Navegando por Assunto "Epidemiologia dos serviços de saúde"

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Incapacidade física em pessoas afetadas pela hanseníase: estudo após alta medicamentosa
(Universidade Federal do Pará, 2013-04-23) GUIMARÃES, Layana de Souza; SALGADO, Claudio Guedes; http://lattes.cnpq.br/2310734509396125
Physical disability is the main problem of leprosy. Despite multidrugtherapy (MDT) success in treating leprosy, it is known that about 25%>50% of patients may have some nerve damage and develop physical disabilities, classified by WHO disability grading (DG) as 0 for normal sensation, no visible impairments, 1 for impaired sensation, no visible impairments, or 2 for visible impairments/deformity. From 2004 to 2010 Brazil registered 21,7% of the cases as DG 1, and 7% as DG 2, while in Pará State 15,3% of the patients were diagnosed with DG 1, and 5,1% with DG 2 on the diagnosis of leprosy. In order to investigate physical disabilities in MDT cured patients, we examined the sensory-motor functions of 517 people affected by leprosy reported from 2004 to 2010 in eight hyperendemic municipalities of the Brazilian Amazon Region, correlating our findings with epidemiological and socio-economic features, and comparing with data found at the National Information System for Notifiable Diseases (SINAN). Additionally, 2164 household contacts of leprosy patients were clinically evaluated for signs and symptoms of leprosy. Patients’ home visits were planned with clinical assessment, simplified neurological evaluation and determination of DG, together with an interview about their demographic and socio-economic characteristics. DG 1 was found on 16,2% and DG 2 on 12,4% of the patients evaluated. It was found a statistically significant correlation between multibacillary (MB) forms and DG 1 or 2 (p<0.001); physical disability and males (p<0.001); impairment and age over 40 years-old (p<0.001). More than half (50,5%) of the cases did not have a BCG scar, and this was correlated to higher ages (p<0.001), MB cases (p<0.001), and disability (p<0.005). Finally, although SINAN showed only 5,6% of DG 2, we found 12,4% during our visits. Among the household contacts were diagnosed 181 new case, 127 (70,2%) were MB forms and 17,1% had physical disability, 5,5% DG 2. The occurrence of physical disability was predominant in MB patients, males, >40 years-old and no BCG scar, all important risk factors for developing disability. The differences of DG found in SINAN in contrast to our study suggest worsening of the sensory-motor functions after discharge from MDT, indicating the importance of monitoring these patients for years after finishing MDT treatment. The high rate of detection in this study reflects the low level of evaluation of household contacts in Pará (58,8%), perpetuating the late diagnosis. Clinical findings suggest that there is a high rate of undiagnosed leprosy and subclinical infection in our sample, indicating a need for periodic clinical evaluation.
Acesso aberto (Open Access)
Perfil epidemiológico dos pacientes com tuberculose pulmonar atendidos na Unidade Básica de Saúde da Pedreira
(Universidade Federal do Pará, 2003) BARBOSA, Heloisa Helena Moreira de Moraes; REZENDE, Manoel Barbosa de
The Pulmonary Tuberculosis is still one of the biggest public health problems all over the world, including Brazil. The control situation aggravates because it's difficult to implant an efficient program because of the proportion between the necessities and the available resources, and even for the limited covery and utilization of the installed capacity of attention, besides, in the end of the 80's, for the HIV propagation. With the aim, of describing the epidemiological profile of the patients infected with the pulmonary tuberculosis, attended in the Basic Health Unit of Pedreira Neighborhood, in the Belem of Para city. 143 patients, considering all rate of ages and sex, with pulmonary tuberculosis, were part of this study, all this data was collected between January of 2001 and July of 2002. It was analyzed the following aspects: signals and symptoms, baciloscopy, thorax radiology, number of communicants in home, antecedent case of pulmonary tuberculosis in family, time between the beginning of the symptoms and the beginning of the treatment, kinds of discharge of treatment, patient's provenance, school degrees, recidivistic cases, occupation and its qualification, familiar resources, daily meals, living conditions, kind of the house's wall, number of windows, number of rooms x the number of people, canalized water, electric light, kind of home fosse of the water closet, smoking and alcoholics practices. Results: Cough was the most frequent symptom with 89,51%; the positive result of baciloscopic test was 60,01%; the radiological founds with infiltration were 42,86%; 84,62% of the patients have at least one in-home communicant, 57,34% have at least one case of pulmonary tuberculosis in family; 65,04% were late 2 months to start the treatment after the symptoms had started; 94,23% received discharge for cure; 3,85% received discharge for quitting and 1,92% discharge for death; 78% from Belem; 7% are illiterate people and 51,75% have not completed the junior high school; 11,19% of recidivous; considering the people that have an occupation, 68,49% don't have qualification; 86% have income less than 6 minimum salaries; 43,68% of the patients are alcoholics. The conclusions were that the predominant sex and rate of ages were respectively male and from 16 to 45; the social, economic, cultural, living aspects were very poor, and it's very important to understand that this disease demonstrate its social determination. Therefor, the biological processes of health are part of the social life of the collectivity, by this way, the health and the diseases are equidistant points in the same process that is a part of a major ground called life. Sanitary education talk is a educational way to create a healthy habit that will certainly contribute to a better human's potentials development. This study proves the researches that were made before.
Acesso aberto (Open Access)
Programa de hepatopatias do Hospital da Fundação Santa Casa de Misericórdia do Pará: infra-estrutura e epidemiologia clínica em 10 anos de atendimento
(2004) MÓIA, Lizomar de Jesus Maués Pereira; AMARAL, Ivanete do Socorro Abraçado; CONDE, Simone Regina Souza da Silva; BARBOSA, Maria Silvia de Brito; MIRANDA, Esther Castello Branco Mello; MACEDO, Zilvana Pinheiro de; ARAÚJO, Marialva Tereza Ferreira de; DEMACHKI, Samia; SOARES, Manoel do Carmo Pereira
The Liver Diseases Program of the Hospital Santa Casa de Misericordia do Pará was create because of the need to attend patients with liver diseases of the Amazônia area, taking as priority to attend with quality, diagnosis of aetiologies, clinical following and specific treatment. This study aim to describe dates related to epidemiology, aetiologics agents and histopathologic analisys. One thousand sixthy nine patients were evaluated through medical, laboratory, endoscopic, ultrasound or computadorized tomography and histopathologic examination. Nine hundred thirty five (63,6%) patients within 1469 patients were diagnose as chronic liver disease. The average age was 50 year, 666 (71,2%) were male, and the most patients lived in Belem, state of Pará. The aetiologic agents most prevail were alcoholism (53,7%) and viral hepatitis (39,1%). Hepatic biopsy were done in 403 (43,1%) within the 935 patients and the results showed chronic hepatitis (34%) and chirrosis (34%). In sumary the chronic liver disease in the amazon region is more prevail in male than female, the alcoholism is the principal aetiologie, and the most of these cases were diagnose in the severe phase.
Acesso aberto (Open Access)
Tendência da incidência de hanseníase em menores de 15 anos em Jacundá - Pará e sua relação com a implantação dos serviços de saúde
(Universidade Federal do Pará, 2010-09-28) COELHO JÚNIOR, José Maria dos Santos; XAVIER, Marília Brasil; http://lattes.cnpq.br/0548879430701901
Leprosy is an infectious disease caused by Mycobacterium leprae which constitutes serious public health problem in Brazil, mainly in the North. The annual detection rate of leprosy in children under 15 years is used by the Health Ministery of Brazil to assess the spreading of transmission in a given population. The study aimed to investigate and analyze the incidence of leprosy in children under 15 years in the city of Jacundá - Pará State, in a historical series (1999-2008) and its relation to the implantation of services of surveillance. The study found 210 cases that were reported during the period. The research was conducted in the information system database of Health department in the city searching for data from two instruments: Type of notification and follow-up report. It was observed that in the year followed by deployment of health services, an increase in the detection rate and the city remained hyperendemic in the last nine years of the series (> 1.0/ ten thousand inhabitants), however in the last three years, decline in the incidence presented with evidence that the deployment of new services contributed to the new scenario. Most patients included in the age group between 10 and 14 years (64.76%), male (50.5%), coming from the urban area (84.3%) with predominance of dimorphous (42 4%) at diagnosis. It was observed that according to the operational classification, the paucibacillary form was predominant (52,9%), which can be attributed to the improvement of the diagnosis in early stages. It was concluded, based on the gauge of the study, there is declining trend in the disease in the city.