Epidemiologia da paralisia cerebral em crianças e adolescentes e associação com a vulnerabilidade em saúde

Detalhes bibliográficos
Autor(a) principal: Peixoto, Marcus Valerius da Silva
Data de Publicação: 2018
Tipo de documento: Tese
Idioma: por
Título da fonte: Repositório Institucional da UFS
Texto Completo: http://ri.ufs.br/jspui/handle/riufs/10531
Resumo: Introduction: Cerebral Palsy (CP) is the main cause of physical disability in childhood, however many aspects of the CP are still inconclusive. The association of CP with areas of vulnerability can be considered a knowledge gap. Did not are find population epidemiological studies and information systems on CP in Brazil. Objective: To analyze the epidemiological characteristics of Cerebral Palsy in children and adolescents and the association with health vulnerability. Methods: The study was divided into five stages that involved four designs of epidemiological research and a technological production. The first step was a study of the methodological type of construction and validation of a synthetic indicator of health vulnerability (VIHealth). In the second stage, a cross-sectional epidemiological study was carried out through a primary care survey on CP in children and adolescents in the city of Aracaju. In the third step, an ecological study was performed with spatial analysis of the PC with data produced from the survey and added with secondary data. In the fourth stage, a casecontrol study was carried out with prenatal and birth information of the cases and controls collected in the Records of the Live Birth Information System of the Brazilian Ministry of Health (SINASC). The fifth stage consisted of the production of an Information System for the Epidemiological Monitoring of Cerebral Palsy. Were used descriptive analyzes, main component analysis, exploratory spatial data analysis, multiple linear regression and multiple logistic regression. Results: A consensus was obtained for the composition of the synthetic indicator of vulnerability, statistical validation and applicability in Aracaju territory. The prevalence of CP among children and adolescents in Aracaju was 1.64 / 1000, with a higher frequency in males (56.25%), race / color brown or black (67.50%), the most common bilateral spastic subtype 45.42%), with higher comorbidities of epilepsy (48.33%) and intellectual disability (30%). Fifty-eight percent of families have family incomes of up to 1 minimum wage. Associations of prevalence of CP with areas of vulnerability in health were found. The associated factors were low birth weight, prematurity, low Apgar score, advanced maternal age and congenital anomalies. The information system for PC registration has met the needs of storage, database, intuitive interface, simple layout, access with different levels and generation of reports. Conclusion: Cerebral palsy in children and adolescents in Aracaju presents as a characteristic the bilateral spastic subtype, low prevalence, despite disparities within the city, higher frequency in social minority groups of race/color brown or black and in families living in extreme poverty. The prevalence of CP is associated with contextual social inequities and has a relation of spatial dependence with the areas of greatest vulnerability in health. The most important associated factors were congenital anomalies, low Apgar scores, low birth weight and prematurity. The information system in the situation room model can be considered large by the amount of information available that applies to research, surveillance, planning and evaluation of services for the CP.
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spelling Peixoto, Marcus Valerius da SilvaNunes, Marco Antônio Prado2019-02-20T23:36:33Z2019-02-20T23:36:33Z2018-12-18PEIXOTO, Marcus Valerius da Silva. Epidemiologia da paralisia cerebral em crianças e adolescentes e associação com a vulnerabilidade em saúde. 2018. 131 f. Tese (Doutorado em Ciências da Saúde) - Universidade Federal de Sergipe, Aracaju, 2018.http://ri.ufs.br/jspui/handle/riufs/10531Introduction: Cerebral Palsy (CP) is the main cause of physical disability in childhood, however many aspects of the CP are still inconclusive. The association of CP with areas of vulnerability can be considered a knowledge gap. Did not are find population epidemiological studies and information systems on CP in Brazil. Objective: To analyze the epidemiological characteristics of Cerebral Palsy in children and adolescents and the association with health vulnerability. Methods: The study was divided into five stages that involved four designs of epidemiological research and a technological production. The first step was a study of the methodological type of construction and validation of a synthetic indicator of health vulnerability (VIHealth). In the second stage, a cross-sectional epidemiological study was carried out through a primary care survey on CP in children and adolescents in the city of Aracaju. In the third step, an ecological study was performed with spatial analysis of the PC with data produced from the survey and added with secondary data. In the fourth stage, a casecontrol study was carried out with prenatal and birth information of the cases and controls collected in the Records of the Live Birth Information System of the Brazilian Ministry of Health (SINASC). The fifth stage consisted of the production of an Information System for the Epidemiological Monitoring of Cerebral Palsy. Were used descriptive analyzes, main component analysis, exploratory spatial data analysis, multiple linear regression and multiple logistic regression. Results: A consensus was obtained for the composition of the synthetic indicator of vulnerability, statistical validation and applicability in Aracaju territory. The prevalence of CP among children and adolescents in Aracaju was 1.64 / 1000, with a higher frequency in males (56.25%), race / color brown or black (67.50%), the most common bilateral spastic subtype 45.42%), with higher comorbidities of epilepsy (48.33%) and intellectual disability (30%). Fifty-eight percent of families have family incomes of up to 1 minimum wage. Associations of prevalence of CP with areas of vulnerability in health were found. The associated factors were low birth weight, prematurity, low Apgar score, advanced maternal age and congenital anomalies. The information system for PC registration has met the needs of storage, database, intuitive interface, simple layout, access with different levels and generation of reports. Conclusion: Cerebral palsy in children and adolescents in Aracaju presents as a characteristic the bilateral spastic subtype, low prevalence, despite disparities within the city, higher frequency in social minority groups of race/color brown or black and in families living in extreme poverty. The prevalence of CP is associated with contextual social inequities and has a relation of spatial dependence with the areas of greatest vulnerability in health. The most important associated factors were congenital anomalies, low Apgar scores, low birth weight and prematurity. The information system in the situation room model can be considered large by the amount of information available that applies to research, surveillance, planning and evaluation of services for the CP.Introdução: A Paralisia Cerebral (PC) é a principal causa de incapacidade física na infância, no entanto muitos aspectos da PC ainda são inconclusivos e merecem maiores esclarecimentos. A associação da PC com áreas de vulnerabilidade pode ser considerada uma lacuna do conhecimento. Não foram encontrados estudos epidemiológicos populacionais e sistemas de informação sobre a PC no Brasil. Objetivo: Analisar as características epidemiológicas da Paralisia Cerebral em crianças e adolescentes e a associação com a vulnerabilidade em saúde. Métodos: O estudo foi dividido em cinco etapas que envolveram quatro desenhos de pesquisa epidemiológica e uma produção tecnológica. A primeira etapa foi um estudo do tipo metodológico de construção e validação de um indicador sintético de vulnerabilidade em saúde (IVSaúde). Na segunda etapa, foi realizado um estudo epidemiológico do tipo transversal mediante um inquérito na atenção primária sobre a PC em crianças e adolescentes na cidade de Aracaju. Na terceira etapa, foi realizado um estudo ecológico com análise espacial da PC com dados produzidos a partir do inquérito e acrescidos de dados secundários. Na quarta etapa, foi realizado um estudo caso-controle com informações do pré-natal e do nascimento dos casos e controles colhidas nos registros do Sistema de Informações de Nascidos Vivos do Ministério da Saúde do Brasil (SINASC). A quinta etapa constou da produção de um Sistema de Informação para o Monitoramento Epidemiológico da Paralisia Cerebral. Foram utilizadas análises descritivas, análise de componentes principais, análise exploratória de dados espaciais, regressão linear múltipla e regressão logística múltipla. Resultados: Foi obtido consenso para a composição do indicador sintético de vulnerabilidade, validação estatística e aplicabilidade no território de Aracaju. A prevalência da PC entre crianças e adolescentes em Aracaju foi de 1,64/1000, com maior frequência no sexo masculino (56,25%), raça/cor parda ou preta (67,50%), subtipo mais comum bilateral espástica (45,42%), com maior acometimento das comorbidades de epilepsia (48,33%) e da deficiência intelectual (30%). Cinquenta e oito por cento das famílias têm renda familiar de até 1 salário mínimo. Foram encontradas associações da prevalência da PC com áreas de vulnerabilidade em saúde. Os fatores associados foram o baixo peso ao nascer, prematuridade, baixo escore de Apgar, idade materna avançada e anomalias congênitas. O sistema de informação para o registro da PC atendeu as necessidades de armazenamento, banco de dados, interface intuitiva, layout simples, acesso com diferentes níveis e geração de relatórios. Conclusão: A paralisia cerebral em crianças e adolescentes em Aracaju apresenta como característica o subtipo bilateral espástica, prevalência baixa, apesar das disparidades dentro da cidade, maior frequência nos grupos de minorias sociais de raça/cor parda ou preta e nas famílias que vivem na linha da extrema pobreza. A prevalência da PC está associada com as iniquidades sociais contextuais e possui relação de dependência espacial com as áreas de maior vulnerabilidade em saúde. Os fatores associados mais importantes são as anomalias congênitas, baixos escores de Apgar, baixo peso ao nascer e prematuridade. O sistema de informação no modelo de sala de situação pode ser considerado de grande porte pela quantidade de informações disponíveis que se aplicam para pesquisa, vigilância, planejamento e avaliação de serviços para a PC.AracajuporParalisia cerebralEpidemiologiaDeterminantes sociaisSistemas de informação em saúdeAnálise espacial em saúdeCerebral palsyEpidemiologySocial determinantsHealth information systemsCIENCIAS DA SAUDEEpidemiologia da paralisia cerebral em crianças e adolescentes e associação com a vulnerabilidade em saúdeEpidemiology of cerebral palsy in children and adolescents and association with health vulnerabilityinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisPós-Graduação em Ciências da SaúdeUniversidade Federal de Sergipereponame:Repositório Institucional da UFSinstname:Universidade Federal de Sergipe (UFS)instacron:UFSinfo:eu-repo/semantics/openAccessTEXTMARCUS_VALERIUS_SILVA_PEIXOTO.pdf.txtMARCUS_VALERIUS_SILVA_PEIXOTO.pdf.txtExtracted texttext/plain225733https://ri.ufs.br/jspui/bitstream/riufs/10531/3/MARCUS_VALERIUS_SILVA_PEIXOTO.pdf.txt56acf74552f4b00524f01013346ea0b9MD53THUMBNAILMARCUS_VALERIUS_SILVA_PEIXOTO.pdf.jpgMARCUS_VALERIUS_SILVA_PEIXOTO.pdf.jpgGenerated Thumbnailimage/jpeg1280https://ri.ufs.br/jspui/bitstream/riufs/10531/4/MARCUS_VALERIUS_SILVA_PEIXOTO.pdf.jpgde0e97d24f6c14e0c85036b90dcb900aMD54LICENSElicense.txtlicense.txttext/plain; charset=utf-81475https://ri.ufs.br/jspui/bitstream/riufs/10531/1/license.txt098cbbf65c2c15e1fb2e49c5d306a44cMD51ORIGINALMARCUS_VALERIUS_SILVA_PEIXOTO.pdfMARCUS_VALERIUS_SILVA_PEIXOTO.pdfapplication/pdf8419901https://ri.ufs.br/jspui/bitstream/riufs/10531/2/MARCUS_VALERIUS_SILVA_PEIXOTO.pdfbb154bea98b6b8700fa4ac7d15ae0f54MD52riufs/105312019-02-20 20:36:34.551oai:ufs.br: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Repositório InstitucionalPUBhttps://ri.ufs.br/oai/requestrepositorio@academico.ufs.bropendoar:2019-02-20T23:36:34Repositório Institucional da UFS - Universidade Federal de Sergipe (UFS)false
dc.title.pt_BR.fl_str_mv Epidemiologia da paralisia cerebral em crianças e adolescentes e associação com a vulnerabilidade em saúde
dc.title.alternative.eng.fl_str_mv Epidemiology of cerebral palsy in children and adolescents and association with health vulnerability
title Epidemiologia da paralisia cerebral em crianças e adolescentes e associação com a vulnerabilidade em saúde
spellingShingle Epidemiologia da paralisia cerebral em crianças e adolescentes e associação com a vulnerabilidade em saúde
Peixoto, Marcus Valerius da Silva
Paralisia cerebral
Epidemiologia
Determinantes sociais
Sistemas de informação em saúde
Análise espacial em saúde
Cerebral palsy
Epidemiology
Social determinants
Health information systems
CIENCIAS DA SAUDE
title_short Epidemiologia da paralisia cerebral em crianças e adolescentes e associação com a vulnerabilidade em saúde
title_full Epidemiologia da paralisia cerebral em crianças e adolescentes e associação com a vulnerabilidade em saúde
title_fullStr Epidemiologia da paralisia cerebral em crianças e adolescentes e associação com a vulnerabilidade em saúde
title_full_unstemmed Epidemiologia da paralisia cerebral em crianças e adolescentes e associação com a vulnerabilidade em saúde
title_sort Epidemiologia da paralisia cerebral em crianças e adolescentes e associação com a vulnerabilidade em saúde
author Peixoto, Marcus Valerius da Silva
author_facet Peixoto, Marcus Valerius da Silva
author_role author
dc.contributor.author.fl_str_mv Peixoto, Marcus Valerius da Silva
dc.contributor.advisor1.fl_str_mv Nunes, Marco Antônio Prado
contributor_str_mv Nunes, Marco Antônio Prado
dc.subject.por.fl_str_mv Paralisia cerebral
Epidemiologia
Determinantes sociais
Sistemas de informação em saúde
Análise espacial em saúde
topic Paralisia cerebral
Epidemiologia
Determinantes sociais
Sistemas de informação em saúde
Análise espacial em saúde
Cerebral palsy
Epidemiology
Social determinants
Health information systems
CIENCIAS DA SAUDE
dc.subject.eng.fl_str_mv Cerebral palsy
Epidemiology
Social determinants
Health information systems
dc.subject.cnpq.fl_str_mv CIENCIAS DA SAUDE
description Introduction: Cerebral Palsy (CP) is the main cause of physical disability in childhood, however many aspects of the CP are still inconclusive. The association of CP with areas of vulnerability can be considered a knowledge gap. Did not are find population epidemiological studies and information systems on CP in Brazil. Objective: To analyze the epidemiological characteristics of Cerebral Palsy in children and adolescents and the association with health vulnerability. Methods: The study was divided into five stages that involved four designs of epidemiological research and a technological production. The first step was a study of the methodological type of construction and validation of a synthetic indicator of health vulnerability (VIHealth). In the second stage, a cross-sectional epidemiological study was carried out through a primary care survey on CP in children and adolescents in the city of Aracaju. In the third step, an ecological study was performed with spatial analysis of the PC with data produced from the survey and added with secondary data. In the fourth stage, a casecontrol study was carried out with prenatal and birth information of the cases and controls collected in the Records of the Live Birth Information System of the Brazilian Ministry of Health (SINASC). The fifth stage consisted of the production of an Information System for the Epidemiological Monitoring of Cerebral Palsy. Were used descriptive analyzes, main component analysis, exploratory spatial data analysis, multiple linear regression and multiple logistic regression. Results: A consensus was obtained for the composition of the synthetic indicator of vulnerability, statistical validation and applicability in Aracaju territory. The prevalence of CP among children and adolescents in Aracaju was 1.64 / 1000, with a higher frequency in males (56.25%), race / color brown or black (67.50%), the most common bilateral spastic subtype 45.42%), with higher comorbidities of epilepsy (48.33%) and intellectual disability (30%). Fifty-eight percent of families have family incomes of up to 1 minimum wage. Associations of prevalence of CP with areas of vulnerability in health were found. The associated factors were low birth weight, prematurity, low Apgar score, advanced maternal age and congenital anomalies. The information system for PC registration has met the needs of storage, database, intuitive interface, simple layout, access with different levels and generation of reports. Conclusion: Cerebral palsy in children and adolescents in Aracaju presents as a characteristic the bilateral spastic subtype, low prevalence, despite disparities within the city, higher frequency in social minority groups of race/color brown or black and in families living in extreme poverty. The prevalence of CP is associated with contextual social inequities and has a relation of spatial dependence with the areas of greatest vulnerability in health. The most important associated factors were congenital anomalies, low Apgar scores, low birth weight and prematurity. The information system in the situation room model can be considered large by the amount of information available that applies to research, surveillance, planning and evaluation of services for the CP.
publishDate 2018
dc.date.issued.fl_str_mv 2018-12-18
dc.date.accessioned.fl_str_mv 2019-02-20T23:36:33Z
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dc.identifier.citation.fl_str_mv PEIXOTO, Marcus Valerius da Silva. Epidemiologia da paralisia cerebral em crianças e adolescentes e associação com a vulnerabilidade em saúde. 2018. 131 f. Tese (Doutorado em Ciências da Saúde) - Universidade Federal de Sergipe, Aracaju, 2018.
dc.identifier.uri.fl_str_mv http://ri.ufs.br/jspui/handle/riufs/10531
identifier_str_mv PEIXOTO, Marcus Valerius da Silva. Epidemiologia da paralisia cerebral em crianças e adolescentes e associação com a vulnerabilidade em saúde. 2018. 131 f. Tese (Doutorado em Ciências da Saúde) - Universidade Federal de Sergipe, Aracaju, 2018.
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