Alzira Maria d'Ávila Nery Guimarães

Anemia and intestinal parasitic infections in primary school students in Aracaju, Sergipe, Brazil.

Anemia is estimated to affect half the school-age children and adolescents in developing countries. The main causes are parasitic infections, malaria, and low iron intake. This study aimed to describe the prevalence of anemia, parasitic infections, and nutritional status of children attending public primary schools in Aracaju, Northeast Brazil. Of 360 students, 26.7% were anemic, and prevalence was higher in children under 8 and over 15 years of age. Overall prevalence of intestinal parasites was 42%, with Ascaris lumbricoides (28.7%), Trichuris trichiura (15.6%), and hookworm (1. 7%) most frequently found. There was an association between parasitic infections and poor sanitary conditions, but there was no association between anemia and presence of intestinal parasites. Height-for-age Z scores were lower than the NCHS standard, and prevalence of stunting was 5.4%. Although intestinal parasites were not associated with anemia, children with parasites had lower nutritional indices (weight- and height-for-age Z scores) than those without parasites.

Risk factors for inadequate prenatal care use in the metropolitan area of Aracaju, Northeast Brazil.

BackgroundThe aim of prenatal care is to promote good maternal and foetal health and to identify risk factors for adverse pregnancy outcomes in an attempt to promptly manage and solve them. Although high prenatal care attendance is reported in most areas in Brazil, perinatal and neonatal mortalities are disproportionally high, raising doubts about the quality and performance of the care provided. The objective of the present study was to evaluate the adequacy of prenatal care use and the risk factors involved in inadequate prenatal care utilization in the metropolitan area of Aracaju, Northeast Brazil.MethodsA survey was carried out with puerperal women who delivered singleton liveborns in all four maternity hospitals of Aracaju. A total of 4552 singleton liveborns were studied. The Adequacy of Prenatal Care Utilization Index, modified according to the guidelines of the Prenatal Care and Birth Humanization Programme, was applied. Socioeconomic, demographic, biological, life style and health service factors were evaluated by multiple logistic regression. Results: Prenatal care coverage in Aracaju was high (98.3%), with a mean number of 6.24 visits. Prenatal care was considered to be adequate or intensive in 66.1% of cases, while 33.9% were considered to have inadequate usage. Age < 18 to 34 years at delivery, low maternal schooling, low family income, two or more previous deliveries, maternal smoking during pregnancy, having no partner and prenatal care obtained outside Aracaju were associated with inadequate prenatal care use. In contrast, private service attendance protected from inadequate prenatal care use.ConclusionPrenatal care coverage was high. However, a significant number of women still had inadequate prenatal care use. Socioeconomic inequalities, demographic factors and behavioural risk factors are still important factors associated with inadequate prenatal care use.

Informações dos adolescentes sobre métodos anticoncepcionais

A transversal study was realized in order to identify information about anticonceptive methods in high school students. The sample included 816 adolescents of both genders from public schools in Aracaju, Sergipe. With respect to this information, demographic, pedagogical, behavioral and reproductive aspects were also analyzed. It was verified that 59.0% of the teenagers have an active sexual life and 57.7% affirmed that they do not receive information about anticonceptive methods in school. Magazines, books and newspapers obtained 28% as sources of information and the male condom (84.5%) was the best known method. The analysis made it possible to identify the need for further discussion in school and the insertion of the parents in this process.Realizou-se estudo de corte transversal, com o objetivo de identificar, em escolares do ensino medio, informacoes relativas aos metodos anticoncepcionais. A amostra compreendeu 816 adolescentes de ambos os sexos de escolas publicas de Aracaju, Sergipe. Em relacao a essas informacoes, foram investigados tambem aspectos demograficos, pedagogicos, comportamentais e reprodutivos. Verificou-se que 59% dos adolescentes possuiam vida sexual ativa e 57,7% afirmaram nao receber informacoes sobre metodos anticoncepcionais nas escolas. As fontes de informacoes, revistas, livros e jornais, alcancaram o percentual de 28% e o condon masculino (84,5%) foi o metodo mais conhecido. A analise possibilitou identificar a necessidade de maior discussao na escola e a insercao dos pais nesse processo.

Is adolescent pregnancy a risk factor for low birth weight

OBJETIVO: Evaluar el embarazo en la adolescencia como factor de riesgo para bajo peso al nacer. METODOS: Estudio transversal incluido en una cohorte de puerperas y sus respectivos recien nacidos, en las cuatro maternidades de Aracaju, SE (Brasil), de marzo a julio de 2005. Se estudiaron 4.646 pares de madres/recien nacidos. Los datos se colectaron consecutivamente durante cuatro meses. Variables sociales, biologicas y asistenciales se obtuvieron por medio de cuestionario estandarizado. Se realizo regresion logistica multiple, con control de factores de confusion y de modificacion. RESULTADOS: Del total analizadas, 20,6% eran adolescentes (<20 anos). Las madres adolescentes presentaron peores condiciones socioeconomicas, reproductivas y resultados perinatales mas adversos, al compararse con otros grupos etarios. Se identificaron como factores de riesgo asociados al bajo peso al nacer, la ausencia de asistencia en el prenatal y tabaquismo en la gestacion. Se identifico interaccion de la edad materna con la situacion conyugal: madres adolescentes sin companero tuvieron mayores proporciones de bajo peso al nacer. CONCLUSIONES: La adolescencia se mostro como factor de riesgo para bajo peso al nacer entre las madres sin companero. Tabaquismo durante la gestacion y ausencia de asistencia prenatal se asocian al bajo peso al nacer.

Asma e gravidez: repercussões no recém-nascido

OBJETIVO: Descrever, numa coorte de nascimentos, aspectos socioeconomicos e comportamentais de gestantes com asma e analisar as repercussoes desta sobre alguns parâmetros perinatais. METODOS: Estudo observacional, transversal e analitico a partir de informacoes de parturientes da coorte de nascimentos ocorridos no periodo entre 8 de marco e 15 de julho de 2005 nas maternidades da Grande Aracaju (SE). A identificacao de asma nas gestantes foi obtida segundo informacao destas a partir do diagnostico emitido anteriormente por um medico. Foram analisadas variaveis epidemiologicas, obstetricas e perinatais. RESULTADOS: Das 4.757 parturientes incluidas no estudo, 299 (6,3%) eram asmaticas. As maes asmaticas tinham menor renda familiar e mais frequentemente procuraram assistencia no pre-natal e no parto em servicos publicos que as maes sem asma. Embora somente 9,4% das gestantes asmaticas fumaram, e 27,6% ingeriram bebidas alcoolicas, as proporcoes em relacao ao grupo controle foram significativamente maiores. Nao se detectou associacao entre asma e problemas obstetricos ou do recem-nascido. Nao foi encontrada associacao entre asma e parto cesariano, prematuridade ou recem-nascido sendo pequeno para a idade gestacional. CONCLUSOES: O nivel socioeconomico inferior parece ser um fator de risco para a asma.

Barriers in health care to breast cancer: perception of women

Identifying the barriers in the access to health care to breast cancer perceived by women undergoing chemotherapy.Method: An exploratory descriptive study. The sample consisted of 58 women with breast cancer receiving chemotherapy and registered in the public oncology ambulatory of Aracaju-Sergipe. Data collection was carried out between October 2011 and March 2012 by semistructured interviews, and data were processed using the SPSS, version 17. Results: Among the interviewed women, 37 (63.8%) reported at least a barrier in the trajectory of care for breast cancer. The organizational and health services barriers were the most reported in the periods of investigation and treatment of breast cancer.Conclusion: In face of these findings, the barriers should be considered in public health policies and programs for the control of breast cancer in Sergipe.OBJECTIVE Identifying the barriers in the access to health care to breast cancer perceived by women undergoing chemotherapy. METHOD An exploratory descriptive study. The sample consisted of 58 women with breast cancer receiving chemotherapy and registered in the public oncology ambulatory of Aracaju-Sergipe. Data collection was carried out between October 2011 and March 2012 by semistructured interviews, and data were processed using the SPSS, version 17. RESULTS Among the interviewed women, 37 (63.8%) reported at least a barrier in the trajectory of care for breast cancer. The organizational and health services barriers were the most reported in the periods of investigation and treatment of breast cancer. CONCLUSION In face of these findings, the barriers should be considered in public health policies and programs for the control of breast cancer in Sergipe.

Visita domiciliar: validação de um instrumento para registro e acompanhamento dos indivíduos e das famílias

OBJETIVO:elaborar e validar um instrumento para visita domiciliar (ficha B-VD) visando ao acompanhamento das visitas domiciliares pelas equipes de Saude da Familia (eSF) na Rede de Atencao Primaria a Saude do municipio de Aracaju, estado de Sergipe, Brasil.METODOS:a validacao da ficha B-VD foi realizada pelos profissionais das equipes de saude utilizando-se da tecnica de Delphi e da escala de Likert; os itens da ficha foram agrupados em tres dimensoes; a consistencia interna dos itens da ficha foi investigada mediante o coeficiente alfa de Cronbach.RESULTADOS:na analise de consistencia interna das 17 variaveis investigadas, obteve-se coeficiente alfa de Cronbach de 0,95; na dimensao I (identificacao do usuario), esse coeficiente foi de 0,94, na dimensao II (aspectos do territorio), 0,93, e na dimensao III, (visita domiciliar) 0,82.CONCLUSAO:a ficha B-VD foi validada pelos profissionais das eSF de Aracaju-SE, confirmando-se um instrumento util para acompanhamento das familias.

Qualidade de vida relacionada à saúde de pessoas com Diabetes Mellitus

O diabetesmellituse uma doenca que apresenta alta prevalencia e esta relacionado as elevadas taxas de morbimortalidade. Com este estudo,objetivou-se avaliar a qualidade de vida relacionada a saude (QVRS) de pessoas com diabetesmellituse sua relacao com sexo, idade, tempo dediagnostico do diabetes e pratica de atividade fisica. Trata-se de estudo descritivo, tipo transversal, no qual foi utilizado o SF-36 para avaliar aQVRS. Dentre os 170 participantes, 74,1% eram mulheres, 52,9% casados e as medias (desvio-padrao) da idade e do tempo de diagnostico dadoenca foram, respectivamente, 61,8 anos (11,3) e 15,9 anos (7,9). As medias entre os componentes do SF-36 variaram de 46,2 (Capacidadefuncional) a 84,8 (Aspectos sociais). Os homens apresentaram melhor avaliacao da QVRS. A pratica de atividade fisica se associou a melhorQVRS. Nao se constatou associacao entre QVRS, idade, estado civil e anos de diabetes. Concluiu-se que os participantes do estudo apresentarammaior comprometimento nos componentes que avaliam a saude fisica.(AU) Diabetes mellitusis a highly prevalent disease that is linked to high rates of morbidity and mortality. The study aimed to evaluate the health-related quality of life (HRQOL) of people with diabetesmellitusand its relation to gender, age, time spent since the diagnosis of diabetes andthe practice of physical activity. This is a cross-sectional descriptive study that evaluates HRQL based on SF-36 questionnaire. Among the 170participants, 74,1% were female, 52,9% were married, and the means (standard deviation) of age and time of diagnosis of the disease wererespectively 61.8 years (11.3) and 15.9 years (7.9). The SF-36 components means ranged from 46,2 (Physical function) to 84,8 (Social function).Men have shown better assessment of HRQOL. The practice of physical activity was associated with a better HRQOL. There was no associationbetween HRQL, age, marital status and years spent since the diagnosis of diabetes. We conclude that the study participants had greater loss incomponents that assess physical health.(AU) La diabetesmellituses una enfermedad muy frecuente y esta asociada a altas tasas de morbilidad y mortalidad. El objetivo del estudio fue evaluarla calidad de vida relacionada con la salud (CVRS) de personas con diabetesmellitusy su relacion con genero, edad, momento de diagnostico dela diabetes y practica de actividad fisica. Es un estudio descriptivo transversal que utilizo el cuestionario SF-36 para evaluar la CVRS. Entre los 170participantes, 74,1% eran mujeres, 52,9% casados, y las medias (desviacion estandar) de edad y tiempo de diagnostico de la enfermedad fueronrespectivamente 61.8 anos (11,3) y 15.9 anos (7,9). El promedio de los componentes del cuestionario SF-36 oscilo entre 46,2 (capacidad funcional)y 84,8 (aspectos sociales). Los hombres mostraron mejor evaluacion de la CVRS. La practica de actividad fisica fue asociada a mejor CV. Nohubo asociacion entre la CVRS, edad, estado civil y anos de diabetes. Llegamos a la conclusion de que en los participantes del estudio hubo peordesempeno de componentes que evaluan la salud fisica.(AU)

Teenagers' information about anticonceptive methods

A transversal study was realized in order to identify information about anticonceptive methods in high school students. The sample included 816 adolescents of both genders from public schools in Aracaju, Sergipe. With respect to this information, demographic, pedagogical, behavioral and reproductive aspects were also analyzed. It was verified that 59.0% of the teenagers have an active sexual life and 57.7% affirmed that they do not receive information about anticonceptive methods in school. Magazines, books and newspapers obtained 28% as sources of information and the male condom (84.5%) was the best known method. The analysis made it possible to identify the need for further discussion in school and the insertion of the parents in this process.Realizou-se estudo de corte transversal, com o objetivo de identificar, em escolares do ensino medio, informacoes relativas aos metodos anticoncepcionais. A amostra compreendeu 816 adolescentes de ambos os sexos de escolas publicas de Aracaju, Sergipe. Em relacao a essas informacoes, foram investigados tambem aspectos demograficos, pedagogicos, comportamentais e reprodutivos. Verificou-se que 59% dos adolescentes possuiam vida sexual ativa e 57,7% afirmaram nao receber informacoes sobre metodos anticoncepcionais nas escolas. As fontes de informacoes, revistas, livros e jornais, alcancaram o percentual de 28% e o condon masculino (84,5%) foi o metodo mais conhecido. A analise possibilitou identificar a necessidade de maior discussao na escola e a insercao dos pais nesse processo.

Fetal and neonatal deaths of children of patients classified as near miss

Objective: identify the epidemiological aspects of early fetal and neonatal deaths in children of patients classified with near miss and the factors associated with this outcome. Method: a cross-sectional study of 79 women identified with near miss and their newborns. The variables were analyzed using Fishers exact test. Risk factors were estimated based on unadjusted and adjusted odds ratios, and by means of multiple correspondence analysis, with significance for p <0.05. Results: hypertensive disorders totaled 40.5%; Of these, 58.3% had adverse fetal and neonatal outcome. The newborns admitted to the Neonatal Intensive Care Unit proved to be significant for the outcome (70.8%), gestational age <32 weeks (41.6%), birth weight <2500 (66.7%), neonatal asphyxia (50%) and early respiratory discomfort (72.2%). Conclusion: prematurity, neonatal asphyxia, and early respiratory distress were significant characteristics for the outcome among newborns.Objetivo: identificar os aspectos epidemiologicos dos obitos fetais e neonatais precoces em filhos de pacientes classificadas com near miss e os fatores associados a este desfecho. Metodo: estudo transversal realizado com 79 mulheres identificadas com near miss e seus recem-nascidos. As variaveis foram analisadas utilizando-se o teste Exato de Fisher. Os fatores de risco foram estimados com base nas razoes de chances nao ajustadas e ajustadas, e por meio de analise de correspondencia multipla, com significância para p < 0,05. Resultados: as desordens hipertensivas totalizaram 40,5%; destas, 58,3% tiveram desfecho fetal e neonatal adverso. Mostraram-se significantes para o desfecho os recem-nascidos admitidos na Unidade Terapia Intensiva Neonatal (70,8%), idade gestacional < 32 semanas (41,6%), peso ao nascer < 2500 (66,7%), asfixia neonatal (50%) e desconforto respiratorio precoce (72,2%). Conclusao: prematuridade, asfixia neonatal e desconforto respiratorio precoce constituiram caracteristicas significantes para o desfecho entre os recem-nascidos.