Deise Maria do Nascimento Sousa

Sífilis congênita no Ceará: análise epidemiológica de uma década

Se objetivo evaluar la incidencia de la sifilis congenita en Ceara entre 2000 y 2009; describir perfil epidemiologico de gestantes cuyos recien nacidos presentaron sifilis congenita y verificar la realizacion del prenatal y de tratamiento de sus companeros. Estudio documental, realizado en julio 2010, sobre banco de datos disponible en Nucleo de Informacion y Analisis en Salud, conteniendo informaciones del Sistema Nacional de Patologias de Notificacion Obligatoria. Se notificaron 290 casos de sifilis congenita, demostrando una serie creciente ano tras ano. La mayoria de las gestantes tenia entre 20 y 34 anos (1832-62,7%), ninguna o escasa escolarizacion (162355,4%) y prenatal efectuado (207770,9%). El tratamiento inadecuado de las gestantes y la falta de tratamiento de sus companeros son una realidad en el SUSCE. La incidencia de sifilis congenita indica la calidad de atencion prenatal. Consecuentemente, su aumento en los ultimos diez anos resalta necesidad de acciones orientadas a su control.This study evaluates the incidence of congenital syphilis in the Brazilian state of Ceará from 2000 to 2009, describes the epidemiologic profile of pregnant women whose newborns had congenital syphilis and verifies the receipt of prenatal care and treatment of their partners. It is a retrospective study that was conducted in July 2010 using a Center for Information and Analysis in Health database that contains information on National Notifiable Diseases. There were 2,930 reported cases of congenital syphilis, demonstrating an annual ascending historical series. The majority of the pregnant women were 20 to 34 years of age (n=1,836, 62.7%), illiterate or with little education (n=1623, 55.4%) and had received prenatal care (n=2077, 70.9%). The inadequate treatment of women and the lack of treatment for their partners is a reality in Ceará. The incidence of congenital syphilis is a quality indicator of prenatal care. Therefore, its increase in the last ten years highlights the necessity of syphilis control.

[Congenital syphilis in Ceará: epidemiological analysis of one decade].

Se objetivo evaluar la incidencia de la sifilis congenita en Ceara entre 2000 y 2009; describir perfil epidemiologico de gestantes cuyos recien nacidos presentaron sifilis congenita y verificar la realizacion del prenatal y de tratamiento de sus companeros. Estudio documental, realizado en julio 2010, sobre banco de datos disponible en Nucleo de Informacion y Analisis en Salud, conteniendo informaciones del Sistema Nacional de Patologias de Notificacion Obligatoria. Se notificaron 290 casos de sifilis congenita, demostrando una serie creciente ano tras ano. La mayoria de las gestantes tenia entre 20 y 34 anos (1832-62,7%), ninguna o escasa escolarizacion (162355,4%) y prenatal efectuado (207770,9%). El tratamiento inadecuado de las gestantes y la falta de tratamiento de sus companeros son una realidad en el SUSCE. La incidencia de sifilis congenita indica la calidad de atencion prenatal. Consecuentemente, su aumento en los ultimos diez anos resalta necesidad de acciones orientadas a su control.This study evaluates the incidence of congenital syphilis in the Brazilian state of Ceará from 2000 to 2009, describes the epidemiologic profile of pregnant women whose newborns had congenital syphilis and verifies the receipt of prenatal care and treatment of their partners. It is a retrospective study that was conducted in July 2010 using a Center for Information and Analysis in Health database that contains information on National Notifiable Diseases. There were 2,930 reported cases of congenital syphilis, demonstrating an annual ascending historical series. The majority of the pregnant women were 20 to 34 years of age (n=1,836, 62.7%), illiterate or with little education (n=1623, 55.4%) and had received prenatal care (n=2077, 70.9%). The inadequate treatment of women and the lack of treatment for their partners is a reality in Ceará. The incidence of congenital syphilis is a quality indicator of prenatal care. Therefore, its increase in the last ten years highlights the necessity of syphilis control.

O perfil das puérperas adolescentes atendidas em uma maternidade de referência de Fortaleza-Ceará

El objetivo de ese estudio fue caracterizar el perfil de las madres adolescentes atendidas en una maternidad de referencia en Fortaleza, Ceara. Estudio descriptivo, transversal y cuantitativo, llevado a cabo en el alojamiento conjunto de la Maternidade Escola Assis Chateaubriand, de marzo a julio de 2009, con 200 adolescentes. Los datos fueron obtenidos por medio de entrevistas. La mayoria tenia entre 15 y 19 anos (91,0%), residia en la capital (78,0%), vivia con el padre de su hijo (64,5%), tenia bajo nivel de educacion (55,5%), consideraba a si misma como mixta (61,5%) y era ama de casa (53%). Sobre los metodos anticonceptivos, el 73,5% utilizaron algun metodo antes del embarazo, el 65,5% deseaban embarazar y el 32,5% planearon el embarazo. Durante este periodo, el 18,5% fueron hospitalizados y el 82,5% no consumia drogas. Es importante el papel de la enfermera como educadora de salud para guiarlos y hacerles autonomas en la promocion de la salud sexual.

Construção e Validação de cartilha para prevenção da transmissão vertical do HIV

Resumo Objetivo: Descrever processo de construcao e validacao de cartilha educativa para prevencao da transmissao vertical do HIV. Metodo: Estudo metodologico em tres etapas: levantamento bibliografico, elaboracao da cartilha e validacao do material por especialistas no assunto e representantes do publico-alvo. Realizou-se a validacao por 9 juizes e 30 representantes do publico-alvo. Considerou-se o Indice de Validade de Conteudo (IVC) minimo de 0,78, para validacao de conteudo e concordância minima de 75% para validacao de aparencia. Resultados: A cartilha apresentou IVC global de 0,87 pelos juizes e nivel de concordância excelente entre os juizes (91,1%-100%) e representantes do publico-alvo (98,1%-100%). Entretanto, os juizes propuseram sugestoes de melhorias da cartilha, que foram acatadas e modificadas para versao final do material. Conclusao: A cartilha foi validada quanto ao conteudo e aparencia, devendo-se ser considerada no contexto das atividades educativas como instrumento capaz de favorecer para prevencao da transmissao vertical do HIV

The profile of the puerperal adolescents treated in a referenced maternity in Fortaleza-Ceará

El objetivo de ese estudio fue caracterizar el perfil de las madres adolescentes atendidas en una maternidad de referencia en Fortaleza, Ceara. Estudio descriptivo, transversal y cuantitativo, llevado a cabo en el alojamiento conjunto de la Maternidade Escola Assis Chateaubriand, de marzo a julio de 2009, con 200 adolescentes. Los datos fueron obtenidos por medio de entrevistas. La mayoria tenia entre 15 y 19 anos (91,0%), residia en la capital (78,0%), vivia con el padre de su hijo (64,5%), tenia bajo nivel de educacion (55,5%), consideraba a si misma como mixta (61,5%) y era ama de casa (53%). Sobre los metodos anticonceptivos, el 73,5% utilizaron algun metodo antes del embarazo, el 65,5% deseaban embarazar y el 32,5% planearon el embarazo. Durante este periodo, el 18,5% fueron hospitalizados y el 82,5% no consumia drogas. Es importante el papel de la enfermera como educadora de salud para guiarlos y hacerles autonomas en la promocion de la salud sexual.

Development of a clinical protocol for detection of cervical cancer precursor lesions

ABSTRACT Objective: to develop and validate the content of a clinical protocol aimed at prevention of cervical cancer in primary care. Method: technological research according to the steps: (1) submission of the project to the research ethics committee; (2) bibliographic survey; (3) elaboration of the clinical protocol; and (4) content validation. In the third step, the information was collected through bibliographic research and gynecology specialists were consulted. For the final step, four judges were selected to evaluate the clinical protocol according to AGREE 2. Domains that reached the minimum level of agreement of 75% in the scores were considered validated. Results: the scores obtained in each domain of the instrument were as follows: domain 1 (scope and purpose) = 87.5%; domain 2 (stakeholder involvement) = 83.3%; domain 3 (development rigor) = 79.7%; domain 4 (clarity of presentation) = 76.3%; domain 5 (applicability) = 78.1%; and domain 6 (editorial independence) = 85.4. Conclusion: the clinical protocol proved to be a validated material with scores above the minimum required. The protocol obtained positive recommendations with modifications and went through adjustments in order to make it more effective.Objetivos: desenvolver e validar o conteudo de um protocolo clinico direcionado a prevencao do câncer cervical na atencao primaria. Metodo: Trata-se de uma pesquisa de desenvolvimento tecnologico em saude(8) realizada em quatro etapas: (1) submissao do projeto ao comite de etica em pesquisa; (2) levantamento bibliografico; (3) elaboracao do protocolo clinico; e (4) validacao de conteudo. Na terceira etapa, as informacoes foram levantadas mediante pesquisa bibliografica e consultados especialistas em ginecologia. Para a etapa final, foram selecionados quatro juizes que avaliaram o protocolo clinico segundo o AGREE 2. Foram considerados validados os dominios que obtiveram nivel de concordância minimo de 75% nas pontuacoes. Resultados: as pontuacoes obtidas, em cada dominio do instrumento, foram as seguintes: dominio 1 (escopo e finalidade)=87,5%; dominio 2 (envolvimento das partes interessadas)=83,3%; dominio 3 (rigor do desenvolvimento)=79,7%; dominio 4 (clareza da apresentacao)=76,3%; dominio 5 (aplicabilidade)=78,1%; e dominio 6 (independencia editorial)=85,4. Conclusao: o protocolo clinico mostrou-se um material validado com pontuacoes superiores ao minimo exigido. Obteve recomendacoes positivas com modificacoes e passou por ajustes a fim de torna-lo mais efetivo.

Desarrollo de protocolo clínico para detección de lesiones precursoras del cáncer de cuello uterino

ABSTRACT Objective: to develop and validate the content of a clinical protocol aimed at prevention of cervical cancer in primary care. Method: technological research according to the steps: (1) submission of the project to the research ethics committee; (2) bibliographic survey; (3) elaboration of the clinical protocol; and (4) content validation. In the third step, the information was collected through bibliographic research and gynecology specialists were consulted. For the final step, four judges were selected to evaluate the clinical protocol according to AGREE 2. Domains that reached the minimum level of agreement of 75% in the scores were considered validated. Results: the scores obtained in each domain of the instrument were as follows: domain 1 (scope and purpose) = 87.5%; domain 2 (stakeholder involvement) = 83.3%; domain 3 (development rigor) = 79.7%; domain 4 (clarity of presentation) = 76.3%; domain 5 (applicability) = 78.1%; and domain 6 (editorial independence) = 85.4. Conclusion: the clinical protocol proved to be a validated material with scores above the minimum required. The protocol obtained positive recommendations with modifications and went through adjustments in order to make it more effective.Objetivos: desenvolver e validar o conteudo de um protocolo clinico direcionado a prevencao do câncer cervical na atencao primaria. Metodo: Trata-se de uma pesquisa de desenvolvimento tecnologico em saude(8) realizada em quatro etapas: (1) submissao do projeto ao comite de etica em pesquisa; (2) levantamento bibliografico; (3) elaboracao do protocolo clinico; e (4) validacao de conteudo. Na terceira etapa, as informacoes foram levantadas mediante pesquisa bibliografica e consultados especialistas em ginecologia. Para a etapa final, foram selecionados quatro juizes que avaliaram o protocolo clinico segundo o AGREE 2. Foram considerados validados os dominios que obtiveram nivel de concordância minimo de 75% nas pontuacoes. Resultados: as pontuacoes obtidas, em cada dominio do instrumento, foram as seguintes: dominio 1 (escopo e finalidade)=87,5%; dominio 2 (envolvimento das partes interessadas)=83,3%; dominio 3 (rigor do desenvolvimento)=79,7%; dominio 4 (clareza da apresentacao)=76,3%; dominio 5 (aplicabilidade)=78,1%; e dominio 6 (independencia editorial)=85,4. Conclusao: o protocolo clinico mostrou-se um material validado com pontuacoes superiores ao minimo exigido. Obteve recomendacoes positivas com modificacoes e passou por ajustes a fim de torna-lo mais efetivo.

Desenvolvimento de protocolo clínico para detecção de lesões precursoras do câncer de colo uterino

ABSTRACT Objective: to develop and validate the content of a clinical protocol aimed at prevention of cervical cancer in primary care. Method: technological research according to the steps: (1) submission of the project to the research ethics committee; (2) bibliographic survey; (3) elaboration of the clinical protocol; and (4) content validation. In the third step, the information was collected through bibliographic research and gynecology specialists were consulted. For the final step, four judges were selected to evaluate the clinical protocol according to AGREE 2. Domains that reached the minimum level of agreement of 75% in the scores were considered validated. Results: the scores obtained in each domain of the instrument were as follows: domain 1 (scope and purpose) = 87.5%; domain 2 (stakeholder involvement) = 83.3%; domain 3 (development rigor) = 79.7%; domain 4 (clarity of presentation) = 76.3%; domain 5 (applicability) = 78.1%; and domain 6 (editorial independence) = 85.4. Conclusion: the clinical protocol proved to be a validated material with scores above the minimum required. The protocol obtained positive recommendations with modifications and went through adjustments in order to make it more effective.Objetivos: desenvolver e validar o conteudo de um protocolo clinico direcionado a prevencao do câncer cervical na atencao primaria. Metodo: Trata-se de uma pesquisa de desenvolvimento tecnologico em saude(8) realizada em quatro etapas: (1) submissao do projeto ao comite de etica em pesquisa; (2) levantamento bibliografico; (3) elaboracao do protocolo clinico; e (4) validacao de conteudo. Na terceira etapa, as informacoes foram levantadas mediante pesquisa bibliografica e consultados especialistas em ginecologia. Para a etapa final, foram selecionados quatro juizes que avaliaram o protocolo clinico segundo o AGREE 2. Foram considerados validados os dominios que obtiveram nivel de concordância minimo de 75% nas pontuacoes. Resultados: as pontuacoes obtidas, em cada dominio do instrumento, foram as seguintes: dominio 1 (escopo e finalidade)=87,5%; dominio 2 (envolvimento das partes interessadas)=83,3%; dominio 3 (rigor do desenvolvimento)=79,7%; dominio 4 (clareza da apresentacao)=76,3%; dominio 5 (aplicabilidade)=78,1%; e dominio 6 (independencia editorial)=85,4. Conclusao: o protocolo clinico mostrou-se um material validado com pontuacoes superiores ao minimo exigido. Obteve recomendacoes positivas com modificacoes e passou por ajustes a fim de torna-lo mais efetivo.

Sífilis congénita en Ceará: análisis epidemiológico de una década

Se objetivo evaluar la incidencia de la sifilis congenita en Ceara entre 2000 y 2009; describir perfil epidemiologico de gestantes cuyos recien nacidos presentaron sifilis congenita y verificar la realizacion del prenatal y de tratamiento de sus companeros. Estudio documental, realizado en julio 2010, sobre banco de datos disponible en Nucleo de Informacion y Analisis en Salud, conteniendo informaciones del Sistema Nacional de Patologias de Notificacion Obligatoria. Se notificaron 290 casos de sifilis congenita, demostrando una serie creciente ano tras ano. La mayoria de las gestantes tenia entre 20 y 34 anos (1832-62,7%), ninguna o escasa escolarizacion (162355,4%) y prenatal efectuado (207770,9%). El tratamiento inadecuado de las gestantes y la falta de tratamiento de sus companeros son una realidad en el SUSCE. La incidencia de sifilis congenita indica la calidad de atencion prenatal. Consecuentemente, su aumento en los ultimos diez anos resalta necesidad de acciones orientadas a su control.This study evaluates the incidence of congenital syphilis in the Brazilian state of Ceará from 2000 to 2009, describes the epidemiologic profile of pregnant women whose newborns had congenital syphilis and verifies the receipt of prenatal care and treatment of their partners. It is a retrospective study that was conducted in July 2010 using a Center for Information and Analysis in Health database that contains information on National Notifiable Diseases. There were 2,930 reported cases of congenital syphilis, demonstrating an annual ascending historical series. The majority of the pregnant women were 20 to 34 years of age (n=1,836, 62.7%), illiterate or with little education (n=1623, 55.4%) and had received prenatal care (n=2077, 70.9%). The inadequate treatment of women and the lack of treatment for their partners is a reality in Ceará. The incidence of congenital syphilis is a quality indicator of prenatal care. Therefore, its increase in the last ten years highlights the necessity of syphilis control.

EpidEmiological analysis of congEnital syphilis in thE statE of cEará, Brazil

Introduction: congenital syphilis is a systemic infectious disease of chronic evolution caused by the Treponema pallidum bacterium dissemination to the fetus through the placenta of infected pregnant women untreated or treated improperly, occurring at any stage of pregnancy or clinical stage of the disease. Objective: epidemiological analysis of congenital syphilis in the State of Ceara from 2007 to 2010. Methods: documentary study conducted in March, 2013, through the database available at the Center for Information and Analysis in Health which keep the information about the National System of Notifiable Diseases records. There were 1,577 notifications of congenital syphilis cases. Results: the following results were observed: 71.78% (n = 1,132) of women who had their children diagnosed with congenital syphilis attented to prenatal consultation; 46.16% (n = 728) had a diagnosis of syphilis identified only during delivery/curettage; about 69.5% (n = 1,096) of pregnant women partners did not undergo any treatment for congenital syphilis. It was noted that over 90% of children were diagnosed with congenital syphilis until the sixth day of birth, and the most prevalent final classification was recent syphilis with 83.83% (n = 1,322) of cases. The most common clinical evolution for children had a favorable outcome, as more than 75% of them underwent treatment and remained alive during the studied period. Conclusion: the thorough analysis of congenital syphilis cases and the factors involved in the process are of fundamental importance to support the actions to prevent and control the disease.