Maria Conceição Oliveira Costa

Perfil antropométrico e consumo alimentar de adolescentes de Teixeira de Freitas - Bahia

OBJECTIVE: The objective was to describe the anthropometric profile and food intake in adolescents from public schools in a municipality of Bahia, Brazil. METHODS: A cross-sectional experimental design was employed with a random conglomerate sample of 354 adolescents, 17 to 19 years old, from a total of 1.678 students enrolled in 23 eligible schools of the municipality. Qualitative data on the frequency of food consumption and anthropometric indicators were collected. Body weight/ height index, triceps skeletal muscle and sub-scapular skinfold measurements, were carried out according to World Health Organization. Bivariate and stratified analyses were then carried out, and statistical significance at the 5% level verified using chi-square (c2) and the exact Fischer test. RESULTS: An analysis of the anthropometric indicators showed prevalence for overweight and obesity in 5.1% of the females and prevalence for underweight in 6.4% of the males. Growth deficiency was noted in 25.0% of the adolescents; the deficiency being classified as moderate in 15.0% and severe in 10.0% of the adolescents. The usual food intake consisted of cooked rice, beans, manioc flour, wheat bread, butter, coffee and sugar. A low consumption of dairy products, fruits, vegetables and greens was observed. 96.6% of the adolescents had three meals per day, which were consumed at home by 80.0% of those interviewed. CONCLUSION: The results point to a need to implement preventive strategies for nutritional problems, recommending appropriate food intake and healthier life styles. Furthermore, possible factors inhibiting growth in the adolescents should be studied.

Childbirth and live newborns of adolescent and young adult mothers in the municipality of Feira de Santana, Bahia State, Brazil, 1998

Data from the Brazilian Ministry of Health and the literature indicate that adolescents may be overrepresented in the prevalence of maternal morbidity and mortality and neonatal complications. This study focused on childbirth and live newborns among adolescent and young adult mothers in the municipality of Feira de Santana, Bahia, identifying risk factors for morbidity and mortality. A cross-sectional cohort study was conducted based on data from the Information System on Live Births (SINASC) in the municipality in 1998, totaling 5,279 live births among adolescent (10 to 19 years) and young adult mothers (20 to 24 years). Variables were age, schooling, prenatal care, gestational care, form of delivery, and birthweight. The authors measured the association between maternal age and the childs birthweight, while controlling potential confounders. Some 21.6% of live births were to adolescent mothers, 51.2% of whom had not finished primary school; there was an association between the 10 to 16-year age bracket and incomplete primary schooling, lack of prenatal care, and low and insufficient birthweight as compared to the other age brackets; there was also a high rate of underrecording in the SINASC. The results suggest the need for specific measures focusing on the reproductive health of adolescents in the municipality.

Avaliação de um serviço de atenção integral à saúde do adolescente

The authors evaluate the Adolescent Health Clinic in the Emaus community in Belem, Para, Brazil with regard to coverage, adequacy, accessibility, and utilization for the period 1994 to 1996. Coverage was calculated on the basis of clinical records and information collected from the target population. Adequacy was analyzed by comparing the service performance with goals established by PAHO/WHO for this kind of institution. Accessibility and utilization patterns were evaluated from information obtained by a population-based survey among adolescents living in the area. Results showed: a good degree of program adequacy vis-a-vis the final purpose, although some adjustments are needed, especially in human resources; lack of barriers to user access; reasonable coverage, despite the low proportion of consultations by adolescents; and utilization pattern compatible with the service provision profile, mainly directed towards curative and individual care. Recommendations are made to revise the hegemonic health care model to emphasize preventive, collective, and educational activities.

Gravidez na adolescência e co-responsabilidade paterna: trajetória sociodemográfica e atitudes com a gestação e a criança

O objetivo foi analisar mudancas sociodemograficas e atitudes dos co-responsaveis pela gravidez de adolescentes, nas ocasioes da gravidez e da entrevista. Estudo transversal, amostragem aleatoria por conglomerado, com 438 entrevistas realizadas com adolescentes e adultas jovens, que foram maes na adolescencia e frequentaram as Unidades Basicas de Saude de Feira de Santana, de agosto a dezembro de 2001. Foram calculados o qui-quadrado (x2) com significância em 5% e Razao de Prevalencia. Entre as ocasioes da gravidez e da entrevista foram verificadas mudancas significantes (p< 0,05): 57% cursavam o fundamental, diminuindo para 32,8%; aumento expressivo dos que deixaram de estudar, de 6,4% (28) para 25,6% (111); diminuicao das proporcoes de solteiros de 71,4% para 12,3% e aumento dos casados, de 23,8% para 66,3%. Nas ocasioes da gravidez e da entrevista, mais de 80% trabalhavam; mais de 30% com renda < que um salario. Cerca de 80% dos homens aceitaram a gestacao e registraram a crianca e cerca de 12% propuseram abortamento, com maior frequencia entre adolescentes. Verificaram-se mudancas significantes na escolaridade e situacao conjugal dos co-responsaveis, a maioria apresentou atitudes positivas diante da gestacao e registro civil da crianca.

Desenvolvimento neuropsicomotor: o teste de Denver na triagem dos atrasos cognitivos e neuromotores de pré-escolares

O objetivo deste estudo foi verificar a prevalencia e fatores associados no que se refere ao desempenho anormal do desenvolvimento neuropsicomotor de criancas matriculadas na educacao infantil publica em Feira de Santana, Bahia, Brasil, em 2009 (n = 438). Esta e uma pesquisa epidemiologica de corte transversal, com amostragem por conglomerado e sorteio das escolas e criancas. Foram verificados os fatores associados por meio de aplicacao de questionario as maes e de teste Denver II ao filho. A analise estatistica realizou o teste χ2 com intervalo de 95% de confianca e α = 5%. A prevalencia de desempenho anormal do desenvolvimento foi 46,3%. Na analise de regressao logistica, as variaveis estatisticamente significantes associadas foram: sexo masculino (RP = 1,43; p = 0,00), cinco anos de idade (RP = 1,42; p = 0,00), nao realizacao de pre-natal (RP = 1,41; p = 0,00), inicio do pre-natal > 3 meses (RP = 1,25; p = 0,00) e consumo alcoolico na gestacao (RP = 1,55; p = 0,00). A prevalencia foi elevada, apontando a necessidade de pre-natal precoce, alertando sobre o consumo alcoolico, e de vigilância nos primeiros anos de vida, visando a prevenir ou tratar precocemente as alteracoes.

Indicadores Materno-infantis na adolescência e juventude: sociodemográfico, pré-natal, parto e nascidos-vivos

OBJECTIVE: to identify characteristics and associations between maternal age and gestation, delivery, and livebirths of adolescent and young adult mothers in the city of Feira de Santana, state of Bahia, Brazil. METHODS: we carried out a cross-sectional, epidemiological study with a population of livebirths and adolescent mothers (aged 10-16 and 17-19 years) and young adult mothers (aged 20-24 years). The information were obtained from the Livebirths Information System (SINASC-1998) for a total of 5,279 livebirths. Study variables were classified into socio-demographic factors (age, schooling of the mother, sex of the newborn) and related to term, delivery, gestational age, birth weight, and Apgar score. Data were processed using prevalence ratio and multivariate analysis. Logistic regression was used to control confounding factors (prenatal and gestational age) and to establish an association between maternal age and birth weight. RESULTS: in 1998, 21.6% of all livebirths in the city of Feira de Santana were from adolescent mothers; out of these mothers, 51.2% had not finished junior high or elementary school. Prevalence ratio and adjusted odds ratio for the 10-16 years of age group indicated increased prevalence of illiteracy, no prenatal examination, and low birth weight and a low prevalence of adequate weight of the newborn in comparison to other age groups studied. Logistic regression showed a positive association between maternal age and low birth weight. We also observed that the SINASC database lacked information in many different fields. CONCLUSIONS: our results indicated, for adolescent mothers, a high prevalence of livebirths and low schooling. Also, especially for the 10-16 years of age group, we observed increased risks for illiteracy, no prenatal examinations, low birth weight, and inadequate weight of the newborn in comparison to other age groups.

Fatores associados à infecção pelo HIV/AIDS entre adolescentes e adultos jovens matriculados em Centro de Testagem e Aconselhamento no Estado da Bahia, Brasil

The study seeks to investigate factors associated with HIV infection among adolescents and young adults registered in the Counseling and Testing Center (CTC) of Feira de Santana, Bahia. An analytical study with a cross-sectional design was conducted using data from the CTC Information System in the period from 2007 to 2011. Information on 3,768 individuals were studied and the proportional difference was checked using the Pearson chi-squared test and stratified analysis by Prevalence Rate (PR) with confidence intervals of 95%, considering the serological status as the outcome. During the period under study, 73 young people were infected with HIV (1.94%). In the female population, statistically significant associations were identified for HIV status and drug use and consumption of alcohol and other drugs, as well as being married or in a stable relationship. In males, the consumption of other drugs and homosexual/bisexual orientation were associated with HIV status. In both sexes, in the category in a stable relationship the HIV status was associated with a partner using drugs and/or infected with a STD and/or HIV. These findings indicate the need for effective measures for the control and prevention of HIV infection among young people.

Experimentação e uso regular de bebidas alcoólicas, cigarros e outras substâncias psicoativas/SPA na adolescência

OBJECTIVE To analyze the use of alcoholic beverages, cigarettes, other psychoactive substances - PAS , among adolescents of public schools of Feira de Santana, Bahia/Brazil. METHOD Cross sectional study with random samples, stratified in terms of conglomerate units (schools and students). The sample of the study totalled 1,409 adolescents between 14 and 19 years old from 10 public schools; 30% of the total of schools of the municipality with 500,000/inhabitants. The representation of schools and students was respected. The self-report instrument was elaborated according to OMS recommendations and as used in others studies. The data were collected according to guaranteed the anonymity of the subjects investigated. RESULTS 86,5% of the adolescents were considered well informed on PAS; 57,0% reported alcoholic beverage consumption, mainly beers and wines; 23,3% used cigarettes and 5.2% other PAS (marijuana, solvents and cocaine); 29,3% reported drinking alcoholic beverages one to three times/month and 13% every weekend. Among subjects 10 to 14 years old, 47% reported drinking alcohol and 16.7% using other PAS. The statistics analysis showed that consumption of alcohol, cigarettes and other PAS is significantly higher among 17-19 years males. Interestingly, the main motivation for drug use is the company of friends and parents. CONCLUSIONS implement of a drug prevention programs in schools.

Avaliação da qualidade de serviço de saúde para adolescentes

OBJETIVO: Avaliar a qualidade tecnico-cientifica do atendimento oferecido a adolescentes, gestantes adolescentes e seus filhos, por um servico de saude. METODOS: Os dados para caracterizacao da clientela e dos criterios do atendimento de saude foram coletados de 360 prontuarios e comparados com padroes da Organizacao Panamericana da Saude/Organizacao Mundial da Saude e do Ministerio da Saude. RESULTADOS: Os resultados foram satisfatorios: no atendimento de adolescentes, na avaliacao antropometrica e de maturacao sexual; no pre-natal, o intervalo entre consultas, os registros de peso e de pressao arterial e as condutas nas intercorrencias; no atendimento a criancas: na insercao precoce no servico, o calendario vacinal atualizado, os registros de peso/desenvolvimento motor e a adequacao nas condutas clinicas. Os resultados menos satisfatorios foram: baixo registro de condutas clinicas para adolescentes e elevado percentual de condutas inadequadas ou parcialmente adequadas; ingresso tardio ao pre-natal e baixa frequencia de registros de imunizacao antitetânica de gestantes; indices elevados de desmame precoce e sub-registro da estatura de criancas. CONCLUSAO: O tipo de avaliacao adotado e de facil execucao, permite avaliar a qualidade do atendimento prestado e possibilita o redirecionamento de atividades e condutas clinicas, no sentido de oferecer uma atencao a saude mais qualificada e voltada as necessidades e demandas da populacao.

Gravidez na adolescência: análise de fatores de risco para baixo peso, prematuridade e cesariana

O objetivo do estudo foi analisar possiveis associacoes entre a faixa etaria materna ate 16 anos, com o peso e a idade gestacional do recem-nascido, assim como a ocorrencia de cesaria na. Estudo transversal com dados das Declaracoes de Nascidos Vivos/DN obtidos atraves do Sistema Nacional de Nascidos Vivos/SINASC, de Feira de Santana, Bahia, Brasil, no periodo 2006 a 2012. Nas analises, utilizou-se regressao logistica, em razao de odds (OR) e intervalo de confianca de 95 %, medindo a forca de associacao entre variaveis, ajustadas aos fatores de confundimento. Os Recem Nascidos de baixo peso e de peso insuficiente mostraram associacao significante com a faixa etaria materna (< 16 anos); e interacao estatistica do pre-natal inadequado e cesariana; em gestantes adolescentes com idade abaixo de 16 anos, a cesariana mostrou associacao significante com estado civil solteira (OR 1,24), pre-natal inadequado (OR 1,58) e Recem Nascidos de baixo peso (OR 1,34). Os dados sugerem que multiplos fatores podem interferir no tipo de parto e resultado gestacional de adolescentes em idade muito precoce, apontando a importância de investimentos em politicas e acoes direcionadas a esse grupo, considerado de alta vulnerabilidade aos agravos gestacionais e perinatais.