Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-08-22T22:37:22Z No. of bitstreams: 1 MarquionyMarquesDosSantos_DISSERT.pdf: 515406 bytes, checksum: 721e10a5f51bb581301f352d6f424312 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-08-22T22:56:01Z (GMT) No. of bitstreams: 1 MarquionyMarquesDosSantos_DISSERT.pdf: 515406 bytes, checksum: 721e10a5f51bb581301f352d6f424312 (MD5) / Made available in DSpace on 2016-08-22T22:56:01Z (GMT). No. of bitstreams: 1 MarquionyMarquesDosSantos_DISSERT.pdf: 515406 bytes, checksum: 721e10a5f51bb581301f352d6f424312 (MD5) Previous issue date: 2015-02-27 / O perfil epidemiol?gico dos indiv?duos que desenvolvem aids no Brasil mudou no decorrer do tempo. Dentre estas modifica??es, um dado preocupante ? o aumento da incid?ncia de aids em idosos em todo pa?s. Mas, no entanto, ainda n?o est? claro se o aumento dos casos de aids ? suficiente para produzir uma mudan?a nas medidas de tend?ncia nos ?ltimos anos nos estados brasileiros, e se esse aumento possui um efeito a partir dos indicadores socioecon?mico-demogr?ficos. Neste sentido, o objetivo do presente estudo ? analisar as taxas de incid?ncia de aids em idosos no Brasil e o seu efeito nas desigualdades socioecon?mico-demogr?ficas, no per?odo de 2000 a 2012. Trata-se de um estudo ecol?gico de s?ries temporais para conhecer o comportamento da s?rie hist?rica das taxas de incid?ncia de aids em idosos no per?odo de 2000 a 2012. As taxas foram calculadas utilizando os dados secund?rios do Sistema de Informa??o de Agravos de Notifica??o e do Instituto Brasileiro de Geografia e Estat?stica. Os dados foram submetidos a tratamento estat?stico para conhecer as tend?ncias das taxas de incid?ncia, atrav?s do modelo de regress?o polinomial e do modelo de regress?o log-linear joinpoint, como tamb?m, a an?lise de regress?o linear simples para conhecer a rela??o das tend?ncias com as vari?veis socioecon?mico-demogr?ficas. Foram utilizados os programas SPSS 20.0? e Joinpoint 4.1.1. Todos os testes foram realizados considerando uma signific?ncia estat?stica de 5%. Ap?s a an?lise, no Brasil foram notificados 62.052 casos novos de aids em idosos no per?odo de 2000 a 2012. Neste per?odo, foi encontrado um crescimento significativo para o sexo masculino, tanto na faixa et?ria de 50 a 59 anos (APPC: 3,46%; p<0,001), como acima de 59 anos de (AAPC: 4,38%; p<0,001). Para o sexo feminino, o crescimento foi significativo e possui os maiores incrementos da s?rie hist?rica, quando comparado ao sexo masculino, nas duas faixas et?rias, (AAPC: 4,62%; p<0,001 e AAPC: 6,53%; p<0,001) respectivamente. Os maiores incrementos s?o observados em mulheres e nos estados das Regi?es Norte e Nordeste. Nos estados da Regi?o Sudeste observa-se estabiliza??o das taxas em toda s?rie hist?rica. As tend?ncias da raz?o entre os sexos tiveram uma redu??o significativa, como tamb?m, uma aproxima??o nas duas faixas et?rias do estudo, chegando a uma propor??o de 1,7 homens para cada mulher na faixa et?ria mais jovem. As tend?ncias estiveram relacionadas com as taxas de analfabetismo, com o aumento da desigualdade social e com o menor desenvolvimento humano nos estados brasileiros. Conclui-se que no Brasil a incid?ncia de aids em idosos segue uma tend?ncia de aumento em indiv?duos maiores de 50 anos. Destacam-se os maiores ?ndices do estudo em mulheres e nos estados das Regi?es Norte e Nordeste. Nesse sentido, o pa?s precisa aprimorar as pol?ticas voltadas aos idosos com DST/aids, capacitando profissionais de sa?de e desenvolvendo medidas eficazes para a preven??o e diagn?stico precoce das pessoas contaminadas, principalmente em locais com recursos limitados e com alta desigualdade social. Em longo prazo, cabe desenvolver novos estudos para compreender se as medidas tomadas foram eficazes para reduzir as tend?ncias apontadas neste estudo. / The characteristics profile of individuals who develop AIDS in Brazil has changed over time. Among these modifications, a worrying finding is the increased incidence of AIDS in the elderly across the country. But, however, is not yet clear whether the increase in AIDS cases is sufficient to produce a change in the trend of measures in recent years in the Brazilian states, and this increase has an effect from the socioeconomic and demographic indicators. In this sense, the objective of this study is to analyze the AIDS incidence rates among the elderly in Brazil and its effect on socioeconomic and demographic inequalities in the period 2000 to 2012. This is an ecological time-series study to meet behavior of the time series of the incidence rates of AIDS in the elderly from 2000 to 2012. the rates were calculated using the secondary data from Diseases Information System Notification and the Brazilian Institute of Geography and Statistics. Data were analyzed statistically to know the trends in incidence rates, by polynomial regression model and joinpoint log-linear regression model, but also the simple linear regression analysis to find the relationship of trends with variables socioeconomic and demographic. SPSS 20.0? and Joinpoint 4.1.1 programs were used. All tests were carried out considering a significance of 5%. After the analysis, in Brazil were reported 62,052 new cases of AIDS in the elderly from 2000 to 2012. During this period, a significant increase was found for males, both aged 50-59 years (APPC: 3.46 %, p <0.001), such as above 59 years (AAPC: 4.38%; p <0.001). For females, the increase was significant and has the largest increments in the time series, when compared to males in both age groups (AAPC: 4.62%, p <0.001 and AAPC: 6.53%; p <0.001) respectively. The largest increases are observed in women and in the states of North and Northeast. In the Southeast Region is observed stabilization of rates throughout the series. The reason of trends between the sexes had a significant reduction, but also an approach in both age groups of the study, reaching a ratio of 1.7 males for every female in the youngest age group. The trends were related to illiteracy rates, with increasing social inequality and the lowest human development in the Brazilian states. We conclude that in Brazil the incidence of AIDS in the elderly follows an increasing trend in individuals over 50 years. Noteworthy are the highest rates of study in women and in the states of North and Northeast. In this sense, the country needs to enhance policies towards older people with STD / AIDS, training health professionals and developing effective measures for the prevention and early diagnosis of infected people, especially in places with limited resources and high social inequality. In the long term, it is developing new studies to understand whether the measures taken were effective in reducing the trends identified in this study.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2018-02-15T13:14:25Z No. of bitstreams: 1 EmelynneGabriellyDeOliveiraSantos_DISSERT.pdf: 2125823 bytes, checksum: 19956fefd9994017e8d234c8b0e20e9b (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2018-02-20T00:29:32Z (GMT) No. of bitstreams: 1 EmelynneGabriellyDeOliveiraSantos_DISSERT.pdf: 2125823 bytes, checksum: 19956fefd9994017e8d234c8b0e20e9b (MD5) / Made available in DSpace on 2018-02-20T00:29:32Z (GMT). No. of bitstreams: 1 EmelynneGabriellyDeOliveiraSantos_DISSERT.pdf: 2125823 bytes, checksum: 19956fefd9994017e8d234c8b0e20e9b (MD5) Previous issue date: 2017-12-04 / O suic?dio constitui um dos tipos de mortes violentas mais incidentes no mundo e, apesar da difus?o de programas de preven??o desse agravo no Brasil, o panorama de mortalidade por essa causa no pa?s ? preocupante, principalmente em algumas regi?es em que se observa uma eleva??o no percentual de ?bitos. O objetivo deste estudo foi analisar a distribui??o espa?o-temporal da mortalidade por suic?dio no estado do Rio Grande do Norte no per?odo de 2000 a 2015. Trata-se de um estudo ecol?gico misto que avaliou os ?bitos decorrentes de suic?dio registrados no Rio Grande do Norte, ocorridos no per?odo de 1? de janeiro de 2000 a 31 de dezembro de 2015. Os dados dos ?bitos foram obtidos no Sistema de Informa??o sobre Mortalidade, e as informa??es sobre popula??o foram obtidas do Instituto Brasileiro de Geografia e Estat?stica. A an?lise espacial foi realizada utilizando as taxas brutas, taxas padronizadas e taxas pelos estimadores Bayesianos. A an?lise univariada foi realizada atrav?s do ?ndice de Moran Global e Local para avaliar a intensidade e signific?ncia dos aglomerados espaciais utilizando o software Terraview 4.2. A an?lise bivariada espacial foi realizada pelo cruzamento entre as vari?veis sociodemogr?ficas e as taxas de mortalidade padronizadas por suic?dio utilizando o software GeoDa 1.6.1. Os Anos Potenciais de Vida Perdidos tamb?m foram calculados ao longo da s?rie hist?rica. Foi aplicada a Regress?o loglineal (Joinpoint regression) com taxas padronizadas (popula??o mundial) para estimar o Annual Percentage Change, o intervalo de confian?a 95% e os pontos de inflex?o da curva, a fim de verificar a tend?ncia de mortalidade por suic?dio no Rio Grande do Norte utilizando o software Joinpoint 4.5.0. A an?lise estat?stica cl?ssica foi aplicada para avaliar a correla??o entre as vari?veis do estudo e para isso utilizou-se o software SPSS 23.0. Foram registrados 2.266 ?bitos por suic?dio de 2000 a 2015, sendo a raz?o entre os sexos de 5:1 no ?ltimo ano. A an?lise espacial mostrou fraca autocorrela??o espacial para as Taxas de Mortalidade Padronizadas para ambos os sexos, com forma??o de aglomerados espaciais na Regi?o do Serid?, principalmente, para o sexo masculino. A an?lise bivariada mostrou forma??o de clusters na Regi?o do Serid? com as vari?veis IDH e Envelhecimento. Os estimadores bayesianos mostraram uma homogeneiza??o das taxas de mortalidade, sobretudo nos munic?pios com pequenos grupos populacionais. Foram perdidos 63582.5 anos potenciais de vida ao longo da s?rie hist?rica. Al?m disso, foi observada uma tend?ncia de aumento da mortalidade no sexo masculino at? o ano de 2003, seguido de um per?odo de estabilidade. Para o sexo feminino, a tend?ncia foi de estabilidade. A an?lise de vari?ncia apontou ainda para aus?ncia de diferen?as estatisticamente significativa entre as TMP e o porte dos munic?pios e regi?es de sa?de para a maioria dos anos do estudo. Conclui-se que a mortalidade por suic?dio no RN est? desigualmente distribu?da no territ?rio, estando associando espacialmente ?s ?reas com os melhores indicadores socioecon?micos. N?o h? tend?ncia significativa de aumento, por?m as diferen?as entre as regi?es do estado e de acordo com o porte dos munic?pios aumentaram ao longo da s?rie hist?rica. / Suicide is one of the most pervasive types of violent deaths in the world, and despite the diffusion of programs to prevent this condition in Brazil, the mortality situation in this country is worrying, especially in some regions where there is an increase in percentage of deaths. The objective of this study was to analyze the spatio-temporal distribution of mortality by suicide in the State of Rio Grande do Norte from 2000 to 2015. This is a mixed ecological study that evaluated the suicide deaths recorded in Rio Grande do Norte , occurring in the period from January 1, 2000 to December 31, 2015. Death data were obtained from the Mortality Information System, and population information was obtained from the Brazilian Institute of Geography and Statistics. Spatial analysis was performed using crude rates, standardized rates and rates by Bayesian estimators. The univariate analysis was performed using the Moran Global and Local Index to evaluate the intensity and significance of the spatial clusters using the Terraview 4.2 software. The spatial bivariate analysis was performed by crossing the sociodemographic variables with mortality rates standardized by suicide using GeoDa software 1.6.1. The Potential Years of Lost Life were also calculated throughout the historical series. The regression regression with standardized rates (world population) was used to estimate the Annual Percentage Change, the 95% confidence interval and the inflection points of the curve, in order to verify the suicide mortality trend in Rio Grande using the Joinpoint 4.5.0 software. The classical statistical analysis was applied to evaluate the correlation between the variables of the study and for that the software SPSS 23.0 was used. There were 2,266 deaths from suicide from 2000 to 2015, with the ratio between the sexes being 5: 1 in the last year. Spatial analysis showed poor spatial autocorrelation for the Standardized Mortality Rates for both sexes, with formation of spatial clusters in the Serid? Region, mainly for males. The bivariate analysis showed the formation of clusters in the Serid? Region with the HDI and Aging variables. Bayesian estimators showed a homogenization of mortality rates, especially in municipalities with small population groups. 6,3582.5 potential years of life were lost throughout the historical series. In addition, there was a trend of increased male mortality up to 2003, followed by a period of stability. For females, the trend was for stability. The analysis of variance also pointed to the absence of statistically significant differences between PMT and the size of municipalities and health regions for most of the study years. It is concluded that the mortality due to suicide in the NB is unequally distributed in the territory, being associated spatially to the areas with the best socioeconomic indicators. There is no significant trend of increase, however the differences between the regions of the state and according to the size of the municipalities increased during the historical series.