Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-04-03T23:22:19Z No. of bitstreams: 1 ErotidesTerezaDeOliveiraDamascenoLucas_DISSERT.pdf: 1467928 bytes, checksum: 29bd7c5ed6ace04ebc914d03de04e066 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-04-12T00:21:18Z (GMT) No. of bitstreams: 1 ErotidesTerezaDeOliveiraDamascenoLucas_DISSERT.pdf: 1467928 bytes, checksum: 29bd7c5ed6ace04ebc914d03de04e066 (MD5) / Made available in DSpace on 2017-04-12T00:21:18Z (GMT). No. of bitstreams: 1 ErotidesTerezaDeOliveiraDamascenoLucas_DISSERT.pdf: 1467928 bytes, checksum: 29bd7c5ed6ace04ebc914d03de04e066 (MD5) Previous issue date: 2016-08-31 / A transi??o demogr?fica que vem ocorrendo no mundo e no Brasil traz consigo uma modifica??o no padr?o de doen?as encontradas nas popula??es. As doen?as cr?nicas n?o-transmiss?veis (DCNT) tem aparecido com bastante destaque nesse cen?rio de transi??o epidemiol?gica, e suas morbidades t?m afetado de forma consider?vel os indiv?duos, como ? o caso do Diabetes Mellitus (DM), associado ao p? diab?tico e ?s amputa??es. O objetivo deste trabalho foi analisar a distribui??o espa?o-temporal das taxas de preval?ncia do p? diab?tico e amputa??es por diabetes mellitus no Brasil, antes e ap?s a lei n? 11.347/06, que disp?e sobre a distribui??o gratuita de medicamentos e materiais para sua aplica??o e monitora??o da glicemia capilar aos portadores de DM. Trata-se de um estudo ecol?gico, que utilizou como unidades de an?lise 161 Regi?es de Articula??o Urbana intermedi?rias e dados do DATASUS de indiv?duos acima de 40 anos em 2003-2012. Utilizou-se os testes de Moran Global e Local, e an?lise joinpoint das taxas no pa?s. Realizou-se an?lise espacial bivariada entre as vari?veis principais e taxas de cobertura da aten??o b?sica (profissionais/estabelecimentos). Os resultados mostraram que em 2003, as taxas de preval?ncia do p? diab?tico e amputa??es foram as mais elevadas (2,47/100.000 e 1,66/100.000, respectivamente). Observou-se redu??o anual de 9,4% na taxa de preval?ncia do p? diab?tico e de 7,3% em rela??o ? taxa de amputa??es de 2003 a 2012. Houve uma maior concentra??o espacial das taxas do p? diab?tico nas regi?es norte, nordeste e centrooeste. Observou-se autocorrela??o negativa quando realizada a an?lise bivariada com a taxa de estabelecimentos na aten??o b?sica (variando entre I= -0,07 a -0,12, p< 0,05). O que sugere importante rela??o entre o baixo n?mero de estabelecimentos nas regi?es e as maiores preval?ncias. Conclui-se que apesar da diminui??o nas taxas de preval?ncias, n?o foi poss?vel identificar influ?ncia direta da lei na redu??o das taxas do p? diab?tico e amputa??es por diabetes mellitus no Brasil. / The demographic transition that has taken place in the world and in Brazil brings with it a change in the pattern of diseases found in populations. The chronic noncommunicable diseases (NCDs) has appeared rather prominently in this epidemiological transition scenario, and its morbidities have affected considerably individuals, such as Diabetes Mellitus (DM) associated with diabetic foot and amputations. The aim of study was analyze the space-time distribution of prevalence rates of diabetic foot and amputations for diabetes mellitus in Brazil, before and after the law 11.347/06, which talking about the free distribution of medicines and materials for its implementation and monitoring of blood glucose to DM. This is an ecological study, which used as units of analysis 161 Urban Articulation Regions intermediate and DATASUS data of individuals over 40 years in 2003- 2012. We used the Global Moran and Local Moran tests and joinpoint analysis of rates in the country. We conducted bivariate spatial analysis of the main variables and primary care coverage rates (professionals/institutions). The results showed that in 2003, the prevalence rates of diabetic foot and amputations were higher (2.47/100.000 and 1.66/100.000, respectively). There was an annual reduction of 9.4% in the prevalence of diabetic foot and 7.3% in the amputation rate from 2003 to 2012. There was a higher spatial concentration of diabetic foot rates in the North, Northeast and Midwest. There was negative autocorrelation when performed bivariate analysis with the rate of establishments in primary care (ranging from I= -0,07 a -0,12, p< 0,05). This suggests important relationship between the small number of establishments in the regions and the highest prevalence. It concludes that despite the decrease in prevalence rates, it was not possible to identify direct influence of the law on reduced rates of diabetic foot and amputations for diabetes mellitus in Brazil.