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Gomes RF, Oliveira PSD, Silva MLO, Miranda SVCD, Sampaio CA. Therapeutic itineraries in health care in Quilombola communities. CIENCIA & SAUDE COLETIVA 2024; 29:e01602023. [PMID: 38451635 DOI: 10.1590/1413-81232024293.01602023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 06/17/2023] [Indexed: 03/08/2024] Open
Abstract
This article aimed to map therapeutic itineraries in health care within rural Quilombola communities in the north of Minas Gerais, Brazil. This is a section of a qualitative research conducted in six visited communities. The data was collected through 18 individual interviews, analyzed using the theoretical-methodological framework of Therapeutic Itineraries, and organized into three empirical themes. The narratives allowed for understanding the paths taken in health care by the Quilombola population, identifying the components of the popular subsystem (natural resources, the use of teas and home remedies), the family subsystem (transmission of knowledge and cultural heritage of care), and the professional subsystem (hospital level, medical care, primary and specialized attention). The difficulties of access are not only due to geographical distances, but also broader aspects of social determination, such as institutional racism, low availability of services, the need for payment for transportation and medical procedures. In this sense, it is necessary to have an approach and interventions from public policies to address ethnic-racial, economic, and access inequalities in health care services.
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Affiliation(s)
- Rafael Fernandes Gomes
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Estadual de Montes Claros. Av. Rui Braga s/n, Vila Mauricéia. 39401-089 Montes Claros MG Brasil.
| | - Pâmela Scarlatt Durães Oliveira
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Estadual de Montes Claros. Av. Rui Braga s/n, Vila Mauricéia. 39401-089 Montes Claros MG Brasil.
| | | | - Sérgio Vinícius Cardoso de Miranda
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Estadual de Montes Claros. Av. Rui Braga s/n, Vila Mauricéia. 39401-089 Montes Claros MG Brasil.
| | - Cristina Andrade Sampaio
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Estadual de Montes Claros. Av. Rui Braga s/n, Vila Mauricéia. 39401-089 Montes Claros MG Brasil.
- Departamento de Saúde Mental e Saúde Coletiva, Universidade Estadual de Montes Claros. Montes Claros MG Brasil
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Paiva SG, Rivara AC, de Castro Nóbrega M, de Cesare Parmesan Toledo R, de Nazaré Klautau‐Guimarães M, Madrigal L, de Oliveira SF. Cardiovascular risk factors across different levels of urbanization in Brazilian Afro‐derived communities (
quilombos
). Am J Hum Biol 2022; 35:e23839. [PMID: 36426735 DOI: 10.1002/ajhb.23839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 09/21/2022] [Accepted: 11/07/2022] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES The frequency of cardiovascular diseases has increased throughout the world. People of African descent have been disproportionately affected, particularly if they reside in urban settings. In this work, we evaluate risk factors associated with cardiovascular diseases (CVD) and other chronic diseases in rural and urban Afro-derived communities (quilombo) in Central Brazil. We also determine if there are associations between the frequency of CVD risk factors, sex, and proximity to urban environments. METHODS Through a cross-sectional study of participants (n = 347) within three Brazilian Afro-derived communities: Kalunga (a semi-isolated rural community; n = 214), Cocalinho (a non-isolated rural village; n = 70), and Pé do Morro (an urban community; n = 63), we collected data regarding chronic disease (i.e., CVD, diabetes, and hypertension) risk through questionnaires, anthropometrics, blood pressure, and blood samples using standard protocols. Differences between variables were tested by the Chi-square test of Pearson and Fisher's Exact Test, independent sample t-tests, analysis of variances, and Kruskal-Wallis tests (p ≤ .05). RESULTS The prevalence of hypertension, overweight, obesity, and other cardiovascular risk factors were higher in the non-isolated rural and urban communities than in the semi-isolated rural community. We found significant sex differences in the distribution of the CVD risk factors, with all occurring at a higher frequency among females. CONCLUSIONS Our findings indicate that Brazilian Afro-derived communities are currently going through an epidemiological transition. The urban lifestyle and its environmental factors are likely contributing to an escalation in cardio-metabolic disease risk. However, the magnitude of this transition differentially impacts the sexes, as females suffer a higher frequency of risk factors compared to males.
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Affiliation(s)
- Sabrina Guimarães Paiva
- Instituto de Ciências Biológicas Universidade de Brasília Brasília Distrito Federal Brazil
- Instituto Federal de Educação, Ciência e Tecnologia do Tocantins Araguaína Tocantins Brazil
- Programa de Pós‐Graduação (Mestrado) em Demandas Populares e Dinâmicas Regionais (PPGDire) Universidade Federal do Norte do Tocantins Araguaína Tocantins Brazil
| | - Anna C. Rivara
- Department of Chronic Disease Epidemiology, School of Public Health Yale University New Haven Connecticut USA
| | - Matheus de Castro Nóbrega
- Instituto de Ciências Biológicas Universidade de Brasília Brasília Distrito Federal Brazil
- Programa de Pós‐Graduação em Genética e Biologia Molecular Universidade Federal do Rio Grande do Sul Porto Alegre Brazil
| | | | | | - Lorena Madrigal
- Department of Anthropology University of South Florida Tampa Florida USA
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Mota BG, Barp M, Guimarães RA, Rosso CFW, Rocha BS, Nunes CADB, Pagotto V. Prevalence of diabetes mellitus according to associated factors in rural traditional populations in Goiás, Brazil: a cross-sectional study. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2022; 25:e220016. [PMID: 35830064 DOI: 10.1590/1980-549720220016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 05/09/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To identify the prevalence of and factors associated with diabetes mellitus in rural traditional communities. METHODS Cross-sectional study carried out in 115 rural communities distributed in 45 municipalities in the state of Goiás, including: 13 river communities, 51 quilombolas and 63 agrarian reform settlements. Probabilistic sampling was performed, and participants were selected at random. The outcome variable was self-reported diabetes mellitus, while exposure variables were sociodemographic, lifestyle, health conditions and access to health services. Multiple regression was used to determine the association between study variables. RESULTS Among the 2,537 participants, the overall prevalence of diabetes was 9.8%, with 13.5% in river dwellers, 10.0% in quilombolas and 9.3% in settlers. Factors associated with diabetes were negative self-perception of health, being a former smoker, high blood pressure, hypercholesterolemia, and living in a river community. CONCLUSION The results reinforce the need to strengthen strategies for the prevention and control of diabetes and its complications in rural populations, especially among river dwellers.
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Affiliation(s)
- Brenda Godoi Mota
- Universidade Federal de Goiás, School of Nursing - Goiânia (GO), Brazil
| | - Milara Barp
- Universidade Federal de Goiás, Post-Graduation Program in Nursing - Goiânia (GO), Brazil
| | - Rafael Alves Guimarães
- Universidade Federal de Goiás, School of Nursing, Post-Graduation Program in Nursing - Goiânia (GO), Brazil
| | | | | | | | - Valéria Pagotto
- Universidade Federal de Goiás, School of Nursing, Post-Graduation Program in Nursing - Goiânia (GO), Brazil
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Mota BG, Barp M, Guimarães RA, Rosso CFW, Rocha BS, Nunes CADB, Pagotto V. Prevalência de diabetes mellitus autorreferido e fatores associados em população rural e tradicional de Goiás: estudo transversal. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2022. [DOI: 10.1590/1980-549720220016.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO: Objetivo: Identificar a prevalência e os fatores associados ao diabetes mellitus em comunidades rurais. Métodos: Estudo transversal desenvolvido em 115 comunidades rurais distribuídas em 45 municípios do Estado de Goiás, sendo: 13 ribeirinhas, 51 quilombolas e 63 assentamentos de reforma agrária. Realizou-se amostragem probabilística, e os participantes foram selecionados de forma aleatória. A variável desfecho foi diabetes mellitus autorreferido, enquanto as de exposição foram sociodemográficas, estilo de vida, condições de saúde e acesso a serviços de saúde. Utilizou-se regressão múltipla para verificar a associação entre variáveis de estudo. Resultados: Entre os 2.537 participantes, a prevalência geral de diabetes foi de 9,8%, sendo 13,5% nos ribeirinhos, 10,0% nos quilombolas e 9,3% nos assentados. Os fatores associados ao diabetes foram a autopercepção negativa de saúde, ser ex-fumante, hipertensão arterial, hipercolesterolemia e residir em comunidade ribeirinha. Conclusão: Os resultados reforçam a necessidade de fortalecer estratégias para prevenção e controle da diabetes e suas complicações em populações rurais, especialmente entre os ribeirinhos.
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de Sousa AR, da Silva Santana T, Caldas Santos HS, Escobar OJV, Daza AIR, de Santana Carvalho ES, de Andrade Nhamuave E, de Camargo C. Conceptions About Health and Care Practices of Black Men from a Quilombola Community. Open Nurs J 2021. [DOI: 10.2174/1874434602115010335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction:
Universal health coverage will be guaranteed to all individuals, safeguarding the rights of traditional communities, as in the quilombola population, respecting the dimensions of interculturality, gender and ethnicity.
Objective:
The aim of this study is to describe the conceptions of health and health care practices of Afro-Brazilian men from a quilombola community.
Methods:
This was a qualitative descriptive study conducted with Afro-Brazilian men from a quilombola community in Bahia, Brazil, where there is a significant concentration of black people and quilombola communities.
Results:
This group’s conceptions of health are based on the combination of the individual body with the body that is socially and culturally situated in the community. Health care practices are anchored in cultural knowledge and strengthened by the bonds with nature, friends and religious leaders.
Conclusion:
The black men from quilombola communities are in a state of vulnerability due to the lack of access to health services.
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Neves FDJ, Ferreira AA, Welch JR. [Nutritional status and factors associated with stunting in children under five years of age in maroon communities in Northeast Brazil]. CAD SAUDE PUBLICA 2021; 37:e00060220. [PMID: 34287583 DOI: 10.1590/0102-311x00060220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 12/02/2020] [Indexed: 11/21/2022] Open
Abstract
Quilombolas, or members of maroon communities in Brazil, are part of the country's ethnic/racial minorities exposed to health inequities, reflecting a historical process of harsh socioeconomic disadvantages. The study aimed to assess nutritional status and factors associated with stunting in quilombola children under five years of age living in land-deeded quilombola communities in Northeast Brazil. The study used secondary data from the Survey on Food and Nutritional Security in Land-Deeded Quilombola Communities (2011). The target outcomes were stunting (height-for-age < -2z), excess weight (weight-for-height > 2z), and underweight (weight-for-age < -2z). Chi-square test was used to assess the significance of differences between prevalence rates. Multivariate analysis used a hierarchical conceptual model on stunting. Prevalence rates for excess weight and underweight were 2.8% and 6,1%, respectively. Stunting was diagnosed in 14.1% of the sample. The hierarchical model for stunting evidenced higher prevalence rates among children without access to primary healthcare (PR = 1.63; 95%CI: 1.11; 2.41) and safe water (PR = 2.09; 95%CI: 1.42; 3.08) and those with a history of low birthweight (PR = 2.19; 95%CI: 1.33; 3.61). The high prevalence of stunting showed that the quilombola' population in the Northeast experiences unfavorable health condition, reflecting lack of access to primary healthcare and precarious sanitation.
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Affiliation(s)
- Félix de Jesus Neves
- Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brasil
| | - Aline Alves Ferreira
- Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | - James R Welch
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
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Cavalcante AL, Ferreira HDS. Accuracy of the Simplified Version of the Global Risk Score in Detecting Cardiovascular Risk in Women from Quilombola Communities in the State of Alagoas, Brazil. INTERNATIONAL JOURNAL OF CARDIOVASCULAR SCIENCES 2021. [DOI: 10.36660/ijcs.20210068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Passos TS, Almeida-Santos MA, Hora AB, Oliveira CCDC. Condom use and vulnerabilities to sexually transmitted infections in quilombola communities: a descriptive study, Sergipe, Brazil, 2016-2017. ACTA ACUST UNITED AC 2021; 30:e2020617. [PMID: 33978128 DOI: 10.1590/s1679-49742021000200011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 10/09/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To analyze frequency of condom use according to vulnerability factors for sexually transmitted infections in quilombola communities in Sergipe state, Brazil. METHODS This was a descriptive cross-sectional study carried out in 2016-2017. A structured questionnaire with sociodemographic and behavioral questions was used; rapid HIV and syphilis tests were performed. Comparisons between categorical variables were performed using Fisher's exact test. RESULTS Among the 367 individuals from 14 communities, the majority had low levels of education (72.8%), were not working (59.7%) and had a stable sex partner (90.7%). Lack of access to prevention supplies and information accounted for respondent programmatic vulnerability. There was a higher proportion of inconsistent condom use with a stable partner (90.1%) among individuals who reported lack of access to information (p=0.001) and inconsistent use with a casual partner (p<0.001). CONCLUSION Frequency of condom use with a stable partner was significantly proportional to condom use with a casual partner and access to information on prevention.
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Affiliation(s)
| | | | - Aline Barreto Hora
- Universidade Tiradentes, Pós-Graduação em Saúde e Ambiente, Aracaju, SE, Brasil
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Santana KC, Silva EKPD, Rodriguez RB, Bezerra VM, Souzas R, Medeiros DSD. Health service utilization by Quilombola and non-Quilombola adolescents living in a rural area in the semi-arid region of the state of Bahia, Brazil. CIENCIA & SAUDE COLETIVA 2021; 26:2807-2817. [PMID: 34231693 DOI: 10.1590/1413-81232021267.09712021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 04/29/2021] [Indexed: 11/22/2022] Open
Abstract
This article describes health service utilization by Quilombola and non-Quilombola adolescents living in a rural area in the semi-arid region of Bahia. Quantitative and qualitative methods were used to gain a more in-depth understanding of the object of study. A cross-sectional household survey was conducted with 390 adolescents. Health service utilization was described using frequency distribution and 95% confidence intervals. Discussions were held with four focus groups, which were transcribed and analyzed using content analysis. The most commonly reported usual place of care was the local family care center (70,0%) and 15,1% of the adolescents had sought health care in the last 15 days. The main reason for seeking care was illness (37,3%). The findings of the qualitative component of the study reveal multiple factors influencing access to services, including long waiting times, lack of prioritization of adolescent care and geographical barriers. Health services should attempt to get closer adolescents and provide care tailored to the specific needs of this group.
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Affiliation(s)
- Katiuscy Carneiro Santana
- Secretaria Municipal de Saúde, Prefeitura Municipal de Vitória da Conquista. Rua Coronel Gugé 211, Centro. 45040-150 Vitória da Conquista BA Brasil.
| | | | | | | | - Raquel Souzas
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia. Salvador BA Brasil
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Dias JA, Luciano TV, Santos MCLFS, Musso C, Zandonade E, Spano LC, Miranda AE. [Sexually transmissible infections in African-descendant women in maroon communities in Brazil: prevalence and associated factors]. CAD SAUDE PUBLICA 2021; 37:e00174919. [PMID: 33624738 DOI: 10.1590/0102-311x00174919] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 06/29/2020] [Indexed: 11/22/2022] Open
Abstract
The study aimed to estimate the prevalence of sexually transmissible infections (STIs) and associated factors in women in quilombola (maroon) communities in Brazil. This was a population-based cross-sectional study of quilombola women from March 2017 to January 2019. A questionnaire was used with sociodemographic, behavioral, and clinical information. A gynecological examination was performed for the collection of uterine cervical cells for oncotic cytology and the detection of Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, and human papillomavirus (HPV) via polymerase chain reaction. Rapid tests for HIV and syphilis were performed. The main outcome was defined as infection with one or more sexually transmissible pathogens. The analysis used chi-square test and hierarchical logistic regression. From a total of 380 women, 352 (92.6%) were included in the study. Prevalence of at least one STI was 18.5% (95%CI: 14.76-22.85). The highest prevalence was for HPV, with 11.1%, followed by 6.3% for T. vaginalis and 4.3% for C. trachomatis. There were no cases of N. gonorrhoeae. Prevalence was 0.3% for HIV and 4.3% for syphilis. Cervical-vaginal cytology was altered in 7.7% of the women. Detection of one or more STIs was significantly associated with age 25 to 44 years (OR = 2.33; 95%CI: 1.05-5.18), alcohol consumption (OR = 1.96; 95%CI: 1.06-3.64), altered cervical cytology (OR = 3.96; 95%CI: 1.65-9.48), and bacterial vaginosis (OR = 3.61; 95%CI: 2.01-6.47). Quilombola women showed high prevalence of one or more STIs, emphasizing the importance of organizing prevention strategies targeted to these women.
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Affiliation(s)
| | | | | | - Carlos Musso
- Universidade Federal do Espírito Santo, Vitória, Brasil
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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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Fernandes ETBS, Ferreira SL, Ferreira CSB, Cardoso VB. Condições de vida de mulheres quilombolas e o alcance da autonomia reprodutiva. ESCOLA ANNA NERY 2021. [DOI: 10.1590/2177-9465-ean-2020-0147] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivo explicar a interferência das condições de vida de mulheres quilombolas na autonomia reprodutiva. Método trata-se de um estudo qualitativo com 10 mulheres quilombolas com idade entre 23 e 49 anos, residentes em comunidades rurais do Território de Identidade da Bahia Sertão Produtivo. Estas compareceram aos encontros e assinaram o Termo de Consentimento Livre e Esclarecido. Os dados foram coletados através de grupos focais e analisados pela análise temática de Bardin. O software NVivo foi utilizado para organização dos dados. Procedeu-se à coleta de dados após a aprovação do Comitê de Ética em Pesquisa. Resultados Considerando o fato de que metade do quantitativo de mulheres era primigesta, a maioria usava contraceptivo oral, não usava preservativo e nem participava do planejamento reprodutivo. Os dados revelaram que a autonomia reprodutiva das mulheres quilombolas sofre interferência do patriarcado, entretanto, vem se remodelando com a independência financeira das mulheres. Após agregação das unidades de registro, emergiram três categorias: “Teria que casar e ter filho(a)!”, “Marcas da submissão e a conquista da autonomia” e “Planejamento reprodutivo: conflitos entre liberdade e obrigação”. Conclusão e implicações para a prática condições de vida desfavoráveis impedem mulheres quilombolas de vivenciarem a autonomia reprodutiva em plenitude; o conhecimento dessas condições poderão revelar reais necessidades de saúde reprodutiva e subsidiar ações direcionadas a este público.
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Dantas MNP, Souza DLBD, Souza AMGD, Aiquoc KM, Souza TAD, Barbosa IR. Factors associated with poor access to health services in Brazil. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2020; 24:e210004. [PMID: 33331413 DOI: 10.1590/1980-549720210004] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 08/11/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To analyze factors associated with poor access to health services among the Brazilian population aged 19 years or older. METHODS This is a cross-sectional study based on data from the 2013 National Health Survey, obtained from a complex sample. The poor access outcome was defined as not having received care the last time the participant sought a health service and not seeking care again for lack of accessibility. We analyzed the prevalence of poor access and its association with socioeconomic and health factors by calculating prevalence ratios (PR) with 95% confidence intervals. We also used Poisson's multivariate regression model with the Wald test for robust estimation. RESULTS Out of the 60,202 valid responses, 12,435 individuals met the criteria for poor access. Poor access had a prevalence of 18.1% (95%CI 16.8 - 19.4) and was associated with the following factors: being black/multiracial (PR = 1.2; 95%CI 1.0 - 1.4); living in the North (PR = 1.5; 1.3 - 1.9) and Northeast (PR = 1.4; 1.2 - 1.6) regions compared to the Southeast region; living in a rural area (PR = 1.2; 1.1 - 1.4); being a smoker (PR = 1.2; 1.0 - 1.4); having poor/very poor self-rated health (PR = 1.3; 1.1 - 1.6); not having private health insurance (PR = 2.3; 1.7 - 2.9). CONCLUSION Access to health services is still precarious for a considerable part of the Brazilian population, especially the most vulnerable groups.
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Affiliation(s)
| | | | - Ana Mayara Gomes de Souza
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Rio Grande do Norte - Natal (RN), Brasil
| | - Kezauyn Miranda Aiquoc
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Rio Grande do Norte - Natal (RN), Brasil
| | - Talita Araujo de Souza
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal do Rio Grande do Norte - Natal (RN), Brasil
| | - Isabelle Ribeiro Barbosa
- Faculdade de Ciências da Saúde do Trairi, Universidade Federal do Rio Grande do Norte - Santa Cruz (RN), Brasil
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Fernandes NFS, Galvão JR, Assis MMA, Almeida PFD, Santos AMD. [Access to uterine cervical cytology in a health region: invisible women and vulnerable bodies]. CAD SAUDE PUBLICA 2019; 35:e00234618. [PMID: 31596403 DOI: 10.1590/0102-311x00234618] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 04/15/2019] [Indexed: 11/22/2022] Open
Abstract
This article evaluates access to the Papanicolaou test in the Family Health Strategy (FHS) in municipalities in a health region. Cervical cancer control depends on a well-organized Family Health Strategy, so assessment of access to the Papanicolaou test reflects the quality of care at this level. This is a qualitative study with data produced in 10 focus groups, totaling 70 participants in four municipalities. We analyzed the organizational, symbolic, and technical dimensions of access to the Pap test, with cervical cancer control as the marker. The results indicate that living in rural areas was a barrier to access to the Papanicolaou test and exacerbated the inequalities. Nurses were the principal reference for access to the Pap test. The absence of necessary items for collecting cervical cytopathology specimens was a barrier to access in all the municipalities. There were obstacles to access for women with disabilities and lesbian women, with care that was fragmented and out of sync with individual characteristics. The numerous obstacles to access to the Papanicolaou test exposed the selectiveness of the Family Health Strategy in the health region, since it reproduced the invisibility of women with greater social vulnerability and exacerbated the existing inequalities.
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Mussi RFDF, Petróski EL. Indicadores de obesidade: capacidade preditiva para síndrome metabólica em adultos quilombolas. CIENCIA & SAUDE COLETIVA 2019; 24:2471-2480. [DOI: 10.1590/1413-81232018247.19032017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Accepted: 10/19/2017] [Indexed: 12/15/2022] Open
Abstract
Resumo O objetivo deste estudo foi avaliar a capacidade preditiva da síndrome metabólica (SM) por diferentes indicadores de obesidade (IO) em adultos quilombolas. Estudo transversal com amostra representativa de 850 adultos (18 à 92 anos de idade) quilombolas residentes na microrregião geográfica de Guanambi/Bahia. Foram construídas curvas Receiver Operating Characteristic (ROC) entre os IO (percentual de gordura - %G; índice de adiposidade corporal – IAC; índice de massa corporal – IMC) e a SM. O equilíbrio entre sensibilidade e especificidade definiu os melhores pontos de corte preditores da SM pelos IO. Os três IO apresentaram capacidade preditiva para SM (curva ROC significativamente > 0,5). Entre as mulheres, o %G apresentou área sob a curva ROC (0,69 - IC95%: 0,65:0,73) significativamente maior que os demais IO. Entre os homens as áreas do %G e do IMC foram iguais (0,81 - IC95%: 0,76:0,85) e maiores que a do IAC. Os melhores pontos de corte dos IO para identificar a presença da SM respectivamente em mulheres e homens foram: 24,97 e 25,36 kg/m2 para IMC, 34,30 e 26,14% para IAC e 37,7 e 23,8% para %G. Os IO testados são válidos para rastrear a SM em adultos quilombolas a partir da utilização dos pontos de corte específicos para a população estudada.
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Silva RMA, Bezerra VM, Medeiros DSD. Experimentação de tabaco e fatores associados entre adolescentes da zona rural de Vitória da Conquista, BA, Brasil. CIENCIA & SAUDE COLETIVA 2019; 24:431-441. [DOI: 10.1590/1413-81232018242.02962017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 03/24/2017] [Indexed: 11/22/2022] Open
Abstract
Resumo O objetivo deste artigo é descrever a experimentação do tabaco e fatores associados em adolescentes da zona rural do sudoeste da Bahia. Este foi um recorte da pesquisa Adolescer, do tipo seccional, em 2015, com 390 adolescentes. Os dados foram analisados através de medidas de frequência e qui-quadrado; e regressão de Poisson, com variância robusta, para estimar as razões de prevalências (RP) para a experimentação do tabaco em relação às variáveis explicativas. Dos adolescentes, 5,1% experimentaram cigarro alguma vez na vida e 0,3% faziam uso regular. Mostraram-se associados à experimentação: sexo masculino (RP = 6,46); ter tido relação sexual alguma vez na vida (RP = 20,55); ter pais que raramente ou nunca entenderem os seus problemas (RP = 7,89); ter 3 ou mais amigos (RP = 0,10). Apesar das baixas prevalências de experimentação do tabaco e do seu uso regular, que indicam a adoção de um estilo de vida mais saudável ou ainda uma maior autonomia e capacidade de decisão para o não consumo, sabe-se que não existe nível seguro de exposição ao tabaco. Sugere-se o estabelecimento de parceria intersetorial educação-saúde para fortalecer ações de promoção da saúde e prevenção de doenças, com ênfase no tabagismo.
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Silva EKPD, Santos PRD, Chequer TPR, Melo CMDA, Santana KC, Amorim MM, Medeiros DSD. Oral health of quilombola and non-quilombola rural adolescents: a study of hygiene habits and associated factors. CIENCIA & SAUDE COLETIVA 2019; 23:2963-2978. [PMID: 30281734 DOI: 10.1590/1413-81232018239.02532018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 04/22/2018] [Indexed: 11/22/2022] Open
Abstract
This study evaluated oral hygiene habits and their association with sociocultural, environmental factors and factors related to the use of dental services among Quilombola and non-Quilombola rural adolescents from inland Bahia. Thiswas a cross-sectional study conducted in 2015. Prevalence and prevalence ratios were estimated for the outcomes and multiple Poisson regression analysis with robust variance was performed. We interviewed 390 adolescents, of which 42.8% were Quilombola. Poor tooth brushing and non-flossing were found in 33.3% and 46.7% of adolescents, respectively. Poor tooth brushing was increased by male gender (PR = 1.45), not living with both parents (PR = 1.45), lower hand hygiene habit (PR = 1.72) and worse oral health self-assessment (PR = 1.38). Non-flossing was associated with economic level E (PR = 1.54), older age (PR = 0.91), lower hand hygiene habit (PR = 1.53) and worse oral health self-assessment (PR = 1.33). Different associated factors were observed between Quilombola and non-Quilombola. It is necessary to consider the specificities of the populations for the promotion of adolescent oral health and the importance of the intersectoriality between education and health and care to families.
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Affiliation(s)
- Etna Kaliane Pereira da Silva
- Instituto Multidisciplinar em Saúde , Universidade Federal da Bahia . R. Hormindo Barros 58/quadra 17/lote 58, Candeias. 45029-094 Vitória da Conquista BA Brasil .
| | - Patrícia Reis Dos Santos
- Instituto Multidisciplinar em Saúde , Universidade Federal da Bahia . R. Hormindo Barros 58/quadra 17/lote 58, Candeias. 45029-094 Vitória da Conquista BA Brasil .
| | - Tatiana Praxedes Rodrigues Chequer
- Instituto Multidisciplinar em Saúde , Universidade Federal da Bahia . R. Hormindo Barros 58/quadra 17/lote 58, Candeias. 45029-094 Vitória da Conquista BA Brasil .
| | | | - Katiuscy Carneiro Santana
- Secretaria Municipal de Saúde , Prefeitura Municipal de Vitória da Conquista . Vitória da Conquista , BA , Brasil
| | - Maise Mendonça Amorim
- Instituto Multidisciplinar em Saúde , Universidade Federal da Bahia . R. Hormindo Barros 58/quadra 17/lote 58, Candeias. 45029-094 Vitória da Conquista BA Brasil .
| | - Danielle Souto de Medeiros
- Instituto Multidisciplinar em Saúde , Universidade Federal da Bahia . R. Hormindo Barros 58/quadra 17/lote 58, Candeias. 45029-094 Vitória da Conquista BA Brasil .
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Alves JFDS, Martins MAC, Borges FT, Silveira C, Muraro AP. Use of health services by Haitian immigrants in Cuiabá-Mato Grosso, Brazil. CIENCIA & SAUDE COLETIVA 2018; 24:4677-4686. [PMID: 31778517 DOI: 10.1590/1413-812320182412.32242017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 05/07/2018] [Indexed: 11/22/2022] Open
Abstract
This paper aims to analyze the use of health services by Haitian immigrants in Cuiabá, Mato Grosso. This is a cross-sectional study with a random sample of 452 Haitian immigrants in Cuiabá and Várzea Grande, interviewed between December 2014 and February 2015. Sociodemographic and health characteristics, lifestyle factors, and the use of health services were evaluated. Data analysis included Chi-square test and Poisson regression to investigate the factors associated with the use of health services. We found that 45.6% of respondents used some health service in Brazil, with a higher prevalence of use among women, those with higher income, longer residence time in Brazil, better understanding of the Portuguese language, and with poor self-reported health. The PHC Unit (UBS) and public urgent and emergency care were the primary services used. We conclude by saying that the SUS assisted the immigrants under the Brazilian constitutional principle of the right to health.
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Affiliation(s)
- Jenniffer Francielli de Sousa Alves
- Instituto de Saúde Coletiva, Universidade Federal de Mato Grosso. Av. Fernando Corrêa da Costa 2367, Boa Esperança. 78060-900 Cuiabá MT Brasil.
| | - Maria Angela Conceição Martins
- Instituto de Saúde Coletiva, Universidade Federal de Mato Grosso. Av. Fernando Corrêa da Costa 2367, Boa Esperança. 78060-900 Cuiabá MT Brasil.
| | | | - Cássio Silveira
- Faculdade de Ciências Médicas da Santa Casa de São Paulo. São Paulo SP Brasil
| | - Ana Paula Muraro
- Instituto de Saúde Coletiva, Universidade Federal de Mato Grosso. Av. Fernando Corrêa da Costa 2367, Boa Esperança. 78060-900 Cuiabá MT Brasil.
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Bezerra VM, Andrade ACDS, Medeiros DSD, Caiaffa WT. [Arterial prehypertension in slave-descendant communities in southeast Bahia State, Brazil]. CAD SAUDE PUBLICA 2017; 33:e00139516. [PMID: 29091177 DOI: 10.1590/0102-311x00139516] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 01/06/2017] [Indexed: 11/22/2022] Open
Abstract
Arterial prehypertension is a precursor of arterial hypertension and a risk factor for cardiovascular diseases. Vulnerable populations are more prone to this condition due to difficulties in access to health services. A previous study in quilombola communities (descendants of African slaves) reported a high prevalence of arterial hypertension. The current study aimed to estimate the prevalence of arterial prehypertension in quilombolas and to assess associated factors. This was a cross-sectional population-based study in individuals 18 years and older. Prehypertension was defined as arterial systolic pressure ≥ 121mmHg and < 140mmHg and/or diastolic ≥ 81mmHg and < 90mmHg. Multivariate Poisson regression with robust variance was used. Population-attributable fractions (PAF) were also calculated for the modifiable associated factors. Prevalence of prehypertension was 55% (95%CI: 50.2-59.7). Male gender (PR = 1.54), 1 to 4 complete years of schooling (PR = 1.44), and BMI classified as overweight (PR = 1.39) and obesity (PR = 1.87) showed positive association with prehypertension. Higher attributable fractions were observed in individuals with 1 to 4 years of schooling (13.7%) and those classified as overweight (9.35%) and obese (4.6%). Prevalence of prehypertension in quilombola communities was high, and its identification may allow screening and awareness-raising in a group with increased risk of cardiovascular disease and progression to full-blown hypertension. The study highlights the need for broad access to health services and specific measures for orientation, prevention, and health promotion in this population.
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Affiliation(s)
- Vanessa Moraes Bezerra
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista, Brasil.,Departamento de Medicina Preventiva e Social, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
| | | | | | - Waleska Teixeira Caiaffa
- Departamento de Medicina Preventiva e Social, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
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Oliveira SKM, Pereira MM, Guimarães LS, Caldeira AP. Self-perceived health among 'quilombolas' in northern Minas Gerais, Brazil. CIENCIA & SAUDE COLETIVA 2017; 20:2879-90. [PMID: 26331519 DOI: 10.1590/1413-81232015209.20342014] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Over a century has passed since slavery was abolished in Brazil, yet quilombola communities remain socially vulnerable, especially when it comes to health. The goal of this study was to understand self-perceived health (SPH) in quilombola communities in Northern Minas Gerais, and the factors associated with their negative -perceived their own health. A household survey of a representative sample of quilombola communities in the study region. Validated tools were used to gather data about SPH, socioeconomic conditions, demographics, lifestyle and self-referred morbidity. Following a bivariate analysis, we proceeded to conduct a hierarchical logistics regression analysis. The prevalence of negative SPH was 46.0%. The following variables were statistically associated with negative SPH: age and years of schooling as distal variables, and high blood pressure, diabetes, arthritis, depression and back problems as proximal variables. SPH is associated with demographic and socioeconomic dimensions, and in particular with self-referred morbidity. The concept of health among the quilombola communities included in this study seems to be intimately linked to the absence of disease, especially chronic disease.
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Bidinotto AB, D'Ávila OP, Martins AB, Hugo FN, Neutzling MB, Bairros FDS, Hilgert JB. Oral health self-perception in quilombola communities in Rio Grande do Sul: a cross-sectional exploratory study. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2017; 20:91-101. [PMID: 28513797 DOI: 10.1590/1980-5497201700010008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 09/08/2016] [Indexed: 11/22/2022] Open
Abstract
Objective: There's a shortage of evidence on the oral health of quilombolas. This study aims to describe oral health self-perception, as well as to verify its associated factors in quilombola communities in the state of Rio Grande do Sul. Methods: The data for this cross-sectional health survey were collected by application of a questionnaire. Since this study was part of a survey on nutritional security, the probabilistic cluster sample was estimated for the outcome of nutritional insecurity, comprising 583 individuals across quilombola communities in Rio Grande do Sul. The association between the outcome of negative oral health self-perception and sociodemographic, general health, and oral health variables was measured by prevalence ratios obtained through Poisson regressions with robust variance and 95% confidence intervals. Results: Negative self-rated oral health was reported by 313 (53.1%) of the individuals. Satisfaction with chewing ability and satisfaction with oral appearance were associated with a higher prevalence of negative perception of oral health, while there was no association between the outcome and number of teeth. Use of alcohol had a borderline association with the outcome. Conclusion: Satisfaction with appearance and chewing ability are factors associated with oral-health self-perception of the quilombolas in Rio Grande do Sul.
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Affiliation(s)
- Augusto Bacelo Bidinotto
- Programa de Pós-graduação em Epidemiologia da Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brasil
| | - Otávio Pereira D'Ávila
- Programa de Pós-graduação em Odontologia da Universidade Federal de Rio Grande do Sul - Porto Alegre (RS), Brasil
| | - Aline Blaya Martins
- Departamento de Odontologia Preventiva e Social, Faculdade de Odontologia da Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brasil
| | - Fernando Neves Hugo
- Centro de Pesquisa em Odontologia Social da Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brasil
| | - Marilda Borges Neutzling
- Programa de Pós-graduação em Epidemiologia da Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brasil
| | - Fernanda de Souza Bairros
- Programa de Pós-graduação em Epidemiologia da Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brasil
| | - Juliana Balbinot Hilgert
- Programa de Pós-graduação em Epidemiologia da Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brasil
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Bezerra VM, Andrade ACDS, César CC, Caiaffa WT. [Unawareness of hypertension and its determinants among 'quilombolas' (inhabitants of 'quilombos' - hinterland settlements founded by people of African origin) living in Southwest Bahia, Brazil]. CIENCIA & SAUDE COLETIVA 2017; 20:797-807. [PMID: 25760120 DOI: 10.1590/1413-81232015203.14342014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Accepted: 09/29/2014] [Indexed: 11/21/2022] Open
Abstract
This study sought to evaluate the prevalence of unawareness of arterial hypertension (AH) and associated factors among the quilombola population and to describe aspects of the non-pharmacological management of AH. It involved a cross-sectional study with a sample of 358 people with AH aged 18 years or more. AH was considered systolic blood pressure (BP) ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg and/or reported use of antihypertensive drugs. Unawareness of AH was classified as persons answering negatively when asked if they suffered from AH. Poisson regression was then used. The prevalence of unawareness of AH was 44.1% (95% CI: 38.9-49.3). Among those who already knew the diagnosis and had drug treatment only 24.8% had controlled BP. The unawareness of AH was positively associated with the male sex and Stage 1 of AH and negatively with increasing age, overweight, negative self-perception of health and medical visits. For non-pharmacological management, low percentages of quilombola reported appropriate standard recommendations of care. Arterial hypertension is a serious public health issue among the quilombola population, revealing great vulnerability in health due to poor levels of awareness, treatment and control.
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Affiliation(s)
- Vanessa Moraes Bezerra
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista, Bahia, Brasil,
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Household food insecurity in black-slaves descendant communities in Brazil: has the legacy of slavery truly ended? Public Health Nutr 2016; 20:1513-1522. [PMID: 27995820 DOI: 10.1017/s1368980016003414] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To identify the factors associated with food insecurity among Quilombolas communities in Brazil. DESIGN An analysis of secondary data assessed in the 2011 Quilombolas Census was performed. The Brazilian Food Insecurity Measurement Scale (Escala Brasileira de Insegurança Alimentar, EBIA) was used to assess household food security status. Sociodemographic conditions and access to social programmes and benefits were also evaluated. SETTING National survey census from recognized Quilombolas Brazilian territories. SUBJECTS Quilombolas households (n 8846). RESULTS About half (47·8 %) of the Quilombolas lived in severely food-insecure households, with the North and Northeast regions facing the most critical situation. Households located in North Brazil, whose head of the family had less than 4 years of education, with a monthly per capita income below $US 44, without adequate sanitation and without adequate water supply had the greatest chance of experiencing moderate or severe food insecurity. Households that had access to a water supply programme for dry regions (Programa Cisternas) and an agricultural harvest subsidy programme (Programa Garantia Safra) had less chance of experiencing moderate and severe food insecurity. Households that did not have access to health care (Programa Saúde da Família) had greater chance of suffering from moderate or severe food insecurity. CONCLUSIONS Interventions are urgently needed to strengthen and promote public policies aimed to improve living conditions and food security in Quilombolas communities.
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Silva HP, Padez C, Moura EAF, Filgueiras LA. Obesity, hypertension, social determinants of health and the epidemiologic transition among traditional Amazonian populations. Ann Hum Biol 2016; 43:371-81. [DOI: 10.1080/03014460.2016.1197967] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Hilton P. Silva
- Programa de Pós-Graduação em Antropologia & Programa de Pós-Graduação em Saúde, Ambiente e Sociedade na Amazônia, Laboratório de Estudos Bioantropológicos em Saúde e Meio Ambiente, Instituto de Filosofia e Ciências Humanas, Universidade Federal do Pará, Belém, PA, Brazil
| | - Cristina Padez
- Department of Life Sciences, Research Centre for Anthropology and Health, University of Coimbra, Portugal
| | - Edila A. F. Moura
- Programa de Pós-Graduação em Sociologia e Antropologia, Instituto de Filosofia e Ciências Humanas, Universidade Federal do Pará & Instituto de Desenvolvimento Sustentável Mamirauá, Belém, PA, Brazil
| | - Lígia A. Filgueiras
- Programa de Pós-Graduação em Antropologia & Programa de Pós-Graduação em Saúde, Ambiente e Sociedade na Amazônia, Laboratório de Estudos Bioantropológicos em Saúde e Meio Ambiente, Instituto de Filosofia e Ciências Humanas, Universidade Federal do Pará, Belém, PA, Brazil
- Universidade do Estado do Pará-Departamento de Ciências Naturais, Centro de Ciências Sociais e de Educação, Belém, PA, Brazil
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Santos VC, Boery EN, Pereira R, Rosa DDOS, Vilela ABA, Anjos KFD, Boery RNSDO. SOCIOECONOMIC AND HEALTH CONDITIONS ASSOCIATED WITH QUALITY OF LIFE OF ELDERLY QUILOMBOLAS. TEXTO & CONTEXTO ENFERMAGEM 2016. [DOI: 10.1590/0104-07072016001300015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT This study aimed to identify the socioeconomic and health conditions associated with quality of life of elderly quilombolas. Cross-sectional, epidemiological and census study, conducted with 427 elderly individuals of a quilombola population enrolled in Family Health Strategies of 17 quilombas communities in Vitória da Conquista, Bahia, four districts of the region. Data collection was performed using tools and analyzed based on descriptive statistics and Spearman correlation (rsp). The factors associated with some areas of Quality of Life and the General Quality of Life Index included the per capita income, the self-assessment of health status and the classification of depression cases, which most strongly affected the quality of life of the elderly quilombolas investigated. The expanded access to health services and the integrality of health care for this group are essential, particularly involving Family Health Teams.
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Barroso SM, Melo AP, Guimarães MDC. Factors associated with depression: sex differences between residents of Quilombo communities. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2015; 18:503-14. [DOI: 10.1590/1980-5497201500020017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Accepted: 09/30/2014] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION: The Quilombola population is subject to numerous sources of social vulnerability, but few studies investigate their physical or mental health conditions. OBJECTIVES: To investigate the factors associated with depression in men and women, separately. METHODOLOGY: Cross-sectional population-based study with 764 randomly selected participants from five quilombo communities in Vitória da Conquista, Bahia, Brazil. The cutoff point for depression was ≥ 10 points, assessed by the Patient Health Questionnaire score (PHQ-9), and the presence of five or more symptoms. We estimated the prevalence ratio with 95% confidence intervals using Poisson regression models with robust estimators stratified by gender. RESULTS: Among men, factors associated with depression were previous diagnosis of chronic illnesses, poor/very poor health self-assessment, and poor access to health services. Among women, the associated factors were previous diagnosis of psychiatric disorders, poor/very poor health self-perception, history of tobacco smoking, and self-declaration of race as not black. CONCLUSION: Factors associated with depression differ between men and women and must be considered in interventions to fight depression within this population.
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Kochergin CN, Proietti FA, César CC. [Slave-descendent communities in Vitória da Conquista, Bahia State, Brazil: self-rated health and associated factors]. CAD SAUDE PUBLICA 2015; 30:1487-501. [PMID: 25166945 DOI: 10.1590/0102-311x00141213] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Accepted: 01/14/2014] [Indexed: 11/22/2022] Open
Abstract
This study aimed to analyze the prevalence of negative self-rated health and associated factors in the quilombola community (descendants of escaped slaves) in Vitória da Conquista, Bahia State, Brazil. A household survey was conducted with 797 adults in 2011. Data on self-rated health, socioeconomic and demographic characteristics, lifestyle, social support, health status, and access to health services were obtained through questionnaires. Multivariate logistic regression analysis was performed, adjusted for sex and age. Prevalence of negative self-rated health was 12.5%. After statistical modeling, the following variables remained associated with self-rated health: skin color, schooling, adequate consumption of fruits and vegetables, chronic illness, physical limitations, and at least one medical visit in the previous 12 months. Self-rated health was associated with socioeconomic/demographic dimensions, lifestyle, social support, and health status.
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Abstract
O presente texto é um relato de experiência sobre a Telessaúde como estratégia de apoio assistencial, fortalecendo a integração entre os serviços de saúde, ampliando a resolutividade e estabelecendo uma relação custo-efetividade dos processos de saúde pública, além de qualificar Equipes de Saúde da Família através da educação permanente. A Bahia destaca-se por possuir um projeto único no cenário nacional com o objetivo de nortear os projetos intermunicipais, além de mobilizar gestores municipais e profissionais da Atenção Básica, através de treinamento realizado em todas as regiões de saúde. O resultado é ampliação das ações profissionais e acesso a especialidades nos locais mais remotos.
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Martins LCG, Lopes MVDO, Guedes NG, Teixeira IX, Souza VECD, Montoril MH. Nursing diagnosis sedentary lifestyle in individuals with hypertension: an analysis of accuracy. Rev Esc Enferm USP 2014; 48:804-10. [DOI: 10.1590/s0080-6234201400005000005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Accepted: 07/28/2014] [Indexed: 11/22/2022] Open
Abstract
Objective Assessing the accuracy of the defining characteristics (DC) of the nursing diagnosis Sedentary Lifestyle (SL) in people with hypertension. Method A cross-sectional study carried out in a referral center in the outpatient care of people with hypertension and diabetes, with a sample of 285 individuals. The form used in the study was designed from operational definitions constructed for each DC of the diagnosis. Four nurses with training to carry out diagnostic inferences did the clinical assessment for the presence of SL. Results The prevalence of SL was 55.8%. Regarding measures of accuracy, the main DC for SL was chooses a daily routine lacking physical exercise, with sensitivity of 100% and specificity of 84.13%. Two DC stood out in the logistic regression, namely: reports preference for activities low in physical activity and poor performance in instrumental activities of daily living (IADL). Conclusion The results allowed identifying the best clinical indicators for SL in hypertensive adults.
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