TEDE Coleção:

Mortalidade por doenças crônicas não transmissíveis no Maranhão: análise temporal e alinhamento com a agenda 2030

Mon, 05 Jan 2026 00:00:00 GMT

Título: Mortalidade por doenças crônicas não transmissíveis no Maranhão: análise temporal e alinhamento com a agenda 2030 Autor: SILVA FILHO, José Américo da Primeiro orientador: BRAGANÇA, Maylla Luanna Barbosa Martins Abstract: Introduction: Brazil's Northeast region, particularly the state of Maranhão, exhibits high rates of premature mortality from non-communicable chronic diseases (NCDs), a situation exacerbated by persistent socioeconomic inequalities and structural challenges within the health system. Analysis of the historical evolution of these mortality rates is essential to inform public policies capable of accelerating the reduction of preventable deaths and contributing to the achievement of Sustainable Development Goal 3 (Good Health and Well-being) of the 2030 Agenda. Objective: To analyze the temporal evolution of premature mortality rates (ages 30-69 years) attributed to cardiovascular diseases, cancer, diabetes mellitus, and chronic respiratory diseases in the state of Maranhão, as well as health expenditures, during the period 2015-2023. Methods: An ecological, exploratory study with an analytical approach, based on secondary data from the Brazilian Indicators for Sustainable Development Goals (ODS Brasil/IBGE), specifically indicator 3.4.1. Time series of premature mortality rates due to NCDs in Maranhão between 2015 and 2023 were analyzed, stratified by sex and age groups. Temporal trends were estimated using Prais-Winsten regression, with calculation of the annual percentage change (APC) and respective 95% confidence intervals. Results: Premature NCD mortality in Maranhão declined from 14.59 to 13.26 deaths per 100,000 between 2015 and 2023 (APC ≈ 1.03%/year). Among men, mortality decreased from 16.02 to 15.35 (not statistically significant), whereas among women there was a significant decline from 13.23 to 11.34 deaths per 100,000 (APC = –1.47%, p < 0.05). By age group, mortality rates in 2023 were 2.29 (ages 55–59 years), 3.59 (ages 60–64), and 5.66 per 100,000 (ages 65 69), with the largest declines (APC ≈ –1.20% to –1.45%); the 40–44 age group remained stable (0.53–0.61 per 100,000). Regarding financing, state per capita health expenditure increased from R$ 1,597.19 (2015) to R$ 2,603.19 (2023), with a mean of R$ 2,038.97 over the period. Correlation between mortality and per capita expenditure was strong and negative (r = –0.884), and negative for overall revenue (r = –0.8165), whereas federal transfers showed weaker correlation (r = –0.4122). In log-log models, per capita expenditure demonstrated a significant inverse association with mortality (β ≈ –0.17, p < 0.05), indicating negative elasticity; analysis with a 1-year lag confirmed a similar effect (β ≈ –0.15, p < 0.05). Stratified analyses revealed significant effects among women (β ≈ –0.14 to –0.18, p < 0.05) and absence of significance among men (β ≈ –0.08 to –0.10, p > 0.05). Federal transfers showed no statistically relevant association in most models. Conclusion: There was a moderate decline in NCD mortality in Maranhão and an inverse association with health financing; however, progress remains insufficient to meet the SDG 3.4 target. More effective actions are necessary to accelerate the reduction of preventable deaths from NCDs in the state. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação

Uso da monitorização residencial da pressão arterial (MRPA) na avaliação do controle de hipertensos

Mon, 18 Nov 2024 00:00:00 GMT

Título: Uso da monitorização residencial da pressão arterial (MRPA) na avaliação do controle de hipertensos Autor: CARNEIRO, Laís Nogueira Chaves Primeiro orientador: OLIVEIRA, Márcio Moysés de Abstract: Introduction: Systemic Arterial Hypertension (SAH) is a highly prevalent chronic disease and is considered the leading cause of cardiovascular and cerebrovascular diseases, which are the main causes of death in Brazil. Thus, controlling blood pressure levels is crucial to prevent or delay the onset of chronic complications. Despite this, there is a low rate of disease control, and Home Blood Pressure Monitoring (HBPM) is recognized not only as a tool for assessing blood pressure levels but also for improving hypertensive patients' adherence to treatment. Objective: To identify uncontrolled hypertensive patients and the factors related to low treatment adherence, based on the use of HBPM. Methods: This is a prospective, observational, cross sectional, descriptive study with a quantitative approach, through blood pressure measurement and the application of a structured interview with hypertensive patients treated by the Family Health Strategy at the Camaçari Basic Health Unit, in Imperatriz, MA. Results: A total of 133 individuals were included in the study. In this sample, patients had an average age of 62 years. The majority were elderly, female, of mixed race, with elementary education, retired or pensioners. In about 80% of the cases, both the family and patient income were at most two minimum wages. Most had been in treatment for more than 5 years (56.4%), were on monotherapy, were non-smokers, did not consume alcohol, and were sedentary. Cardiovascular risk was classified as high in 60.2% of the patients. Most of them had moderate or high adherence to treatment and had controlled blood pressure (64.7%). Among hypertensive patients with blood pressure within the control target, the majority were female and had low or medium cardiovascular risk. Moreover, a greater proportion of patients with moderate or high treatment adherence, according to the Morisky Scale, had controlled blood pressure. Additionally, male gender and alcohol consumption were associated with low treatment adherence. Final considerations: The study on the use of HBPM (Home Blood Pressure Monitoring) concludes that this tool is effective in identifying controlled and uncontrolled hypertensive patients. Although many patients have achieved blood pressure control, the rates are still insufficient, highlighting the need for health education and training. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação

EDUCAÇÃO E PROMOÇÃO DA SAÚDE: Avaliação da Saúde Bucal em Escolares de uma Comunidade do Município de São Luís – MA

Tue, 10 Dec 2024 00:00:00 GMT

Título: EDUCAÇÃO E PROMOÇÃO DA SAÚDE: Avaliação da Saúde Bucal em Escolares de uma Comunidade do Município de São Luís – MA Autor: VIANA, Maria Wilma Lacerda Primeiro orientador: BARBOSA, Maria do Carmo Lacerda Abstract: Introduction: Despite the principle of integrality of the Unified Health System of Brazil, Primary Care still lacks financial investment, especially in relation to the oral health of the vulnerable population. Caries, one of the most prevalent chronic diseases in the world, affects individuals of all ages and is responsible for the early loss of teeth, which leads to physical and mental damage as it affects nutritional status, raises low self-esteem and predisposes the individual to systemic infections. Objectives: To evaluate the oral health conditions of schoolchildren of one institution in the city of São Luís - Maranhão, Brazil and to promote educational actions. Methodology: The study was developed as a quantitative and qualitative research on the oral health of schoolchildren regularly enrolled in a school unit in the city of São Luís - MA. The quantitative research was a simple random sample from an estimated two hundred and seventy students, from which the convenience group for the qualitative analysis was obtained. Results: The study showed that the students had poor oral hygiene conditions and that the educational measures applied were not sufficient to reverse the condition found in the initial evaluation. Parents/guardians resent the lack of oral health care at school, the difficulty to access the public service and the high costs of the private sector. Conclusion: It is concluded that the tooth brushing technique, although understood by the individuals, was not incorporated into the daily lives of the students because they represent a population without access to oral health care and without educational programs at the school., Therefore, it is needed the implementation of oral health policies provided by the public system with permanent actions capable of inducing the incorporation of oral hygiene practices into the students' routine. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação

AVALIAÇÃO DA PREVALÊNCIA DA ASMA APÓS INTERVENÇÃO EDUCATIVA NA ATENÇÃO BÁSICA: Uma experiência em comunidade quilombola

Fri, 22 Nov 2024 00:00:00 GMT

Título: AVALIAÇÃO DA PREVALÊNCIA DA ASMA APÓS INTERVENÇÃO EDUCATIVA NA ATENÇÃO BÁSICA: Uma experiência em comunidade quilombola Autor: SÁ FILHO, João Batista Carlos de Primeiro orientador: COUTINHO, Nair Portela Silva Abstract: Introduction: Asthma is a highly prevalent chronic respiratory disease, and in Brazil, it is considered one of the highest in the world. Underdiagnosis and overdiagnosis are common in all health services, but the issue is particularly concerning in primary care, where the "Inverse Care Law" prevails, especially in quilombola communities. Objective: To carry out an educational intervention on asthma in primary care in a quilombola community. Methods: The research uses a qualitative and quantitative, interventionist approach and is conducted at a primary health unit in Itapecuru-Mirim, Maranhão. Three technical products were applied: a medical care guide, an asthma patient card, and an educational video about asthma. Results: Of the 355 screened participants, 41% showed indications of asthma. The analysis revealed a prevalence ranging from 10.98% to 68.42%. The intervention resulted in 37 new diagnoses, whereas previously only two patients were recognized as asthmatic in the community. Additionally, diagnosed patients received guidance, an asthma monitoring card, and watched educational videos. Conclusion: The educational interventions proved effective in expanding asthma diagnosis and raising disease awareness in vulnerable communities, standing out as a replicable and economically viable strategy for primary care in Brazil. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação