Fatores associados a violências contra crianças em Serviços Sentinela de Urgência nas capitais brasileiras

Prevalence and factors associated child neglect in a Brazilian state

ABSTRACT Objective To quantify the prevalence of neglect against the child and identify its associated factors, based on the cases reported in the state of Espírito Santo between 2011 and 2018. Methods Cross-sectional study with data reported in the Notifiable Diseases Information System (SINAN) with all reported cases of child neglect from 2011 to 2018 in the state of Espírito Santo, Brazil. The characteristics of the victim, author, and aggression were studied, and the associations were analyzed by Poisson regression. Results The frequency of neglect was 31.3%, being more prevalent in males (PR: 1.48; 95%CI: 1.34-1.63); for the age group of zero to two years (PR: 3.05; 95%CI: 2.65-3.51); among female aggressors (PR: 16.20; 95%CI: 9.98-26.32), and regarding the bond to the victim, we note the highest prevalence of parents/stepfathers (PR: 6.69; 95%CI: 4.16-10.74), both parents (PR: 4.41; 95%CI: 2.84-6.85) and mothers/stepmothers (PR: 2.94; 95%CI: 2.20-3.93). Conclusions and Implications for the practice The magnitude of child neglect in Espírito Santo was significant, showing the need to advance in the understanding of this phenomenon and in the implementation of expanded intersectoral public policies aimed at ensuring adequate conditions for growth and development in childhood.

Prevalência e fatores associados à negligência contra crianças em um estado brasileiro

RESUMO Objetivo Quantificar a prevalência da negligência contra a criança e identificar seus fatores associados, a partir dos casos notificados no estado do Espírito Santo no período entre 2011 e 2018. Métodos Estudo transversal com dados notificados no Sistema de Informação de Agravos de Notificação (SINAN) com todos os casos notificados de negligência contra a criança no período de 2011 a 2018 no Espírito Santo, Brasil. Foram estudadas as características da vítima, do autor e da agressão e as associações foram analisadas por meio da Regressão de Poisson. Resultados A frequência de negligência foi 31,3%, sendo mais prevalente no sexo masculino (RP: 1,48; IC95%: 1,34-1,63); na faixa etária de 0 a 2 anos (RP: 3,05; IC95%: 2,65-3,51); entre agressores do sexo feminino (RP: 16,20; IC95%: 9,98-26,32), e, em relação ao vínculo nota-se a maior prevalência de pais/padrastos (RP: 6,69; IC95%: 4,16-10,74), ambos os pais (RP: 4,41; IC95%: 2,84-6,85) e mães/madrastas (RP: 2,94; IC95%: 2,20-3,93). Conclusões e Implicações para a prática A magnitude de negligência contra crianças no Espírito Santo foi expressiva, demonstrando a necessidade de avançar no entendimento deste fenômeno e na implementação de políticas públicas intersetoriais ampliadas que visem garantir condições adequadas para o crescimento e desenvolvimento na infância.

Prevalence and Factors Associated with Sexual Violence against Children in a Brazilian State

Sexual violence is one of the forms of violence against children worldwide. Understanding its magnitude and its associated factors is essential to promote effective protection policies to childhood. The objective was to verify the prevalence and analyze the factors associated with sexual violence against children in a Brazilian state. This is a cross-sectional study analyzing data from reported cases of violence against children in the state of Espírito Santo, Brazil, between 2011 and 2018. The characteristics of the victim, perpetrator and aggression were studied, and the associations were analyzed using Poisson regression. The frequency of sexual violence was 41.8% and was more prevalent in girls, in the age groups 3 to 5 and 6 to 9 years old, in white ethnicity/color and in the urban area. The offenders were mainly men, known to the victim and occurred mainly in the residence. Sexual violence was the most reported violence among children in Espírito Santo, occurring within their circle of trust, demonstrating the need to provide support for families and to advance public policies to guarantee children's rights.

Circumstances and Consequences of Violence-Related Injuries Presenting at Hospital. A Study at the Pediatric Emergency and Forensic Medicine Units of Maputo Central Hospital, Mozambique

Rates of violence against children are high in Sub-Saharan Africa and information is scarce on the resulting injuries. This study investigates sex-related differences in the circumstances and consequences of sexual and physical violence in the Mozambican context. Hospital records from 2019 at the pediatric emergency and forensic medicine units of Maputo Central Hospital were scrutinized using a standardized form. Of the 321 cases identified, 60% resulted from sexual violence. Girls represented 86.4% of the victims of sexual violence and boys, 66.1% of those from physical violence. Being injured in a familiar environment and by a parent, a relative, or someone known was strikingly common. The injury pattern varied by form of violence and sex of the child. About half of the injuries sustained by physical violence were minor/superficial. Severe injuries requiring hospitalization (33% in total) and some specialized care (27% in total) were mainly sustained by girl victims of sexual violence. While circumstances and consequences of violence-related injuries have several similarities, being severely injured is more typical of girl victims of sexual violence. Besides medical care, hospital services in Mozambique must be prepared to offer pediatric victims of violence the necessary social care.

Recurrent violence against children: analysis of cases notified between 2011 and 2018 in Espírito Santo state, Brazil

OBJECTIVE

To identify the frequency of reported cases and factors associated with recurrent childhood violence in Espírito Santo State, Brazil.

METHODS

This was a cross-sectional study of cases notified on the Notifiable Health Conditions Information System between 2011-2018. Associations were tested using Pearson's Chi-Square test and Poisson Regression stratified by sex.

RESULTS

The frequency of recurrent violence was 32.5%. In boys, it was associated with the child's age (PR=1.38 - 95%CI 1.11;1.73) and the aggressor's age (PR=1.85 - 95%CI 1.30;2.63) and occurrence at home (PR=1.61 - 95%CI 1.23;2.11); in girls, it was associated with age (PR=1.39 - 95%CI 1.20;1.60), presence of disabilities/disorders in the victim (PR=1.43 - 95%CI 1.22;1.67), abusive parents (PR=3.70 - 95%CI 1.65;8.32) and occurrence at home (PR=1.39 - 95%CI 1.10;1.75).

CONCLUSION

Recurrent violence was present in almost one third of the reports of violence against children in Espírito Santo State, requiring the recognition of its associated factors for the development of prevention policies.

Profile of cases due to burn attended in emergency care units in Brazilian capitals in 2017

OBJECTIVES

To describe the profile of burn victims attended in emergency services and to identify associations between the variables investigated.

METHODS

Cross-sectional study based on data from the 2017 survey "Surveillance of violence and accidents in emergency units". We used descriptive analysis, according to demographic characteristics and aspects related to the burn injury, as well as the correspondence analysis technique, which allowed to verify possible associations between the variables investigated.

RESULTS

Burns were more frequent: in adults aged between 20 and 39 years (40.7%); in men (57.0%); in the household (67.7%); due to hot substances (52.0%). Household accidents were more frequent in the age group 0-15 years (92.0%) and elderly (84.4%), and in women (81.6%). Accidents in commerce, services and industry affected individuals aged 16 to 59 years (73.6%). Referral to other hospitals was associated with cases in the elderly and hospitalization with the cases in individuals aged between 0 and 15 years old. Events in the working age population were associated with alcohol use and the workplace. Among women, it is suggested to associate burn accidents with household and hot substances.

CONCLUSIONS

The results point to the need for oriented actions in the field of health education, as well as labor regulation and supervision.

Fatores que interferem no enfrentamento da violência infantil por conselheiros tutelares

RESUMO A presente pesquisa objetivou apresentar perspectivas de conselheiros tutelares sobre a atuação nos casos de violência contra a criança. Para tanto, foram entrevistados 16 profissionais atuantes no município de Palmas (TO), Brasil. Os dados foram submetidos à análise de conteúdo. Identificou-se que interferem no enfrentamento da violência infantil, por esses atores, a falta de conhecimento e habilidades para identificar crianças em risco ou situação de violência, o envolvimento das famílias nos casos, a precariedade de recursos materiais, o quantitativo insuficiente de profissionais, falhas na rede de proteção à criança, estereótipos culturais, a desvalorização profissional e a impunidade do agressor. Sendo assim, para que o Conselho Tutelar consiga exercer plenamente suas funções e contribuir para a interrupção do ciclo de violência infantil, são necessários investimentos em diversas áreas, tais como a qualificação dos conselheiros tutelares, por meio da oferta de cursos periódicos, e a implantação de ambientes de trabalho com recursos material e humano suficientes, de modo a contribuir para que se exerçam ações integradas, intersetoriais e resolutivas.