a viral zoonotic disease usually found in forest areas of Central and Western Africa,has spread worldwide through new modes of transmission little understood.The WHO on 23 July 2022,declared the virus a Public Health Emergency of International Concern(PHEIC).The declaration has stirred criticism from leading scientists that the criteria for PHEIC as defined by International Health Regulation have not been met and it is non-transparent and contradictory.This paper reviews the criteria of PHEIC and weighs the rationales behind the declaration to increase the clarity of the WHO's decision,justifications,and legitimacy in the ongoing outbreak.

全健康(One Health)视角下绿色健康社区景观设计体系构建

以全健康(OneHealth)视角为出发点,保障人、环境和动物的健康对于社区健康环境规划与设计具有重要意义。在现有健康社区景观设计体系中,人、环境、物种三者关系虽被提及,但未被系统探究,健康社区建设实践也需要系统性的景观设计体系支持。基于全健康理念中人、环境和物种的相互关系,结合生态系统服务功能、康复景观理论和园艺疗法,进一步探讨人、环境、物种健康之间的关联途径。通过对全健康理念视角下的3个层次进行演绎发展,归纳总结了人的健康、环境健康和物种健康的组成要素及内容,构建了以人的健康需求为导向的社区健康设计框架,提出了以人与人际、人与环境和人与物种为三大圈层的健康社区景观设计体系。全健康视角为社区健康环境设计提供了一个系统性、整合性且具有操作性的框架,未来应重视健康社区体系中各类疗愈空间的设计与使用,以增进社区居民共享的健康福祉。

Does higher tax rate affect tobacco usage?Unravelling the nexus between tobacco regulatory control and public health concern

Objectives:Bangladesh stands as a prominent global consumer of tobacco,with alarming consequences on public health.The Global Adult Tobacco Survey reported that tobacco consumption claimed over 126000 lives in 2018,contributing to 13.5%of all deaths in the country.This study aims to explore the effectiveness of higher tax rates and tobacco use regulation as control mechanisms in mitigating tobacco consumption and health care cost burden,with a particular emphasis on its implications for public health.Methods:This study is based on the annual time series data over the period 2000-2020.The study employs the ordinary least square method to analyze the quantitative confirming the stationarity of data at level.This research uses different models to investigate individual effects and combined effects on both tobacco consumption and tobacco health care cost burden.Results:The study finds a negative relationship between tobacco tax rate and tobacco consumption.More specifically,the higher tax rate of tobacco(low(β=-0.3495),medium(β=-0.2319),high(β=-0.9033),premium(β=-0.7322),filtered(β=-0.2114),and non-filtered(β=-0.3452)categories)is significant to reduce tobacco use at 1%level of significance.The study finds similar results when it applied tobacco retail price instead of tobacco tax rate as the independent variable.Finally,the study investigates the impact on health care cost through tobacco consumption,tobacco control law,growth rate,export-import,and tobacco production.The results indicate that tobacco consumption,export-import,and tobacco production increases health care cost burden while tobacco use regulatory decreases it.By reducing tobacco consumption,higher taxes and tobacco use regulation contribute to alleviating the burden on the healthcare system,promoting healthier lifestyles,and aligning with global health objectives.Conclusions:Higher tax rate on tobacco products is necessary to increase the retail price so that tobacco users cannot consume tobacco.Specific tax and uniform tax base are needed so that tobacco users cannot switch to lower priced brands.Tobacco control laws need to revised and proper implementation should be ensured as well,to achieve the goal of tobacco free Bangladesh by 2040.Tobacco-related diseases,responsible for a significant proportion of deaths in the country,could witness a considerable decline with the successful implementation of higher tax rates and tobacco use regulation.This study provides insights that not only contribute to the economic discourse but also accentuate the broader public health benefits arising from effective tobacco taxation policies.

Leadership,communication,and science:three pillars essential to public health emergency response and closing the gap in the HIV response among key populations

Globally,there have been multiple public health emergencies in recent decades.High rates of morbidity,occasionally mortality,and economic instability are usually associated with pandemics.One of the epidemics that has significantly increased morbidity and mortality worldwide is the human immunodeficiency virus(HIV)and acquired immune deficiency syndrome(AIDS)pandemic.HIV has a disproportionately negative impact on key populations.Strong leadership,effective communication,and sound science are necessary for public health emergency(PHE)responses to be successful.These three PHE response pllars are also essential for bridging the HIV response gap among key populations in the setting of restrictive laws.In this review,we explored the importance of these three pillars of successful PHEs responses,and how they are essential to closing the gap in the HIV response among key populations.Leaders must make decisions and instil a sense of authority in the populace during PHEs to foster trust and confidence.Leaders should base their choices on scientific evidence.Effective communication during PHEs should be proactive,polite,imaginative,innovative,and constructive.To address gaps in the HIV response among key populations,leaders must create a supportive environment for effective communication and scientific research,communication should be used to raise awareness of HIV and to dispel stigma and discrimination,while science should provide evidence of efficacy and effectiveness of interventions amongkey populations.

Reacting to Epidemics:The Innovative Imperial Public Health System during the Late Northern Song Dynasty

Song China was a period in which China experienced a great increase in its population.Concurrently,the Song dynasty also experienced a rise in the frequency of epidemics and two major wars with the Western Xia and Liao dynasties during the 1000s and 1040s.The consequences of these changes were exacerbated by the increased geographical mobility of certain social groups such as traders and examinees attending civil service examinations.Thus,casualties of wars,epidemics,or disease,especially of people whose families were far away and could not care for them were left without care and“their corpses often lay bare along the roads.”This new social environment created a need for general relief.The Northern Song government(960-1127 CE),especially during the reign of Emperor Huizong,established an innovative public health system to address this issue.The public health system included poorhouses,public hospitals,and pauper’s cemeteries.The first were more of charity organizations,whereas the latter two promoted public health by providing medical services for the poor and burial for those that nobody cared for.In terms of rationale behind these institutions,on the one hand,they constituted an attempt to get the poor and homeless off the streets while providing them relief or burial.On the other hand,it seems that Huizong’s deep concern with medicine propelled him to design and implement a comprehensive public health system oriented to prevent contagion and outbreak of epidemics.This article depicts the background,the organization,and the functions of the system.The article also discusses the conditions and reasons that gave rise to such a unique undertaking by the Northern Song government.

Adolescent health issues:The role of publich health nurses

Adolescent health(AH)is an integral part of public health with the goal of improving the healthy development,safety,and well‑being of adolescents because the behavioral patterns established during this period influence the health status of the adolescents and the risk of developing chronic diseases during adulthood.Adolescence being a time of great physical and psychological change,many social and physical conditions as well as behavioral pattern can impact AH and heighten the risk of illness and diseases.This makes adolescents to be susceptible to various health issues by nature because of their stages of development,which affects their ability to make safe decisions,and the need to rely on significant others for support.Other factors like desire for greater autonomy,pressure to conform to peers,exploration of sexual identity,increased access to and use of technology,violence and sexual abuse,social and cultural norms,family circumstances,emotional and physical environment of the adolescents contribute significantly to adolescents’health issues.Therefore,nurses have significant roles to play to ensure optimal growth and development of the adolescents and to prevent and reduce the impact of changes associated with adolescence on the health and well‑being of the adolescents.This article presents the concept of adolescence,components of AH,health‑related challenges associated with adolescence,and role of public health nurses.

Difficulties Faced by Physicians in the Diagnosis of Endometriosis in the Brazilian Public Health System

Endometriosis is a clinical and recurrent condition characterized by the presence of functional endometrial tissue outside the uterine cavity and myometrium. It is estimated that 6% to 10% of women of reproductive age, 50% to 60% of adolescents and adults with pelvic pain, and up to 50% of women with infertility are pregnant from the condition. However, this proportion tends to be even greater due to the difficulty in diagnosing it: because it presents different symptoms, lack of information from health professionals, and a high-cost diagnostic test. Another aggravating factor is the average time from the onset of symptoms to the medical diagnosis, which even today ranges from five to ten years;this delay has consequences for disease progression, as it prevents early treatment, which is important for improving pain levels and physical and psychological well-being. Aware of these mishaps, it is therefore important to assess the difficulties faced by doctors in the diagnosis of endometriosis in the public health system, in Brazil, the Unified Health System (SUS). With this purpose, a cross sectional was carried out, developed in the virtual environment using traffic in Google forms, with the difficulties quantified in the Likert scale. Participating physicians pointed out a medium difficulty for patients with endometriosis to access the consultation (58%) and moderate difficulty (52%) to perform an ultrasound examination;also signaled great difficulty in performing magnetic resonance imaging (77%) and laparotomy (61%) in these patients. It is hoped that knowledge about the difficulties faced by physicians in the diagnosis of endometriosis in the SUS will give these physicians a voice and corroborate, even if minimally, so that there is more research that provokes the search for these difficulties, in order to improving the quality of life of these women.