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Silva Oliveira MT, Oliveira CNT, da Silva LSC, Braga Martins Oliveira H, Sousa Freire R, Marques LM, Santos MLC, de Melo FF, Souza CL, Oliveira MV. Relationship between Mollicutes and spontaneous abortion: An epidemiological analysis. World J Obstet Gynecol 2021; 10:1-15. [DOI: 10.5317/wjog.v10.i1.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 12/21/2020] [Accepted: 01/10/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Abortion is of great importance in public health, as it is among the main causes of maternal morbidity and mortality. In addition to sociodemographic- and lifestyle-related factors, studies have associated infections of the genital tract with higher rates of abortion. Therefore, the exacerbated presence and rise of Mollicutes in the genitourinary tract may be related to higher rates of abortion.
AIM To perform an epidemiological analysis of women who had spontaneous abor-tions and placental colonization by Mollicutes in a maternity hospital.
METHODS This cross-sectional study involved the collection of data and biological material from women hospitalized due to spontaneous abortion or term delivery. The sample consisted of 89 women who miscarried and 20 women who had full term pregnancy. Data collection was carried out in three stages: (1) Conducting research on the information and clinical data in medical records of patients hospitalized due to abortion; (2) Application of a semi-structured questionnaire to identify the patient's epidemiological profile and (3) Collection of placental tissue. Placental samples were collected after the curettage procedure (abortion) and after placental expulsion (delivery), both performed by an obstetrician. Microbial identification in the fragments was performed by real-time polymerase chain reaction. In this study, the following explanatory variables were considered: (1) Sociodemographic variables; (2) Variables related to access to health services; (3) Variables related to lifestyle; and (4) Variables related to sexual and reproductive health, all of which were used to perform descriptive, univariate and multivariate analyses.
RESULTS In the final model, placental colonization by Mollicutes was independently associated with the variables age [odds ratio (OR) = 7.55; CI: 2.37-24.03] and menarche (OR = 3.43; CI: 1.03-11.44). In this investigation, the prevalence of Mollicutes colonization by at least one of the following three species: Mycoplasma hominis, Ureaplasma urealyticum, Ureaplasma parvum in women who had spontaneous abortion was 73.0%. When comparing colonization between the two groups of participating women, there was an 8.12-fold risk of placental colonization by at least one Mollicutes species in the women who had an abortion, compared to those who completed pregnancy. The final multivariate analysis model revealed a statistically significant association between placental colonization by Mollicutes in abortion with the following variables: age, as women up to 29 years old had a 7.55-fold risk of spontaneous abortion, compared to those who were older than 29 years; menarche, where women who had menarche up to 13 years old had a 3.43-fold risk of miscarriage compared to those who had menarche over 13 years old; and a change in eating habits, after the discovery of pregnancy, was a protective factor (OR = 0.16).
CONCLUSION These findings revealed a positive association between spontaneous abortion and placental colonization by Mollicutes. This indicates the need for further investigation of this issue, to guide decision-making for the prevention of abortion.
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Affiliation(s)
- Maria Tânia Silva Oliveira
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029094, Bahia, Brazil
| | | | | | | | - Raquel Sousa Freire
- Universidade Estadual Santa Cruz, Universidade Estadual Santa Cruz, Ilhéus 45662900, Bahia, Brazil
| | - Lucas Miranda Marques
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029094, Bahia, Brazil
| | - Maria Luísa Cordeiro Santos
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029094, Bahia, Brazil
| | - Fabrício Freire de Melo
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029094, Bahia, Brazil
| | - Cláudio Lima Souza
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029094, Bahia, Brazil
| | - Márcio Vasconcelos Oliveira
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029094, Bahia, Brazil
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Feitosa MDO, Gomes MEA, Fontoura IG, Pereira CS, Carneiro AMDCT, de Oliveira MC, Viana JA, Fontoura VM, da Silva KC, Ribeiro RDS, Vieira PCDS, Leite SGDV, Leal LPDA, Feitosa ADNA, Fonseca FLA. Access to Health Services and Assistance Offered to the Afro-Descendant Communities in Northern Brazil: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020368. [PMID: 33418905 PMCID: PMC7825149 DOI: 10.3390/ijerph18020368] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 12/27/2020] [Accepted: 12/28/2020] [Indexed: 12/04/2022]
Abstract
The remnants of quilombos, individuals of African descent, have faced several barriers throughout its history, either due to prejudice imposed by society, or the non-fulfillment of their rights guaranteed in the 1988 Constitution, such as access to health services. Thus, this study aims to evaluate the health care offered to quilombo communities in the northern region of Tocantins. This is an exploratory, descriptive study with a qualitative approach, including field research and focus group, carried out with 58 quilombo remnants people from communities in the northern region of Tocantins. Data collection was carried out between from October 2017 to July 2018, through semi-structured interviews. We found that these communities have limited access to health services, in addition to a negative perception of the assistance offered to the health of their population and the commitment of managers. Therefore, access to health and assistance received by the studied communities required to be prioritized since the care provided is not unique and has not met the health demands and needs of the remaining quilombos in northern Tocantins, Brazil.
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Affiliation(s)
- Marcela de Oliveira Feitosa
- Department of Postgraduate, ABC Faculty of Medicine, ABC University Center, Santo André, 09060-650 São Paulo, Brazil; (M.E.A.G.); (F.L.A.F.)
- Department of Nursing, Federal University of Maranhão, Imperatriz, 65915-240 Maranhão, Brazil;
- Correspondence: ; Tel.: +55-063-99965-2955
| | - Maria Elidiana Araújo Gomes
- Department of Postgraduate, ABC Faculty of Medicine, ABC University Center, Santo André, 09060-650 São Paulo, Brazil; (M.E.A.G.); (F.L.A.F.)
| | - Iolanda Graepp Fontoura
- Department of Nursing, Federal University of Maranhão, Imperatriz, 65915-240 Maranhão, Brazil;
| | - Catilena Silva Pereira
- Department of Nursing, State University of Tocantins, Augustinópolis, 77960-000 Tocantins, Brazil; (C.S.P.); (A.M.d.C.T.C.); (M.C.d.O.); (J.A.V.); (V.M.F.); (K.C.d.S.); (R.d.S.R.)
| | - Ana Maria da Costa Teixeira Carneiro
- Department of Nursing, State University of Tocantins, Augustinópolis, 77960-000 Tocantins, Brazil; (C.S.P.); (A.M.d.C.T.C.); (M.C.d.O.); (J.A.V.); (V.M.F.); (K.C.d.S.); (R.d.S.R.)
| | - Maikon Chaves de Oliveira
- Department of Nursing, State University of Tocantins, Augustinópolis, 77960-000 Tocantins, Brazil; (C.S.P.); (A.M.d.C.T.C.); (M.C.d.O.); (J.A.V.); (V.M.F.); (K.C.d.S.); (R.d.S.R.)
| | - Janayna Araújo Viana
- Department of Nursing, State University of Tocantins, Augustinópolis, 77960-000 Tocantins, Brazil; (C.S.P.); (A.M.d.C.T.C.); (M.C.d.O.); (J.A.V.); (V.M.F.); (K.C.d.S.); (R.d.S.R.)
| | - Volmar Morais Fontoura
- Department of Nursing, State University of Tocantins, Augustinópolis, 77960-000 Tocantins, Brazil; (C.S.P.); (A.M.d.C.T.C.); (M.C.d.O.); (J.A.V.); (V.M.F.); (K.C.d.S.); (R.d.S.R.)
| | - Késia Chaves da Silva
- Department of Nursing, State University of Tocantins, Augustinópolis, 77960-000 Tocantins, Brazil; (C.S.P.); (A.M.d.C.T.C.); (M.C.d.O.); (J.A.V.); (V.M.F.); (K.C.d.S.); (R.d.S.R.)
- Higher Education Unit of South Maranhão, UNISULMA, Imperatriz, 65907-070 Maranhão, Brazil
| | - Renata de Sá Ribeiro
- Department of Nursing, State University of Tocantins, Augustinópolis, 77960-000 Tocantins, Brazil; (C.S.P.); (A.M.d.C.T.C.); (M.C.d.O.); (J.A.V.); (V.M.F.); (K.C.d.S.); (R.d.S.R.)
| | | | | | | | | | - Fernando Luiz Affonso Fonseca
- Department of Postgraduate, ABC Faculty of Medicine, ABC University Center, Santo André, 09060-650 São Paulo, Brazil; (M.E.A.G.); (F.L.A.F.)
- Department of Pharmaceutical Sciences, Federal University of São Paulo (SP), 09913-030 Diadema, Brazil
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Almeida CBD, Santos ASD, Vilela ABA, Casotti CA. Reflexão sobre o controle do acesso de quilombolas à saúde pública brasileira. AVANCES EN ENFERMERÍA 2019. [DOI: 10.15446/av.enferm.v37n1.69141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
OBJETIVO: refletir acerca do acesso de quilombolas brasileiros ao sistema de saúde pública a partir da perspectiva do pensamento do filósofo francês Michael Foucault.SÍNTESE DE CONTEÚDO: ao refletir sobre o acesso dos quilombolas ao sistema de saúde pública, é importante reconhecer a existência de micropoderes nos serviços de saúde e na relação com os usuários deste serviço. Reflete-se sobre a necessidade de exercer o controle social como forma de garantia de direitos à saúde. Assim, apesar do Sistema Único de Saúde possuir avanços, o acesso a este serviço apresenta dificuldades como também inadequação de gerenciamento, além de escassez no exercício do controle social, como pontos a serem questionados.CONCLUSÃO: percebe-se que, à luz do referencial teórico de Michael Foucault, o “poder” político, existente nas relações das comunidades quilombolas referentes aos serviços de saúde pública, cria dificuldades diversas e que há anos se perpetua.
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