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Previous issue date: 2017-04-07 / Este trabalho teve como objetivo identificar a preval?ncia de fissuras labiopalatinas no Brasil e o efeito de fatores sociodemogr?ficos e dos indicadores socioecon?micos municipais no retardo do tratamento cir?rgico prim?rio desta morbidade, no ?mbito do Sistema ?nico de Sa?de, no per?odo de 2009 a 2013. Para tal, foi conduzido um estudo ecol?gico que utilizou dados do Departamento de Inform?tica do Sistema ?nico de Sa?de (DATASUS) e do Atlas de Desenvolvimento Humano do Programa das Na??es Unidas para o Desenvolvimento (PNUD). Foram inclu?dos nascidos vivos com fissuras labiopalatinas dos 5.565 munic?pios brasileiros nos anos de 2009 a 2013, registrados no sistema de informa??es sobre nascidos vivos (SINASC) e portadores de fissuras labiopalatinas que realizaram cirurgias de l?bio e/ou palato que constam dos registros do Sistema de Informa??es Hospitalares do SUS (SIH/SUS), no mesmo per?odo. Foram calculadas taxas de preval?ncia de fissuras labiopalatinas para Brasil, para as cinco regi?es e para as 27 unidades federativas, referentes a cada ano e ao quinqu?nio do estudo. O retardo do tratamento foi avaliado utilizando como par?metro as idades recomendadas pela American Cleft Palate-Craniofacial Association (12 meses para as cirurgias de l?bio e 18 meses para as de palato). Os dados referentes ao retardo do tratamento foram analisados por meio de estat?stica descritiva, de an?lise bivariada, do c?lculo das raz?es de preval?ncia e da regress?o multin?vel de Poisson com vari?ncia robusta. Para todos os testes foi adotado um n?vel de signific?ncia de 5%. Os resultados mostraram que a preval?ncia m?dia de fissuras labiopalatinas no per?odo foi de 5,86 por 10.000 nascidos vivos, com importantes diferen?as regionais e entre unidades federativas. A preval?ncia do retardo para as cirurgias prim?rias de l?bio foi de 66,4% e para as cirurgias de palato 71,2%. As regi?es Norte e Nordeste apresentaram os piores percentuais de retardo. N?o-brancos apresentaram uma probabilidade 27% maior de retardo nas cirurgias de fissuras palatinas e 40% nas de fissuras de l?bio. A an?lise multin?vel identificou influ?ncia da ra?a e do IDH no retardo da cirurgia prim?ria de l?bio, e de IDH e ?ndice de Gini no retardo da cirurgia de palato. Ficou evidente a import?ncia da determina??o social no retardo das cirurgias prim?rias de fissuras labiopalatinas. / This study aimed to identify the prevalence of cleft lip and palate in Brazil and the effect of demographic factors and municipal socioeconomic indicators on the delay of primary surgical treatment of this morbidity in the Brazilian Health System (SUS), from 2009 to 2013. An ecological study was conducted using data from the Department of Informatics of the Brazilian National Health System (DATASUS) and the Human Development Atlas of the United Nations Development Program (UNDP). We included live births with cleft lip and palate from the 5,565 Brazilian municipalities in the years 2009 to 2013, registered in the National Live Birth System (SINASC), and patients with cleft lip and palate that performed lip and / or palate surgeries that appear in the records of the Hospital Information System of the Ministry of Health (SIH / SUS), in the same period. Prevalence rates of cleft lip and paltate for Brazil were calculated for five natural geographic regions and for the 27 federative units, with relation to each year and to the five years of the study. The treatment delay was evaluated using the ages recommended by the American Cleft Palate-Craniofacial Association (12 months for lip surgeries and 18 months for palatal surgeries). The data regarding the treatment delay were analyzed through descriptive statistics, bivariate analysis, prevalence ratios and multilevel Poisson regression with robust variance. For all tests, a significance level of 5% was adopted. The results showed that the average prevalence of cleft lip and palate in the period was 5.86 per 10,000 live births, with important regional differences and between federative units. The prevalence of delay for lip primary surgeries was 66.4% and for palatal surgeries was 71.2%. The North and Northeast regions had the worst percentages of delay. Non-whites had a 27% greater probability of delay in cleft palate surgeries and 40% in cleft lip surgeries. The multilevel analysis identified the influence of race and of Municipal Human Development Index on the delay of primary lip surgery, and of Municipal Human Development Index and of Gini index on the delay of the palate surgery. The importance of social determination in the delay to primary surgeries of cleft lip and palate was evident.
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.ufrn.br:123456789/23471 |
| Date | 07 April 2017 |
| Creators | Sousa, Giselle Firmino Torres de |
| Contributors | 42313384420, http://lattes.cnpq.br/0023445563721084, Lyra, Clelia de Oliveira, 70406030472, http://lattes.cnpq.br/4264395963141865, Fuscella, Maria Alice Pimentel, 10687991889, http://lattes.cnpq.br/8006604693243296, Oliveira, Angelo Giuseppe Roncalli da Costa |
| Publisher | PROGRAMA DE P?S-GRADUA??O EM SA?DE COLETIVA, UFRN, Brasil |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Source | reponame:Repositório Institucional da UFRN, instname:Universidade Federal do Rio Grande do Norte, instacron:UFRN |
| Rights | info:eu-repo/semantics/openAccess |
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