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Fatores sociais e ambientais associados ? ocorr?ncia da esquistossomose no munic?pio de Serro, Minas GeraisSiste, Carlos Eduardo 09 March 2016 (has links)
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Previous issue date: 2016 / A esquistossomose mansoni ? uma doen?a tropical negligenciada afetando anualmente
milh?es de pessoas em todo mundo. ? provocada pelo parasito Schistosoma mansoni que,
al?m do hospedeiro definitivo, depende do ambiente aqu?tico e de caramujos do g?nero
Biomphalaria como hospedeiro intermedi?rio para completar seu ciclo biol?gico. De uma
forma geral, sua ocorr?ncia est? associada a grupos sociais vulner?veis vivendo em ?reas
deficit?rias em servi?os de saneamento ambiental e a padr?es de comportamento da
popula??o. Al?m disso, altera??es promovidas no ambiente por atividades humanas em
diferentes contextos, sobretudo aquelas que afetam diretamente as cole??es h?dricas podem
favorecer a instala??o ou manuten??o de focos da doen?a. Desta forma, o presente estudo
objetivou analisar os fatores ambientais e sociais associados ? din?mica de ocorr?ncia da
esquistossomose no munic?pio de Serro, estado de Minas Gerais. Para tanto, conduziu-se
estudo epidemiol?gico, de car?ter descritivo e quantitativo dos casos de esquistossomose
ocorridos no per?odo 2010-2014, a partir de dados levantados junto ao Programa de Controle
da Esquistossomose de Serro e de entrevistas com a popula??o. Foram identificados 352 casos
diagnosticados no per?odo considerado, dentre os quais 104 participaram das entrevistas. Da
popula??o total afetada, observou-se ser esta predominantemente masculina (62,78%), em
idade economicamente ativa de 15-59 anos (80,1%), com ensino fundamental incompleto
(52,8%) e residindo na ?rea rural (81,5%). Dentre os entrevistados, a maioria era natural do
pr?prio munic?pio (84,7%), morando na atual resid?ncia h? mais de 20 anos (70%) na qual
convivem de 3-6 pessoas (65,4%). A principal forma de ocupa??o s?o as atividades
agropecu?rias (48,1%), com a maioria mantendo h?bito regular de fazer exames e consultas
m?dicas (62,5%). A maior parte faz uso de ?gua proveniente de nascentes (56,7%) e
consideram a ?gua consumida nas casas de boa qualidade (86,5%). A maioria das moradias
possui banheiro com vaso sanit?rio (79,8%) destinando o esgoto para fossas secas no quintal
ou rede de esgoto da rua (73,1%). ? expressivo o n?mero daqueles que declararam frequentar
semanal (90,4%) ou quinzenalmente (79,7%) rios, ribeir?es e c?rregos (74,5%), cachoeiras
(13,8%) e a?udes (9,6%) na regi?o, na maioria das vezes mantendo contato com as ?guas para
pescar (55,3%), nadar (56,6%) e fazer travessia de caminho (41,5%). A maioria dos
entrevistados declarou ter alguma informa??o sobre a doen?a antes de ser diagnosticado
infectado (81,7%) e 62,5% n?o retornaram aos servi?os de sa?de para realizar o exame ap?s
tratamento medicamentoso. A distribui??o da esquistossomose no munic?pio de Serro esteve
significativamente agregada na por??o leste do munic?pio, em ?reas com menor varia??o na
eleva??o e declividade, maiores ?ndice de vegeta??o e umidade, associada a ?reas com maior
propor??o de domic?lios cujo esgotamento sanit?rio ocorria diretamente em cursos d??gua.
Observou-se, ainda, que o maior n?mero de casos da doen?a ocorreu em localidades drenadas
por rios da bacia hidrogr?fica do Rio Doce. Diante das particularidades apresentadas na
extens?o do munic?pio, principalmente em rela??o ? espacializa??o da doen?a entre as duas
grandes bacias hidrogr?ficas do munic?pio (Jequitinhonha e Rio Doce), as informa??es
apresentadas podem contribuir para o direcionamento das a??es de controle na escala
municipal, seja por meio de estrutura??o sanit?ria e ambiental, ou por meio de orienta??es
quanto ao comportamento e exposi??o ?s cole??es h?dricas eventualmente contaminadas por
parte da popula??o. / Disserta??o (Mestrado Profissional) ? Programa de P?s-Gradua??o em Sa?de, Sociedade e Ambiente, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 2016. / Schistosomiasis is an neglected tropical disease that affects annually millions of people
worldwide. It is caused by Schistosoma mansoni worm that besides the definitive host,
depends on the aquatic environment and on the Biomphalaria snails as an intermediate host to
complete its life cycle. In general, its occurrence is associated with vulnerable groups living in
areas where the environmental sanitation services are deficient and also associated to the
population behavior patterns. In addition, changes introduced into the environment by human
activities in different contexts, especially those that directly affect the water sources may
promote the installation or maintenance of the disease outbreaks. Thus, this study aimed to
analyze the environmental and social factors associated with the dynamics of Schistosomiasis
occurrence in the city of Serro, Minas Gerais. For this it was conducted an epidemiological
study, descriptive and quantitative of the Schistosomiasis cases occurred in the period 2010-
2014, from the data collected by the Schistosomiasis Control Program of Serro and interviews
with the population. It was identified 352 diagnosed cases in the considered period, among
which 104 participated in the interviews. Considering the total affected population, it was
observed the predominance of men (62.78%), in work age of 15-59 years old (80.1%), with
incomplete primary education (52.8%) and living in rural areas (81.5%). Among the
respondents, most were natural of the municipality (84.7%), living at the current residence for
more than 20 years (70%) living together with 3-6 people (65.4%). The main form of
occupation is agricultural activities (48.1%), and most of them maintain regular habits of
doing exams and having medical appointments (62.5%). Most of the respondents makes use
of water coming from springs (56.7%) and consider the water consumed in their houses of
good quality (86.5%). Most of the houses have bathroom with toilet (79.8%) intended for dry
sewage tanks in the yard or street sewer network (73.1%). It is significant the number of
those who reported that go to weekly (90.4%)or once every two weeks (79.7%) rivers, brooks
and streams (74.5%), waterfalls (13.8%) and dams (9.6%) in the region, most of the time
having contact with the water to fish (55.3%), to swimming (56.6%) and to crossing the path
(41.5%). Most respondents claimed to have some information about the disease before being
diagnosed infected (81.7%) and 62.5% did not return to health services for the exam after
drug treatment. The distribution of Schistosomiasis in Serro municipality was significantly
aggregated in the eastern portion of the city, in areas with less variation in elevation and
slope, the largest index of vegetation and moisture associated with areas with the highest
proportion of households where the sewage occurred directly into the watercourses. It was
also noted that the highest number of cases of the disease occurred in places drained by rivers
of the Rio Doce basin. Given the particularities presented at the county extension, especially
in relation to the spatial distribution of the disease between two large municipal watersheds
(Jequitinhonha and Rio Doce), the information presented may contribute to the guidance of
the control actions on municipal level, either through health and environmental structuring, or
through guidelines on the behavior and exposure to possibly contaminated water sources by
the population.
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