Análise dos casos de beribéri em indígenas e não indígenas notificados no Brasil, 2013-2018

Detalhes bibliográficos
Autor(a) principal: ASSUNÇÃO, Anne Karine Martins
Data de Publicação: 2021
Tipo de documento: Tese
Idioma: por
Título da fonte: Biblioteca Digital de Teses e Dissertações da UFMA
Texto Completo: https://tedebc.ufma.br/jspui/handle/tede/tede/3981
Resumo: Beriberi is a clinical manifestation of severe and prolonged thiamine (vitamin B1) deficiency, of a multi-causal nature, and usually associated with poverty and food insecurity among vulnerable populations such as indigenous people. The objective of the first article was to perform a spatial analysis of cases of beriberi in indigenous people notified in Brazil from 2013 to 2018. Cross-sectional study with time series data of suspected cases of beriberi reported to the Ministry of Health through FormSUS between July 2013 and September 2018. Indigenous villages were georeferenced and Kernel density estimation was used to identify spatial distribution patterns of beriberi cases. From 2013 to 2018, 414 cases of beriberi were reported in the country, of which 210 (50.7%) were indigenous. All cases in indigenous peoples occurred in states located in the Legal Amazon (Maranhão, Roraima and Tocantins). Kernel density estimation showed high density areas in Tocantins and Roraima. The aim of the second article was to compare cases of beriberi in indigenous people with cases in non-indigenous people in Brazil. This is a cross-sectional study of notified cases of beriberi from 2013 to 2018 through the Ministry of Health's FormSUS. The study variables were used: 1) sociodemographic variables; 2) clinical, behavioral and health service variables; 3) variables constructed for analysis: indigenous (yes, no); performs manual work. For statistical analysis, STATA® software version 14.0 was used. Indigenous and non-indigenous cases were compared using the chi-square test or Fisher's exact test with a significance level of p<0.05. Reported consumption of alcoholic beverages: 58.1% of indigenous people and 71.6% of non-indigenous people (p=0.004), additionally 71.0% of indigenous people consumed caxiri (traditional fermented alcoholic beverage). They reported making daily physical effort: 76.1% of the indigenous people and 40.2% of the non-indigenous people (p<0.001). Beriberi in the country affects more indigenous people and is related to alcohol consumption and physical exertion. The findings can be used to guide actions that contribute to the monitoring and prevention of beriberi among indigenous peoples.
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spelling BRANCO, Maria dos Remédios Freitas Carvalhohttp://lattes.cnpq.br/5449951869928014SANTOS, Alcione Miranda doshttp://lattes.cnpq.br/2709550775435326http://lattes.cnpq.br/2709550775435326http://lattes.cnpq.br/2709550775435326http://lattes.cnpq.br/2709550775435326http://lattes.cnpq.br/2709550775435326http://lattes.cnpq.br/2709550775435326BRANCO, Maria dos Remédios Freitas Carvalhohttp://lattes.cnpq.br/5449951869928014SANTOS, Alcione Miranda doshttp://lattes.cnpq.br/2709550775435326POLEGATO, Bertha Furlanhttp://lattes.cnpq.br/4563764623232492FROTA, Maria Tereza Borges Araújohttp://lattes.cnpq.br/6922517649206885FRANÇA, Ana Karina Teixeira Da Cunhahttp://lattes.cnpq.br/8389486900285691http://lattes.cnpq.br/2521444232857384ASSUNÇÃO, Anne Karine Martins2022-08-17T12:35:10Z2021-09-23Anne Karine Martins ASSUNÇÃO. Análise dos casos de beribéri em indígenas e não indígenas notificados no Brasil, 2013-2018. 2021.169 f. Tese (Programa de Pós-Graduação em Saúde Coletiva/CCBS) - Universidade Federal do Maranhão, São Luís, 2021.https://tedebc.ufma.br/jspui/handle/tede/tede/3981Beriberi is a clinical manifestation of severe and prolonged thiamine (vitamin B1) deficiency, of a multi-causal nature, and usually associated with poverty and food insecurity among vulnerable populations such as indigenous people. The objective of the first article was to perform a spatial analysis of cases of beriberi in indigenous people notified in Brazil from 2013 to 2018. Cross-sectional study with time series data of suspected cases of beriberi reported to the Ministry of Health through FormSUS between July 2013 and September 2018. Indigenous villages were georeferenced and Kernel density estimation was used to identify spatial distribution patterns of beriberi cases. From 2013 to 2018, 414 cases of beriberi were reported in the country, of which 210 (50.7%) were indigenous. All cases in indigenous peoples occurred in states located in the Legal Amazon (Maranhão, Roraima and Tocantins). Kernel density estimation showed high density areas in Tocantins and Roraima. The aim of the second article was to compare cases of beriberi in indigenous people with cases in non-indigenous people in Brazil. This is a cross-sectional study of notified cases of beriberi from 2013 to 2018 through the Ministry of Health's FormSUS. The study variables were used: 1) sociodemographic variables; 2) clinical, behavioral and health service variables; 3) variables constructed for analysis: indigenous (yes, no); performs manual work. For statistical analysis, STATA® software version 14.0 was used. Indigenous and non-indigenous cases were compared using the chi-square test or Fisher's exact test with a significance level of p<0.05. Reported consumption of alcoholic beverages: 58.1% of indigenous people and 71.6% of non-indigenous people (p=0.004), additionally 71.0% of indigenous people consumed caxiri (traditional fermented alcoholic beverage). They reported making daily physical effort: 76.1% of the indigenous people and 40.2% of the non-indigenous people (p<0.001). Beriberi in the country affects more indigenous people and is related to alcohol consumption and physical exertion. The findings can be used to guide actions that contribute to the monitoring and prevention of beriberi among indigenous peoples.Beribéri é uma manifestação clínica da deficiência grave e prolongada de tiamina (vitamina B1), de natureza multicausal, e normalmente associada à pobreza e insegurança alimentar entre as populações vulneráveis, como os indígenas. O objetivo do primeiro artigo foi realizar análise espacial de casos de beribéri em indígenas notificados no Brasil no período de 2013 a 2018. Estudo transversal com dados de séries temporais de casos suspeitos de beribéri notificados ao Ministério da Saúde por meio do FormSUS entre julho de 2013 e setembro de 2018. As aldeias indígenas foram georreferenciadas e a estimativa da densidade do Kernel foi usada para identificar padrões de distribuição espacial dos casos de beribéri. De 2013 a 2018, foram notificados 414 casos de beribéri no país, sendo 210 (50,7%) indígenas. Todos os casos em indígenas ocorreram em estados localizados na Amazônia Legal (Maranhão, Roraima e Tocantins). A estimativa da densidade do Kernel mostrou áreas de alta densidade no Tocantins e Roraima. O objetivo do segundo artigo foi comparar casos de beribéri em indígenas com casos em não indígenas no Brasil. Trata-se de estudo transversal de casos notificados de beribéri de 2013 a 2018 por meio do FormSUS do Ministério da Saúde. As variáveis do estudo utilizadas foram: 1) variáveis sociodemográficas; 2) variáveis clínicas, comportamentais e de serviços de saúde; 3) variáveis construídas para análise: indígena (sim, não); exerce trabalho braçal. Para análise estatística utilizou-se o software STATA® versão 14.0. Comparou-se os casos em indígenas e em não indígenas pelo teste qui-quadrado ou teste exato de Fisher com nível de significância de p<0,05. Referiram consumo de bebidas alcoólicas: 58,1% dos indígenas e 71,6% dos não-indígenas (p=0,004), adicionalmente 71,0% dos indígenas consumiam caxiri (bebida alcoólica tradicional fermentada). Relataram fazer esforço físico diário: 76,1% dos indígenas e 40,2% dos não-indígenas (p<0,001). O beribéri no país acomete mais indígenas e está relacionado ao consumo de álcool e ao esforço físico. Os achados podem ser usados para nortear ações que contribuam para o monitoramento e prevenção do beribéri entre os povos indígenas.Submitted by Daniella Santos (daniella.santos@ufma.br) on 2022-08-17T12:35:10Z No. of bitstreams: 1 ANNEKARINE.pdf: 6834949 bytes, checksum: 42ddf1d17eca2126f0c48efd7b2844c0 (MD5)Made available in DSpace on 2022-08-17T12:35:10Z (GMT). No. of bitstreams: 1 ANNEKARINE.pdf: 6834949 bytes, checksum: 42ddf1d17eca2126f0c48efd7b2844c0 (MD5) Previous issue date: 2021-09-23CNPqapplication/pdfporUniversidade Federal do MaranhãoPROGRAMA DE PÓS-GRADUAÇÃO EM SAÚDE COLETIVA/CCBSUFMABrasilDEPARTAMENTO DE SAÚDE PÚBLICA/CCBSdeficiência de tiamina;pobreza;saúde de populações indígenas;populações vulneráveis;vulnerabilidade social;vigilância em saúde pública;tthiamine deficiency;poverty;health of indigenous populations;vulnerable populations;social vulnerability;public health surveillanceSaúde PúblicaAnálise dos casos de beribéri em indígenas e não indígenas notificados no Brasil, 2013-2018Analysis of beriberi cases in indigenous and non-indigenous people notified in Brazil, 2013-2018info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisinfo:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da UFMAinstname:Universidade Federal do Maranhão (UFMA)instacron:UFMAORIGINALANNEKARINE.pdfANNEKARINE.pdfapplication/pdf6834949http://tedebc.ufma.br:8080/bitstream/tede/3981/2/ANNEKARINE.pdf42ddf1d17eca2126f0c48efd7b2844c0MD52LICENSElicense.txtlicense.txttext/plain; charset=utf-82255http://tedebc.ufma.br:8080/bitstream/tede/3981/1/license.txt97eeade1fce43278e63fe063657f8083MD51tede/39812022-08-17 09:35:10.948oai: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:21312022-08-17T12:35:10Biblioteca Digital de Teses e Dissertações da UFMA - Universidade Federal do Maranhão (UFMA)false
dc.title.por.fl_str_mv Análise dos casos de beribéri em indígenas e não indígenas notificados no Brasil, 2013-2018
dc.title.alternative.eng.fl_str_mv Analysis of beriberi cases in indigenous and non-indigenous people notified in Brazil, 2013-2018
title Análise dos casos de beribéri em indígenas e não indígenas notificados no Brasil, 2013-2018
spellingShingle Análise dos casos de beribéri em indígenas e não indígenas notificados no Brasil, 2013-2018
ASSUNÇÃO, Anne Karine Martins
deficiência de tiamina;
pobreza;
saúde de populações indígenas;
populações vulneráveis;
vulnerabilidade social;
vigilância em saúde pública;
tthiamine deficiency;
poverty;
health of indigenous populations;
vulnerable populations;
social vulnerability;
public health surveillance
Saúde Pública
title_short Análise dos casos de beribéri em indígenas e não indígenas notificados no Brasil, 2013-2018
title_full Análise dos casos de beribéri em indígenas e não indígenas notificados no Brasil, 2013-2018
title_fullStr Análise dos casos de beribéri em indígenas e não indígenas notificados no Brasil, 2013-2018
title_full_unstemmed Análise dos casos de beribéri em indígenas e não indígenas notificados no Brasil, 2013-2018
title_sort Análise dos casos de beribéri em indígenas e não indígenas notificados no Brasil, 2013-2018
author ASSUNÇÃO, Anne Karine Martins
author_facet ASSUNÇÃO, Anne Karine Martins
author_role author
dc.contributor.advisor1.fl_str_mv BRANCO, Maria dos Remédios Freitas Carvalho
dc.contributor.advisor1Lattes.fl_str_mv http://lattes.cnpq.br/5449951869928014
dc.contributor.advisor-co1.fl_str_mv SANTOS, Alcione Miranda dos
dc.contributor.advisor-co1Lattes.fl_str_mv http://lattes.cnpq.br/2709550775435326http://lattes.cnpq.br/2709550775435326http://lattes.cnpq.br/2709550775435326http://lattes.cnpq.br/2709550775435326http://lattes.cnpq.br/2709550775435326http://lattes.cnpq.br/2709550775435326
dc.contributor.referee1.fl_str_mv BRANCO, Maria dos Remédios Freitas Carvalho
dc.contributor.referee1Lattes.fl_str_mv http://lattes.cnpq.br/5449951869928014
dc.contributor.referee2.fl_str_mv SANTOS, Alcione Miranda dos
dc.contributor.referee2Lattes.fl_str_mv http://lattes.cnpq.br/2709550775435326
dc.contributor.referee3.fl_str_mv POLEGATO, Bertha Furlan
dc.contributor.referee3Lattes.fl_str_mv http://lattes.cnpq.br/4563764623232492
dc.contributor.referee4.fl_str_mv FROTA, Maria Tereza Borges Araújo
dc.contributor.referee4Lattes.fl_str_mv http://lattes.cnpq.br/6922517649206885
dc.contributor.referee5.fl_str_mv FRANÇA, Ana Karina Teixeira Da Cunha
dc.contributor.referee5Lattes.fl_str_mv http://lattes.cnpq.br/8389486900285691
dc.contributor.authorLattes.fl_str_mv http://lattes.cnpq.br/2521444232857384
dc.contributor.author.fl_str_mv ASSUNÇÃO, Anne Karine Martins
contributor_str_mv BRANCO, Maria dos Remédios Freitas Carvalho
SANTOS, Alcione Miranda dos
BRANCO, Maria dos Remédios Freitas Carvalho
SANTOS, Alcione Miranda dos
POLEGATO, Bertha Furlan
FROTA, Maria Tereza Borges Araújo
FRANÇA, Ana Karina Teixeira Da Cunha
dc.subject.por.fl_str_mv deficiência de tiamina;
pobreza;
saúde de populações indígenas;
populações vulneráveis;
vulnerabilidade social;
vigilância em saúde pública;
topic deficiência de tiamina;
pobreza;
saúde de populações indígenas;
populações vulneráveis;
vulnerabilidade social;
vigilância em saúde pública;
tthiamine deficiency;
poverty;
health of indigenous populations;
vulnerable populations;
social vulnerability;
public health surveillance
Saúde Pública
dc.subject.eng.fl_str_mv tthiamine deficiency;
poverty;
health of indigenous populations;
vulnerable populations;
social vulnerability;
public health surveillance
dc.subject.cnpq.fl_str_mv Saúde Pública
description Beriberi is a clinical manifestation of severe and prolonged thiamine (vitamin B1) deficiency, of a multi-causal nature, and usually associated with poverty and food insecurity among vulnerable populations such as indigenous people. The objective of the first article was to perform a spatial analysis of cases of beriberi in indigenous people notified in Brazil from 2013 to 2018. Cross-sectional study with time series data of suspected cases of beriberi reported to the Ministry of Health through FormSUS between July 2013 and September 2018. Indigenous villages were georeferenced and Kernel density estimation was used to identify spatial distribution patterns of beriberi cases. From 2013 to 2018, 414 cases of beriberi were reported in the country, of which 210 (50.7%) were indigenous. All cases in indigenous peoples occurred in states located in the Legal Amazon (Maranhão, Roraima and Tocantins). Kernel density estimation showed high density areas in Tocantins and Roraima. The aim of the second article was to compare cases of beriberi in indigenous people with cases in non-indigenous people in Brazil. This is a cross-sectional study of notified cases of beriberi from 2013 to 2018 through the Ministry of Health's FormSUS. The study variables were used: 1) sociodemographic variables; 2) clinical, behavioral and health service variables; 3) variables constructed for analysis: indigenous (yes, no); performs manual work. For statistical analysis, STATA® software version 14.0 was used. Indigenous and non-indigenous cases were compared using the chi-square test or Fisher's exact test with a significance level of p<0.05. Reported consumption of alcoholic beverages: 58.1% of indigenous people and 71.6% of non-indigenous people (p=0.004), additionally 71.0% of indigenous people consumed caxiri (traditional fermented alcoholic beverage). They reported making daily physical effort: 76.1% of the indigenous people and 40.2% of the non-indigenous people (p<0.001). Beriberi in the country affects more indigenous people and is related to alcohol consumption and physical exertion. The findings can be used to guide actions that contribute to the monitoring and prevention of beriberi among indigenous peoples.
publishDate 2021
dc.date.issued.fl_str_mv 2021-09-23
dc.date.accessioned.fl_str_mv 2022-08-17T12:35:10Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/doctoralThesis
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dc.identifier.citation.fl_str_mv Anne Karine Martins ASSUNÇÃO. Análise dos casos de beribéri em indígenas e não indígenas notificados no Brasil, 2013-2018. 2021.169 f. Tese (Programa de Pós-Graduação em Saúde Coletiva/CCBS) - Universidade Federal do Maranhão, São Luís, 2021.
dc.identifier.uri.fl_str_mv https://tedebc.ufma.br/jspui/handle/tede/tede/3981
identifier_str_mv Anne Karine Martins ASSUNÇÃO. Análise dos casos de beribéri em indígenas e não indígenas notificados no Brasil, 2013-2018. 2021.169 f. Tese (Programa de Pós-Graduação em Saúde Coletiva/CCBS) - Universidade Federal do Maranhão, São Luís, 2021.
url https://tedebc.ufma.br/jspui/handle/tede/tede/3981
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dc.publisher.initials.fl_str_mv UFMA
dc.publisher.country.fl_str_mv Brasil
dc.publisher.department.fl_str_mv DEPARTAMENTO DE SAÚDE PÚBLICA/CCBS
publisher.none.fl_str_mv Universidade Federal do Maranhão
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