BackgroundDiarrhea is a waterborne disease that affects children, especially those under 5 years of age. The objective of this study was to identify the spatial patterns of distribution of diarrheal disease in under 5-year-old children in the State of Tocantins, Brazil, from 2008 to 2013.MethodsGeoprocessing tools were used to carry out an epidemiological study, to prepare thematic maps in the TerraView 4.2.2 software based on secondary data. General indicators of the disease, presence of spatial dependence through the Global Moran’s Index (I) and the Spatial Association Index (LISA) were described.ResultsThere were 3,015 cases of under 5-year-old children hospitalized for diarrhea, with an average annual rate (AAR) of 4.10/1,000 inhabitants (inhab.). Among the main characteristics were: increasing rates in under 1-year-old children (6.16 to 9.66/1,000 inhabitants); children aged 1 to 4 full years (63%); males (55%); 8 deaths of under one-year-old children (75%); county of Araguaína (67%); incidence in the county of Nazaré (63.97/1,000 inhab.); prevalence and incidence in the Araguaína microregion (45%, AAR 9.38/1,000 inhab.). The presence of a cluster with spatial autocorrelation was found in the Araguaína microregion, which was statistically significant (I = 0.11, p-value < 0.03), with priority of intervention (Moran Map).ConclusionsThere was an increase in the number of hospitalizations for diarrhea in under 5–year-old children in the state of Tocantins. The spatial analysis identified clusters of priority areas for measures of maintenance and control of diarrheal diseases.
The remnants of quilombos, individuals of African descent, have faced several barriers throughout its history, either due to prejudice imposed by society, or the non-fulfillment of their rights guaranteed in the 1988 Constitution, such as access to health services. Thus, this study aims to evaluate the health care offered to quilombo communities in the northern region of Tocantins. This is an exploratory, descriptive study with a qualitative approach, including field research and focus group, carried out with 58 quilombo remnants people from communities in the northern region of Tocantins. Data collection was carried out between from October 2017 to July 2018, through semi-structured interviews. We found that these communities have limited access to health services, in addition to a negative perception of the assistance offered to the health of their population and the commitment of managers. Therefore, access to health and assistance received by the studied communities required to be prioritized since the care provided is not unique and has not met the health demands and needs of the remaining quilombos in northern Tocantins, Brazil.
Os métodos alternativos para o alívio da dor têm a finalidade de tornar o parto o mais natural possível, reduzindo as intervenções desnecessárias e prejudiciais, segundo a Organização Mundial da Saúde, e resgatando a autonomia da parturiente. O objetivo deste estudo foi investigar as terapias alternativas para o alívio da dor do parto normal na literatura disponível em diferentes partes do mundo. Foi feita uma revisão sistemática de literatura nas bases de dados PubMed®, Scientific Electronic Library Online (SciELO), Biblioteca Virtual em Saúde (BVS) e ScienceDirect de estudos publicados entre os anos de 2002 e 2019. A pesquisa ocorreu entre os meses de fevereiro a abril de 2020, conforme os descritores “parturição”, “terapias complementares”, “dor” e “parto normal”. Utilizaram-se as recomendações PRISMA e registradas no PROSPERO (CRD42020186056). Foram analisados 6.758 artigos. Foram incluídos 16 artigos para síntese qualitativa, envolvendo cinco países diferentes. Os estudos tiveram, em sua maioria, participantes primíparas, e, por critérios das inclusões, mulheres saudáveis e com risco habitual de pré-natal. Os 16 estudos envolveram dez técnicas não farmacológicas diferentes, sendo a acupuntura e o banho de aspersão com termoterapia quente as mais utilizadas. A maioria das terapias alternativas respondeu satisfatoriamente ao auxílio da dor do parto, além de não se apresentarem prejudiciais aos recém-nascidos. Os métodos alternativos no parto são abrangentes e colaborativos durante todo o processo gestacional e parturitivo, sendo estaticamente significativos em relação à dor e oportunizando uma gama de modelos que podem ser planejados e empregados pelas maternidades de modo fácil e econômico.
Background Congenital syphilis is an infectious disease that affects 1 million children a year worldwide. Methods The objective of this study was to describe a spatial analysis of the epidemiological characteristics of congenital syphilis in the state of Maranhão, Brazil from 2007 to 2018. This was an ecological study using data obtained in May 2020 from three Brazilian information systems. The spatial correlation was analyzed according to local and global Moran indexes. Results During the 12-y period, 1 426 177 children were born. Of these children, 3684 acquired congenital syphilis (0.26%; mean annual rate of 2.62/1000 live births) and 70 died (1.90%; mean annual rate 0.05). The clusters were statistically significant according to the global Moran index of 0.40 (p=0.01). Spearman's correlation coefficient between the rate of detection of syphilis in pregnant women and family health strategy teams was strong, positive and significant (ρ=0.73; p<0.00). Most of the variables studied showed a trend of annual increase (p<0.05). Conclusions The use of spatial analysis tools have made it possible to detect areas with both a greater and a lesser need for intervention, and to more effectively improve and monitor those areas to change the epidemiological profile of the disease.
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