Antonia Maria Rosa

Análise das internações por doenças respiratórias em Tangará da Serra - Amazônia Brasileira

OBJECTIVE To analyze hospitalizations for respiratory diseases among children under 15 years of age in an area with high levels of environmental pollution. METHODS A cross-sectional study of hospitalizations due to respiratory diseases of patients residing in the city of Tangará da Serra, located in the state of Mato Grosso (Brazilian Amazon region), from 2000 to 2005. Data on hospital admissions were obtained from the Brazilian Unified Health Care System and from Brazilian Institute of Geography and Statistics population estimates. RESULTS In 2005, the rate of hospitalization for respiratory diseases among children under 15 years of age in the microregion of Tangará da Serra was 70.1/1,000 children. Between 2000 and 2005, there were 12,777 such admissions, of which 8,142 (63.7%) were for respiratory diseases. During the dry season (May to October), the rate of admissions for respiratory diseases was 10% higher than during the rainy season (November to April). The principal causes of admission included pneumonia (90.7%) and respiratory insufficiency (8.5%). Admissions of children under 5 years of age for pneumonia were 4 times the expected number for the city. Children under 12 months of age were the most frequently hospitalized, with an average increase of 32.4 admissions per 1,000 children per year. CONCLUSIONS Tangará da Serra presented a high number of pediatric admissions for respiratory diseases. Therefore, it is logical to consider it a priority area for investigation and monitoring of the environmental risk factors for such diseases.

Prevalence of asthma in children and adolescents in a city in the Brazilian Amazon region

OBJECTIVE To analyze the prevalence of asthma and asthma symptoms in students of two distinct age brackets residing in the city of Tangará da Serra, Brazil. METHODS Cross-sectional, population-based study of the prevalence of asthma in children from 6 to 7 years of age and adolescents from 13 to 14, using the standardized International Study of Asthma and Allergies in Childhood, phase 1 questionnaire, validated for use in Brazil. Students who responded affirmatively to question 2 (presence of wheezing in the preceding 12 months) were classified as suffering from asthma. RESULTS The study comprised 3,362 students, of whom 1,634 (48.6%) were children and 1,728 (51.4%) were adolescents. Of the 1,634 children, 816 (49.9%) were male, and 818 (50.1%) were female. Of the 1,728 adolescents, 773 (45.0%) were male, and 955 (55.0%) were female. The prevalence of asthma among the children was 25.2%, whereas that among the adolescents was 15.9% (chi2 = 8.34; p = 0.00). The children presented higher prevalences of the following symptoms of asthma than did the adolescents: wheezing ever (54.3%), nocturnal dry cough (43.9%), wheezing in the preceding 12 months (25.2%), and from 1 to 3 attacks of wheezing in the preceding 12 months (19.1%). There were no differences between the two groups regarding physician-diagnosed asthma (approximately 4.5%). There were no statistical differences regarding the prevalence of asthma by gender in the two groups. CONCLUSIONS Tangará da Serra has a high prevalence of asthma in children and adolescents, and this result is compatible with other studies carried out in Brazil and Latin America using the same methodology.

Respiratory disease and climatic seasonality in children under 15 years old in a town in the Brazilian Amazon

OBJECTIVE To analyze the climatic seasonality of primary care visits for respiratory disease (RD) in children less than 15 years old. METHODS This was a descriptive, epidemiological study based on data from the municipal records of primary care events from basic healthcare centers for the period 2004-2005, for the municipality of Tangará da Serra (MT), Brazil. Population estimates were obtained from the Brazilian Institute of Geography and Statistics (Instituto Brasileiro de Geografia e Estatística, IGBE), and data on temperature and relative humidity of the air, from the National Meteorology Institute (Instituto Nacional de Meteorologia, INMET). Mean rates of primary care visits for RD were calculated according to sex, age group and anatomic location of complaint. The ratio of dry season to rainy season visits was calculated according to anatomic location of the RD. Data were analyzed using Epi-Info 3.2, testing differences between proportions using the chi-square test to a significance level of 5%. RESULTS Male children had an almost 50% greater (37.3/25.0) rate of primary care visits for diseases of the lower respiratory tract than did females. The rates of primary care visits due to RD in children under 15 years of age varied as age increased, varying from 457.7 per thousand of children less than 1 year of age to 133.5 per thousand in the 10 to 14 years-of-age group. During the dry season there were an average of 21% (4,148/5,231) fewer visits for RD (p = 0.000). Peaks in numbers of visits were observed during the months of March and August, being more accentuated in March, which is the wet season in the region. CONCLUSION Primary care visits for RD, especially those due to upper airway diseases, are related to the rainy season in this municipality.

Distribuição espacial das internações por asma em idosos na Amazônia Brasileira

INTRODUCAO: No Brasil ocorrem aproximadamente 370 mil internacoes por asma anualmente, constituindo a quarta causa de hospitalizacoes pelo sistema publico de saude. Considerando as implicacoes da asma na qualidade de vida dos idosos, os estudos referentes a essa tematica na Amazonia sao escassos. OBJETIVO: Analisar a distribuicao geografica e a sazonalidade climatica das internacoes hospitalares por asma em idosos na Amazonia brasileira, no periodo de 2001 a 2007. MATERIAL E METODO: Estudo descritivo das autorizacoes de internacoes hospitalares (AIHs) de curta permanencia, nao-eletivas, baseado em suavizacao espacial pelo metodo de Kernel, taxas padronizadas de internacao em series anuais e mensais e sazonalidade climatica e comparacao das proporcoes de internacoes nos periodos seco, intermediario e chuvoso, ao nivel de significância de 5%. RESULTADOS: As internacoes por asma em idosos se distribuem espacialmente na area meridional e oriental da Amazonia brasileira. Toda a Amazonia apresentou declinio nas taxas de internacao durante o periodo estudado. O Estado de Rondonia apresentou aproximadamente o dobro de internacoes em relacao aos outros estados em analise, com variacao de 10,9‰ em 2002 a 13,4‰ em 2006 nas taxas padronizadas. No periodo seco verificou-se ate o triplo de internacoes se comparado ao periodo de chuvas, com taxas mais elevadas em Rondonia (5,8‰) e Mato Grosso (3,3‰). CONCLUSAO: as internacoes por asma em idosos apresentam tendencia decrescente ao longo do periodo estudado, bem como importante variacao sazonal com predominância deste evento durante o periodo seco.

Análise dos atendimentos ambulatoriais por doenças respiratórias no Município de Alta Floresta - Mato Grosso - Amazônia brasileira

OBJECTIVE: to analyze the seasonality of the ambulatory care due to respiratory disease (RD) in the Municipality of Alta Floresta, State of Mato Grosso, Brazilian Amazon. METHODOLOGY: cross-sectional study of the ambulatory care for RD records including inhabitants of Alta Floresta-MT from July 2006 to June 2007. RESULTS: the ambulatory care facilities registered 11,818 patients due to RD, 9,174 (77.6%) due to upper airways diseases, and 2,644 (22.4%) for lower airways diseases; two seasonal peaks in the number ofconsultations were verified, in September - dry season - and March - rainy season end -; the consultations related to lower airways diseases in children underfive years of age were 53% more frequent during the dry season (χ2=21.87; p=0.000); for all age groups, the RD was 36% more frequent during the dry season (χ2=206.40; p=0.000). CONCLUSION: the visitsfor RD were more frequent during the dry season, in all age groups; children and elderly were the most vulnerable age groups to seasonal climate..

Socioeconomic factors and risk for hospitalisation due to asthma in children in the municipalities of Mato Grosso State, Brazil

This ecological study used data accumulated between 2001 and 2012 hospital admissions of children under five years of age with asthma in 141 municipalities in the Mato Grosso. Hospital data were extracted from the SIH/SUS system, and hospitalisation rates were estimated using the Bayesian inference method. SaTScan software was used for the calculation of the relative risk (RR). Differences in socioeconomic characteristics among municipalities with high and low hospitalization rates were evaluated by nonparametric Wilcoxon-Mann-Whitney test. This test indicates that municipalities with better socioeconomic characteristics have lower hospitalization rates. The analysis of the linear models in the two study periods indicated that the decreasing trend in the number of admissions was 3-fold higher in the 2005-2012 period compared with the 2001-2004 period. In addition, a decrease of 76% in the hospitalisation incidence rate was observed during the 12-year study period; this decrease was more evident from 2005 onward. The municipalities identified as having increased risk of hospitalisation of children with asthma were located in areas subjected to intense burning practices and with low municipal development indices.

Estudo transversal dos fatores associados ao uso de corticoide inalatório em crianças residentes no município de Cuiabá, Estado de Mato Grosso, Brasil, 2010

Objective: to analyse factors associated with inhaled corticosteroid use in children under 5 years old. Methods: cross-sectional study carried out in Cuiaba with a sample of 733 children. Crude odds ratios (OR) and adjusted odds ratios (OR aj ) and Confidence Intervals (95%CI) were estimated using logistic regression models. Results: the prevalence of inhaled corticosteroid use in the past 12 months was 13.2% (95%CI = 8.4; 18.0%). It was associated with the use of private health services (OR aj = 4.62; 95%CI = 2.41; 8.85), asthma diagnosed by a doctor (OR aj = 3.97; 95%CI = 1.37; 11.48), bronchitis hospitalization (OR aj = 2.31; 95%CI = 1.04; 5.12), and three or more wheezing episodes in the past 12 months (OR aj = 2.78; 95% CI = 1.10; 7.03). Conclusion: the use of inhaled corticosteroids was associated with private health services, medical diagnosis of asthma and severe asthma indicators.