A trajetória dos casos de transmissão vertical do HIV na região noroeste do Paraná : identificando os nós críticos da assistência

Detalhes bibliográficos
Autor(a) principal: Botti, Maria Luciana
Data de Publicação: 2008
Tipo de documento: Dissertação
Idioma: por
Título da fonte: Repositório Institucional da Universidade Estadual de Maringá (RI-UEM)
Texto Completo: http://repositorio.uem.br:8080/jspui/handle/1/2315
Resumo: Epidemiological, scientific and social changes occurred since the beginning of AIDS epidemic until 2007. The growing number of AIDS in women resulted in vertical transmission (TV) and human immunodeficiency virus where infected mothers transmit the illness to their babies during the pregnancy, childbirth or breastfeeding. The programmatic actions established by the Ministério da Saúde done by the health service in order to prevent these illnesses can reduce the number of infected children occurrence or it can have almost nonexistent chance of occurrence. From the 145 HIV cases that presented TV, where 28 (19,3%) infected children are registered by the Attendance Specialized Service (SAE) from Maringá, used as reference for 30 municipality located in the northeast Paraná region. We tried to analyze the infected women profile, identify the municipality with the highest rates in TV and also check possible mistakes made by the Program de DST/AIDS during the prevention and control of seven infected children. Among these 28 cases of vertical transmission it was observed a low HIV testing coverage during the pregnancy, a late onset or a nonexistence of the TARV introduction in infected mothers, no elective cesareans guarantee and mothers breast feeding compliance. The socioepidemiological characteristics that present TV occurrence showed these profiles: women between 29 and 30 (64,1%), 4 years of study (49,0%), women with no employment connection and a marriage characterized by the presence of the husband (59,3%), only one pregnancy (70,3%), sexual rote contamination (90,3%), and a follow-p with TARV (55,2%). However, the highest rate of TV occurred in young women (64, 1%), women with 12 or more years of study (40,0%) and women with no employment connection (25,3%). Among the TV cases, we can say that there are more mistakes than correct things, all women had prenatal care, 5 women had more than six appointments and six women got the routine exams. However, two women didn't take the HIV test and five of them were not advised to do so. The TARV was introduced after the twentieth week of pregnancy in five women and only one woman took all the medicine. Packages with necessary things were handed to women and they didn't breastfeed. Only two women had appropriate birth according to their illness and AZT infusion. The study permitted us to conclude that the control and prevention measures reduce the TV (HIV) and protect children from this disease. However, the measures preventions were not totally taken. Strategies that promote professional adherence must be conducted as fundamental and evaluations with the professional that work with the infected people assistance should be taken in order to have less infected children, solutions to solve these problems and an ethical agreement practice.
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spelling A trajetória dos casos de transmissão vertical do HIV na região noroeste do Paraná : identificando os nós críticos da assistênciaHIVTransmissão verticalParaná (Estado)Região NoroesteAvaliação da assistênciaEvento SentinelaBrasil.Vertical Transmission of the HIVAssistance EvaluationBrazilCiências da SaúdeEnfermagemEpidemiological, scientific and social changes occurred since the beginning of AIDS epidemic until 2007. The growing number of AIDS in women resulted in vertical transmission (TV) and human immunodeficiency virus where infected mothers transmit the illness to their babies during the pregnancy, childbirth or breastfeeding. The programmatic actions established by the Ministério da Saúde done by the health service in order to prevent these illnesses can reduce the number of infected children occurrence or it can have almost nonexistent chance of occurrence. From the 145 HIV cases that presented TV, where 28 (19,3%) infected children are registered by the Attendance Specialized Service (SAE) from Maringá, used as reference for 30 municipality located in the northeast Paraná region. We tried to analyze the infected women profile, identify the municipality with the highest rates in TV and also check possible mistakes made by the Program de DST/AIDS during the prevention and control of seven infected children. Among these 28 cases of vertical transmission it was observed a low HIV testing coverage during the pregnancy, a late onset or a nonexistence of the TARV introduction in infected mothers, no elective cesareans guarantee and mothers breast feeding compliance. The socioepidemiological characteristics that present TV occurrence showed these profiles: women between 29 and 30 (64,1%), 4 years of study (49,0%), women with no employment connection and a marriage characterized by the presence of the husband (59,3%), only one pregnancy (70,3%), sexual rote contamination (90,3%), and a follow-p with TARV (55,2%). However, the highest rate of TV occurred in young women (64, 1%), women with 12 or more years of study (40,0%) and women with no employment connection (25,3%). Among the TV cases, we can say that there are more mistakes than correct things, all women had prenatal care, 5 women had more than six appointments and six women got the routine exams. However, two women didn't take the HIV test and five of them were not advised to do so. The TARV was introduced after the twentieth week of pregnancy in five women and only one woman took all the medicine. Packages with necessary things were handed to women and they didn't breastfeed. Only two women had appropriate birth according to their illness and AZT infusion. The study permitted us to conclude that the control and prevention measures reduce the TV (HIV) and protect children from this disease. However, the measures preventions were not totally taken. Strategies that promote professional adherence must be conducted as fundamental and evaluations with the professional that work with the infected people assistance should be taken in order to have less infected children, solutions to solve these problems and an ethical agreement practice.Do início da epidemia de aids até o ano de 2007 ocorreram mudanças epidemiológicas, científicas e sociais. O aumento do número de casos em mulheres resultou na Transmissão Vertical (TV) do Vírus da Imunodeficiência Humana (HIV), de mães infectadas para seus filhos durante a gestação, o parto ou na amamentação. As ações programáticas estabelecidas pelo Ministério da Saúde, para a prevenção e controle dessa forma de transmissão, quando realizadas pelos serviços de saúde podem fazer baixar para quase zero a ocorrência da infecção na criança. A partir de 145 casos de exposição à TV com 28 (19.3%) crianças infectadas registradas no Serviço de Atendimento Especializado (SAE) de Maringá, referência de atendimento para 30 municípios da Região Noroeste do Paraná, se buscou analisar o perfil das mulheres soropositivas, identificar os municípios da Regional com as maiores taxas de TV, reconstruir a trajetória percorrida pelas mães de sete crianças infectadas para verificar possíveis falhas nas ações de prevenção e controle do Programa de DST/AIDS. Nos 28 casos de transmissão vertical foi observada baixa cobertura da testagem sorológica na gestação; início tardio ou inexistência da introdução da terapia anti-retroviral (TARV) para as mães; ausência de garantia para realização da cesárea eletiva; e prática do aleitamento materno. As características sócio-epidemiológicas para as ocorrências de exposição da TV demonstraram o seguinte perfil para as mulheres: faixa etária entre 20 a 29 anos (64.1%); com até quatro anos de estudo (49.0 %); sem vínculo empregatício e situação conjugal caracterizada pela presença do companheiro (59.3%); tiveram uma única gestação (70.3%), infecção por via sexual (90.3%), e atualmente estão em acompanhamento com TARV instituída (55.2%). Porém, as maiores taxas de TV ocorreram em mulheres jovens (64.1%), com 12 ou mais anos de estudo (40.0%); sem vínculo empregatício (25.3%). A análise das sete trajetórias dos casos em que ocorreram a TV demonstrou que: todas as mães tiveram acesso à assistência prénatal, cinco passou por mais que seis consultas, seis realizaram os exames de rotina. Porém, duas não fizeram o teste para o HIV, e cinco não foram aconselhadas anteriormente a testagem. A TARV foi introduzida após a 20ª semana de gestação em cinco casos, e somente uma das mães conseguiu fazer adesão aos medicamentos. O kit contendo o inibidor de lactação, a fórmula láctea, e a Ziduvidina (AZT) para infusão endovenosa e solução xarope para o recém nascido, foi entregue para quatro mães, que também não amamentaram. Apenas duas tiveram o parto mais adequado à sua condição viral, e infusão adequada do AZT. O estudo permitiu concluir que as medidas de prevenção e controle, quando instituídas, reduzem significativamente a possibilidade de TV, e por isso, protegem as crianças do HIV e conseqüentemente da aids. Entretanto, as medidas de prevenção conhecidas e pactuadas nas portarias e rotinas, na população estudada não foram cumpridas na íntegra. Estratégias que promovam a aderência dos profissionais dos serviços devem ser implantadas como fundamentais, para que menos crianças sejam infectadas pelo HIV e ainda, sugere-se que avaliações sejam realizadas nos próprios serviços com os atores envolvidos na assistência, para que soluções locais sejam criadas e compromissos éticos profissionais assumidos.114 fUniversidade Estadual de MaringáBrasilPrograma de Pós-Graduação em EnfermagemUEMMaringáDepartamento de EnfermagemMaria José ScochiMagda Lúcia Félix de Oliveira - UEMHillegonda Maria Dutilh Novaes - USPBotti, Maria Luciana2018-04-10T19:14:30Z2018-04-10T19:14:30Z2008info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesishttp://repositorio.uem.br:8080/jspui/handle/1/2315porinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da Universidade Estadual de Maringá (RI-UEM)instname:Universidade Estadual de Maringá (UEM)instacron:UEM2018-04-10T19:14:30Zoai:localhost:1/2315Repositório InstitucionalPUBhttp://repositorio.uem.br:8080/oai/requestopendoar:2024-04-23T14:55:20.829084Repositório Institucional da Universidade Estadual de Maringá (RI-UEM) - Universidade Estadual de Maringá (UEM)false
dc.title.none.fl_str_mv A trajetória dos casos de transmissão vertical do HIV na região noroeste do Paraná : identificando os nós críticos da assistência
title A trajetória dos casos de transmissão vertical do HIV na região noroeste do Paraná : identificando os nós críticos da assistência
spellingShingle A trajetória dos casos de transmissão vertical do HIV na região noroeste do Paraná : identificando os nós críticos da assistência
Botti, Maria Luciana
HIV
Transmissão vertical
Paraná (Estado)
Região Noroeste
Avaliação da assistência
Evento Sentinela
Brasil.
Vertical Transmission of the HIV
Assistance Evaluation
Brazil
Ciências da Saúde
Enfermagem
title_short A trajetória dos casos de transmissão vertical do HIV na região noroeste do Paraná : identificando os nós críticos da assistência
title_full A trajetória dos casos de transmissão vertical do HIV na região noroeste do Paraná : identificando os nós críticos da assistência
title_fullStr A trajetória dos casos de transmissão vertical do HIV na região noroeste do Paraná : identificando os nós críticos da assistência
title_full_unstemmed A trajetória dos casos de transmissão vertical do HIV na região noroeste do Paraná : identificando os nós críticos da assistência
title_sort A trajetória dos casos de transmissão vertical do HIV na região noroeste do Paraná : identificando os nós críticos da assistência
author Botti, Maria Luciana
author_facet Botti, Maria Luciana
author_role author
dc.contributor.none.fl_str_mv Maria José Scochi
Magda Lúcia Félix de Oliveira - UEM
Hillegonda Maria Dutilh Novaes - USP
dc.contributor.author.fl_str_mv Botti, Maria Luciana
dc.subject.por.fl_str_mv HIV
Transmissão vertical
Paraná (Estado)
Região Noroeste
Avaliação da assistência
Evento Sentinela
Brasil.
Vertical Transmission of the HIV
Assistance Evaluation
Brazil
Ciências da Saúde
Enfermagem
topic HIV
Transmissão vertical
Paraná (Estado)
Região Noroeste
Avaliação da assistência
Evento Sentinela
Brasil.
Vertical Transmission of the HIV
Assistance Evaluation
Brazil
Ciências da Saúde
Enfermagem
description Epidemiological, scientific and social changes occurred since the beginning of AIDS epidemic until 2007. The growing number of AIDS in women resulted in vertical transmission (TV) and human immunodeficiency virus where infected mothers transmit the illness to their babies during the pregnancy, childbirth or breastfeeding. The programmatic actions established by the Ministério da Saúde done by the health service in order to prevent these illnesses can reduce the number of infected children occurrence or it can have almost nonexistent chance of occurrence. From the 145 HIV cases that presented TV, where 28 (19,3%) infected children are registered by the Attendance Specialized Service (SAE) from Maringá, used as reference for 30 municipality located in the northeast Paraná region. We tried to analyze the infected women profile, identify the municipality with the highest rates in TV and also check possible mistakes made by the Program de DST/AIDS during the prevention and control of seven infected children. Among these 28 cases of vertical transmission it was observed a low HIV testing coverage during the pregnancy, a late onset or a nonexistence of the TARV introduction in infected mothers, no elective cesareans guarantee and mothers breast feeding compliance. The socioepidemiological characteristics that present TV occurrence showed these profiles: women between 29 and 30 (64,1%), 4 years of study (49,0%), women with no employment connection and a marriage characterized by the presence of the husband (59,3%), only one pregnancy (70,3%), sexual rote contamination (90,3%), and a follow-p with TARV (55,2%). However, the highest rate of TV occurred in young women (64, 1%), women with 12 or more years of study (40,0%) and women with no employment connection (25,3%). Among the TV cases, we can say that there are more mistakes than correct things, all women had prenatal care, 5 women had more than six appointments and six women got the routine exams. However, two women didn't take the HIV test and five of them were not advised to do so. The TARV was introduced after the twentieth week of pregnancy in five women and only one woman took all the medicine. Packages with necessary things were handed to women and they didn't breastfeed. Only two women had appropriate birth according to their illness and AZT infusion. The study permitted us to conclude that the control and prevention measures reduce the TV (HIV) and protect children from this disease. However, the measures preventions were not totally taken. Strategies that promote professional adherence must be conducted as fundamental and evaluations with the professional that work with the infected people assistance should be taken in order to have less infected children, solutions to solve these problems and an ethical agreement practice.
publishDate 2008
dc.date.none.fl_str_mv 2008
2018-04-10T19:14:30Z
2018-04-10T19:14:30Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/masterThesis
format masterThesis
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://repositorio.uem.br:8080/jspui/handle/1/2315
url http://repositorio.uem.br:8080/jspui/handle/1/2315
dc.language.iso.fl_str_mv por
language por
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv Universidade Estadual de Maringá
Brasil
Programa de Pós-Graduação em Enfermagem
UEM
Maringá
Departamento de Enfermagem
publisher.none.fl_str_mv Universidade Estadual de Maringá
Brasil
Programa de Pós-Graduação em Enfermagem
UEM
Maringá
Departamento de Enfermagem
dc.source.none.fl_str_mv reponame:Repositório Institucional da Universidade Estadual de Maringá (RI-UEM)
instname:Universidade Estadual de Maringá (UEM)
instacron:UEM
instname_str Universidade Estadual de Maringá (UEM)
instacron_str UEM
institution UEM
reponame_str Repositório Institucional da Universidade Estadual de Maringá (RI-UEM)
collection Repositório Institucional da Universidade Estadual de Maringá (RI-UEM)
repository.name.fl_str_mv Repositório Institucional da Universidade Estadual de Maringá (RI-UEM) - Universidade Estadual de Maringá (UEM)
repository.mail.fl_str_mv
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