COMORBIDADE TUBERCULOSE-DIABETES MELLITUS: aspectos clínico- epidemiológicos e análise espacial em Imperatriz – MA
Autor(a) principal: | |
---|---|
Data de Publicação: | 2021 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Biblioteca Digital de Teses e Dissertações da UFMA |
Texto Completo: | https://tedebc.ufma.br/jspui/handle/tede/tede/4331 |
Resumo: | The objective was to analyze the clinical and epidemiological aspects of the comorbidity Tuberculosis (TB) - Diabetes Mellitus (DM) and its spatial distribution in Imperatriz – MA. This is an ecological study with multiple measures of analysis, carried out using data from the Notifiable Diseases Information System, related to TB cases associated with the DM condition, recorded in the period between 2008 and 2019, which were collected in November 2019, with the Health Surveillance Service of the Regional Health Management Unit of Imperatriz. The prevalence was determined in percentage values of TB-DM comorbidity each year, the average and its trend for the period, calculated using the Prais-Winsten regression. To identify the factors associated with comorbidity, Poisson regression models, prevalence ratios (PR) and the respective 95% confidence intervals were used, which were estimated using the SPSS 24.0 software, setting a level of significance at 5%. The cases were geocoded using the TerraView software and the Batch Geocode tool. Kernel analysis and spatial scanning were performed, and the maps were generated using ArcGis 10.5 software. 721 cases of tuberculosis were reported, of which 81 were associated with DM. The prevalence ranged from 3.2% in 2014 to 19.5% in 2018, with an average of 11.5% for the period, showing an increasing trend. The age groups from 30 to 59 years and ≥ 60 years, education <8 years and clinical form of pulmonary tuberculosis were risk factors for comorbidity. Regarding spatial analysis, it was found that the distribution of cases of comorbidity was heterogeneous, ranging from 0.00 to 4.12 cases / km2. The spatial scan analysis detected three spatial clusters of statistically significant high risk (p <0.005), which were: spatial cluster 1 (RR = 4.00; 95% CI = 2.60 - 6.80; p <0.001) that encompassed 4 census sectors involving the Vila Lobão neighborhood; spatial cluster 2 (RR = 5.10; 95% CI = 2.75 - 7.30; p <0.001) which also involved four census sectors, referring to the Vilinha and Parque Alvorada neighborhoods; spatial cluster 3 that presented the highest risk (RR = 6.10; 95% CI = 3.21 - 8.92; p <0.002) and encompassed three census sectors belonging to the Bacuri and Parque do Buriti neighborhoods. The growing trend of the prevalence of TB-DM comorbidity and its associated factors, warns about the need to improve care in the levels of health care. The higher density of cases of comorbidity, as well as clusters, were present in areas of greater circulation of people and vulnerable from a socioeconomic and environmental point of view. Such findings may contribute to the implementation of health actions, aimed at high-risk areas and the integrated management of health problems, in addition to subsidizing public health interventions, aimed at reducing health disparities and social inequalities in the investigated territory. |
id |
UFMA_56164561dbbc241dcc601714c683780c |
---|---|
oai_identifier_str |
oai:tede2:tede/4331 |
network_acronym_str |
UFMA |
network_name_str |
Biblioteca Digital de Teses e Dissertações da UFMA |
repository_id_str |
2131 |
spelling |
SANTOS NETO, Marcelinohttp://lattes.cnpq.br/2762193275718620SANTOS NETO, Marcelinohttp://lattes.cnpq.br/2762193275718620COSTA, Ana Cristina Pereira de Jesushttp://lattes.cnpq.br/2286953939662462PASCOAL, Lívia Maiahttp://lattes.cnpq.br/7758811580828545http://lattes.cnpq.br/2552748193893987SOUSA, Giana Gislanne da Silva de2022-11-24T14:05:35Z2021-03-22SOUSA, Giana Gislanne da Silva de. Comorbidade tuberculose-diabetes mellitus: Aspectos clínico- epidemiológicos e análise espacial em Imperatriz – MA. 2021. 121 f. Dissertação( Programa de Pós-graduação em Enfermagem/CCBS) - Universidade Federal do Maranhão, São Luís, 2021.https://tedebc.ufma.br/jspui/handle/tede/tede/4331The objective was to analyze the clinical and epidemiological aspects of the comorbidity Tuberculosis (TB) - Diabetes Mellitus (DM) and its spatial distribution in Imperatriz – MA. This is an ecological study with multiple measures of analysis, carried out using data from the Notifiable Diseases Information System, related to TB cases associated with the DM condition, recorded in the period between 2008 and 2019, which were collected in November 2019, with the Health Surveillance Service of the Regional Health Management Unit of Imperatriz. The prevalence was determined in percentage values of TB-DM comorbidity each year, the average and its trend for the period, calculated using the Prais-Winsten regression. To identify the factors associated with comorbidity, Poisson regression models, prevalence ratios (PR) and the respective 95% confidence intervals were used, which were estimated using the SPSS 24.0 software, setting a level of significance at 5%. The cases were geocoded using the TerraView software and the Batch Geocode tool. Kernel analysis and spatial scanning were performed, and the maps were generated using ArcGis 10.5 software. 721 cases of tuberculosis were reported, of which 81 were associated with DM. The prevalence ranged from 3.2% in 2014 to 19.5% in 2018, with an average of 11.5% for the period, showing an increasing trend. The age groups from 30 to 59 years and ≥ 60 years, education <8 years and clinical form of pulmonary tuberculosis were risk factors for comorbidity. Regarding spatial analysis, it was found that the distribution of cases of comorbidity was heterogeneous, ranging from 0.00 to 4.12 cases / km2. The spatial scan analysis detected three spatial clusters of statistically significant high risk (p <0.005), which were: spatial cluster 1 (RR = 4.00; 95% CI = 2.60 - 6.80; p <0.001) that encompassed 4 census sectors involving the Vila Lobão neighborhood; spatial cluster 2 (RR = 5.10; 95% CI = 2.75 - 7.30; p <0.001) which also involved four census sectors, referring to the Vilinha and Parque Alvorada neighborhoods; spatial cluster 3 that presented the highest risk (RR = 6.10; 95% CI = 3.21 - 8.92; p <0.002) and encompassed three census sectors belonging to the Bacuri and Parque do Buriti neighborhoods. The growing trend of the prevalence of TB-DM comorbidity and its associated factors, warns about the need to improve care in the levels of health care. The higher density of cases of comorbidity, as well as clusters, were present in areas of greater circulation of people and vulnerable from a socioeconomic and environmental point of view. Such findings may contribute to the implementation of health actions, aimed at high-risk areas and the integrated management of health problems, in addition to subsidizing public health interventions, aimed at reducing health disparities and social inequalities in the investigated territory.Objetivou-se analisar os aspectos clínico-epidemiológicos da comorbidade Tuberculose (TB)-Diabetes Mellitus (DM) e sua distribuição espacial em Imperatriz - MA. Trata-se de um estudo ecológico com medidas múltiplas de análise, realizado com dados do Sistema de Informação de Agravos de Notificação, relativos aos casos de TB associados ao agravo DM, registrados no período entre 2008 e 2019 que foram coletados em novembro de 2019, junto ao Serviço de Vigilância em Saúde da Unidade Gestora Regional de Saúde de Imperatriz. Determinou-se a prevalência em valores percentuais da comorbidade TB-DM a cada ano, a média e sua tendência para o período, calculada por meio da regressão de Prais-Winsten. Para identificar os fatores associados à comorbidade, utilizou-se os modelos de regressão de Poisson, as razões de prevalências (RP) e os respectivos intervalos de confiança de 95%, que foram estimados por meio do software SPSS 24.0, fixando nível de significância a 5%. A geocodificação dos casos foi realizada utilizando-se o software TerraView e a ferramenta Batch Geocode. Realizaram-se as análises de Kernel e varredura espacial, e os mapas foram gerados no software ArcGis 10.5. Foram notificados 721 casos de tuberculose, dos quais 81 estiveram associados ao DM. A prevalência variou de 3,2%, em 2014, a 19,5%, em 2018, com média de 11,5% para o período, apresentando tendência crescente. As faixas etárias de 30 a 59 anos e ≥ 60 anos, escolaridade < 8 anos e forma clínica da tuberculose pulmonar apresentaram-se como fatores de risco para a comorbidade. Com relação a análise espacial, verificou-se que a distribuição dos casos da comorbidade foi heterogênea, variando de 0,00 a 4,12 casos/km2 . A análise de varredura espacial detectou três aglomerados espaciais de alto risco relativo estatisticamente significantes (p< 0,005), foram eles: aglomerado espacial 1 (RR= 4,00; IC95%= 2,60 – 6,80; p<0,001) que englobou 4 setores censitários envolvendo o bairro Vila Lobão; aglomerado espacial 2 (RR=5,10; IC95%= 2,75 – 7,30; p<0,001) que também envolveu quatro setores censitários, referentes aos bairros Vilinha e Parque Alvorada; aglomerado espacial 3 que apresentou o maior risco (RR= 6,10; IC95%= 3,21 – 8,92; p<0,002) e englobou três setores censitários pertencentes aos bairros bacuri e parque do buriti. A tendência crescente da prevalência da comorbidade TB-DM e seus fatores associados, alertam quanto à necessidade de aperfeiçoamento do atendimento nos níveis de atenção à saúde. A maior densidade de casos da comorbidade, bem como os aglomerados estiveram presentes em áreas de maior circulação de pessoas e vulneráveis do ponto de vista socioeconômico e ambiental. Tais achados podem colaborar para a implementação de ações em saúde, voltadas para as áreas de alto risco e para o manejo integrado dos agravos, além de subsidiar intervenções de saúde pública, destinadas a reduzir as disparidades de saúde e desigualdades sociais no território investigado.Submitted by Maria Aparecida (cidazen@gmail.com) on 2022-11-24T14:05:35Z No. of bitstreams: 1 GIANA GISLANNE DA SILVA DE SOUSA.pdf: 39862543 bytes, checksum: 216edf3e498c00dd1d1e26ff7f5f1042 (MD5)Made available in DSpace on 2022-11-24T14:05:35Z (GMT). No. of bitstreams: 1 GIANA GISLANNE DA SILVA DE SOUSA.pdf: 39862543 bytes, checksum: 216edf3e498c00dd1d1e26ff7f5f1042 (MD5) Previous issue date: 2021-03-22CAPESFAPEMAapplication/pdfporUniversidade Federal do MaranhãoPROGRAMA DE PÓS-GRADUAÇÃO EM ENFERMAGEM/CCBSUFMABrasilDEPARTAMENTO DE ENFERMAGEM/CCBSTuberculose;Diabetes Mellitus;Análise Espacial;Sistemas de Informação Geográfica;Monitoramento EpidemiológicoTuberculosis;Diabetes mellitus;Spatial Analysis;Geographic Information Systems;Epidemiological MonitoringEnfermagem de Saúde PúblicaCOMORBIDADE TUBERCULOSE-DIABETES MELLITUS: aspectos clínico- epidemiológicos e análise espacial em Imperatriz – MATUBERCULOSIS-DIABETES MELLITUS COMORBIDITY: clinical-epidemiological aspects and spatial analysis in Imperatriz - MAinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisinfo:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da UFMAinstname:Universidade Federal do Maranhão (UFMA)instacron:UFMAORIGINALGIANA GISLANNE DA SILVA DE SOUSA.pdfGIANA GISLANNE DA SILVA DE SOUSA.pdfapplication/pdf39862543http://tedebc.ufma.br:8080/bitstream/tede/4331/2/GIANA+GISLANNE+DA+SILVA+DE+SOUSA.pdf216edf3e498c00dd1d1e26ff7f5f1042MD52LICENSElicense.txtlicense.txttext/plain; charset=utf-82255http://tedebc.ufma.br:8080/bitstream/tede/4331/1/license.txt97eeade1fce43278e63fe063657f8083MD51tede/43312022-11-24 11:05:35.43oai:tede2: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Biblioteca Digital de Teses e Dissertaçõeshttps://tedebc.ufma.br/jspui/PUBhttp://tedebc.ufma.br:8080/oai/requestrepositorio@ufma.br||repositorio@ufma.bropendoar:21312022-11-24T14:05:35Biblioteca Digital de Teses e Dissertações da UFMA - Universidade Federal do Maranhão (UFMA)false |
dc.title.por.fl_str_mv |
COMORBIDADE TUBERCULOSE-DIABETES MELLITUS: aspectos clínico- epidemiológicos e análise espacial em Imperatriz – MA |
dc.title.alternative.eng.fl_str_mv |
TUBERCULOSIS-DIABETES MELLITUS COMORBIDITY: clinical-epidemiological aspects and spatial analysis in Imperatriz - MA |
title |
COMORBIDADE TUBERCULOSE-DIABETES MELLITUS: aspectos clínico- epidemiológicos e análise espacial em Imperatriz – MA |
spellingShingle |
COMORBIDADE TUBERCULOSE-DIABETES MELLITUS: aspectos clínico- epidemiológicos e análise espacial em Imperatriz – MA SOUSA, Giana Gislanne da Silva de Tuberculose; Diabetes Mellitus; Análise Espacial; Sistemas de Informação Geográfica; Monitoramento Epidemiológico Tuberculosis; Diabetes mellitus; Spatial Analysis; Geographic Information Systems; Epidemiological Monitoring Enfermagem de Saúde Pública |
title_short |
COMORBIDADE TUBERCULOSE-DIABETES MELLITUS: aspectos clínico- epidemiológicos e análise espacial em Imperatriz – MA |
title_full |
COMORBIDADE TUBERCULOSE-DIABETES MELLITUS: aspectos clínico- epidemiológicos e análise espacial em Imperatriz – MA |
title_fullStr |
COMORBIDADE TUBERCULOSE-DIABETES MELLITUS: aspectos clínico- epidemiológicos e análise espacial em Imperatriz – MA |
title_full_unstemmed |
COMORBIDADE TUBERCULOSE-DIABETES MELLITUS: aspectos clínico- epidemiológicos e análise espacial em Imperatriz – MA |
title_sort |
COMORBIDADE TUBERCULOSE-DIABETES MELLITUS: aspectos clínico- epidemiológicos e análise espacial em Imperatriz – MA |
author |
SOUSA, Giana Gislanne da Silva de |
author_facet |
SOUSA, Giana Gislanne da Silva de |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
SANTOS NETO, Marcelino |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/2762193275718620 |
dc.contributor.referee1.fl_str_mv |
SANTOS NETO, Marcelino |
dc.contributor.referee1Lattes.fl_str_mv |
http://lattes.cnpq.br/2762193275718620 |
dc.contributor.referee2.fl_str_mv |
COSTA, Ana Cristina Pereira de Jesus |
dc.contributor.referee2Lattes.fl_str_mv |
http://lattes.cnpq.br/2286953939662462 |
dc.contributor.referee3.fl_str_mv |
PASCOAL, Lívia Maia |
dc.contributor.referee3Lattes.fl_str_mv |
http://lattes.cnpq.br/7758811580828545 |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/2552748193893987 |
dc.contributor.author.fl_str_mv |
SOUSA, Giana Gislanne da Silva de |
contributor_str_mv |
SANTOS NETO, Marcelino SANTOS NETO, Marcelino COSTA, Ana Cristina Pereira de Jesus PASCOAL, Lívia Maia |
dc.subject.por.fl_str_mv |
Tuberculose; Diabetes Mellitus; Análise Espacial; Sistemas de Informação Geográfica; Monitoramento Epidemiológico |
topic |
Tuberculose; Diabetes Mellitus; Análise Espacial; Sistemas de Informação Geográfica; Monitoramento Epidemiológico Tuberculosis; Diabetes mellitus; Spatial Analysis; Geographic Information Systems; Epidemiological Monitoring Enfermagem de Saúde Pública |
dc.subject.eng.fl_str_mv |
Tuberculosis; Diabetes mellitus; Spatial Analysis; Geographic Information Systems; Epidemiological Monitoring |
dc.subject.cnpq.fl_str_mv |
Enfermagem de Saúde Pública |
description |
The objective was to analyze the clinical and epidemiological aspects of the comorbidity Tuberculosis (TB) - Diabetes Mellitus (DM) and its spatial distribution in Imperatriz – MA. This is an ecological study with multiple measures of analysis, carried out using data from the Notifiable Diseases Information System, related to TB cases associated with the DM condition, recorded in the period between 2008 and 2019, which were collected in November 2019, with the Health Surveillance Service of the Regional Health Management Unit of Imperatriz. The prevalence was determined in percentage values of TB-DM comorbidity each year, the average and its trend for the period, calculated using the Prais-Winsten regression. To identify the factors associated with comorbidity, Poisson regression models, prevalence ratios (PR) and the respective 95% confidence intervals were used, which were estimated using the SPSS 24.0 software, setting a level of significance at 5%. The cases were geocoded using the TerraView software and the Batch Geocode tool. Kernel analysis and spatial scanning were performed, and the maps were generated using ArcGis 10.5 software. 721 cases of tuberculosis were reported, of which 81 were associated with DM. The prevalence ranged from 3.2% in 2014 to 19.5% in 2018, with an average of 11.5% for the period, showing an increasing trend. The age groups from 30 to 59 years and ≥ 60 years, education <8 years and clinical form of pulmonary tuberculosis were risk factors for comorbidity. Regarding spatial analysis, it was found that the distribution of cases of comorbidity was heterogeneous, ranging from 0.00 to 4.12 cases / km2. The spatial scan analysis detected three spatial clusters of statistically significant high risk (p <0.005), which were: spatial cluster 1 (RR = 4.00; 95% CI = 2.60 - 6.80; p <0.001) that encompassed 4 census sectors involving the Vila Lobão neighborhood; spatial cluster 2 (RR = 5.10; 95% CI = 2.75 - 7.30; p <0.001) which also involved four census sectors, referring to the Vilinha and Parque Alvorada neighborhoods; spatial cluster 3 that presented the highest risk (RR = 6.10; 95% CI = 3.21 - 8.92; p <0.002) and encompassed three census sectors belonging to the Bacuri and Parque do Buriti neighborhoods. The growing trend of the prevalence of TB-DM comorbidity and its associated factors, warns about the need to improve care in the levels of health care. The higher density of cases of comorbidity, as well as clusters, were present in areas of greater circulation of people and vulnerable from a socioeconomic and environmental point of view. Such findings may contribute to the implementation of health actions, aimed at high-risk areas and the integrated management of health problems, in addition to subsidizing public health interventions, aimed at reducing health disparities and social inequalities in the investigated territory. |
publishDate |
2021 |
dc.date.issued.fl_str_mv |
2021-03-22 |
dc.date.accessioned.fl_str_mv |
2022-11-24T14:05:35Z |
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.citation.fl_str_mv |
SOUSA, Giana Gislanne da Silva de. Comorbidade tuberculose-diabetes mellitus: Aspectos clínico- epidemiológicos e análise espacial em Imperatriz – MA. 2021. 121 f. Dissertação( Programa de Pós-graduação em Enfermagem/CCBS) - Universidade Federal do Maranhão, São Luís, 2021. |
dc.identifier.uri.fl_str_mv |
https://tedebc.ufma.br/jspui/handle/tede/tede/4331 |
identifier_str_mv |
SOUSA, Giana Gislanne da Silva de. Comorbidade tuberculose-diabetes mellitus: Aspectos clínico- epidemiológicos e análise espacial em Imperatriz – MA. 2021. 121 f. Dissertação( Programa de Pós-graduação em Enfermagem/CCBS) - Universidade Federal do Maranhão, São Luís, 2021. |
url |
https://tedebc.ufma.br/jspui/handle/tede/tede/4331 |
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.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Universidade Federal do Maranhão |
dc.publisher.program.fl_str_mv |
PROGRAMA DE PÓS-GRADUAÇÃO EM ENFERMAGEM/CCBS |
dc.publisher.initials.fl_str_mv |
UFMA |
dc.publisher.country.fl_str_mv |
Brasil |
dc.publisher.department.fl_str_mv |
DEPARTAMENTO DE ENFERMAGEM/CCBS |
publisher.none.fl_str_mv |
Universidade Federal do Maranhão |
dc.source.none.fl_str_mv |
reponame:Biblioteca Digital de Teses e Dissertações da UFMA instname:Universidade Federal do Maranhão (UFMA) instacron:UFMA |
instname_str |
Universidade Federal do Maranhão (UFMA) |
instacron_str |
UFMA |
institution |
UFMA |
reponame_str |
Biblioteca Digital de Teses e Dissertações da UFMA |
collection |
Biblioteca Digital de Teses e Dissertações da UFMA |
bitstream.url.fl_str_mv |
http://tedebc.ufma.br:8080/bitstream/tede/4331/2/GIANA+GISLANNE+DA+SILVA+DE+SOUSA.pdf http://tedebc.ufma.br:8080/bitstream/tede/4331/1/license.txt |
bitstream.checksum.fl_str_mv |
216edf3e498c00dd1d1e26ff7f5f1042 97eeade1fce43278e63fe063657f8083 |
bitstream.checksumAlgorithm.fl_str_mv |
MD5 MD5 |
repository.name.fl_str_mv |
Biblioteca Digital de Teses e Dissertações da UFMA - Universidade Federal do Maranhão (UFMA) |
repository.mail.fl_str_mv |
repositorio@ufma.br||repositorio@ufma.br |
_version_ |
1809926183988494336 |