Navegando por Autor "GORDON, Ariadne Siqueira de Araujo"

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Acesso aberto (Open Access)
Diagnóstico situacional e operacional das ações de controle da hanseníase em município hiperendêmico do maranhão
(Universidade Federal do Pará, 2023-06-16) GORDON, Ariadne Siqueira de Araujo; BARRETO, Josafá Gonçalves
INTRODUCTION: Limitations for the proper implementation of leprosy control actions (LCA) in states and municipalities can strongly contribute to the perpetuation of Mycobacterium leprae transmission in their communities. Thus, constant monitoring of local leprosy control programs seems to be essential for identifying weaknesses, performance and implementing solutions. OBJECTIVE: To conduct a situational and operational diagnosis of leprosy control actions in a hyperendemic municipality in Maranhão. METHOD: Exploratory, analytical, ecological study, with qualitative and quantitative research approach. Developed in the municipality of Imperatriz, covering the teams of the family health strategy (FHS), professionals linked to the leprosy control program, individuals notified with leprosy in the period from 2001 to 2020. Data from the Notifiable Diseases Information System (SINAN) were collected and analyzed. The cases were georeferenced and analyzed to identify spatial clusters. The home addresses of notified cases were georeferenced and analyzed to identify spatial clusters. The FHS territories were also georeferenced to produce digital maps of the coverage areas. These results guided an active search among contacts of index cases and students from two municipal public schools. RESULTS: After evaluating the ACH in the city through the LEM, it was identified that the Basic Health Units (BHU) do not act as recommended for the evaluation of people affected by the disease, causing difficulties in making a diagnosis and initiating treatment. From 2001 to 2020, 6,726 cases were reported in the municipality of Imperatriz, 5,842 were georeferenced (90.8%). The spatial distribution pattern of the cases was heterogeneous with the formation of statistically significant clusters. The distribution of cases by BHU identified that 13.99% of all cases in the period were identified by a BHU. Until 2020, the municipality of Imperatriz had 41 FHS teams in the urban area of the municipality, which represented 60% of FHS coverage. The coverage area of 39 teams (95%) was georeferenced. The analysis indicated that individuals residing in a discovered area by the FHS are 14% more likely to be diagnosed with multibacillary (OR: 1.14; 95%:1.05-1.32; p=0.04) and 40% more chance of having chronic grade 2 disabilities at diagnosis (OR: 1.40; 95% :1.07-1.84; p=0.01). It was observed that over the years the chance of occurrence of multibacillary cases increased (year 2002: OR: 1.67; 95%:1.14-2.44; p<0.001; year 2019: OR: 8.06; 95%:4.86-13.36; p<0.001). The active search action resulted in three (17.6%) diagnoses of relapses among the index cases, 17 (25.3%) new cases among their household contacts and nine (12.3%) new cases among the students. CONCLUSION: Despite the high number of diagnoses carried out by the municipality, the present study identified weaknesses that result in relevant hidden endemic disease. The desired control of leprosy as a public health problem will not be achieved before the effective diagnosis and treatment of current cases that have not yet been identified. Case detection would increase significantly if the fight against leprosy was adequately carried out by the health system.
Acesso aberto (Open Access)
Incidência de Hanseniase em menores de 15 anos acompanhados no município de Imperatriz no período de 2004 a 2010
(Universidade Federal do Pará, 2012) GORDON, Ariadne Siqueira de Araujo; XAVIER, Marília Brasil; http://lattes.cnpq.br/0548879430701901
The present study aimed to estimate the overall incidence and rate of leprosy cases in children under 15 years in the city of Imperatriz, analyzing spatial distribution and surveillance actions recommended by the Ministry of Health was a longitudinal study, the incidence of cases of leprosy among children under 15 years, retrospective information with notifications generated by the offense, aside SINAN NET system. Data collection was conducted in the month of June 2012, 284 patients were investigated that were reported in the city of Imperatriz, in the period 2004-2010, as ranked new case, the input mode. The detection rate had its peak in 2005, 83.38 / 100,000 inhabitants. The highest coefficient of patients with Grade Physical Disability (GIF) at diagnosis was in 2004 where it was 39.62%. The coefficient of contacts investigated was 24.44%. As for the detection of new cases were male (51.06%), the color brown (55.65%), aged 10-14 years with 60.22% and schooling average of 6 to 11 years study (59.8%). Regarding the classification and treatment, the type Indefinite (40.13%) and tuberculoid (31.68%) prevailed, and paucibacillary MDT was the treatment of choice in 72.17% of cases reported in the period. Disability was prevalent in 22.2% of all cases. The data confirm the maintenance of hyperendemicity leprosy, especially in children under 15 years, demonstrating the maintenance of the chain of disease transmission, with operating indicators for the surveillance and control program well short of acceptable parameters. The distribution of cases in the county occurred in the area of greatest agglomeration and poor sanitary conditions, represented by District 4, which is composed mainly by neighborhoods Santa Rita, San Jose and New Imperatriz. The number of contacts investigated was considered precarious and operational indicator that assessed degree of disability at diagnosis presented above, specifically with GIF II, demonstrating the late diagnosis of leprosy in children under 15 years in the city.