Análise da tendência da cárie e influência de fatores individuais e contextuais em escolares de 12 anos em Goiânia-GO, no período de 1988 a 2010
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2013-08-29
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Universidade Federal de Goiás
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The monitoring of oral health and its determinants are of utmost importance for the planning and evaluation of health programs at the local level and to expand knowledge about this issue in Brazil. The aim of this study was to analyze the trend of dental caries and its association with individual and contextual factors in 12 years-old in the city of Goiânia. We conducted a cross-sectional study using data from epidemiological surveys of oral health conducted in the county from 1988 to 2010 and data from local information systems on contextual factors related to schools. For trend analysis of caries from 1988 to 2010 the Spearman correlation coefficient was used. Comparisons among Health Districts (HD) were made for the years 1994 and 2010. To analyze the association of the disease with individual and contextual factors in 2010 a multilevel analysis and log-linear regression negative binomial ratio averages were conducted, considering the complex sampling design. The dependent variable was the DMFT index and the independent variables were individual (sex, race and maternal education) and contextual related to schools (type of school, health district and the presence of oral health programs). The mean DMFT decreased 78.5% in the period, from 8.26 in 1988 to 1.78 in 2010 (r = -1.0, p ≤ 0.01) and there was a decrease of 86.8% in the decayed component, 73.3% in the missing due to caries and 41.7% in the filled teeth. There was an increase of 86.8% in the number of caries-free schoolchildren from 1994 to 2010 (r = 1.0, p ≤ .01). Children attending schools located in the HD with the worst socioeconomic indicators showed higher caries prevalence and lower percentage reductions compared with those with better indicators. In the multilevel model, female students and those whose mothers had less education, attending public schools located in districts with the worst socioeconomic indicators, and covered by the Family Heath Strategy had a higher DMFT in 2010. We concluded that there was a decrease in the prevalence of caries in Goiania from 1988 to 2010 and inequalities in the disease distribution in relation to sociodemographic factors related to individuals and school environment, which indicate the need for more effective actions seeking to reduce the inequalities, with emphasis on the school population less economically favored.
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OLIVEIRA, Lorena Batista de. Análise da tendência da cárie e influência de fatores individuais e contextuais em escolares de 12 anos em Goiânia-GO, no período de 1988 a 2010. 2013. 98 f. Dissertação (Mestrado em Saúde Coletiva) - Universidade Federal de Goiás, Goiânia, 2013.