ABSTRACT ABSTRACT This 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. K K K K Key wor ey wor ey wor ey wor ey words ds ds ds ds: : : : : Maternal mortality; Women's health; Delivery of health care; Vital statistics. RESUMEN RESUMEN RESUMEN RESUMEN RESUMEN Estudio de corte transversal cuyo objetivo ha sido describir las características epidemiológicas de los óbitos maternos de residentes en la ciudad de Recife, PE, Brasil ocurridos entre los años 2000 y 2006. La fuente de datos la constituyeron las fichas de investigación de óbito materna de la Secretaría de Salud de Recife. Para el análisis de los datos se ha hecho uso del programa EpiInfo 6.04d. Han sido investigados 111 óbitos, lo que corresponde a una Razón de Muerte Materna de 65,99/100.000 nacidos vivos. Los datos obstétricos han demostrado la realización de menos de seis consultas prenatales, entre una y cuatro gestaciones previas, parto cesáreo, ingreso en estado grave, con demanda de asistencia bajo terapia. Los trastornos hipertensivos constituyeron la principal causa del óbito. En su mayor parte, los óbitos han sido considerados evitables. Los resultados señalan la necesidad de aprimorar la asistencia a la salud de la gestante en el período prenatal, el parto y el puerperio.

Objective:To describe the epidemiological characteristics of perinatal deaths by actions of the Public Health System. Methods: Descriptive study of temporal analysis, population composed of perinatal deaths of mothers residing in Recife, 2010Recife, -2014 Used List of causes of preventable deaths to classify avoidance and, EpiInfo version 7 for analysis of variables. Results: There were 1,756 perinatal deaths (1,019 fetal, 737 neonatal premature), reduction of early neonatal deaths (-15.8%), and fetal increase (12.1%). Main causes: fetus and newborn affected by maternal condition and asphyxia/hypoxia at birth. Conclusions: Most deaths were avoidable, concentrating on the adequate grouping of attention given to the woman during pregnancy. Failures in the care given to the woman at birth explain the percentage of asphyxia/ hypoxia. Reduction of preventable perinatal mortality is associated with increased access and quality of care to ensure promotion, prevention, treatment, and specific and timely care. Keywords: Perinatal mortality. Vital statistics. Obstetric nursing. Neonatal nursing. Public health. RESUMOObjetivo: Descrever características epidemiológicas dos óbitos perinatais por ações do Sistema Público de Saúde. Métodos: Estudo descritivo de análise temporal, população composta por óbitos perinatais de mães residentes no Recife, 2010-2014. Utilizado Lista de causas de mortes evitáveis para classificar a evitabilidade e EpiInfo versão 7 para análise das variáveis. Resultados: Ocorreram 1.756 óbitos perinatais (1.019 fetais e 737 neonatais precoce), observou-se redução dos óbitos neonatais precoces (-15,8%) e aumento dos fetais (12,1%). Apresentou como principais causas: feto e recém-nascido afetado por afecção materna e asfixia/hipóxia ao nascer. Conclusões: A maior parte dos óbitos foi evitável, concentrando-se no grupamento de assistência adequada dispensada à mulher na gestação. Lacunas na assistência dispensada à mulher no parto, explicam o percentual de asfixia/hipóxia. Redução da mortalidade perinatal evitável associa-se à ampliação do acesso e qualidade da assistência para garantir promoção, prevenção, tratamento, cuidados específicos e oportunos. Palavras-chave: Mortalidade perinatal. Estatísticas vitais. Enfermagem obstétrica. Enfermagem neonatal. Saúde pública. RESUMEN Objetivo:Describir las características epidemiológicas de las muertes perinatales por acciones del Sistema de Salud Pública. Métodos: Estudio descriptivo del análisis temporal, población compuesta por muertes perinatales de madres residentes en Recife, 2010-2014. Lista de causas de muertes evitables para clasificar la evitación y, EpiInfo versión 7 para el análisis de variables. Resultados: Hubo 1.756 muertes perinatales (1.019 fetales, 737 prematuros neonatos), reducción de muertes neonatales tempranas (-15,8%) y aumento fetal (12,1%). Principales causas: feto y recién-nacido afectados por afección materna y asfixia / hipoxia al nacer. Conclusiones: La mayoría de las muertes fueron evitables, concentrándose en la agrupació...

Fatores associados ao estilo de vida de policiais militares

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. ResumoObjetivo: Analisar a tendência temporal da mortalidade infantil na cidade de Recife, Pernambuco, Brasil e avaliar a contribuição da vigilância do óbito como instrumento para aprimoramento das estatísticas vitais e planejamento de ações. Métodos: Foram calculados os coeficientes de mortalidade infantil, neonatal e pós-neonatal para o período de 1980 a 2012. Utilizou-se o modelo de regressão exponencial para análise da tendência. Para avaliar a contribuição da vigilância do óbito infantil foi realizado um estudo sobre as variáveis, causas básicas e associadas da Declaração de Óbito, e da evitabilidade. Resultados: A tendência do coeficiente de mortalidade infantil e seus componentes etários foram decrescentes. Após a investigação da vigilância do óbito infantil nenhuma variável da Declaração de Óbito ficou incompleta e, em 52% dos óbitos, a causa básica foi melhor definida. Quase 80% dos óbitos foram classificados como evitáveis e 51,3% reduzíveis por adequada atenção à mulher na gestação. Conclusão: A mortalidade infantil apresentou tendência decrescente e a vigilância do óbito infantil contribuiu para aprimorar as estatísticas vitais, fundamental para o planejamento das ações de saúde materno-infantil.

O objetivo foi analisar as condições de trabalho e a morbidade referida por Policiais Militares (PM) do Recife-PE. Estudo epidemiológico de corte transversal do qual participaram 288 PMs do Comando de Policiamento da Capital, Recife-PE. Os dados foram coletados mediante questionário semiestruturado, sobre aspectos sociodemográficos, morbidades referidas, demandas e controle no trabalho (Job Content Questionnaire). O perfil sociodemográfico revelou que a maioria dos PMs tinha 39 anos ou mais de idade, era cor parda ou negra (71,3%), era casada (77,3%), possuía dois ou mais filhos (63,7%), tinha cursado até o ensino médio (64,9%) e estava no nível econômico C1 e C2 (61,8%). A maior parte identificou seu trabalho como de baixo controle (56,4%), alta demanda física (53,9%) e baixo suporte social (59,8%). Sendo classificado para 27,8% como de alta exigência; para estes os riscos de sofrimento psíquico e de doenças são maiores, necessitando mudanças na organização do trabalho. O maior tempo de serviço (OR=2,99) e a ausência de folgas semanais (OR=0,47) revelaram-se condicionantes mais importantes da morbidade referida. Sugere-se a utilização de estratégias que promovam maior integração social e cooperação entre os níveis hierárquicos superiores e os comandados, e redução da carga excessiva de trabalho.

This paper describes the construction and application of a social deprivation index that was created to explore the relationship between lymphatic filariasis and socioenvironmental variables in the municipality of Jaboatão dos Guararapes, Pernambuco, Brazil, thereby contributing towards identifying priority areas for interventions. This indicator was obtained from principal-component factor analysis. Variables available from the national census representing socioenvironmental conditions, household characteristics and urban services were used. Epidemiological data came from a parasitological survey on lymphatic filariasis. 23 673 individuals were examined and 323 were positive (1.4%). Two factors that together explained 80.61% of the total variance were selected. The social deprivation strata were capable of indicating a risk gradient, with 74.9% of the microfilaremia cases situated in the high-risk stratum. Principal-component factor analysis was shown to be sensitive for selecting indicators associated with the risk of lymphatic filariasis transmission and for detecting areas potentially at risk. The capacity of the social deprivation index for picking up social inequalities qualifies it as a new tool for use in planning interventions aimed at controlling lymphatic filariasis in urban spaces.

The aim of this study was to investigate the epidemiological characteristics, antigenic profile, perceptions, attitudes and practices of individuals who have been systematically non-compliant in mass drug administration (MDA) campaigns targeting lymphatic filariasis, in the municipality of Olinda, State of Pernambuco, Northeastern Brazil. A pretested questionnaire was used to obtain information on socioenvironmental demographics, perceptions of lymphatic filariasis and MDA, and reasons for systematic noncompliance with treatment. A rapid immunochromatographic test (ICT) was performed during the survey to screen for filariasis. It was found that the survey subjects knew about filariasis and MDA. Filariasis was identified as a disease (86.2%) and 74.4% associated it with the presence of swelling in the legs. About 80% knew about MDA, and the main source of information was healthcare workers (68.3%). For men the main reasons for systematic noncompliance with MDA were that “the individual had not received the medication” (p=0.03) and for women “the individual either feared experiencing adverse reactions”. According to the ICT, the prevalence of lymphatic filariasis was 2%. The most important causes of systematic noncompliance were not receiving the drug and fear of side-effects. For successful implementation of MDA programs, good planning, educational campaigns promoting the benefits of MDA, adoption of measures to minimize the impact of adverse effects and improvement of drug distribution logistics are needed.

Summaryobjective To describe the spatial distribution of lymphatic filariasis and its relationship with the socioenvironmental risk indicator, thus identifying priority localities for interventions in endemic urban areas.methods The study area was the municipality of Jaboatã o dos Guararapes, State of Pernambuco, Brazil. The data sources were a parasitological survey and the 2000 demographic census. From these data, a socioenvironmental composite risk indicator was constructed using the 484 census tracts (CT) as the analysis units, based on the score-formation technique. Census tracts with higher indicator values presented higher risk of occurrences of filariasis.results Six thousand five hundred and seven households were surveyed and 23 673 individuals were examined, among whom 323 cases of microfilaremia were identified. The mean prevalence rate for the municipality was 1.4%. The indicator showed that 73% (237 ⁄ 323) of the cases of microfilaremia were in high-risk areas (third and fourth quartiles) with worse socioenvironmental conditions (RR = 4.86, CI = 3.09-7.73, P < 0.05).conclusions The socioenvironmental composite risk indicator demonstrated sensitivity, since it was able to identify the localities with greater occurrence of infection. Because it can stratify spaces by using official and available data, it constitutes an important tool for use in the worldwide program for eliminating lymphatic filariasis.