Saúde Coletiva
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Programa de Pós-Graduação em Saúde Coletiva
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Navegando Saúde Coletiva por Autor "Almeida, Márcia Valéria de Souza"
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- ItemAvaliação da qualidade dos dados do sistema de informação do câncer do colo do útero, do município de Vitória, Espírito Santo, 2007(Universidade Federal do Espírito Santo, 2009-07-06) Almeida, Márcia Valéria de Souza; Amorim, Maria Helena Costa; Zandonade, Eliana; Maciel, Ethel Leonor Nóia; Thuler, Luiz CláudioThis study has evaluated the Information System SISCOLO along the year 2007 in Vitoria. It has analyzed accessibility, opportunity and completeness as data quality evaluation criteria aiming at the recognition of the system potential for becoming an epidemiological tool, widening its current usage for accountancy and control of the cytopathological tests pay roll. It has been defined in two dimensions: (1) System Quality, composed by data quality components, accessibility, opportunity and completeness; (2) System Production, looking upon the components ratio of the cervical screening in women 25 to 59 years and women in this age group, lesion prevalence, lesion profile change, lesion chronology and sample adequateness. The data is from the SISCOLO data bank covering the period from January to December of 2007, supplied by the Municipal Coordination of Viva Mulher. For each dimension group analysis has been done using the Program SPSS, version 15.0. For the prevalence calculation and its respective 95% confidence interval the Stata program has been used. The SISCOLO is an accessible system, with the opportunity (time lapse between collection and result release) varying from 14 to 45 days. Attributes completeness were found excellent for ―has done preventive testing before‖ and for ―material adequateness‖; good for ―year of the last preventive‖; and bad for school history and all the attributes on the fields of anamnesis and inspection of the uterus colon (Cytopathological Test Formulary - uterus colon). The provision of cervical screening by the municipality reached a ratio of 0,25 test/female/year. Lesion prevalence presented the following distribution: 9,56 for ASCUS (IC95% 8,4-10,8); 11,58 for LIE BG (IC95% 10,3-12,9) and 2,07 for LIE AG (IC95% 1,5-2,7). The ratio between low and high degree lesions was of 4, 19 women, with an average age for precursory lesions showing up in younger women (29 to 38 years of age). Among the slides examined 1, 1% presented unsatisfactory adequateness.. The information presented point to the need of improvement in traceability and uterus colon cancer control in Vitoria. The possibility of the components accessibility, opportunity and completeness usage for SISCOLO data production quality, will contribute to make it a more improved tool not only for finances but also for epidemiological use.
- ItemCovid-19 Em Gestantes E Recém-Nascidos: Situação Epidemiológica Do Espírito Santo(Universidade Federal do Espírito Santo, 2024-04-23) Santos, Ana Paula Brioschi Dos; Vicente, Creuza Rachel; https://orcid.org/0000-0003-0182-7969; http://lattes.cnpq.br/0530544422426629; Miranda, Angelica Espinosa; https://orcid.org/0000-0002-5556-8379; http://lattes.cnpq.br/5842271060162462; https://orcid.org/0000-0002-9701-0314; http://lattes.cnpq.br/5392815933543240; Brito, Ana Maria de; https://orcid.org/0000-0003-4347-6730; http://lattes.cnpq.br/0105337613337822; Pinto Neto, Lauro Ferreira da Silva; https://orcid.org/0000-0003-2964-8516; http://lattes.cnpq.br/1528710938091794; Prado, Thiago Nascimento do; https://orcid.org/0000-0001-8132-6288; http://lattes.cnpq.br/6388559394015871; Almeida, Márcia Valéria de Souza ; https://orcid.org/0000-0002-1318-7084; http://lattes.cnpq.br/9372951429429767Introduction: The Coronavirus disease (COVID-19), caused by SARS-CoV2, was declared a pandemic by the World Health Organization (WHO) in 2020. Pregnancy was not initially considered a risk group, however, it was noticed that when infected, pregnant women were more likely to present a more severe clinical picture and death compared to non-pregnant reproductive-aged women, especially among low- and middle-income countries. Objective: To analyze the effects of COVID-19 on maternal and infant outcomes and the quality of data from 2020 to 2022 in Espírito Santo. Methodology: To achieve the objectives, three stages were carried out in the study. The first stage was a descriptive study using data obtained from e-SUS VS. Completeness in filling out the notification was classified as excellent (less than 5% incomplete filling), good (5% to 10%), fair (10% to 20%), poor (20% to 50%), or very poor (50% or more). The timeliness was defined by the difference between the dates of symptom onset and notification. The second stage was a retrospective cohort study among pregnant women with secondary data from the National Live Birth Information System (SINASC), the National Mortality Information System (SIM), and the e-SUS Surveillance Health System. Pregnant women confirmed for COVID-19 had a positive RT-PCR between March 2020 and May 2021, while pregnant women without COVID-19 were those without notification for the disease. Maternal death, fetal death, and stillbirth were evaluated as primary outcomes. In the third stage, a case-control study was conducted from a historical cohort of pregnant women confirmed for COVID-19 in the state of Espírito Santo between 2020 and March 2022. Cases were selected from maternal deaths confirmed by COVID-19 registered in e-SUS VS and SIM, and controls were selected from the cohort of pregnant women confirmed for COVID-19 who were cured of the disease. Results: In the first stage of the study, 8,989 notifications in pregnant women were identified. The notification for COVID-19 in e-SUS VS has 59 variables, the completeness of 53 (89.83%) variables was excellent, good, or fair in 1 (1.70%), and poor in 4 (6.77%). The timeliness had an average of 3.37 days. In the second stage, 68,673 pregnant women not notified as suspected of COVID-19 and 1,386 with a confirmed diagnosis of COVID-19 were included. Among pregnant women with COVID-19, 1,013 (73.0%) were aged 20 to 34 years, 655 (47.2%) were of mixed race, 907 (65.4%) had ≥ 8 years of schooling, in the third trimester of pregnancy (41.5%), undergoing cesarean section (64.5%). In adjusted analyzes, COVID-19 in pregnancy presented a higher risk of maternal death (relative risk [RR] 18.73 - 95% confidence interval [CI95%] 11.07-31.69), fetal death/stillbirth (RR 1.96 - CI95% 1.18 -3.25), premature birth [RR 1.18-CI95% 1.01-1.39], cesarean section (RR 1.07 - CI95% 1.02-1.11), and cesarean section before the onset of labor (RR 1.33 - CI95% 1.23-1.44). In the third stage, the sample consisted of 2,300 pregnant women, the matching of cases and controls was performed, and 37 cases and 111 controls were selected. Among the pregnant women who died, 35 (67.57%) were non-white, 26 (70.27%) had ≥ 8 years of study. 27 (72.97%) were infected in the 3rd gestational trimester, 24 (77.42%) had up to 6 prenatal consultations, and 15 (48.39%) had 3 or more previous pregnancies. Regarding the vaccination status among the deaths, 3 (8.11%) were vaccinated during pregnancy, and 36 (97.30%) had a record of COVID19 infection before the first vaccine dose, 40.54% had adynamia, and 13 (35.14%) of the pregnant women who died presented at least 1 comorbidity. In the adjusted model, the highest chance of maternal death was described among pregnant women infected in the third gestational trimester (OR 4.67 - CI95% 1.51-14.46), with adynamia (OR 4.33 - CI95% 1.41- 13.31) with at least one comorbidity in pregnancy (OR 3.82 - CI95% 1.16-12.55). Having more than 7 prenatal consultations remained with the lowest chance of progressing to death (OR 0.91 - CI95% 0.31-0.26). Conclusion: The quality of data regarding pregnant women registered in e-SUS VS was excellent. COVID-19 can contribute to unfavorable outcomes in pregnancy. The results showed that pregnant women infected with SARS-CoV-2 had a higher risk of maternal death, fetal death/stillbirth, premature birth, cesarean section, and cesarean section before the onset of labor. Factors related to prenatal care, exposure to the virus in the third trimester of pregnancy, as well as factors related to pre-existing diseases and conditions in pregnant women infected with SARS-CoV-2, increase the chance of maternal death.
- ItemVigilância oncológica e iniquidades no câncer do colo do útero: completude da informação e sobrevida global na rede de atenção à saúde do Espírito Santo(Universidade Federal do Espírito Santo, 2025-04-29) Schuab, Sara Isabel Pimentel de Carvalho; Grippa, Wesley Rocha; https://orcid.org/0000-0003-3572-6031; http://lattes.cnpq.br/5241970584204623; Lopes Júnior, Luís Carlos; https://orcid.org/0000-0002-2424-6510; http://lattes.cnpq.br/5919501773501977; https://orcid.org/0000-0002-8372-325X; http://lattes.cnpq.br/4847886860958146; Dell'Antonio, Larissa Soares; http://lattes.cnpq.br/7471454027993709; Almeida, Márcia Valéria de Souza; https://orcid.org/0000-0002-1318-7084; http://lattes.cnpq.br/9372951429429767Introduction: Cervical cancer remains a major public health concern in Brazil, particularly in socially vulnerable contexts and regions marked by health inequities. Strengthening oncological surveillance and care pathways depends on the quality of information recorded in Hospital Cancer Registries (HCRs), as well as an understanding of care patterns and survival determinants. This dissertation, comprising three interconnected studies, analyzed data completeness, clinical-care profiles, and cause-specific survival among women with cervical cancer treated within the Oncology Care Network (RAO) of Espírito Santo (ES). Aim: To comprehensively examine the quality of cancer registry data and cause-specific survival of women diagnosed with cervical cancer in the RAO of Espírito Santo between 2000 and 2020, based on HCR data. Methods: Retrospective observational study, developed from secondary data from the RHC of Espírito Santo. The first study evaluated 10,140 cases (2000–2020), applying the Mann-Kendall test to assess temporal trends in data incompleteness and the Friedman test to evaluate changes in information quality over time. The second study was a retrospective cohort of 7,633 women diagnosed between 2000 and 2016. HCR data were linked deterministically to the Mortality Information System (SIM/ES). Five-year cause-specific survival was estimated using the Kaplan-Meier method, and factors associated with cancer-related mortality were analyzed through Cox proportional hazards regression. Results: In the first study, most variables showed excellent completeness (<5%). However, key clinical variables—such as TNM staging, family history of cancer, and disease status at the end of treatment—had very poor completeness (>50%). A significant worsening in completeness was observed for variables such as history of alcohol consumption(p=0.001), history of tobacco consumption (p=0.007), and disease status at the end of first treatment (p<0.001). Conversely, completeness improved over time for 18 variables, including initial clinical presentation (p<0.001) and screening year (p=0.005). In the second study, the overall five-year cause-specific survival was estimated at 80.3% (95%CI: 79.4%–81.2%). Women aged ≥70 years had a 93.5% higher risk of cervical cancer-related death (HR=1.935; 95%CI: 1.520–2.464; p<0.001). Marital status without a partner was associated with higher mortality: widowed/divorced (HR=1.187; 95%CI: 1.017–1.386; p=0.030) and single women (HR=1.266; 95%CI: 1.092–1.468; p=0.002). The presence of distant metastases increased the risk of death nearly fourfold (HR=3.945; 95%CI: 3.265–4.766; p<0.001). Higher education level was protective (HR=0.621; 95%CI: 0.406–0.951; p=0.028). Regarding first-line treatment, risk of mortality was significantly higher for patients treated with chemotherapy (HR=19.576; 95%CI: 11.819–32.423), radiotherapy (HR=15.072; 95%CI: 11.291–20.121), or combined chemoradiotherapy (HR=17.953; 95%CI: 13.319–24.199), compared to surgery. Conclusion: This dissertation highlights that, although HCR data completeness is generally satisfactory, significant gaps persist in key clinical variables. Inequities in access to care, reflected in referral source and treatment patterns, compromise continuity of care. Cervical cancer survival is strongly influenced by sociodemographic and clinical factors, underscoring the need for more effective screening strategies, standardized data collection, and policies to promote equitable access to diagnosis and treatment. The findings reinforce the strategic role of HCRs in cancer surveillance, health system management, and public policy planning.
- ItemViolência & diversidade: estudo com escolares LGBT+ da Região Metropolitana da Grande Vitória, Espírito Santo(Universidade Federal do Espírito Santo, 2025-03-11) Alves, Micael Franco; Leite, Franciéle Marabotti Costa; https://orcid.org/0000-0002-6171-6972; https://buscatextual.cnpq.br/buscatextual/busca.do; http://lattes.cnpq.br/7170760158919766; Carvalho, Amâncio Antônio Sousa; Tavares, Fábio lūcio; Sacramento, Weverton Pereira do; Almeida, Márcia Valéria de SouzaIntroduction: Violence against LGBT+ adolescents represents a serious public health issue, significantly affecting their physical, psychological, and social well-being. This population is more vulnerable to various forms of violence, including bullying, physical aggression, and discrimination in school and family environments. Objective: To estimate the prevalence of violent experiences among LGBT+ adolescents in the metropolitan region of Vitória, Espírito Santo, and analyze their epidemiological profile. Methods: This is a cross-sectional, descriptive study conducted in 63 public and private schools in the region, with a sample of 949 adolescents aged 14 to 19 years. Data were collected through self-administered electronic questionnaires and analyzed statistically using relative frequencies and 95% confidence intervals. Results: Bullying prevalence was 67.8%, with 13.0% motivated by sexual orientation, and cyberbullying was reported by 11.5%. Condom use was higher during the first sexual intercourse (50.7%) than in the most recent one (40.2%). Current alcohol use was reported by 47.2%, cigarette use by 9.1%, and drug use by 15.1%. The findings revealed high prevalences of emotional abuse (78.6%), physical abuse (55.2%), and sexual abuse (49.8%). Exposure to violence was significant in both domestic and community environments, with 45.1% of adolescents reporting having witnessed beatings outside their homes. Conclusion: The findings highlight the high prevalence of violence and childhood adversities among LGBT+ adolescents and emphasize the need for inclusive public policies and intervention strategies to promote safe and equitable environments for LGBT+ youth