DISSERTAÇÃO DE MESTRADO - PROGRAMA DE PÓS-GRADUAÇÃO EM ENFERMAGEM
URI Permanente para esta coleçãohttps://tedebc-teste.ufma.br/handle/tede/673
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Navegando DISSERTAÇÃO DE MESTRADO - PROGRAMA DE PÓS-GRADUAÇÃO EM ENFERMAGEM por Autor "CALDAS, Arlene de Jesus Mendes"
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Item Análise espacial dos casos e óbitos da covid-19 e sua relação com indicadores socioeconômicos e de saúde no estado do Maranhão.(Universidade Federal do Maranhão, 2023-04-12) ALENCAR, Larissa Karla Barros de; SOEIRO, Vanessa Moreira da Silva; http://lattes.cnpq.br/2013273011748287; CALDAS, Arlene de Jesus Mendes; http://lattes.cnpq.br/7214761052240294; CALDAS, Arlene de Jesus Mendes; http://lattes.cnpq.br/7214761052240294; SOEIRO, Vanessa Moreira da Silva; http://lattes.cnpq.br/2013273011748287; FERREIRA, Thaís Furtado; http://lattes.cnpq.br/1542923855954206; COUTINHO, Nair Portela Silva; http://lattes.cnpq.br/0041085284657642Introduction: COVID-19 is an infectious disease, caused by the SARS-CoV-2 virus, with high transmissibility and global distribution. Since it was first reported in the city of Wuhan, China, in December 2019, the world has been following the exponential growth of cases of the disease. Objective: To analyze the spatial distribution of COVID-19 cases and deaths in Maranhão and its relationship with socioeconomic and health indicators. Methodology: Ecological study of all cases and deaths of COVID-19 in the state of Maranhão notified until August 2022 at the Secretary of State for Health. Socioeconomic and health indicators were collected from the online sites of the Brazilian Institute of Geography and Statistics (IBGE), Institute of Applied Economic Research (IPEA) and e-Gestor Assistência Básica. The dependent variables used were: incidence, mortality and lethality of COVID-19, and the independent ones were: resident population of the municipalities of Maranhão, Gini Index, Municipal Human Development Index (MHDI), Social Vulnerability Index (SVI), income per capita, proportion of poor people, household crowding, illiteracy rate of people aged 15 years or over, proportion of households with a general water network, unemployment rate of the population aged 18 years or over and coverage of Primary Care (AB). The incidence, mortality and lethality rates of the 217 municipalities in Maranhão were estimated. The Global Moran Index (I) was used to assess the existence of spatial autocorrelation with the dependent variables, and the Local Moran Index to identify high and low risk areas (clusters). The maps were made using the QGIS software version 3.12.0. To calculate the global spatial autocorrelation indices, as well as the regression models, the GeoDa software, version 1.14, was used. Result: Until August 31, 2022, 468,943 cases and 11,524 deaths from COVID-19 were reported in Maranhão. The municipality of São Luís registered the highest number of cases and deaths, with 73,218 (15.61%) and 2,873 (24.93%), respectively, and the municipality of Boa Vista do Gurupi registered the lowest number, 16 cases (0.003 %). The municipality of São Francisco do Brejão did not record a death from COVID-19. The highest incidence rate was recorded in the municipality of Lagoa do Mato (25,957.44/100,000 inhab.) and the lowest rate was in Boa Vista do Gurupi (188.36/100,000 inhab.). The highest mortality rate was recorded in Imperatriz (374.25/100,000 inhab.) and the highest lethality rate was in Boa Vista do Gurupi (31.25%). The Moran I Index showed positive spatial autocorrelation for incidence, mortality and lethality in the studied period, making it possible to identify clusters of high and low risk for the dependent variables. The Ordinary Least Squares Estimation (OLS) regression model confirmed spatial autocorrelation with the dependent variables. Incidence showed a positive association with the Gini Index and AB coverage, and a negative association with IVS, MHDI and proportion of poor people. Mortality was positively associated with the Gini Index and illiteracy rate and negatively associated with the proportion of poor people and IVS. Regarding lethality, there was a positive correlation with household crowding and a negative correlation with primary care coverage and illiteracy rate. Conclusion: The spread of COVID-19 occurred heterogeneously, with wide variation between the municipalities of Maranhão, making it possible to identify areas of greater and lesser risk for the disease. Socioeconomic and health indicators influenced the evolution of the pandemic, and that such characteristics should be considered in the formulation of public policies to control the disease, as well as to reduce existing inequalities in the State.Item Distribuição espacial e temporal da tuberculose em povos indígenas no estado do Maranhão.(Universidade Federal do Maranhão, 2016-08-04) Sá, Karina Vanessa Chagas da Silva; CALDAS, Arlene de Jesus Mendes; 067.220.913-68Tuberculosis (TB) presents as a serious public health problem in the world, constituting a relevant infectious disease with high morbidity and mortality, particularly in indigenous people, considered a population at risk for having an incidence rate ten times higher if compared to the general population. Maranhão, from the point of view of the ethnic constitution of its population, has 38,831 indigenous people, distributed in 19 regional units of health. It's the objective of this study to analyze the spatial and temporal distribution of new cases of tuberculosis in indigenous in the state of Maranhão. We conducted an ecological study of historical series of new cases of TB in indigenous from 2010 to 2014 reported in the System for Notifiable Diseases Information System (SINAN). The population consisted of all new cases of tuberculosis in indigenous in the State of Maranhão , reported in the System for Notifiable Diseases Information System (SINAN), from January 2010 to December 2014. For mapping TB in indigenous was held the organization of addresses as to type of the public place,street name, house number, neighborhood, zip code, longitude, latitude, city of residence, health regional, state of residence. The results, after georeferencing of cases during the study period, were presented in thematic maps elaborated in the Geographical Information System (GIS), ArcGIS Program, version 10.1. As to the sociodemographic characteristics of the indigenous population, the highest frequency was observed in the age group of 20-39 years (38.8%), males (68.3%), with ≤8 years of study (50.0%) and residents in rural areas (74.2%); and clinical and laboratory aspects, the pulmonary form was the most frequent (94.4%) and the non-performance of the tuberculin skin test (78.7%), the positive Gram stain in the first sample (50.0%), the negativity second sample (32.0%), the non-performance of the culture (90.4%), and the negative result of HIV testing (53.4%). When evaluating TB cases per year of occurrence it was observed that 2012 (58,1 / 100.000 hab.) And 2014 (77,0 / 100,000 hab.) had the lowest incidence rates, and in 2010 (95,2 / 100,000 hab .) the highest. The areas of Regional Units of Health - RUH with the highest incidences were: Bacabal, Codó, Rosário, Pinheiro, São Luís, Itapecuru-Mirim, Balsas, Chapadinha e Presidente Dutra. It is concluded that the number of cases of TB in indigenous in Maranhao is still quite high and is distributed in RUH, especially in those presenting the highest concentration of indigenous areas, requiring the adoption of more effective measures to prevent and control the disease the indigenous population of the state.Item PREVALÊNCIA E FATORES ASSOCIADOS À COINFECÇÃO TUBERCULOSE E VÍRUS DA IMUNODEFICIÊNCIA HUMANA (HIV) NO ESTADO DO MARANHÃO, NO PERÍODO DE 2001 A 2011(Universidade Federal do Maranhão, 2014-04-28) Pereira, Luis Fernando Bogéa; CALDAS, Arlene de Jesus Mendes; CPF:06722091368; http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=N603359In 2007 were estimated 9.27 million TB cases, 1.4 million of these were also seropositive for HIV. That same year were 456 000 registered cases of deaths from TB who were also infected with HIV. The association between tuberculosis (TB) and HIV infection affects mortality in two ways: TB presents significant lethality for people infected with HIV, and HIV acts as an indirect cause of the increased incidence of TB. Has to analyze the prevalence and factors associated with TB / HIV in patients with tuberculosis in the state of Maranhão. We conducted a cross-sectional analytical study of time series of TB cases notified in the period 2001 to 2011 in the state of Maranhão, totaling 4,553 cases of tuberculosis. Information was collected from the database of State Department of State Health Information Disease Surveillance System (SINAN). To identify associations between outcome (TB / HIV) and the independent variables (age, sex, race / color, education, middle region, place of residence, clinical type, input type, foreclosure situation), we used regression Poisson with robust adjustment of variance. Prevalence ratios (PR) and the ranges of 95 % confidence intervals (95 % CI) were estimated. We found a prevalence of TB / HIV coinfection of 15,1 % in the state. The highest prevalence ranged from 52.9 % in 2001, 11.8% in 2011, and the minimum prevalence ranged of1, 8 % in 2001, 5.9% in 2011. The prevalence of anti - HIV tests ranged from 4.3 % in 2001, 65.9% in 2011. According to the crude analysis, the most significant associations for TB / HIV were males (p ≤ 0.001), age group 20-39 years (p = 0.003) and 40-59 years (p = 0.036) have ≤ 8anos study (p = 0.001), be transferred (p = 0.053), living on the west mesoregion state (p = 0.009) and have closure for oncompliance (p = 0.016) or death (p ≤ 0.001). In the adjusted analysis, both males, age 29-30 years ≤ 8 years, living in the middle region west of the state, like having closure due to death, proved significant for TB / HIV coinfection. On the other hand, the non-white category and Pulmonary TB is presented both as a protective factor in the crude analysis as adjusted, and age ≥ 60 years in only adjusted. High rate of TB / HIV in the state (15,1%), being clear that young males with low education may be contributing to this increase was observed. There needs to adopt specific strategies to monitor this clientele, seeking to reduce the rate of coinfection.