Especificidades e desafios das políticas públicas de saúde na Amazônia

Garnelo, Luíza

doi:10.1590/0102-311x00220519

Cited by 40 publications

(31 citation statements)

References 4 publications

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“…A mesma justificativa se aplica à doença de Chagas, tendo Belém (PA) com maior número de casos notificados, com o agravante de que sua transmissão mais provável seja por via oral, resultado de uma progressiva urbanização da doença, com maior concentração da população em área urbana, juntamente com degradação ambiental, tornando-se os principais determinantes e condicionantes sociais para a transmissão de T. cruzi ao homem (Martins-Melo et al, 2018;Coura, Viñas, & Junqueira, 2014 Research, Society and Development, v. 9, n. 9, e502997502, 2020 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v9i9.7502 Research, Society and Development, v. 9, n. 9, e502997502, 2020 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v9i9.7502 A Amazônia sempre foi vista como uma área promissora de grandes empreendimentos que prometem grandes avanços socioeconômicos, o que resulta num processo de aumento populacional, e que requer também um aumento na produtividade econômica, na expansão do comércio, mais investimento em educação e nos serviços sociais (Lima et al, 2016;Hotez, 2017;Garnelo, 2019). No entanto, este mesmo processo, sem a infraestrutura adequada, é um dos determinantes que podem explicar parte importante do perfil epidemiológico atual, visto que a vulnerabilidade relacionada a essas doenças se refere às questões que superam o nível individual, tornando as pessoas mais expostas aos riscos em determinadas condições (Silva & Ramalho, 2015;Macedo et al, 2020).…”

Section: Resultsunclassified

“…Diversas cidades amazônicas têm apresentado um contínuo processo de expansão populacional, resultando na necessidade de se ampliar a oferta de serviços públicos, forçando a sociedade e o espaço urbano a se reconfigurarem (Staevie, 2015). Importante ressaltar que a Amazônia apresenta um cenário socioambiental heterogêneo, com centros urbanos populosos, populações tradicionais diversas, indicadores socioeconômicos e sanitários díspares, crescimento demográfico e econômico acelerado e massiva concentração de renda e condições de vida amplamente desfavoráveis para a maioria da população (Garnelo, 2019).…”

Section: Resultsunclassified

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Doenças tropicais negligenciadas e as vulnerabilidades socioambientais nas capitais amazônicas

Oliveira

Aguiar

Pontes

2020

RSD

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O presente estudo avalia a situação epidemiológica das doenças tropicais negligenciadas (DTN) com maior ocorrência na Amazônia e sua associação com as vulnerabilidades socioambientais. Foi realizado um estudo ecológico, descritivo, no período entre 2007 e 2016 acerca das DTN notificadas, além de dados sobre o Índice de Desenvolvimento Humano Municipal (IDHM), saneamento básico e o crescimento populacional nas capitais da Amazônia Legal. Os dados obtidos foram organizados em planilhas Excel para a aplicação da estatística descritiva, análise de componentes principais (PCA) e análise hierárquica de agrupamentos (HCA). As doenças notificadas foram dengue, tuberculose, leishmaniose tegumentar americana, esquistossomose, leishmaniose visceral e doença de Chagas. Todas as capitais apresentaram, ao menos, quatro DTN. Estes dados foram confirmados através do PCA e HCA, que constataram que as DTN identificadas puderam ser agrupadas por similaridades entre os valores. A maioria das capitais apresentaram crescimento populacional e IDHM elevados nos últimos anos, no entanto, os serviços de esgotamento sanitário e abastecimento de água deixam a desejar. O estudo mostrou que há uma associação entre as doenças notificadas e os dados de crescimento populacional e saneamento básico, os quais podem evidenciar uma negligência geográfica. Uma forma de mudar essa realidade epidemiológica na Amazônia é elaborando políticas públicas, com planejamento financeiro direcionado para a realização de projetos viáveis e eficazes que ofereçam serviços constantes de saneamento básico, água potável e educação em saúde para esta população.

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Section: Resultsunclassified

Doenças tropicais negligenciadas e as vulnerabilidades socioambientais nas capitais amazônicas

Oliveira

Aguiar

Pontes

2020

RSD

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“…The geographic isolation of the region is a recurrent justification for the historical lack of public policies directed at this population. As a result, social exclusion deepens, which is evidenced in lower income strata with lower levels of schooling deprived of access to the job market and public services [42]. The intensification of these social disparities, mainly in territories historically marked by social inequalities, is among the impacts of the pandemic by the new SARS-CoV-2.…”

Section: Discussionmentioning

confidence: 99%

Hunger and Its Associated Factors in an Urban Cluster in the Western Brazilian Amazon: A Population-Based Study

Mata¹,

Neves²,

Medeiros³

2021

Preprint

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Background: Hunger affects millions of people worldwide. In the current pandemic scenario of COVID-19, Brazil experienced an epidemic peak of hunger, amplifying existing pre-pandemic vulnerabilities, mainly in the Northern Region of the Country. The aim of the present study was to investigate the prevalence of food insecurity and its associated factors in homes with children under five years of age in an urban cluster of a municipality of the Western Brazilian Amazon. Methods: A household survey was conducted with a probabilistic sample of 557 children and their families. Food insecurity (FI) was determined using the Brazilian Food Insecurity Scale. Associations between variables were analyzed based on the prevalence ratio (PR) and respective 95% confidence intervals (CI) calculated through multiple Poisson regression analysis. Variables with a p -value <0.05 after adjustments were considered significantly associated with the outcome. Results: A high prevalence of food insecurity was found among the families in the study (76.47%, PR=1.90, CI: 1.36-2.67, p <0.001); 42.90% had moderate (PR=1.93, CI: 1.31-2.83, p <0.01) and severe FI (PR=1.41, CI: 1.10-1.83, p <0.02), which was associated with low family income, participation in governmental income transfer programs, and heads of households with less than seven years of schooling. Moreover, substantial frequencies of height deficit and overweight were found among the children. Conclusions: The high prevalence of hunger and food insecurity and its associated factors reflects the context of geographic isolation and social exclusion in which these families live, suggesting that a substantial portion of the population under five years of age had experienced episodes of hunger in the 90 days prior to the survey. The high prevalence of height deficit and overweight among the children reveals a scenario of epidemiological/nutritional polarization, requiring the formulation of specific public policies for this population.

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“…to receive antivenom treatment. Thus, healthcare network management in the Amazon needs to be considered not only with regards to the geographical, economic and cultural characteristics of the region, but also regarding their insufficient financing, governance and technical capacity [47,48]. Distance as a barrier was combined with geographical barriers such as rivers and badly maintained roads, which in fact influenced some itineraries.…”

Section: Plos Neglected Tropical Diseasesmentioning

confidence: 99%

A painful journey to antivenom: The therapeutic itinerary of snakebite patients in the Brazilian Amazon (The QUALISnake Study)

et al. 2021

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Access to antivenoms is not guarranteed for vulnerable populations that inhabit remote areas in the Amazon. The study of therapeutic itineraries (TI) for treatment of snakebites would support strategies to provide timely access to users. A TI is the set of processes by which individuals adhere to certain forms of treatment, and includes the path traveled in the search for healthcare, and practices to solve their health problems. This study aims to describe TIs of snakebite patients in the Brazilian Amazon. This study was carried out at the Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, in Manaus, state of Amazonas, Brazil. The itinerary from the moment of the bite to the patient’s admission to the reference unit was analyzed. Sample size was defined by saturation. After an exploratory survey to collect epidemiological variables, in-depth interviews were conducted following a semi-structured guide. Patients originated from rural areas of 11 different municipalities, including ones located >500 kilometers from Manaus. A great fragmentation was observed in the itineraries, marked by several changes of means of transport along the route. Four themes emerged from the analysis: exposure to snakebite during day-to-day activities, use of traditional therapeutic practices, and personal perception of the severity, as well as the route taken and its contingencies. Access to healthcare requires considerable effort on the part of snakebite patients. Major barriers were identified, such as the low number of hospitals that offer antivenom treatment, poor access to healthcare due to long distances and geographic barriers, low acceptability of healthcare offered in countryside, lack of use of personal protective equipment, common use of ineffective or deleterious self-care practices, late recognition of serious clinical signs and resistance to seeking medical assistance. Health education, promotion of immediate transport to health centers and decentralization of antivenom from reference hospitals to community healthcare centers in the Brazilian Amazon are more effective strategies that would to maximize access to antivenom treatment.

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Especificidades e desafios das políticas públicas de saúde na Amazônia

Cited by 40 publications

References 4 publications

Doenças tropicais negligenciadas e as vulnerabilidades socioambientais nas capitais amazônicas

Doenças tropicais negligenciadas e as vulnerabilidades socioambientais nas capitais amazônicas

Hunger and Its Associated Factors in an Urban Cluster in the Western Brazilian Amazon: A Population-Based Study

A painful journey to antivenom: The therapeutic itinerary of snakebite patients in the Brazilian Amazon (The QUALISnake Study)

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