Monografias, Dissertações e Teses
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Item Tuberculose em Fernandópolis, São Paulo, Brasil: uma abordagem integrada em Saúde Única(Universidade Brasil, 2024) Machado, Eduardo Félix; Frias, Danila Fernanda RodriguesTuberculosis (TB) is a "forgotten" disease by society, yet it holds great significance for public health as it affects numerous people annually. This research aimed to describe the socio-epidemiological profile of those affected by tuberculosis in the municipality of Fernandópolis, from 2014 to 2023, with the goal of developing control and prevention actions based on the "One Health" approach. The study is characterized by an epidemiological, descriptive, cross-sectional, retrospective, and quantitative qualitative design. It was conducted using Fernandópolis/SP as the unit of analysis, with data collected from the DATASUS database of the Notifiable Diseases Information System (SINAN), along with home visits to 28 individuals reported between January 2019 and December 2023. During the study period, 159 cases of tuberculosis were reported. The profile of those affected primarily included males aged 20 to 39 years, with incomplete high school education, and residents of urban areas. Among the reported cases, 20 involved HIV co-infection. The predominant clinical form was pulmonary tuberculosis, and among those affected, 42% did not complete or abandoned the treatment. The case fatality rate was 4.4%, with a mortality rate of 2 deaths per 100,000 inhabitants. The interviews revealed that most TB patients belonged to social class D, facing economic and housing vulnerability. Poor living conditions hindered treatment, and limited knowledge about the disease led to delayed diagnoses, increasing the risk of transmission. Socioeconomic and environmental factors influence the spread of tuberculosis, underscoring the need for public policies to reduce inequalities and improve awareness. The study concluded that there has been an increase in the prevalence of tuberculosis cases in the municipality. It indicates that the disease requires an integrated approach from a "One Health" perspective, surpassing medical boundaries and incorporating strategies that promote health and improve the quality of life for affected populations. The integrated vision emerges as a fundamental strategy to address the multifaceted challenges of tuberculosis, tackling both treatment and the social, economic, and environmental determinants contributing to its spread.Item Características epidemiológicas e moleculares da infecção pelo vírus da imunodeficiência humana em gestantes no Estado do Piauí, Brasil(Universidade Brasil, 2020) Lima Verde, Roseane Mara Cardoso; Pavinatto, Adriana; Costa, Mardoqueu Martins daIt is estimated that, since its discovery in 1981 until the end of 2018, 74.9 million people have been infected with HIV and that 32 million people have died of AIDS-related illnesses since the beginning of the pandemic. Regardind infection in children (up to 13 years old), 84% of cases are due to vertical transmission. In this context, the present study aimed to identify the main epidemiological characteristics of HIV infection in pregnant women attended at a reference maternity hospital in Piauí, northeastern Brazil. This is a prospective study with the participation of 873 pregnant women attended at Maternidade Dona Evangelina Rosa (MDER), carried out between January 2016 and December 2017. For this purpose, samples were collected, epidemiological information and the diagnosis of HIV infection, carried out through anti-HIV-1/2 antibodies tests (Immunoblot HIV-1/2). In addition, syphilis diagnosis (VDRL and Rapid Treponemic Test), LTCD4 count (Flow Cytometry) and Viral Load (PCR-Real Time) counts were performed. Phylogenetic analysis allowed the comparison with other strains in the literature and the presence of resistance mutations. The data were analyzed using the statistical program Statistical Package for the Social Sciences 20.0 (SPSS). For comparative analysis, the chi-square test (2) was used, with a significance level 5% (p <0.05). Of the total participants, 17 samples tested positive for HIV and were genotyped to determine the subtypes. The prevalence of pregnant women with HIV was 1.95%, characterized as housewives, aged 12 to 35 years, heterosexual, with a partner, elementary school, residents of an urban area, own home, and family income of one to two minimum wages. It was found that 41.2% of pregnant womwn had between 0 and 6 consultations; 76% were in the 3rd trimester; 54.3% of deliveries were cesarean; 44.6% were primiparous and that 72.5% of newborns were over 2.5 kg. No statistical significance was observed in the correlations between the HIV-1 viral load and LTCD4 count parameters with the observed behavioral parameters. All HIV-1 seropositive samples were classified as subtype B (100%). DRM were detected for two samples, the PW 300 and PW 815 sequences. In the PW 300 sequence, the L90M mutation was found, while in the PW 815 sequence, L90M and K103N mutations were detected. L90M is a HIV-1 protease inhibitors (IP) resistance mutation classified as highly resistance to the drug nelfinavir and intermediate resistance to indinavir and saquinavir; the K103N mutation is associated with non-nucleoside inhibitors of HIV-1 reverse transcriptase (INNTR) and classified as highly resistant to nelfinavir and nevirapine. In the end, an flowchart for monitoring the health of pregnant women was developed to guide care and comprehensive care for HIV positive pregnant women in the State of Piauí. It is concluded that, in order to reduce the risk factors of the mother-child binomial and vertical HIV transmission, early diagnosis, quantification of viral load, genotyping and a correct decision in choosing the therapeutic scheme are of fundamental importance, thus avoiding the appearance of resistance strains.Item Perfil epidemiológico de abortamentos espontâneos na região Sudoeste de Mato Grosso - proposição de um novo fluxograma de atendimento(Universidade Brasil, 2020) Dalbem, Catarina Maria Mesquita Garcia; Fávero, Priscila PereiraIntroduction: Spontaneous abortion is an important public health problem, usually occurring in first 12 weeks of pregnancy, and is often underreported in current literature. In Brazil, there is currently no flowchart for the care of patients diagnosed with initial pregnancy undergoing abortion recommended by the Ministry of Health. Objective: Analyze the epidemiological profile of patients diagnosed with spontaneous abortion in the Southwest region of Mato Grosso between January 2018 at July 2019 and to propose a flow chart of care for these patients. Method: Cross-sectional study based on the analysis of the medical records of pregnant women admitted to the obstetrics service of a reference hospital in the Southwest region of Mato Grosso. Clinical and epidemiological data were analyzed and the incidence rate of early abortions was calculated. Data were only collected and analyzed after approval by the Research Ethics Committee of Universidade Brasil, under opinion No. 3,658,979. Results: 348 patients were included in the study. The mena age was 29.36 years, the most common ethnicity was brown (87.64%) and 56% of the patients were single. The incidence rate of abortions in the period of 2018 was 54.5 cases per 1,000 live births, the highest rates were observed in the older population, 40 to 49 years (113.2 cases / 1,000 live births). Several data regarding the epidemiological profile were missing from the medical record. Once the incompleteness of information and the importance of this data was verified, as well as the systematization of data collection in the medical records of patients hospitalized with this diagnosis, a flowchart of screening and care for these patients was proposed.Item Análise temporal da incidência de hanseníase e suas reações em Cáceres-MT(Universidade Brasil, 2020) Dias, Bárbara Klein Bisinella Dias; Amaral, Marcelo Magri; Cortela, Denise CostaLeprosy is a highly prevalent infectious disease in tropical regions and in low to medium income countries, with social inequality and poverty being important risk factors. As it is a contagious infectious disease whose prolonged contact is a primary factor for the transmission of this communicating pathway, the analysis of the distribution of the disease and its determinants in populations, space and time are fundamental aspects. The aim of the present study was to analyze the incidence of leprosy and its reactions in an endemic area of the disease. This is a retrospective observational cross-sectional cut, with data obtained from the Health Surveillance Database, from the National Medical Service System, in the municipality of Cáceres between 2008 to 2018. The variables analyzed were: sex, age, type of leprosy (Paucibacillary or Multibacillary), type of leprosy reaction and location of the notified patient for geoprocessing. In all, 398 cases were reported, 59.11% were male, mean age 44,7 ± 16,9 years and the most common clinical form was multibacillary (53,3%), mostly male (58,8%). Of the total, 50 patients had leprosy reactions, 46% of which were type 1, 36% of type 2 and 18% had both type 1 and type 2 reactions. The neighborhoods with the highest incidence of cases were Rodeio, Vitória Régia, Cavalhada 3 and Jardim Guanabara. From the use of geoprocessing in individuals diagnosed with leprosy, it was possible to find areas with a higher density of cases, which helps in directing public policies for treatment and prevention of the disease.Item Sífilis em gestantes: uma análise espacial no território Vale do Rio Guaribas/PI(Universidade Brasil, 2020) Leal, Antonia Lucimary de Sousa; Marciano, Fernanda Roberta; Navarro, Ricardo ScarparoSyphilis is a Sexually Transmitted Infection (STI) that is easy to diagnose. Its treatment is carried out in a simple and freeway, guaranteed by the Unified Health System (SUS), however, it still presents itself as a public health problem, due to its high incidence, associated comorbidities and, above all, due to its magnitude, mainly when presented in pregnant women, gestational syphilis (SG). Therefore, conducting a spatial analysis of this condition becomes relevant because it allows the exact determination of the geographic space where SG has a smaller and greater distribution within the studied territory, for this the compulsory notification acts as a thermometer indicating where there is a need for disease control, since the pregnant woman with syphilis not treated properly and in a timely manner can transmit the disease vertically to the fetus: Congenital Syphilis (SC), which can cause spontaneous abortion, premature birth, fetal and neonatal death, fetal malformation, deafness , blindness and mental disability. This research aims to analyze the distribution of cases of SG in the territory of Vale do Rio Guaribas/PI, from 2008 to 2018. It is an epidemiological survey with a spatial approach to the cases notified in the Information System for Notifiable Diseases ( SINAN). The data found were tabulated in the Excel program and presented in tables, graphs and a map was designed to view the SG scenario in the Vale do Rio Guaribas / PI Territory. The survey included all SG notifications. In the graphs, tables and map presented, it is feasible to observe the current scenario of SG distribution in the various municipalities that make up the Vale do Rio Guaribas/PI territory and to score a larger cluster of SG cases in the municipality of Picos, with high rates of detection proving efficient in the notification of the disease. However, many municipalities did not present any notification of the disease, suggesting, therefore, underreporting of cases. In several municipalities, there is a lower number of SG notifications than that of congenital syphilis (SC), evidencing the underreporting of SG. The study showed that municipalities have priority in their work, as they are at risk for the occurrence of the disease, making it necessary to raise the awareness of managers, training and health education of this population and health professionalsItem Doenças tropicais negligenciadas: caracterização dos indivíduos e distribuição espacial em um município no semiárido do Piauí(Universidade Brasil, 2020) Macedo, Juliana Bezerra; Costa, Adriana Pavinatto da; Rodrigues, Bruno V. M.The study of the occurrence of neglected tropical diseases (NTDs) based on the location of cases and local epidemiology provides data on their distribution, allowing the identification of clusters and understanding at an expanded level, constituting a important management tool in the control and elimination programs. Considering that the majority of NTDs found in the worldoccur in Brazil, a country that has millions of people living at the level of extreme poverty concentrated in Northeast region, this study aimed to perform spatial analysis and characterize individuals diagnosed with NTDs from 2013 to 2018 in the city of Picos, which is a municipality in the semi-arid region of the state of Piauí, northeast region of Brazil. Thus, this research is an ecological, analytical and exploratory study carried out through access to compulsory notification forms contained in the municipality's Epidemiological Surveillance.The final population consisted of 1,532 cases in which descriptive statistics were performed, such as absolute and relative frequencies, proportion ratios and incidence calculations. After verifying the global autocorrelation through the Moran index, the local autocorrelation was evaluated through the LISA (Local Indicators of Spatial Association) using Moran Maps for the spatial representation of the Moran scattering diagram.The results were presented in four axes according to methodological specifications and analyzed diseases. A higher percentage of notified cases of dengue was observed, followed by leprosy and tuberculosis. There was a predominance of cases in female in the reports of dengue, leprosy and schistosomiasis. As for the age group, there is a predominance among adults (20 - 59 years). Most of the notifications pointed out as incomplete elementary schooling, however, the high percentage of ignored in the notifications of dengue cases stands out. The brown race was identified as the majority in all NTD notifications. Only for dengue cases were reported in pregnant women. The reported cases of NTD were concentrated in the urban residence area; however, the incidence is higher in the rural area. Although the highest percentage of cases of tuberculosis and leprosy has been verified in primary care points, thelarge number of notifications in secondary care points stands out. The municipality of showed hyper endemic for leprosy. Regarding dengue, most notifications occurred at the tertiary level. The spatial analysis of the cases located in the urban network showed a cluster of neighborhoods with similar incidence rates in neighborhoods close to the city center. A high-risk cluster was identified in the central neighborhoods of the city, which can help to define the priority areas for specific interventions. The information evidenced in the study on local epidemiology and spatial analysismay contribute to the definition of actions aimed at improving the control and reducing the incidence of NTD cases in the city.Item Análises epidemiológica e espacial da Covid-19 no Estado do Piauí(Universidade Brasil, 2021) Macedo, Glauber Bezerra; Tim, Carla Roberta; Garcia, Lívia AssisThe emergence of a new coronavirus in humans, first diagnosed in 2019, has many deaths and serious survival and psychosocial consequences. Through statistical tools and techniques associated with geographic technologies, this ecological, analytical and exploratory study is being developed, whose general objective is to carry out epidemiological and spatial analyzes of the distribution of confirmed cases and deaths from Coronavirus 2019 disease (Coronavirus Disease 2019 - COVID-19), in the year 2020, in the state of Piauí, Brazil. The variables listed are being assigned via the IBGE and SESAPI database. All confirmed cases and deaths with COVID-19 infection that were reported in 2020 in that state were included in the study. In the epidemiological analyzes descriptive statistics were carried out and in the spatial analyses, maps are being constructed using geoprocessing techniques, through the statistical analysis of Moran Global and Local. Preliminary results showed that, in 2020, 143,179 confirmed cases and 2,840 deaths caused by COVID-19 were reported in Piauí. A higher percentage of cases was observed in relation to females, young adults, and deaths in elderly, males, with chronic diseases. The capital Piauiense led the number of cases and deaths from the disease, probably due to the high population density. However, when considering the incidence and mortality coefficients of COVID-19, the highest rates in the state were considered in the municipalities of União and Água Branca, respectively. The spatial analysis of the cases showed clusters of high-high pattern of cases of the disease in the metropolitan region of Teresina, the region between Rios and the region of Tabuleiros do Alto do Parnaíba. A high-high cluster for mortality was verified in fillings in the region of Entre Rios and Vale do Sambito. The analyzes performed provided the visualization of spatial clusters and an identification of vulnerable areas, resulting in information that was not visualized working only with tabular data.Item Esporotricose felina: relato de caso(Universidade Brasil, 2023) Oliveira, Mirian Tavares de; Justo, FabianaItem Perfil epidemiológico dos casos de hanseníase notificados no município de Fernandópolis, São Paulo, no período de 2014 a 2016 = epidemiological profile of hanseníase cases notified in the municipality of Fernandópolis, São Paulo, in the period 2014 to 2016(Universidade Brasil, 2019) Sobrinho Neto Junior, ManoelItem Caracterização epidemiológica da Leishmaniose tegumentar e visceral no estado de Tocantins, Brasil(Universidade Brasil, 2020) Moreira, Marilene Alves Rocha; Farias, Danila Fernanda RodriguesLeishmaniasis is one of the six priority endemic diseases in the world, and environmental and socioeconomic conditions in its transmission cycle affect the behavior of its vector and reservoirs. This study characterizes the epidemiological profile of cutaneous and visceral leishmaniasis in the state of Tocantins, Brazil, from 2009 to 2019. A cross-sectional, descriptive, retrospective and qualitative study was undertaken. The sample was limited to the period from 2009 to 2019 and data were collected on the TABNET/DATASUS website and the Health Portal of the Ministry of Health. Once the data were collected and the indices calculated, a descriptive statistical analysis was conducted and results were presented as graphs and tables. A total of 4899 cases of American cutaneous leishmaniasis (ACL) and 3128 cases of visceral leishmaniasis (VL) were recorded in the period. The incidence coefficients of ACL and VL were classified as “low” and "high", respectively. Most of the cases occurred in male individuals, especially in the age group of 20-34 years for ACL, and 1-4 years for VL. As regards the area of residence of the affected individuals, the urban area was the most reported. Of the individuals positive for ACL, 94.6% had cutaneous lesions, whereas the most common symptoms in VL cases were fever, weakness and weight loss. Deaths computed by ACL were 0.4% of the affected individuals, and by VL, 5.8%. Leishmaniasis in the state of Tocantins is a serious public health problem and requires special attention from public and civil institutions in the most diverse sectors of society to consistently address this social problem. There is, therefore, a need for intersectoral articulation aiming at the collective co-responsibility of the initiative of the socio-democratic institutions constituted and directed to a broad debate with civil society and private entities so public policies to combat the disease are outlined with a view to consolidating and promoting collective health