Introduction: Tuberculosis (TB) is an infectious and contagious disease caused by Mycobacterium tuberculosis. TB emerged in the 21st century as an unsolved public health problem. This study aimed to analyze the relationship between the characteristics of basic health units (BHUs) and the number of TB cases detected in Maranhão, Brazil. Methods: An ecological, analytical study was conducted using the municipalities in the state of Maranhão as the unit of analysis. Data regarding the number of detected TB cases was obtained from the Sistema de Informação de Agravos de Notificação database, and the characteristics of the BHUs were obtained from the first cycle of data collection for the Program to Improve Access and Quality of Basic Care. The BHU structure was classified as adequate (80%-100%), partially adequate (60%-79%), poorly adequate (40%-59%), or inadequate (<40%) according to the presence of specified items. The number of BHUs per municipality in each adequacy category was estimated. Inflated Poisson regression analysis was performed to estimate the incidence density ratios (IDRs) and the 95% confidence intervals (95% CIs). Results: Municipalities with a higher level of BHU adequacy had a higher number of detected TB cases (IDR = 1.61, 95% CI: 1.01-2.60). Conclusions: Better structured health services in primary care may be associated with better detection and/or notification of TB cases.
Objective: to study uterine cervical cancer among women in prison. Method: an exploratory-descriptive and quantitative study conducted at a women's penitentiary in São Luís, Maranhão. The sample was composed of 38 women. A questionnaire was applied and, subsequently, a Papanicolau´s test was performed. The study was approved by the Committee of Ethics in Research by the University Hospital of the Federal University of Maranhão (protocol 010.07). Results: the predominant age was between 26 and 30 years of age (47.4%); 23 (60.6%) had incomplete elementary education; and 24 (63.2%) had no income. Regarding smoking, 20(52.6%) women were smokers, 10 (50.0) for more than fifteen years. Regarding sexuality, 24 (63.2%) do not use condoms at all during sexual relations; the majority of their first sexual intercourses occurred between 13 and 16 years of age (68.4%); the Papanicolau´s test has been previously performed by 30 (78.9%) and 08 (21.1%) never had one. The cytology showed that 97.4% of the tests were negative for intraepithelial lesion or malignancy, 2.6% were compatible with low-grade epithelial injury and 58% have compatibility with Gardnerella vaginallis. Conclusion: despite not showing a high prevalence of cancer precursor lesions, the women had risk factors for this type of cancer, demonstrating the importance of health strategies that target these factors. Descriptors: neoplasms; uterine cervical neoplasms; women´s health; health vulnerability.RESUMOObjetivo: estudar o câncer cérvico uterino entre mulheres em cárcere. Método: estudo exploratório-descritivo, quantitativo, realizado em uma penitenciária feminina da cidade de São Luís-MA. Participaram da pesquisa 38 mulheres na qual se aplicou um questionário e, posteriormente, realizou-se exame Papanicolau. Para a tabulação de dados foi construído um banco de dados no programa EPI INFO® os quais foram apresentados em tabelas. O estudo foi aprovado por Comitê de Ética em Pesquisa do Hospital Universitário, da Universidade Federal do Maranhão, com número de protocolo 010.07. Resultados: verificou-se que a faixa etária predominante foi de 26 a 30 anos (47,4%); 23 (60,6%) detentas possuíam ensino fundamental incompleto; e 24 (63,2%) não possuíam renda. Quanto ao hábito tabagista, 20 (52,6%) fumavam, 10 (50,0%) há mais de quinze anos. Quanto à sexualidade, 24 (63,2%) não utilizavam preservativo em todas as relações sexuais, a primeira relação sexual da maioria ocorreu entre 13 e 16 anos (68,4%), o Papanicolau já foi realizado anteriormente por 30 (78,9%) e 08 (21,1%) nunca o fizeram. A citologia oncótica evidenciou que 97,4% dos testes foram negativos para lesão intra-epitelial e malignidade, 2,6% foram compatíveis com lesão epitelial de baixo grau e 58.3% apresentaram compatibilidade com Gardnerella vaginallis. Conclusão: mesmo não evidenciando prevalência alta de lesões precursoras de câncer, as mulheres apenadas apresentaram fatores de risco para este câncer, mostrando a importância de estratégias de saúde direcionadas a estas. Descritores: neoplasias; neoplasias do colo do útero; saúde da mulher; vulnerabilidade em saúde.RESUMENObjetivo: estudiar el cáncer de cuello entre mujeres en la cárcel. Métodos: estudio exploratorio descriptivo, cuantitativo, desarrollado en una penitenciaría para mujeres en la cuida São Luis, en el estado de Maranhão, Brasil. Participaron 38 mujeres. Fue aplicado un cuestionario y fue realizada la prueba de Papanicolaou. El estudio fue aprobado por el Comité de Ética del Hospital Universitario de la Universidad Federal de Maranhão (protocolo 010.07). Resultados: la edad predominante del grupo fue entre 26 y 30 años (47,4%); 23 reclusas (60,6%) tenían una educación primaria incompleta; y 24 (63,2%) no tenían renta. En cuanto al habito tabáquico, 20 (52,6%) fumaban, 10 (50,0%) durante más de quince años. Con respecto a la sexualidad, 24 (63,2%) no utilizan el preservativo en todas las relaciones sexuales, la primera relación sexual de la mayoría ocurrió entre 13 y 16 años (68,4%), la prueba de Papanicolaou ha sido hecha por 30 (78,9%) y 08 (21,1%) nunca la hicieron. La citología oncótica mostró que 97,4% de pruebas fueron negativas para lesión epitelial o malignidad, 2,6% eran compatibles con lesión epitelial baja y 58% tenían Gardnerella vaginallis. Conclusión: mismo no mostrando una alta prevalencia de lesiones precursoras del cáncer, las mujeres tuvieron factores de riesgo, mostrando la importancia de las estrategias de salud dirigidas a estos factores. Descriptores: neoplasias; neoplasias del cuello uterino; salud de la mujer; vulnerabilidad en salud.
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