Cristine Vieira do Bonfim

Características epidemiológicas dos óbitos maternos ocorridos em Recife, PE, Brasil (2000-2006)

Estudo de corte transversal que objetivou descrever as caracteristicas epidemiologicas dos obitos maternos de residentes no Recife, PE, Brasil, ocorridos entre 2000 e 2006. A fonte de dados foi constituida pelas fichas de investigacao de obito materno da Secretaria de Saude do Recife. Para a analise dos dados, utilizou-se o programa EpiInfo 6.04d. Foram estudados 111 obitos, correspondendo a uma Razao de Morte Materna de 65,99/100.000 nascidos vivos. Os dados obstetricos mostraram a realizacao de menos de seis consultas pre-natais, entre uma e quatro gestacoes previas, parto cesario e admissao em estado grave. Os transtornos hipertensivos constituiram a principal causa de obito. A maioria dos obitos foi considerada evitavel. Os resultados indicam a necessidade de aprimorar a assistencia a saude da gestante durante o pre-natal, parto e puerperioThis was a cross-sectional study that aimed to describe the epidemiological characteristics of maternal deaths among women living in Recife, PE, Brazil that occurred between 2000 and 2006. The data source consisted of investigation files on maternal deaths. To analyze the data, the EpiInfo 6.04d software was used. The analysis considered 111 deaths, corresponding to a maternal death ratio of 65.99/100,000 live births. The obstetric data showed that these women had had fewer than six prenatal consultations, between one and four previous pregnancies, cesarean deliveries and hospital admission in a severe condition. Hypertensive disorders were the main cause of death. Most of the deaths were considered avoidable. The results indicate the need to improve the healthcare for pregnant women prenatally, at delivery and during the puerperium.

Exogenic poisoning in children assisted in a pediatric emergency unit

OBJETIVO: Describir las caracteristicas epidemiologicas de los casos de intoxicaciones exogenas en ninos atendidos en una unidad de emergencia pediatrica de Recife (PE), en el periodo de abril a setiembre del 2006. METODOS: Se trata de un estudio descriptivo de los casos de intoxicaciones exogenas ocurridos en ninos del grupo etareo de 0 a 12 anos de edad notificados en el Centro de Asistencia Toxicologica de Pernambuco. Los datos fueron recolectados a traves de entrevistas y consultas a las fichas de atencion hospitalaria. RESULTADOS: Fueron registrados 26 casos de intoxicacion exogena accidental. Predomino el sexo masculino (65,4%) siendo el grupo etareo de menores de cinco anos de edad el mas afectado (65,4%). Los medicamentos estaban involucrados en el 50,0% de los casos. CONCLUSION: La intoxicacion exogena accidental de ninos, sobre todo en menores de cinco anos es un problema de salud publica que requiere medidas preventivas para evitar que ocurra en la infancia.OBJETIVO: Describir las caracteristicas epidemiologicas de los casos de intoxicaciones exogenas en ninos atendidos en una unidad de emergencia pediatrica de Recife (PE), en el periodo de abril a setiembre del 2006. METODOS: Se trata de un estudio descriptivo de los casos de intoxicaciones exogenas ocurridos en ninos del grupo etareo de 0 a 12 anos de edad notificados en el Centro de Asistencia Toxicologica de Pernambuco. Los datos fueron recolectados a traves de entrevistas y consultas a las fichas de atencion hospitalaria. RESULTADOS: Fueron registrados 26 casos de intoxicacion exogena accidental. Predomino el sexo masculino (65,4%) siendo el grupo etareo de menores de cinco anos de edad el mas afectado (65,4%). Los medicamentos estaban involucrados en el 50,0% de los casos. CONCLUSION: La intoxicacion exogena accidental de ninos, sobre todo en menores de cinco anos es un problema de salud publica que requiere medidas preventivas para evitar que ocurra en la infancia.

Intoxicações exógenas em crianças atendidas em uma unidade de emergência pediátrica

OBJETIVO: Describir las caracteristicas epidemiologicas de los casos de intoxicaciones exogenas en ninos atendidos en una unidad de emergencia pediatrica de Recife (PE), en el periodo de abril a setiembre del 2006. METODOS: Se trata de un estudio descriptivo de los casos de intoxicaciones exogenas ocurridos en ninos del grupo etareo de 0 a 12 anos de edad notificados en el Centro de Asistencia Toxicologica de Pernambuco. Los datos fueron recolectados a traves de entrevistas y consultas a las fichas de atencion hospitalaria. RESULTADOS: Fueron registrados 26 casos de intoxicacion exogena accidental. Predomino el sexo masculino (65,4%) siendo el grupo etareo de menores de cinco anos de edad el mas afectado (65,4%). Los medicamentos estaban involucrados en el 50,0% de los casos. CONCLUSION: La intoxicacion exogena accidental de ninos, sobre todo en menores de cinco anos es un problema de salud publica que requiere medidas preventivas para evitar que ocurra en la infancia.OBJETIVO: Describir las caracteristicas epidemiologicas de los casos de intoxicaciones exogenas en ninos atendidos en una unidad de emergencia pediatrica de Recife (PE), en el periodo de abril a setiembre del 2006. METODOS: Se trata de un estudio descriptivo de los casos de intoxicaciones exogenas ocurridos en ninos del grupo etareo de 0 a 12 anos de edad notificados en el Centro de Asistencia Toxicologica de Pernambuco. Los datos fueron recolectados a traves de entrevistas y consultas a las fichas de atencion hospitalaria. RESULTADOS: Fueron registrados 26 casos de intoxicacion exogena accidental. Predomino el sexo masculino (65,4%) siendo el grupo etareo de menores de cinco anos de edad el mas afectado (65,4%). Los medicamentos estaban involucrados en el 50,0% de los casos. CONCLUSION: La intoxicacion exogena accidental de ninos, sobre todo en menores de cinco anos es un problema de salud publica que requiere medidas preventivas para evitar que ocurra en la infancia.

Mortalidade infantil: tendência temporal e contribuição da vigilância do óbito

Objective To analyze the temporal trend in infant mortality in the city of Recife, state of Pernambuco, Brazil and evaluate the contribution of death surveillance as an instrument for improving vital statistics and action planning. Methods Infant, neonatal, and post-neonatal mortality rates were calculated from 1980 to 2012. An exponential regression model was used for trend analysis. A study on the variables, the basic and associated causes of death certificates, and avoidability was conducted to evaluate the contribution of infant death surveillance. Results The trend in infant mortality rate and its age components was shown to be decreasing. After research on infant death surveillance, no death certificate variable remained incomplete, and the underlying cause of death was better determined in 52% of deaths. Almost 80% of deaths were classified as preventable, and 51.3% were classified as reducible by appropriate care provided to women during their pregnancy. Conclusion Infant mortality presented a decreasing trend, and infant death surveillance contributed to improve vital statistics, which are essential for maternal-infant health planning actions.

Burden of lymphatic filariasis morbidity in an area of low endemicity in Brazil.

The Global Programme to Eliminate Lymphatic Filariasis has two main components: interrupting transmission of lymphatic filariasis (LF) and managing morbidity and preventing disability. However, interventions to prevent and manage LF-related disabilities in endemic communities have been of limited extent. The aim of this study was to describe the prevalence of morbidity and its correlation with filarial infection, thereby filling a gap that existed regarding the data on morbidity in Brazil. Presence of Wuchereria bancrofti microfilaria was investigated using the thick smear technique. Information on parasitosis-related clinical manifestations was obtained using a questionnaire applied by community health agents with previous training and capacitation to know about and identify the disease. To analyze correlations, Pearsons correlation coefficient was used with the corresponding statistical significance test. 23,673 individuals were investigated: 323 presented microfilaremia (1.36%) and 741 (3.13%) had clinical complaints that were attributable to LF. Acute dermatolymphangioadenitis (ADLA) was the most prevalent condition (2.2%). Lymphedema, ADLA and chyluria were more commonly reported among female patients. There were positive associations between all the clinical complaints reported and filarial infection. Hydrocele presented the most strongly positive association (r=0.699; p<0.001). The present study showed that there is an association between clinical condition reported and the rate of infection among people living in an area of low endemicity for LF. It contributes data that might provide support for healthcare systems and thus optimize disease management, through incorporating surveillance measures directed towards preventing disability and reducing the psychosocial and economic impact of the disease on poor populations living in areas endemic for LF.

Mortalidade infantil por causas evitáveis em uma cidade do Nordeste do Brasil

This is a cross-sectional study that aimed to describe the occurrence of infant mortality in Recife (PE) between 2000 and 2009, second to avoidable causes. The population composed of cases of deaths between 2000 and 2009 among the infants of mothers living in Recife. Deaths were classified as avoidable by using the List of avoidable causes of deaths resulting from interventions within the Brazilian National Health System (SUS). Descriptive statistics were used for data analysis. A decrease in the infant mortality coefficient from 20.4 to 12.1 per 1.000 live births was observed (reduction of 40.6%). From the total of 3.743 deaths registered, 2.861 (76.4%) were classified as avoidable. It was notable that 61.2% of the deaths could have been avoided through appropriate care for the woman during the pregnancy. An approach in which avoidability is analyzed may assist in discussions relating to organization, quality and access to healthcare service, and in identifying deaths that could have been avoided through appropriate mother-child healthcare.Estudio de corte transversal cuyo objetivo ha sido describir el acaecimiento de mortalidad infantil en Recife (PE) entre 2000 y 2009, segundo causas evitables. El universo se constituye por las defunciones infantiles de madres residentes en la ciudad de Recife entre 2000 y 2009. La clasificacion de muerte evitable adopto la Lista de causas de muerte evitables por intervenciones del Sistema de Sanidad Publica. Para analisis de los datos se utilizo estadistica descriptiva. Se observo reduccion en el coeficiente de mortalidad infantil de 20,4 a 12,1 por 1.000 nacidos vivos. Del total de 3.743 defunciones registradas, 2.861 (76,4%), se clasificaron como evitables. Se destacaron las defunciones factibles de reduccion por adecuada atencion a la mujer en la gestacion. El abordaje de lo evitable de las defunciones aporta en las discusiones relativas a la organizacion, calidad de acceso a los servicios sanitarios asi como en la identificacion de las defunciones podrian haberse prevenidos o evitados por una adecuada atencion a la sanidad materno-infantil.

Spatial analysis of reported new cases and local risk of leprosy in hyper-endemic situation in Northeastern Brazil

To analyse the spatial distribution of the incidence of leprosy and identify areas at risk for occurrences of hyper‐endemic disease in Northeastern Brazil.

Immunomodulation of allergic response in children and adolescents: What we can learn from lymphatic filarial infection

BACKGROUND Although it is well known that allergic diseases involve a strong Th2 immune response, with production of high levels of specific IgE allergen, knowledge on the association between filarial infection and allergies, among paediatric patients is scarce. OBJECTIVE To evaluate the allergic response patterns in cases of filarial infection by comparing peripheral eosinophils, total IgE levels, immediate hypersensitivity and cytokine levels in children and adolescents in Brazil. METHODS This was an exploratory study with three groups: (I) with filarial infection and without allergic diseases; (II) without filarial infection and with allergic diseases; and (III) without filarial infection and without allergic diseases. The prick test and specific IgE tests for aeroallergens were performed using five antigens. Peripheral eosinophils and total IgE were also evaluated. IL-4 and IL-5 were determined using whole-blood culture stimulated by three antigens. RESULTS Eosinophilia and elevated levels of total IgE (≥400IU/dl) were observed in all groups. The prick test was positive in 56.6% of the cases. Group I presented hypersensitive responses similar to the allergic disease groups. In the whole-blood culture stimulated by Dermatophagoides pteronyssinus, average IL-4 production did not differ significantly among the groups, but IL5 production resulting from stimulation was greater in the allergic disease groups (p<0.05). CONCLUSIONS The allergic response pattern in group with filarial infection was similar to that of the groups with and without allergic diseases, but the response to IL-5 in the culture stimulated by D. pteronyssinus was an exclusive characteristic of the allergic group.

Demographic and epidemiological aspects of mortality from penile cancer

OBJECTIVE: Describing the demographic and epidemiological aspects of mortality from cancer of the penis.METHODS: A cross-sectional study consisting of 183 deaths registered in a public information system on mortality that had penile cancer as the primary cause of mortality. It was used descriptive statistics and the mortality rate was calculated.RESULTS: The mean coefficient of mortality was 0.45/100,000 that is an increase of 19.04%. The demographic data revealed a higher prevalence in men aged 60 years or older (50.8%), brown (54.1%), married (47.6%), retired (24%) and residents of the metropolitan region (44.8%).CONCLUSION: The demographic and epidemiological aspects revealed increase of mortality rates from cancer in the penis.

Óbitos perinatais evitáveis por intervenções do Sistema Único de Saúde do Brasil

Objetivo: Descrever caracteristicas epidemiologicas dos obitos perinatais por acoes do Sistema Publico de Saude. Metodos: Estudo descritivo de analise temporal, populacao composta por obitos perinatais de maes residentes no Recife, 2010-2014. Utilizado Lista de causas de mortes evitaveis para classificar a evitabilidade e EpiInfo versao 7 para analise das variaveis. Resultados: Ocorreram 1.756 obitos perinatais (1.019 fetais e 737 neonatais precoce), observou-se reducao dos obitos neonatais precoces (-15,8%) e aumento dos fetais (12,1%). Apresentou como principais causas: feto e recem-nascido afetado por afeccao materna e asfixia/hipoxia ao nascer. Conclusoes: A maior parte dos obitos foi evitavel, concentrando-se no grupamento de assistencia adequada dispensada a mulher na gestacao. Lacunas na assistencia dispensada a mulher no parto, explicam o percentual de asfixia/hipoxia. Reducao da mortalidade perinatal evitavel associa-se a ampliacao do acesso e qualidade da assistencia para garantir promocao, prevencao, tratamento, cuidados especificos e oportunos. Palavras-chave: Mortalidade perinatal. Estatisticas vitais. Enfermagem obstetrica. Enfermagem neonatal. Saude publica.OBJECTIVE To describe the epidemiological characteristics of perinatal deaths through the actions of the Unified Health System. METHODS This is a descriptive study of temporal analysis with a population of perinatal deaths of mothers residing in Recife, Brazil, from 2010 to 2014. A list was used to classify the preventable diseases and the variables were analysed using Epi lnfo™ version 7. RESULTS The perinatal deaths totalled 1,756 (1,019 foetal and 737 neonatal premature) with a reduction of neonatal deaths (-15.8%) and an increase of foetal deaths (12.1%) in the study period. The main causes of death were foetus and newborn affected by the mother´s condition and asphyxia/hypoxia at birth. CONCLUSIONS Most deaths were avoidable, especially in the group of appropriate care to mothers during pregnancy. Faults in the care provided to women at birth explain the percentage of deaths caused by asphyxia/hypoxia. The reduction of preventable perinatal mortality is associated with the increased access and quality of care, which ensures health promotion, disease prevention, treatment and specific and timely care.