https://tedebc.ufma.br/jspui/handle/tede/1013 2026-04-11T19:37:42Z https://tedebc.ufma.br/jspui/handle/tede/6863 Título: Insegurança alimentar e nutricional de uma comunidade quilombola do município de Turiaçu, Maranhão Autor: PINHEIRO, Déborah Belo Paz Primeiro orientador: VARGA, István Van Deursen Abstract: The quilombola communities find themselves in a situation of social vulnerability due to cultural, political, geographic, and economic factors, resulting in a scenario of low income in the majority of these families. This indicates that residents in these communities may be susceptible to a higher prevalence of food and nutritional insecurity. The study aims to estimate the prevalence of (in)food and nutritional insecurity in families from a community in the municipality of Turiaçu, Maranhão. This cross-sectional analytical study was conducted in the year 2023. The study included 40 heads of families of both genders. Participants answered a questionnaire with questions related to socioeconomic and demographic aspects; anthropometric data (weight, height, and waist circumference) and the Brazilian Scale of Food Insecurity were collected. The data were analyzed using Stata® version 16, and the Fisher's Exact Test was performed. The study was approved by the Ethics and Research Committee under the opinion number 6,088,717. Of the interviewed family heads, 67.5% were female, 72.5% were aged 20 to 59 years, 100% self-declared as Black, 45% were single, and 7.5% had completed higher education. Regarding occupation, 40% were farmers, and in terms of income, 47.5% earned a minimum wage. Although 50% had a suitable Body Mass Index, a significant percentage had excess weight (40%). Regarding food and nutritional insecurity, 27.5% experienced severe food insecurity, and 30% experienced moderate food insecurity. It was observed that the majority experienced some level of food and nutritional insecurity. Therefore, it is essential to understand the specific needs of this population to expand the coverage of social policies and facilitate their access to fundamental rights. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação 2023-12-27T00:00:00Z https://tedebc.ufma.br/jspui/handle/tede/6844 Título: ESTADO NUTRICIONAL DE CRIANÇAS INDIGENAS MENORES DE 5 ANOS, DO DISTRITO SANITÁRIO ESPECIAL INDÍGENA, MARANHÃO, BRASIL Autor: SOUSA, Maíra Fernanda Veiga de Primeiro orientador: VARGA, István van Deursen Abstract: Nutritional status is recognized as a relevant health indicator. Its assessment is an essential step in studies involving children, as it allows monitoring their nutritional conditions and identifying possible deviations in growth and development from the expected pattern, whether due to illnesses or unfavorable social conditions. Indigenous health in Brazil is ensured through the Indigenous Health Care Subsystem (SASI-SUS), integrated into the Unified Health System (SUS) and operated by the Special Indigenous Health Districts (DSEIs), such as the DSEI Maranhão, which is responsible for the care of the Guajajara people. In this context, the aim of this study was to analyze the nutritional status of Guajajara indigenous children under five years of age assisted at health centers of the DSEI Maranhão, between 2021 and 2023. This is a crosssectional, descriptive, observational, retrospective, and quantitative study, based on data from the Indigenous Health Care Information System (SIASI). The sample included 13,967 children aged 0 to 59 months, evaluated using weight-for-age and height-for-age indicators according to World Health Organization (WHO) standards. Analyses were conducted in Stata 14.0 softwares, employing descriptive statistics, association tests, and Poisson regression to estimate prevalence ratios and 95% confidence intervals. Results showed a prevalence of stunting of 37% and underweight of 8.3%, in addition to overweight in 2.6% of the children. Significant differences were observed by sex, health center, and year of attendance, highlighting intraethnic and temporal inequalities. It is concluded that monitoring the nutritional status of Guajajara children is essential to support intercultural public policies, strengthen the SASISUS, and promote indigenous food sovereignty. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação 2026-01-30T00:00:00Z https://tedebc.ufma.br/jspui/handle/tede/6817 Título: Relação do polimorfismo RS1801282 do Gene PPARY com obesidade e síndrome metabólica em adolescentes: um estudo de coorte em São Luís-MA Autor: MARTINS, Fabiana do Nascimento Prazeres Primeiro orientador: LIMA, Mayara Ingrid Sousa Abstract: Obesity, characterized by excessive accumulation of body fat, is often identified using the body mass index. Obese individuals, especially those with excess abdominal fat, are at an increased risk of developing metabolic syndrome (MetS). Both, obesity and MetS are directly related to diseases of the cardiovascular system, of multifactorial origin determined by a complex interaction between genetic and environmental factors. Single Nucleotide Polymorphisms (SNP) in several genes have been associated with protective factors or genetic predisposition for the development of these clinical outcomes, such as the rs1801282 polymorphism of the PPARγ gene related to adipogenesis, glucose and lipid metabolism, as well as inflammatory processes. Therefore, the chapter I of this research presents a systematic review, whose main objective was to summarize results of studies that associated the rs1801282 polymorphism with obesity in adolescents and children. The methodology was the active search for scientific articles in databases in Portuguese and English, only studies with genotyping data for this genetic variant being included. The results found demonstrate that the development of obesity and metabolic disorders may be associated with the rs1801282 polymorphism of the PPARγ gene, but this relationship is interfered by other factors such as sex, ethnicity, and lifestyle habits, in addition to complex biomolecular mechanisms, with not therefore, there is a consensus in the literature regarding the action of this gene. In chapter II, the proposal was to correlate obesity, indicators of metabolic syndrome with the presence of the rs1801282 polymorphism in a group of adolescents. This research is a cross-sectional design, nested within a birth cohort in the city of São Luís, MA, with the participation of 491 individuals, 248 obese adolescents (case) and 243 non-obese (control). In the analysis, socioeconomic, demographic, behavioral, anthropometric, clinical, biochemical, and genetic variables were evaluated. The results demonstrated that obese adolescents had altered BMI, waist circumference and LDL compared to the control group (p<0.001). The frequency of the polymorphic allele (G) was 8.55% in the study population, but there was no direct association with the development of obesity. However, the association analysis of genotypes with components related to Metabolic Syndrome demonstrated that systolic blood pressure (SBP) showed significant differences between genotypes in the group of obese adolescents, with GG individuals having lower SBP values (p=0.027), as well as glycemic rates showed differences between the groups, with heterozygous individuals (CG) in the non-obese group having lower blood glucose levels (p=0.005). Thus, in this population of adolescents from a Brazilian cohort, the rs1801282 polymorphism of the PPARγ gene was associated with protective factors related to the components of MetS. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação 2024-03-04T00:00:00Z https://tedebc.ufma.br/jspui/handle/tede/6697 Título: FERRAMENTA DIGITAL PARA GESTÃO E DIAGNÓSTICO SITUACIONAL NO CONTROLE DO CÂNCER DO COLO DO ÚTERO Autor: ALVES, Nayara Gonçalves Primeiro orientador: AMARAL, Flavia Maria Mendonça do Abstract: Cervical cancer remains a significant public health challenge in Brazil, particularly in the state of Maranhão, where screening rates and vaccination coverage have historically been low. This study aimed to develop a digital tool capable of supporting situational diagnosis and enhancing municipal management in addressing the disease. The result was the creation of ONCOCALC, a digital calculator structured through methodologies such as the Delphi technique and based on threshold logic with internal proportionality. The tool incorporates five strategic indicators: Municipal Human Development Index (MHDI), HPV vaccination coverage, cytopathological screening coverage, hospitalizations, and mortality from cervical cancer. Data were sourced from official systems (DATASUS, SISCAN, SIM, SIH/SUS, and UNDP) covering the period from 2014 to 2023. Developed using web technologies (React.js, PHP, and RESTful APIs), ONCOCALC automates score calculations, generates analytical reports, and proposes evidence-based action plans. In its pilot implementation in the municipality of São Luís (Maranhão), the final score was 3.3 out of 10, classified as "poor", highlighting low vaccination coverage (12.9%), limited screening, and high rates of hospitalizations and deaths, despite a high MHDI. The tool demonstrated potential to support strategic decision-making, guide investments, and strengthen women's health surveillance. It is concluded that its adoption can enhance municipalities' response capacity and contribute to reducing regional disparities in cervical cancer control. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação 2025-07-15T00:00:00Z