Programa de Pós-Graduação em Doenças Tropicais - PPGDT/NMT

URI Permanente desta comunidadehttps://repositorio.ufpa.br/handle/2011/3558

O Programa de Pós-Graduação em Doenças Tropicais (PPGDT) integra o Núcleo de Medicina Tropical (NMT) da Universidade Federal do Pará (UFPA), realizando atividades de ensino, pesquisa e extensão e atuando na formação de docentes-pesquisadores para o estudo e o ensino das doenças tropicais e das patologias regionais no estado do Pará e na Amazônia.

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Análise espacial das condições ecoepidemiológicas para estabelecimento da Esquistossomose mansonica em duas áreas do Distrito de Mosqueiro, Belém-PA
(Universidade Federal do Pará, 2012) PEREIRA, Alba Lúcia Ribeiro Raithy; GONÇALVES, Nelson Veiga; http://lattes.cnpq.br/8811269146444725; BICHARA, Cléa Nazaré Carneiro; http://lattes.cnpq.br/2161704040280760
The dynamics process of Mansonic Schitomiasis endemization is multifactorial, which sometimes retards it’s installation process, but also difficult the control of epidemiological surveillance. The Geo-technologies have brought contributions to the public health, creating thematic maps that make easier understand of dynamic population at space used, and their interrelationship with the water resources and with the sickness process. The proposal of this work was to identify through spatial analysis the eco-epidemiological factors related with the Mansonic Schitosomiasis endemization. It was achieved a descriptive study in two coverage areas from Family Health Strategy, Carananduba and Furo das Marinhas, In Mosqueiro District, Belém-PA, between 2010 and 2012, using geoprocessing Techniques like: Remote Sensing and Geographic Information Systems (GIS), through the tools: ERDAS 8.3.1 and ENVI 4.5, for classification of these satellites images, with the variables: Soil, vegetation cover and hydrography; The Global Positioning System (GPS) for georreferencing at study area and capturing collecting points of breeding sites; and ARCGIS 9.3.1 for manipulation and teatring of the Geographic Data Banks and Kernel estimation for identification of risk zones about high resolution satellite images and cartographic bases. Were analyzed, also, environmental and ecological data through geoprocessing techniques. The geo-technologic tools producing thematic maps of Family Health Strategic abrangency, the work routes, environmental classification, and the localization of breeding sites that generating seven agglomerated Kernel points that identified the risk zones of transmission aggravating in 3 boroughs of Carananduba Zone. This zone has been presenting antrophic characteristics due disordered human occupation and hydro siltation collections. The Furo das Marinhas area still keeps native forest and great quantity of hydro collections yet and not being found Biomphilaria. In both studied areas the structure of sanitation is insufficient, and isn’t still there focus active of transmission from Mansonic Schitosomiasis. However, could be a great vulnerability in a short time to happen this incidence at Caranaduba area. So, the geo-technologies applied have enabling a geographic information system that made feasible the diagnostic of risk on the process of Mansonic Schitosomiasis Endemization in more than one location in Para.
Acesso aberto (Open Access)
Avaliação da vulnerabilidade do potencial de endemização da esquistossomose mansônica no Distrito de Mosqueiro Belém, Pará
(Universidade Federal do Pará, 2014) PINTO, Sônia Claudia Almeida; PINHEIRO, Maria da Conceição Nascimento; http://lattes.cnpq.br/6353829454533268; BICHARA, Cléa Nazaré Carneiro; http://lattes.cnpq.br/2161704040280760
Schistosomiasis mansoni (SM) is an endemic parasitic disease that occurs in at least 74 countries with illness of 25 million people, including Brazil. It is related to socioeconomic and environmental factors, with emphasis on migratory movements that contribute to the spread of this disease. In northern Brazil only the state of Para has focus of this disease, the main in the city of Belem.The urban sprawl through the occupation of peripheral areas of the metropolitan area of Belem has generated significant social and environmental impacts, reaching areas of environmental preservation.From an ecosystemic perspective, the study assessed the possibility of expansion of SM in the insular area of the one administrative districts of Belem, in Mosqueiro (DAMOS), where there was the environmental characterization, malacological, parasitological and population surveys. Georeferencing techniques were used for spatial analysis of the study area, interview questionnaire at home and collection of material for parasitological examination. The approach adopted for determining the sample size calculation was based on the territory coverage of the family health strategy of the Belem Municipal Health Department. Thus, was realized the zoning of the study area, where Biomphalaria sp. breeding places were found. And was adopted a 50m radius buffer (north, south, east, west), from each breeding. Inside this area size, with the help of GPS technology, has set up a sample of 491 households with an estimate of 5.31 residents per household, with the exclusion of closed or abandoned households obtained the sample of 283 households for visitation with 421 participants. It was necessary to create the schistosomiasis vulnerability index (SVI) for better information with regard the interpretation of the data. The results showed that the DAMOS presents all environmental and population characteristics of the different endemic areas of Brazil; the malacological survey identified 30 breeding of planorbids; presence of the species B. straminea not infected with S. Mansoni; very low sewage network coverage, water and increase the migratory process in disordered occupation areas with populations from endemic areas for SM.The majority of study participants reside in areas considered of medium vulnerability, however 16% are in areas of high vulnerability; the area of Carananduba was considered the highest susceptibility and increased risk potential for entry of SM in Mosqueiro district.The spatial analysis of vulnerability to schistosomiasis in the study area, has led not only support the hypothesis of endemicity of SM in DAMOS, but to show where the first outbreak may occur, what and where the major risk factors are.This study may help in the management processes in public health with the implementation of preventive measures of health education, epidemiological and environmental surveillance.
Acesso aberto (Open Access)
Conhecimento sobre a toxoplasmose e associação com os fatores de risco pelas parturientes de um hospital de referência materno infantil
(Universidade Federal do Pará, 2011) COSTA, Alfredo Cardoso; BICHARA, Cléa Nazaré Carneiro; http://lattes.cnpq.br/2161704040280760
BACKGROUND: Toxoplasmosis is a parasitic infection usually asymptomatic, but with important consequences when it affects the fetus and immunocompromised. However, even in areas of high prevalence little is known about the problem among pregnant women who receive little or no information on prevention and risk factors for transmission in prenatal consultations. OBJECTIVE: To evaluate the knowledge of pregnant women on toxoplasmosis in association with exposure to risk factors, socio-demographic and prenatal care. METHODOLOGY: We conducted a cross-sectional study analytic, from January to May 2011, the Santa Casa de Misericórdia do Pará, regional reference in maternal and child health, with 307 mothers of a total of 2,000 hospitalized in the period . Data were collected through interviews with plug consent protocol, three times a week, between 6-48 hours after delivery, stored in a database. RESULTS: According to the responses to each item in the form of protocol, the sociodemographic data showed the predominance of (p<0.0001), aged 19-24 years (n = 118/296, 39.9%), Pará (n = 290/305, 95.1%), residents in the metropolitan region of Belém (n = 191/307, 62.2%) of mixed ethnicity (n = 156/307, 50.8%), an education incomplete elementary (n = 106/307, 34.5%), Catholic (n = 148/307, 48.2%), in a consensual union (n = 174/307, 56.7%) who identified themselves as housewives (n = 171/299, 57.2%) and income from 1 to 3 minimum wages (234/281, 83.3%), data regarding prenatal care was higher (p <0, 0001): those who received prenatal care (n = 281/295, 95.3%), with the first quarter (n = 97/157, 61.8%), performing 1-3 consultations with a doctor (n = 134/256, 52.3%) in the same way with nurses (n = 152/249, 61%) who presented to the Determine HIV- negative (n = 253/259, 97.7%), VDRL non-reactive (n = 231/237, 97.5%), HIV negative (n = 226/262, 86.3%) underwent obstetric ultrasonography (n = 280/298, 94%) and serological tests, predominantly toxoplasmosis serology (n = 122/307, 39.7%) in relation to risk factors were significant (p <0.0001) information regarding the consumption of meat (n = 305/307, 99.3%) and cooked (n = 289/305, 94.5%), contact with animals, especially dogs (n = 158/307, 51.5%) and cats (n = 121/307, 39.4%), the use piped water (n = 169/297, 56.9%) and filtered (n = 55/129, 42.6%) and does not reside in wetlands (n = 231/292, 79.1%). In relation to knowledge about toxoplasmosis and their associations, it was observed that: 76.9% do not know (n = 210/273, p <0.0001), this knowledge is independent of the implementation of prenatal care (p = 0.0421 ), since only 25% of those who received prenatal care know, and 100% of those who did not know, independent of education (p = 0.0004), with a chance of not knowing (OR) 3.9 times higher in patients with less education, not knowing toxoplasmosis is related to family income (p = 0.0089) and have an income below Minico salary increases (OR) 10.7 on the chance it unknown; guidelines on infectious diseases in pre-natal non- improved knowledge about toxoplasmosis (p = 0.4586) and there was no correlation between knowledge of toxoplasmosis and risk factors, such as cooking meat (p = 0.8743), contact with animals (p = 0.9344) and treatment Water consumption (p = 0.1990). CONCLUSIONS: It is actually the lack of knowledge about toxoplasmosis among pregnant women of the country's largest public maternidde in an area of high prevalence of this disease. No approach to prenatal care on knowledge and attitudes of pregnant women about toxoplasmosis. The cautionary statements should be part of prenatal care, and this information should include a set of actions undertaken by public education and global health, coupled with professional training.
Acesso aberto (Open Access)
Esquistossomose mansônica na Amazônia – reavaliação do primeiro foco com transmissão autóctone, Fordlândia, Pará
(Universidade Federal do Pará, 2013) OLIVEIRA, Sheyla Mara Silva de; BICHARA, Cléa Nazaré Carneiro; http://lattes.cnpq.br/2161704040280760
Some foci of transmission of schistosomiasis are installed in Para State, with the possibility of permanent expansion by major migration flows through the economic and social demands in the region. It was proposed to reassess the epidemiological situation of schistosomiasis transmission in this village of Fordlandia, the city of Aveiro, PA, where it was established in 1951 as a result of intense migration appreciation for the extraction of rubber, as the first indigenous Amazonian focus, being considered extinct for several years. The study was conducted between September and November 2012, involving 204 individuals of households served by Strategy Community Health Workers in the District of Fordlandia, PA, submitted to parasitological survey by the Kato-Katz (one sample per capita, processed 3 blades) with description of the socio-demographic profile through interviews to identify the environmental conditions of peridomicile, housing, sanitation, presence of collections hydro, type and form of contact with them, which would be inserted possible risk factors for transmission . It was found that the majority are women (54%), with more than 20 years (56%), especially students and farmers (32% and 26%), residents in the town of Fordlandia (52%) for months or years (64 %). Although environmental conditions, housing and sanitation remain the similarity of the season's activity focus of schistosomiasis in the district of Fordlandia-PA was not identified no cases of schistosomiasis considering all coproscópicos tests negative for eggs of S. mansoni, possibly for this location this time was not affected by the entry of migrants infected by this worm, allowing the restoration of the cycle in place. The dispersal of Biomphalaria snails in the Amazon floodplain, plus the intensification of migratory networks, requires constant vigilance in the region as the expansion and development of future outbreaks of transmission of schistosomiasis, including the reemergence of outbreaks now extinct like Fordlandia-PA.
Acesso aberto (Open Access)
Estudo da esquistossomose mansônica nas regionais de saúde no estado do Maranhão, 2007-2011
(Universidade Federal do Pará, 2014-06-05) FERNANDES, Orquideia da Silva; BICHARA, Cléa Nazaré Carneiro; http://lattes.cnpq.br/2161704040280760
The Schistosomiasis (MS) is a parasitic infection with a wide geographic distribution that cause important economic and public health implications. This grievance is installed in Brazil since colonial times and remains in all geographic regions, particularly in the northeastern of Brazil. This report shows to be a quantitative, descriptive observational epidemiological research approach across the board, created by active search of secondary data on the prevalence of MS in the state of Maranhão and its regional health from 2007 to 2011, based on data Historic cases reported to the Information System of the Schistosomiasis Control Program and the National Disease Notification Service. The results showed that MS is declining in Brazil, from where 2007 to 2011; most of these are concentrated in the Southeast, with xxx the study period, followed by the Northeast with xxx cases. However, in the northeast is that MS stands for stability and the southern region where there is the lowest recorded levels. The state of Maranhão accumulated more cases of MS in this period than the north, south and center-west regions. We observed two pieces of information regarding the total number of cases in the Maranhão according to base consulted, with 18,884 cases reported by SISPCE \ SINAN and 317,661 by the PCE. In this state the picture remains, but with a tendency to decline as well, focusing on cases of Maranhão marshland region. Among its 19 regional health in 15 case reports were made, predominantly in the eastern St. Louis (129,999), Bacabal (67,735), total years studied. Empress was no increase in the number of cases of 1.63 in 2009 to 10.99 in 2011, which was attributed to the acceleration of, especially migratory sociodemographic and health problems. The analysis shows that the parasitic load Maranhao remains low to medium endemicity in most cases eliminating from 1 to 4 eggs/g of faeces. Thus, this study shows that MS whilst under control in Brazil, Northeast and Maranhão, needs to be better controlled, which depends directly improving the structural conditions of life of its inhabitants.
Acesso aberto (Open Access)
Estudo de prevalência da esquistossomose mansônica no bairro do Maracajá, distrito de Mosqueiro, Belém, Pará
(Universidade Federal do Pará, 2012) MALCHER, Sérgio Alexandre Oliveira; BICHARA, Cléa Nazaré Carneiro
Schistosomiasis mansoni is one of the most widespread parasitic diseases in the world and has a higher prevalence in developing countries, and is currently a serious public health problem in Brazil. In Belém-PA, District Administrative Mosqueiro (DAMOS), there are possibilities of occurrence of autochthonous cases of schistosomiasis mansoni, due to geographical proximity to other areas where there are records of this disease, as well as the presence of other environmental risk factors, as the presence of Biomphalaria straminea. With the proposal to determine the prevalence of schistosomiasis mansoni in the neighborhood of Marazion-DAMOS, a cross-sectional study was conducted prospectively between March 2011 and January 2012, through parasitological survey by the quantitative method of Kato- Katz, associated with social inquiry demographic and environmental location. Participated in the sampling universe included 407 individuals in the care of the Family Health Strategy, which voluntarily agreed to participate in the survey, according to the ethical regulations. The socio-demographic profile of the population was mainly aged between 11 and 40 years without gender differences, whose occupation of housewife and student, with incomplete primary education were the most cited. Most residents were born and proceeds from the DAMOS, residents in the neighborhood of Marazion for over 20 years, without reports of significant displacement to other locations. Most households had piped water service, with indoor bathroom, toilet presence of bound stools in the septic tank. Water collections peridomestic ditches were characterized by low flow and small water flow, high concentration of organic products, the presence of vegetation and macrófitica vector Biomphalaria straminea. This population reported having no contact with the water collection and know the planorbid vector, as well as the very schistosomiasis The investigation has resulted in 100% parasitological blade negative and the identification of eggs of S. mansoni, leading to the conclusion that although the neighborhood of Marazion is still harmless, several factors have to install a focus of active transmission of schistosomiasis, but there is still a fragile ecological balance, supported by the reduced exposure of individuals to water collection, bit shift population to areas with established foci of endemic and reasonable coverage of sanitation. This set of variables has acted as limiting factors to the process of endemic schistosomiasis in the neighborhood of Marazion, however, must be kept under surveillance by the peculiarities conducive to closing the cycle of S. mansoni.
Acesso aberto (Open Access)
Perfil antropométrico, qualidade de vida e nível de atividade fisica de pessoas vivendo com HIV/AIDS em Altamira-PA
(Universidade Federal do Pará, 2012-12-20) MELO, Gileno Edu Lameira de; BICHARA, Cléa Nazaré Carneiro; http://lattes.cnpq.br/2161704040280760
Introduction: The HIV and AIDS has reached more than 33 million people in the world and 600,000 in Brazil,that were reached in multiple social and health dimensions with an impact on their epdemologic profile as heterosexualization, feminilization, interiorization and pauperization of this grievance, besides organic and metabolic effectsoccasioned by the virus itself, the sickness and specif treatment. Objetive: describe the anthropometric profile of life quality and and the le level of physical activities from people living with HIV/AIDS in Altamira—PA. Methodology: a descriptive study involving 48 people, from 20 years old on and both genders, living with HIV/AIDS attended at SAE in Altamira—PA, who accepted participate in this research whose socialdemografic and clinical dates, as the number of lymphocytes T CD4+ and viral load were taken from records, and asked a protocol questionaries authenticated to avaliation of life quality WHOQOL HIV – Bref and the International Physical Activity Questionary—IPAQ—short version; it was done an indinvidual physical avaliation to the collect of anthropometric measurements like weight, height, Body Mass Index(BMI),circumferences and Waist Hip Ratio(WHR). The obtained dates were saved on EXCEL to be processed and analysed by descriptive and inferentional statistic. Results: the statistical population was composed by 29 women (60,4%) and 19 men (39,6%) prevailing age between 40-49 years old (37,5%) and age average of 39,4 years old; low education (66,7%); the group of single, widow /widower or separated/divorced (62,5%). In the level of physical activity, it was observed that 64,6% of the population was sedentary, being 41,4% overweighted women. In the distribution of people living with HIV/AIDS there was a significative diference (P=0,0013) in the proportion of cardiovascular risk acording the WHR and of which 70% were using the antiretroviral therapy in the average of 3,55 years. In the avaliation of life quality according WHOQOL HIV—Bref the score of the most positive average found with the WHOQOL HIV—Brief was the mastery of Spirituality and the lowest score was the mastery of Environment. And it was also observed a significantly average (P=0,011) in the psychological domain of the group with TCD4+< 200. There was no significance ancording the TARV. Conclusion: the SAE from Altamira shows the epidemiological trends of global pandemic HIV/AIDS as to the feminilization, pauperization and interiorization of this sickness. The BMI may reflect the most common behavior in the women with high propbability of risk in cardiovascular diseases. The IPAQ demonstrated that there is a population which most part is sedentary, with members physically slothfull and with great chance to suffer with the effects of lipodystrophy, methabolic disorders and bodily changes by the lack of physical activity and physical exercises. Generally, the observations looked like the general population which can be a reflex of the small sample of evaluated pacients. There is the necessity of aditional researches with a bigger sample to well evaluate the prhysical activity level, life style of PVHA, enabling proposals of specific intervention to pacients who live with HIV/AIDS.
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Perfil epidemiológico de grávidas HIV positivas em maternidade pública no estado do Pará
(Universidade Federal do Pará, 2012) MENEZES, Labibe do Socorro Haber de; BICHARA, Cléa Nazaré Carneiro; http://lattes.cnpq.br/2161704040280760
Infection with human immunodeficiency virus (HIV) affects more women of reproductive age, which consequently favors the growth of vertical transmission. With the proposal to obtain information on the epidemiological situation of HIV-infected pregnant women in most public hospital in northern Brazil, was conducted a descriptive retrospective study involving 770 pregnant women attending the obstetric triage of Santa Casa of Misericórdia of Pará, from 2004 to 2010. After analyzing the data obtained from medical records under the ethical guidelines recommended, we obtained the following results: the prevalence and incidence in the period were 1.87% and 0.40% respectively, the predominant age group was between 18 and 23 years (42.1%), and 50.4% had incomplete primary education, 68.2% had home activities, 89% were single and most came from municipalities with over 50,000 inhabitants (Belém, 53.9 %; Ananindeua, 13.0%, 4.8% Castanhal; Paragominas, 3.6%, Tailândia 3.5%, 3.1% Barcarena; Marituba, 2.9%; Abaetetuba, 1.8% and São Miguel do Guamá, 0.6%). Prenatal care was performed by 91.9% of pregnant women, with 4 to 6 appointments (61.0%), 85.2% sought Units Basic Health Units and 12.8% of the reference service and follow-up care of HIV positive women, 75.1% knew that before the current pregnancy were infected with HIV, 3.6%, learned during the prenatal and 21.3% at delivery through the rapid test, totaling 78 7% coverage of the diagnosis of HIV infection before the arrival of motherhood, and of these 75.1% had specific treatment during the prenatal period. The surgical delivery was the most frequent (85.1%), 89.7% of pregnant women received zidovudine prophylaxis at birth, 85,1% of these had cesarean and 14,9% vaginally. Knowledge of epidemiological variables of the largest sample of pregnant HIV-infected Brazilian Amazon, arriving motherhood, concluded that the profile of age, education, adherence to prenatal care and number of appointments is consistent with national data, however, most pregnant merits of municipalities of medium and large are opposed to the phenomenon of internalization of the epidemic as the smaller municipalities in the country is being observed. A rate of 21.3% fault coverage diagnosis of HIV infection at birth, which is still observed in many Brazilian services, militate against the implementation of health programs with quality and above all shows that the care team need to better accommodate pregnant women during prenatal care, regardless of the number of queries, since the HIV test must be requested during their first consultation. These measures should be strengthened in the state of Para, which showed a high prevalence rate, in contrast with other regions of the country where there is a decrease, which has favored the increase in the number of children infected with HIV in Brazil.
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Soroprevalência da rubéola nas puérperas de uma maternidade pública, Belém-PA
(Universidade Federal do Pará, 2013) ROCHA, Margareth Vargas; BICHARA, Cléa Nazaré Carneiro; http://lattes.cnpq.br/2161704040280760
Rubella was considered a disease of little relevance to the fourth decade of the twentieth century, by presenting a benign symptoms, however, in 1941, in Australia, the ophthalmologist Norman McAlister Gregg made association between rubella infection in early pregnancy and the occurrence of defects congenital, passing thus constitute a public health problem today preventable disease, the aim of this study is to evaluate the prevalence of postpartum rubella in a public hospital, Bethlehem PA, describing and correlating the demographic profile (age, origin, education level, marital status, race, and income) and conditions of prenatal seropositivity found. The prospective study involved 228 women, randomly chosen from the wards in Obstetrics Maternity Holy House of Mercy of Para, between January to March 2011, with application protocol form for interview and serology for rubella blood obtained before delivery or immediately after this, using the ELISA method for antibodies to anti-IgG. Prevailed in this study the age range 14-26 years (66.2 %), living in a stable relationship (58.8 %), Caucasian women (58.3 %), with schooling up to primary education (40.8 %), both derived from the capital (45.6 %) as in the state (47.4 %), working only in the home (59.7 %) and those living with 1-3 minimum wages (52.2 %); conditions prenatal showed that 95.2 % reported having acceded to prenatal care, beginning in the first quarter (32.9 %), are vaccinated for rubella (59.2 %) and received guidance on infectious diseases in pregnancy (53.5 %). The prevalence upon detection of IgG Anti- Rubella Virus was 80.2 % (183 /228). The correlation between seropositivity and exposure factors for some of the socio demographic and prenatal associations were not found, however, in the analysis of prevalence rates relative to age and income, observed that this was significant (P < 0.0001), 1.3 times lower seropositivity among the mothers with 19 years or less, with lower prevalence ratio (P = 0.0084), about 1.2 times among those with wage income ≤ the minimum wage. Considering the differences in prevalence data antibodies against rubella and the limited information that is available on the immune status of the population of northern Brazil, it was with this research to evaluate the immune status against rubella in women at the time delivery, yielding a prevalence that is still below that necessary to eliminate the risk of congenital rubella. Important observations are aimed at women under 20 years with low education and income, since it is the strata with higher HIV negative. These data may contribute to the reorientation of public policies that seek to control this disease by vaccination strategies, among others, how to improve the care given to the actions of prenatal education.

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