Banca de DEFESA: EDSON DE ANDRADE NHAMUAVE

Uma banca de DEFESA de MESTRADO foi cadastrada pelo programa.
DISCENTE : EDSON DE ANDRADE NHAMUAVE
DATA : 30/03/2020
HORA: 09:00
LOCAL: Salvador-BA
TÍTULO:

SPATIAL DISTRIBUTION OF TUBERCULOSIS INCIDENCE IN MINORS UNDER 15 YEARS AND THEIR RELATIONSHIP WITH BASIC ATTENTION SERVICES IN THE MUNICIPALITIES OF BRAZIL, IN THE PERIOD OF 2012-2014

PALAVRAS-CHAVES:

Tuberculosis in children under 15, health care, PMAQ, spatial analysis.

PÁGINAS: 67
GRANDE ÁREA: Ciências da Saúde
ÁREA: Saúde Coletiva
SUBÁREA: Epidemiologia
RESUMO:

Introduction: Until a recent past, TB was considered a lower priority disease as a public health problem among children and adolescents, but recent data have shown an increase in TB morbidity and mortality in this population group. Objective: to analyze the pattern of TB incidence distribution in children under 15 years and its relationship with the quality of health care services offered, in the municipalities that participated in the PMAQ during the period from 2012 to 2014. Method: spatial ecological study of population-based, having as unit of analysis Brazilian municipalities that participated in the II PMAQ-AB evaluation cycle and that notified at least one new case of TB in children under 15 in SINAN. Data from SINAN, PMAQ-AB, IBGE and SIAB were used to build quality indicators for TB prevention and/or detection actions. Exploratory spatial analysis of thematic maps was carried out to identify patterns of TB incidence distribution. For spatial autocorrelation analysis, the Moran Global Index was used. Moran's Local Spatial Autocorrelation Index was used to identify clusters, with a significance level of 0.05. To evaluate the association between the quality of the health care actions offered and the TB incidence rates, the bivariate and multivariate SEM (Spatial Error Models) model was used. Results: 1074 municipalities participated in the II PMAQ-AB evaluation cycle. The Northeast region had the highest proportion (41%) and the Midwest region the lowest (8.2%). 7344 cases of TB in children under 15 were reported in these municipalities, with an average annual rate of 7.8/100 thousand inhabitants. The Southeast region had the highest proportion of cases (41.4%) and the Midwest the smallest (6.1%). Spatial autocorrelation (p<0.001) was observed between TB incidence rates in neighboring municipalities in Brazil. The Northeast, Southeast and South regions presented local autocorrelation (LISA) with a greater number of High-High areas and the Southeast and South regions presented a greater number of Low-Low areas. A positive association was observed between the spatial variation in TB incidence rates and the following variables: FHS coverage (β = 1.53; p = 0.000), request for chest X-ray examinations (β = 1.73; p = 0.047); conducting an active TB search (β = 3.73; p = 0.049). There was also a negative association with the performance of risk and vulnerability assessment in the reception of users (β = -5.55; p = 0.000), performance of the user's DOT (β = -5.46; p = 0.038), performance groups with a focus on advising on communicable diseases, according to the needs of the territory (β = -7.75; p = 0.052), visits to families in the area covered by AB at different intervals according to risk and vulnerability assessments (β =-1.15; p = 0.000). Conclusion: The results suggest that TB incidence rates in children under 15 years old are associated with the quality of offered health care services, highlighting the need to strengthen risk assessment, vulnerability, diagnosis and active search for new TB cases in children under 15 years old considering the possibility of TB infection or disease in all visits.

MEMBROS DA BANCA:
Presidente - 2224251 - FLORISNEIDE RODRIGUES BARRETO
Externo à Instituição - JOSE UELERES BRAGA - UERJ
Externo ao Programa - 1323871 - MARCIO SANTOS DA NATIVIDADE
Interno - 183.169.805-68 - SUSAN MARTINS PEREIRA - UFBA