Programa de Pós-graduação em Enfermagem e Saúde
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Navegando Programa de Pós-graduação em Enfermagem e Saúde por Por Orientador "Caetano, Karlla Antonieta Amorim"
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Item Perfil epidemiológico do vírus da hepatite B em adultos e idosos de um município de pequeno porte de Goiás(Universidade Federal de Goiás, 2019-03-11) Brandão, Leyla Gabriela Verner Amaral; Teles, Sheila Araújo; http://lattes.cnpq.br/4975298732179917; Caetano, Karlla Antonieta Amorim; http://lattes.cnpq.br/0112036159794570; Caetano, Karlla Antonieta Amorim; Teles, Sheila Araújo; Pagotto, Valéria; Oliveira, Michele Dias da Silva; Carneiro, Megmar Aparecida dos SantosIn Brazil, current trends in the epidemiology of hepatitis B show a shift in its profile, indicating an increase among elderly populations. We conducted a cross-sectional and analytical study in order to investigate the epidemiological profile of the hepatitis B virus (HBV) in adult and elderly residents of a small-sized municipality in the Southeast region of the state of Goiás. Data were gathered between July and August 2017, and 445 individuals aged 40 and over were recruited. All participants were interviewed and tested for serologic markers of hepatitis B (HBsAg, anti-HBs and anti-HBc) by means of an immunoenzymatic assay (ELISA). Reactive HBsAg samples were tested for serologic markers of HBeAg, anti-HBe, and anti-HBclgM, as well as for HBV DNA through semi-nested PCR. We carried out bivariate and multiple analyses by means of logistic regression in order to identify the association between HBV exposure and sociodemographic and behavioral variables. Study participants included mostly females (61.8%), of which nearly half (44.3%) were aged 60 and over, and 57.5% were married or in consented relationships. As for education, over 60% had over 5 years of schooling. Regarding their place of residence, 11% dwelt in the countryside. Sixty-six participants presented at least one HBV exposure serologic marker adding up to a global prevalence of 14.8% (IC95%: 11.7% - 18.5%), whereas HBsAg prevalence was 0.6% (IC95%:0.2% -2.0%). Our findings show that variables such as being 50-59 (p=0.023) and ≥ 60 years of age (p=0.007), dwelling in the countryside (p=0.009), having a history of genital warts (p=0.034), and having sexual intercourse with sex workers (p=0.023) were significantly associated with HBV exposure. We identified a knowledge gap regarding the parenteral transmission of the virus among the participants, with 42.7% being unaware of the risk of HBV transmission through the shared used of razor blades, and 38.4% of the risk of transmission of viral hepatitis during surgical procedures. At last, three study participants tested positive for HBsAg indicating active hepatitis B infection. Risky parenteral and sexual behaviors were identified among the carriers, which contributes effectively to HBV transmission. Results highlight the necessity for effective preventive measures of hepatitis B targeting the elderly and corroborate individual, social and programmatic vulnerability. To do so, ongoing awareness campaigns for health care providers with emphasis on STDs prevention for individuals in their forties are necessary.Item Cobertura vacinal em crianças assentadas, quilombolas e ribeirinhas do estado de Goiás, nascidas entre 2010 e 2017(Universidade Federal de Goiás, 2021-08-05) Lima, Juliana de Oliveira Roque e; Rosso, Claci Fátima Weirich; http://lattes.cnpq.br/1137218060736306; Caetano, Karlla Antonieta Amorim; http://lattes.cnpq.br/0112036159794570; Caetano, Karlla Antonieta Amorim; Pagotto, Valéria; Minamisava, Ruth; Pessoni, Grécia Carolina; Junqueira, Ana Luiza NetoVaccination is considered one of the most cost-effective and most effective measures in healthcare services. On the other hand, some population groups that live in geographic and cultural isolation have been showing low rates of vaccination. In Brazil, there are no data evaluating adherence to vaccines recommended by the National Program for the Immunization of Unified Health System, better known by the acronym SUS considering children from rural and traditional communities. Therefore, this study aimed to evaluate vaccination coverage according to the national calendar of vaccination of children for the first year of life, and their distributions in space and trends in time in children living in rural settlements, communities of quilombolas, and riverside dwellers in the state of Goiás, born from 2010 to 2017. This is an epidemiological, retrospective cohort study, carried out in 40 municipalities of Goiás, followed by an ecological study. The sample consisted of 616 children born between 2010 and 2017, residents of a settled, quilombolas or riverside dwellers community in Goiás. To calculate the vaccination coverage, the percentage of children with a complete general vaccination schedule or by the vaccine was considered, with a 95% confidence interval. In the time-series, trend analysis was estimated for communities according to mesoregions of Goiás, and for this purpose, the Prais-Winsten linear regression was used, with robust variance. Trends were classified as increasing, decreasing, or stationary, according to the p-value and regression coefficient. The spatial distribution of vaccination coverage, according to the mesoregions of Goiás, was carried out along the time-series. In total, 616 children had their vaccine data evaluated, most were male (53.7%) and belonging to the quilombolas community (54.7%). The overall vaccination coverage for the recommended vaccines during the first year of life at 12 months and at 18 months was 52.4% (CI95%: 48.5% - 56.3%) and 57.8% (CI95%: 53.9% - 61.6%), respectively. For children born in 2017, just the yellow fever vaccine and measles/mumps/rubella vaccine had vaccination coverage > 90%. According to the birth cohort from 2010 to 2017, in Goiás, of the ten vaccines evaluated, six showed an increasing trend in vaccination coverage (POLIO, 10-valent pneumococcal, human rotavirus, meningococcal, yellow fever, and measles/mumps/rubella). Considering the spatial and temporal distribution, according to the mesoregions where the communities are located, a decreasing trend for vaccination coverage was only observed in the Center Goiano mesoregion for the hepatitis B vaccine. In the North Goiano mesoregion, increasing temporal trends were observed for most vaccine coverage, the exception was for BCG and measles/mumps/rubella vaccines. Despite this, the North Goiano mesoregion was the only one in which no vaccine achieved 90% coverage in the period of birth cohort 2016/2017. The results present an unequal scenario in the access to vaccination services for rural populations and traditional Brazilians and point to the need for urgent strategies to achieve and ensure equity in health for a group with distinct traditions and characteristics of the urban population of Brazil.Item Epidemiologia da infecção pelo vírus da hepatite B em cortadores de cana manual do Brasil: um estudo multicêntrico(Universidade Federal de Goiás, 2018-03-05) Rosa, Luana Rocha da Cunha; Caetano, Karlla Antonieta Amorim; http://lattes.cnpq.br/0112036159794570; Caetano, Karlla Antonieta Amorim; Carneiro, Megmar Aparecida dos Santos; Teles, Sheila AraújoDespite the impact of the hepatitis B virus (HBV) worldwide in diverse populations, investigations have focused on urban groups with few studies targeting the rural population. In Brazil, manual sugarcane cutters are rural workers exposed to multiple challenging conditions that increase their vulnerability to HBV. The objective of this study was to investigate the epidemiology of hepatitis B in manual sugar cane cutters from the States of Goiás and Paraíba. This is a multicentric analytical cross-sectional study carried out in the states of Goiás and Paraíba, in the Midwest and Northeast regions of Brazil, respectively. Data collection took place in 2016, and 937 sugarcane cutters aged 18 or over were recruited. All subjects were interviewed and tested for the detection of hepatitis B serological markers (HBsAg, anti-HBs and anti-HBc) by enzyme-linked immunosorbent assay (ELISA). Univariate and multivariate analyses with logistic regression were used to identify association between HBV exposure and sociodemographic and behavioral variables. This study was approved by the Research Ethics Committee of the Federal Universities of Goiás and Paraíba. All participants (n = 937) were male, mostly young adults (68.9%), with an average age of 35.4 years, and natives of the Northeast Region of the country (85.7%). Of the total, 78.8% reported monthly income less than BRL$2,000.00 (about USD$540) and almost half (47.4%) declared four years of education or less. Among the participants, 49.4% started sexual activity early, aged between 7 and 15 years; 77.2% reported history of alcohol use; 29.6% reported experience living in shared housing; 39.8% reported two or more sexual partners in the last year; and 46.5% reported not having used a condom in the same period. In addition, 45.8% shared sharp personal hygiene instruments; 55.0% reported previous hospitalization, and 53.9% had at least one work related accident. The overall prevalence of HBV exposure was 15.9% (95% CI: 13.7% - 18.4%). The HBsAg marker was detected in seven individuals, all of whom presented at least one risk behavior for hepatitis B. Only 20.6% (n = 193, 95% CI: 23.1% - 23.3%) tested positive for isolated anti-HBs, indicating previous vaccination. It was observed that reports of two or more sexual partners in the last 12 months and history of hospital admission (p<0.05) were predictors of HBV exposure, confirming these routes of parenteral and sexual transmission. These results demonstrate the need for effective hepatitis B prevention strategies among sugarcane cutters, focusing on timing, supply and administration of hepatitis B vaccine.