Submitted by Jadson Francisco de Jesus SILVA (jadson@uefs.br) on 2018-05-03T21:47:11Z No. of bitstreams: 1 Disserta??o _Roberta.pdf: 3305166 bytes, checksum: a41670e5ec5d0826e0e9c965b8330933 (MD5) / Made available in DSpace on 2018-05-03T21:47:11Z (GMT). No. of bitstreams: 1 Disserta??o _Roberta.pdf: 3305166 bytes, checksum: a41670e5ec5d0826e0e9c965b8330933 (MD5) Previous issue date: 2017-03-10 / Funda??o de Amparo ? Pesquisa do Estado da Bahia - FAPEB / Studies relating to the investigation of the standards of life and health of Quilombola populations are still limited, especially regarding the analysis of the factors associated with the prevalence of injuries and diseases. Aims: Analyzing diseases and injuries which are more prevalent and verifying their association with socioeconomic, environmental factors and health patters in Quilombola communities in Feira de Santana, Bahia, in 2016. Materials and methods: this is a population-based prevalence study carried out with 864 adults quilombolas of both sexes, aged above 18 years, residents in two Quilombolas communities of Feira de Santana, Bahia. A probabilistic sample was used. The data were collected through home visits, having been applied three validated instruments, containing questions related to demographic, socio-economic standards, environmental, health patterns as well as diseases and injuries. Descriptive and bivariate analyses were carried out, whereas a IC80% and p ? 0,20 were considered to verify the association between the exposure and outcome variables. An exploratory factor analysis, from the use of the tetrachoric correlation, in order to identify which diseases and injuries represent the higher prevalence the most. In order to analyze the factors associated with diseases and injuries, it was used the hierarchical logistic regression analysis. Data were analyzed using the statistical package Stata Corportion College Station, United States (STATA), in version 12.0. As a result of this research findings, two scientific papers were written. The first one is a descriptive study, which aimed to trace the epidemiological profile of the living standards and health of Quilombola communities. To achieve the aims of this article, averages of the quantitative variables and absolute and relative frequencies of qualitative variables of each community were estimated as well as the prevalence of injuries and diseases. The second article is an exploratory study, which analysed the social determinants of disease and injuries in Quilombolas communities of Feira de Santana, Bahia. Through the exploratory factor analysis, latent factors were established. In addition, bivariate and multivariate analyses were carried out to test statistically significant association. Results: in the first article, it was found that Quilombola communities of Feira de Santana, Bahia have very similar demographic andsocioeconomic characteristics and both are vulnerable in theirlife and health standards. From 864 respondents, 63,0% were female, married, with an avarage of 42,6 years of age and an average of 7 years of schooling, as well as 73,4% have informal jobs, especially in the roles of farmer labors and agricultors. In relation to environmental vulnerability, it is pointed out that 99,5 percent have no sanitarian system. Among the data on health patterns, it was noted that 67,1% said that they rarely seek for health services. The most prevalent diseases were: Hypertension (22,3%); diseases of bones (15,8%); diseases of sspine (38,4%) parasitic diseases (25,0%). The most prevalent health aggravations were linked to mental health: anxiety (26,7%); phobias (12,3%) and mental disorders (18,4%). In the second article it was found that the factors which responded more to diseases and most prevalent injuriess were related to mental health diseases (48,8%), chronic diseases (39,2%) and diseases of bones and spine (50,0%). Factor 1: mental health injuries it was found that families who do not receive social benefits have 1,43 times higher chance of having some aggravation in mental health. Factor 2: chronic diseases, it was found that individuals who have little consumption of vegetables and fruits show to have possibility of 1,42 times higher chances to develop a chronic disease. Factor 3: diseases of the bones and spine. It was observed that the individuals who are working have 1,44 times greater chance of having bone and spine diseases. For those who receiving social benefits, that possibility raises to 1,93 times of chance to develop spine and bone diseases. The hierarchical logistic regression analysis was performed for the three factors (1-mental health harms, 2-chronic diseases and bone diseases and 3 column). Multivariate analysis on the associated factors of diseases and injuries in the Quilombola communities, with respect to the factor 1 were: receiving social benefits (HR=1,63 CI80%:1,07; 2,50); material used in the construction of the house (HR=3,22; CI80%:1,17; 8,80); disposal of the garbage (HR=1,51 CI80%:1,07; 2,13); have bathroom (HR=2,82; CI80%:1,17; 6,77); self-assessment of health (HR=2,64 CI80%:1,92; 3,65); type of medication: (HR=0,15; CI80%:0,05; 0,45); problems with cavities/canal (HR=1,47 CI80%:1,07; 2,01); age (HR=1,84; CI80%:1,19; 2,84) and sex (HR=0,48 CI80%:0,34; 0,67). In relation to the factor 2, were: material used in the construction of the house (HR=3,18; CI80%:1,09; 9,28); have bathroom (HR=3,69 CI80%:1,36; 10,01); age (HR=1,87; CI80%:1,18; 2,95) and sex (HR=0,47; IC80%:0,32; 0,68). For factor 3, the variables were: years of study (HR=1,77; CI80%:1,20; 2,62); self-assessment of health (HR=1,64; CI80%:1,15; 2,32); type of medication (HR=6,12; CI80%: 2,59; 14,4) and age (HR=1,61; CI80%:1,03; 2,51). Conclusions: scientific evidence was produced about the living standards and health of Quilombola communities of Feira de Santana, Bahia and of social determinants associated with diseases and injuries that reach these populations the most. Thus, it was found that diseases and injuries in Quilombola populations are determined by demographific, socioeconomic, environmental factors and health patterns. It is expected that the results of this study may support further research with this kind of population and that it may contribute to the implementation of specific health and social policies, as well as to carry out intersectoral interventions with loco-regional applicability. / Ainda s?o escassos os estudos referentes ? investiga??o da condi??o de vida e sa?de das popula??es quilombolas, especialmente no que tange ? an?lise dos fatores associados ? preval?ncia de doen?as e agravos. Objetivos: Analisar as doen?as e agravos mais prevalentes e verificar sua associa??o com fatores socioecon?micos, ambientais e das condi??es de sa?de nas comunidades quilombolas do munic?pio de Feira de Santana, Bahia, no ano de 2016. Materiais e M?todos: Trata-se de um estudo de preval?ncia, de base populacional, realizado com 864 adultos quilombolas, de ambos os sexos, com idade acima de 18 anos, residentes nas duas comunidades quilombolas de Feira de Santana, Bahia. Foi utilizada uma amostra probabil?stica. A coleta de dados foi realizada atrav?s de visitas domiciliares, tendo sido aplicados tr?s instrumentos validados, contendo perguntas referentes ?s condi??es demogr?ficas, socioecon?micas, ambientais, das condi??es de sa?de e acerca das doen?as e agravos. Foram feitas an?lises descritivas e bivariadas, considerando um IC80% e p?0,20 para verificar a associa??o entre as vari?veis de exposi??o e de desfecho. Realizou-se uma an?lise fatorial explorat?ria, a partir do emprego da correla??o tetrac?rica, com objetivo de identificar quais as doen?as e agravos mais prevalentes. Para analisar os fatores associados ?s doen?as e agravos, empregou-se a an?lise de regress?o log?stica hierarquizada. Os dados foram analisados utilizando-se o pacote estat?stico Stata Corportion Colege Station, Estados Unidos (STATA), em sua vers?o 12.0. A partir dos achados desta pesquisa, foram elaborados dois artigos cient?ficos. O primeiro artigo corresponde a um estudo descritivo, o qual visou tra?ar o perfil epidemiol?gico das condi??es de vida e sa?de das comunidades quilombolas. Para atingir os objetivos deste artigo, foram estimadas as m?dias das vari?veis quantitativas e as frequ?ncias absolutas e relativas das vari?veis qualitativas, de cada comunidade, assim como foram estimadas a preval?ncia das doen?as e agravos. O segundo artigo se constitui em um estudo explorat?rio, o qual analisou os fatores associados a doen?as e agravos nas comunidades quilombolas de Feira de Santana, Bahia. Mediante a an?lise fatorial explorat?ria, foram estabelecidos os fatores latentes. Al?m disso, foram realizadas an?lises bivariadas e multivariadas para verifica??o de associa??o estatisticamente significante. Resultados: No primeiro artigo, constatou-se que as comunidades quilombolas de Feira de Santana-BA possuem caracter?sticas demogr?ficas e socioecon?micas bem similares, sendo que as duas se encontram vulnerabilizadas em sua condi??o de vida e sa?de. Dos 864 entrevistados, 63,0% s?o do sexo feminino, casados, apresentando uma m?dia de idade de 42,6 anos, e de escolaridade, uma m?dia de 7 anos de estudo, bem como 73,4% realizam trabalhos informais, especialmente nas fun??es de lavrador e agricultor. Em rela??o ? vulnerabilidade ambiental, destaca-se que 99,5% n?o possuem rede de esgoto. Dentre os dados relativos ?s condi??es de sa?de, observou-se que 67,1% disseram raramente procurar os servi?os de sa?de. As doen?as de maior preval?ncia foram: doen?as de ossos (15,8%); hipertens?o arterial (22,3%); doen?as parasit?rias (25,0%); doen?as de coluna (38,4%). Os agravos em sa?de mais prevalentes ligados ? sa?de mental foram: fobias (12,3%); transtornos mentais comuns (18,4%) e ansiedade (26,7%). No segundo artigo verificou-se que, os fatores que mais respondiam ?s doen?as e agravos mais prevalentes estavam relacionados a doen?as cr?nicas (39,2%); agravos em sa?de mental (48,8%) e a doen?as de ossos e coluna (50,0%). Do fator 1: agravos em sa?de mental, verificou-se que fam?lias que n?o recebem benef?cios sociais t?m 43% mais chances de ter algum agravo em sa?de mental. Do fator 2: doen?as cr?nicas, constatou-se que os indiv?duos que fazem pouco consumo de verduras, frutas e legumes apresentam possibilidade de 1,42 mais chances de desenvolver uma doen?a cr?nica. Do fator 3: doen?as dos ossos e de coluna, averiguou-se que sujeitos que est?o trabalhando t?m 1,44 mais chances de ter doen?as de ossos e coluna, e para os que n?o recebem benef?cios sociais, essa possibilidade aumenta para 1,93 vezes. A an?lise de regress?o log?stica hier?rquica foi realizada para os tr?s fatores (1- agravos em sa?de mental, 2- doen?as cr?nicas e 3- doen?as de ossos e coluna). Na an?lise multivariada os fatores associados ?s doen?as e agravos nas comunidades quilombolas, no que tange ao fator 1 foram: recebimento de benef?cios sociais (OR=1,63 IC80%:1,07; 2,50); material utilizado na constru??o da casa (OR=3,22; IC80%:1,17; 8,80); destino do lixo (OR=1,51 IC80%:1,07; 2,13); ter banheiro (OR=2,82; IC80%:1,17; 6,77); autoavalia??o de sa?de (OR=2,64 IC80%: 1,92; 3,65); tipo de medica??o: (OR=0,15; IC80%:0,05; 0,45); problemas com c?ries/canal (OR=1,47 IC80%:1,07; 2,01); idade (OR=1,84; IC80%:1,19; 2,84) e sexo (OR=0,48 IC80%: 0,34; 0,67). Em rela??o ao fator 2 foram: material utilizado na constru??o da casa (OR=3,18; IC80%:1,09; 9,28); ter banheiro (OR=3,69 IC80%:1,36; 10,01); idade (OR=1,87; IC80%: 1,18; 2,95) e sexo (OR=0,47; IC80%:0,32; 0,68). No fator 3 as vari?veis foram: anos de estudo (OR=1,77; IC80%:1,20; 2,62); autoavalia??o de sa?de (OR=1,64; IC80%:1,15; 2,32); tipo de medica??o (OR=6,12; IC 80%:2,59; 14,4) e idade (OR=1,61; IC80%:1,03; 2,51). Conclus?es: Produziram-se evid?ncias cient?ficas acerca das condi??es de vida e sa?de das comunidades quilombolas do munic?pio de Feira de Santana-BA e dos fatores associados ?s doen?as e agravos que mais atingem essas popula??es. Nesta dire??o, verificou-se que as doen?as e agravos nas popula??es quilombolas s?o determinados por fatores demogr?ficos, socioecon?micos, ambientais e das condi??es de sa?de. Espera-se que os resultados encontrados subsidiem novas pesquisas com essa popula??o e que possam contribuir para a implementa??o de pol?ticas sociais e de sa?de espec?ficas, assim como para a realiza??o de interven??es intersetoriais com aplicabilidade loco-regional.