Navegando por Assunto "Syphilis"

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Da Belle Époque à cidade do vício: o combate à sífilis em Belém do Pará, 1921-1924
(Fundação Oswaldo Cruz, 2016-06) HENRIQUE, Márcio Couto; AMADOR, Luiza Helena Miranda
This article analyzes the fight against syphilis in Belém, capital of the Brazilian state of Pará, between 1921 and 1924. When Instituto de Profilaxia e Doenças Venéreas (Institute for Prophylaxis and Venereal Diseases) was founded, headed by Dr. Heraclídes de Souza Araújo, many restrictions were imposed on prostitution in a bid to make prostitutes partners in the city’s sanitation reform. The documents produced by the institute and published in newspapers of the day reveal the various clashes that occurred between doctors, the civil police force, and prostitutes, highlighting the prostitutes’ attitudes to state intervention in their activities.
Acesso aberto (Open Access)
Elaboração e validação semântica de tecnologia educacional sobre sífilis para mulheres ribeirinhas da Amazônia
(Universidade Federal do Pará, 2022-07-11) FERNANDES, Ticianne Alcântara de Oliveira; ABEN-ATHAR, Cintia Yolette Urbano Pauxis; http://lattes.cnpq.br/8844398079793605; https://orcid.org/0000-0002-6951-3547
The riverside population tends to have a high prevalence of sexually transmitted infections, related to behavioral and social vulnerabilities, especially low education, which makes it difficult to promote sexual health. In this sense, educational health technologies, when validated, are allies in the process of disseminating quality and safe information. Objective: This study aimed to elaborate and validate the semantics of a booklet on syphilis based on the knowledge of riverside women. Study methods: This is a methodological research carried out in three stages, namely: development of educational technology in health; application of the pilot test on the island of Maracujazinho, in the municipality of Acará and validation of the semantics by the target audience on the island of Combu, in Belém do Pará. Result: The elaboration stage was carried out based on the situational diagnosis, for the selection of the generating theme, and by an integrative literature review, which identified the booklet-type printed health educational technology as adequate to address the theme. In the pilot test, carried out with 22 riverside women, the technology was evaluated, where a semantic validity index equal to 1 was obtained, that is, with 100% agreement of the answers in all blocks of questions of the evaluation questionnaire. In the third stage, the semantic validation was carried out with 23 women from the island of Combu, where a semantic validity index of 1 was obtained, that is, 100% agreement using the same evaluation questionnaire as the pilot test. Conclusion:The educational technology needed adjustment only in the quality of the printing paper, its other requirements were considered appropriate and satisfactory. The booklet can be considered valid semantically to address the issue of syphilis with riverside women. In the future, the booklet will receive validation of the reliability and stability of the content by expert judges in the area of health and other higher education.
Acesso aberto (Open Access)
Fatores da vulnerabilidade associados à sífilis e HIV em uma comunidade ribeirinha amazônica
(Universidade Federal do Pará, 2022-08-26) PINHO, Ellen Christiane Corrêa; SILVA, Richardson Augusto Rosendo da; http://lattes.cnpq.br/2184669241700299; https://orcid.org/0000-0001-6290-9365; CINHA, Carlos Leonardo Figueiredo; http://lattes.cnpq.br/9603271880856443; https://orcid.org/0000-0002-1891-4201
Background: There is an intensification of cases by the human immunodeficiency virus (HIV) and syphilis in some population segments, mainly in the northern region of Brazil. The state of Pará has the second highest AIDS mortality rate in the country, and a growing increase in the incidence of notifiable sexually transmitted infections (STIs). In this epidemiological sphere, the riverside population of the Amazon is included, which are miscegenations of indigenous peoples, Africans, and others, who suffer from low socioeconomic indicators, geographic barriers and access to health. Objective: To analyze vulnerability factors associated with the occurrence and knowledge of STIs (syphilis and HIV) in a riverside population in the Brazilian Amazon. Method: This is a cross-sectional study carried out in Ilha do Combu – Belém/PA. The sample calculation was performed using the Statcalc module – Sample size and power of the EPI INFO Version 7.2.2.16 program. For the sample, people aged 18 years or older and residents of the island were considered. Data collection took place through the application of two instruments: Sexually Transmitted Disease Knowledge Questionnaire (STD-KQ) used to measure the level of knowledge of riverside people; and to survey the population and the dimensions of vulnerability, the adapted instrument applied in the nationwide household survey of the “Research of Knowledge, Attitudes and Practices in the Brazilian Population” (PCAP) was used. The investigation for infections was carried out by means of a rapid test for HIV and syphilis, and peripheral blood collection for rapid plasma reaginine in cases of rapid test reagents for syphilis. For data analysis, descriptive statistics and a logistic regression model were used. In univariate binary regression were selected for multiple regression. The variables with the highest p-value were removed one at a time until the final fit of the multiple ordinal logistic regression model. All statistical analyzes were performed using Minitab 20® software. A significance level of 5%, confidence interval (CI) of 95% and Odds Ratio (OR) were adopted. Results: The total consisted of 325 riverside dwellers with a prevalence of syphilis of 6.15% (20) and of HIV of 0.61% (2), being a coinfection. 190 were female and 135 were male. 68.9% (220) had a mean age of 40 years and 56.6% (184) had never attended school or had elementary school. The variables related to individual vulnerability that were associated with the outcome/chance of infection for STIs in the final regression were almost four times higher in participants aged 48 years or older (p=0.022), having had a blood transfusion (p=0.023 ), people who had more than one sexual partner in the last 6 months (p=0.028) and did not know the female condom (p=0.031); and having a current sexual partner (p=0.041) had a low risk of 0.33 for the outcome. For social vulnerability, no variable was associated. And in the programmatic dimension, not having taken a rapid test for HIV presented a low risk of 0.26 (p=0.021). Regarding the level of knowledge in the riverside population, 65.5% (213) participants had low knowledge (0 to 14 correct answers/28 questions). On the other hand, in the association between the factors of level of knowledge about STIs, the three dimensions of vulnerability were present. Among them, participants aged 48 years or older had a risk 1.93 times higher (p=0.012) for low level of knowledge about STIs, not knowing their partner's serology had a risk of 1.92 times (p=0.011 ); almost 4 times greater chance (p=0.000) was obtained among riverside dwellers with low schooling; never having been tested for STIs in life had a chance of 2.51 (p=0.000), and not having access to condoms in the last year the risk was 1.95 times (p=0.006) of low knowledge. Conclusion: The riverside population was vulnerable to syphilis and HIV in the individual and programmatic dimensions. Regarding the level of knowledge about STIs, this population suffers from a deficit, and is vulnerable in all dimensions.
Acesso aberto (Open Access)
Preditores da sífilis gestacional em um estado da Amazônia brasileira: um estudo de caso e controle
(Universidade Federal do Pará, 2021-12-03) UCHÔA, Thais Lopes do Amaral; FERREIRA, Glenda Roberta Oliveira Naiff; http://lattes.cnpq.br/7459094802051187; https://orcid.org/0000-0002-8206-4950; ARAÚJO, Eliete da Cunha; http://lattes.cnpq.br/5906453187927460
Introduction: Advances in public policies aimed at maternal and child care implemented in Brazil in recent decades have not yet had an impact on reducing gestational syphilis and, especially, congenital syphilis. In Pará, there is still a high number of cases of gestational syphilis detected in childbirth and puerperium. The factors that relate to the maintenance of this context are unknown. Objective: To determine the predictors of gestational syphilis in a state in the Brazilian Amazon region. Methods: Unpaired case-control study, carried out in a public reference maternity hospital in Pará. Data were collected from November 2020 to July 2021, from the application of the form, analysis of the pregnant woman's card and medical records. Women diagnosed with syphilis during pregnancy, childbirth or puerperium were considered as cases. Controls were women without a diagnosis of syphilis in the pregnancy puerperal cycle. The response variable was the diagnosis or not of gestational syphilis, the event being considered the diagnosis of gestational syphilis in the prenatal, delivery or postpartum period. Independent variables were grouped into: a) sociodemographic; b) gynecological and obstetric by two (02) categorical variables and five (05) discrete variables; c) sexual and obstetric practices by eight (08) categorical variables; d) knowledge is composed of fifteen (15) categorical variables and e) Attitudes is composed of six (06) categorical variables. The sample size, calculated using the Kelsey method, was 204 participants, 68 cases and 136 controls. To test the main hypothesis of the study, multiple logistic regression analysis was performed. In the Bioestat 5.3® program, the chi-square test of independence, tendency and G test were applied. In the Minitab 20® program, descriptive analyzes and logistic regression were performed. Odds ratio, 95% confidence interval was calculated. P values <0.05 were considered statistically significant. Results: Among the 68 cases and 137 controls, age ranged from 15 to 41 years, mean age was 26.1 years (SD: 6.2). In the multiple logistic regression, the cases are independently associated with the lowest number of prenatal consultations (OR: 0.82; p = 0.02), history of previous STI (OR: 24.8; p = 0.00 ), spontaneous abortion (OR: 2.86; p = 0.025) and difficulty in talking with the partner about the use of sexual condoms in relationships (OR: 4.43; p = 0.00). Among the factors of knowledge and attitudes, cases were associated with knowledge about vertical transmission (OD: 0.24; p= 0.019), treatment with penicillin (OD: 0.47; p= 0.023) and on the availability of treatment in basic health units (OD: 0.14; p= 0.014). However, they are associated with the lack of knowledge about the lack of vaccine (OD: 1.94; p= 0.04). The analysis of variables related to attitudes showed an association of cases (OD: 2.40; p= 0.016) with inadequate attitude about the beginning of prenatal care. There is an increase in reactive cases from the 1st trimester to the puerperium with p < 0.0001, with the highest significant proportions of reactive cases during delivery and postpartum. Conclusion: gynecological-obstetric factors, sexual and reproductive practices and knowledge are associated with gestational syphilis. In a population with precarious socioeconomic conditions, no association of these factors was demonstrated. Actions for monitoring and evaluating prenatal care are urgent.