Teses em Doenças Tropicais (Doutorado) - PPGDT/NMT
URI Permanente para esta coleçãohttps://repositorio.ufpa.br/handle/2011/3560
O Doutorado Acadêmico em Doenças Tropicais iniciou em 2007 e pertence ao Programa de Pós-Graduação em Doenças Tropicais do Núcleo de Medicina Tropical (NMT) da Universidade Federal do Pará (UFPA).
Navegar
Navegando Teses em Doenças Tropicais (Doutorado) - PPGDT/NMT por Assunto "Anajás - PA"
Agora exibindo 1 - 2 de 2
- Resultados por página
- Opções de Ordenação
Item Acesso aberto (Open Access) Estimativa da não adesão ao tratamento da malária em área endêmica no Marajó estado do Pará(Universidade Federal do Pará, 2014) ALMEIDA, Eduardo Dias; VIEIRA, José Luiz Fernandes; http://lattes.cnpq.br/2739079559531098The association of Chloroquine (CQ) and Primaquine (PQ) is used as first-line treatment for malaria caused by Plasmodium vivax in Brazil. Treatment failure of this association is recognized worldwide and frequently reported. Multifactorial, involving related to the host, the vector and the etiological agent variables. Among these, treatment adherence is critical to establish the efficacy and effectiveness of antimalarial drugs, because the behavior of non-compliance tends to increase the rates of parasite recurrence and foster the emergence of strains resistant to antimalarial drugs. Despite the high incidence of P. vivax malaria in the Brazilian Amazon basin, few studies have evaluated treatment adherence and behavioral factors and environmental determinants. This study aimed to estimate the rate of non-adherence to treatment of P. vivax malaria in the municipality of Anajás, PA. We conducted a survey of demographic data (age, location, gender) and observational studies on the perception of the local population about the disease and its treatment. Then become a validated instrument to measure non-adherence to treatment in different metrics, based on the study by Morisky et al. (1986), with the addition of an item on the self-replication of doses for use in patients with P. vivax malaria. Finally, we proposed an evaluation model of non-adherence based on therapeutic drug monitoring of pharmacokinetic parameters of CQ, considering different scenarios of noncompliance. The results showed that the disease occurs in both sexes and in most cases are from rural areas. Risk factors such as gender, origin, parasitaemia at admission to treatment and age had no significant impact on rates of nonadherence. However, the abandonment of treatment to feel better, the need to return to work, or worse activities, the adverse effects of CQ, were the key behaviors for non-compliance to full treatment regimen. The instrument for measuring non-adherence, consisting of five items presented satisfactory validation parameters, in particular in its Likert scale dichotomized so that estimated non-adherence to the therapeutic regimen in 33.3%. After construction and validation of the mono-compartmental pharmacokinetic model by non-linear regression and evaluation of various scenarios for non-adherence, it is found that the loss of two consecutive doses without replacement was regarded as the only scenario that can significantly change the pharmacokinetic parameters and CK interfere with the therapeutic response.Item Acesso aberto (Open Access) Perfil lipídico e aspectos nutricionais de crianças e adolescentes com malária por Plasmodium vivax, no município de Anajás-PA(Universidade Federal do Pará, 2017) DIAS, Rosa Maria; ANDRADE, Marcieni Ataide de; http://lattes.cnpq.br/8514584872100128; VIEIRA, José Luiz Fernandes; http://lattes.cnpq.br/2739079559531098Objective: To evaluate the social-demographic and epidemiologic aspects of children and adolescents residents in the municipality of Anajás-PA, with P. vivax Malaria and to associate the lipid profile to the nutritional status, parasitemia and number of episodes of the disease. Methods: An observational, analytical-prospective study with children and adolescents aged 2-16, between January, 2014 and September, 2016. It was selected two groups of study: a) Cases (n=58): children and adolescents with a positive diagnosis to P. vivax and; b) Control (n=61): healthy children and adolescents without any history of Malaria and with two negative exam for Malaria. Social-demographic and anthropometric (weight, height) data were collected and it was carried out a clinical examination. The lipid profile (cholesterol and fractions, triglycerides) was determined in venous blood collected after 12 hours of fast. In the participants of the Case group, collection has occurred in three moments: D0 (day of diagnosis and admission to the study), D7 and D14 (post -treatment). Results: Most participants of the Case group was male (65,5%), whose mothers or legal tutors presented a maximum of four years of formal education, lived with minimum wage and had the government benefit program of “Bolsa Família”. The evaluation of the nutritional status pointed out a high percentage of linear growth deficits for children (25,0%), as well as for the adolescents (22,2%) in the Case group, when compared to the Control group (p<0.05). The BMI has indicated and adequacy of weight and height, independently from the group of study. It was not observed significant associations between the nutritional status (independently from the index used) with the history of Malaria, levels of parasitemia and clinical manifestations. The evaluation of the lipid profile has indicated that the Case group has presented the levels of total cholesterol and LDL-c in its wished limits and low level of HDL-C (p<0.05), when compared to the Control group. All participants presented hyper-triglyceridemia, independently from the group studied. Sex, age, parasitemia at admission and history of Malaria did not significantly influence the levels of serum lipids. It was observed significant alterations in the lipid levels in the cases follow up, characterized by the significant reduction (p<0.05) of the levels of triglycerides and VLDL between D0 and D14 and significant raise (p<0.05) of the total cholesterol, HDL and LDL-c. The serum levels of total cholesterol and LDL-c were similar at admission and D7. However, the levels of triglycerides and VLDL have quickly decreased so that they were similar between D7 and D14. Conclusion: Malaria has predominated in male children and adolescents with unfavorable socioeconomic conditions. The cases presented a high percentage of linear growth deficits, though it was with a low significance when compared to the Control group. There is a modification of the lipid profile in the acute phase of the disease.