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Previous issue date: 2017-03-17 / A coqueluche, doen?a infectocontagiosa, atualmente vem apresentando um perfil reemergente. Fatores como diminui??o da imunidade, anos ap?s a vacina??o, mudan?as no gen?tipo da bact?ria e maior susceptibilidade entre jovens e adultos s?o considerados como contribuintes para o aumento da taxa da incid?ncia da doen?a. Assim, esse estudo teve como objetivos verificar a distribui??o espacial dos casos confirmados de coqueluche entre o per?odo de 2007 a 2015; identificar o comportamento da s?rie hist?rica da taxa de incid?ncia da coqueluche durante o per?odo de 2001 a 2015 no Brasil e verificar a associa??o da vacina contra coqueluche e a ocorr?ncia da doen?a no estado do Rio Grande do Norte. Dessa forma, o caminho metodol?gico da pesquisa foi dividido em tr?s partes. A an?lise da distribui??o espacial considerou como unidade de an?lise as 482 Regi?es Imediatas de Articula??o Urbana e utilizou o software Terraview para constru??o dos mapas tem?ticos. Para se verificar a tend?ncia da s?rie optamos por utilizar o ajuste de uma fun??o polinomial no tempo, utilizando-se assim modelos de regress?o polinomial. Em rela??o a associa??o foi estabelecido como crit?rio de inclus?o a confirma??o do caso de acordo com os crit?rios estabelecidos pelo Minist?rio da Sa?de, sendo exclu?dos aqueles cujas fichas n?o encontravam-se devidamente preenchidas ou que estivessem com algum tipo de d?vida que comprometesse a coleta dos dados. Os resultados demonstraram que a doen?a apresentou uma distribui??o espacial democr?tica em todo territ?rio nacional, formando pequenos clusters com altas taxas de incid?ncia nas regi?es de articula??o urbana presentes nas regi?es sul e sudeste. Identificamos tamb?m que houve, na s?rie hist?rica, uma tend?ncia crescente da doen?a ao longo de 15 anos. E por fim, os resultados apontam que independentemente do estado vacinal os indiv?duos est?o adoecendo por coqueluche, o que n?o gerou evid?ncia cient?fica suficiente para medir a efetividade da vacina. Os achados sugerem que aspectos relacionados a vacina??o precisam ser melhor investigados para que se possa garantir o controle da doen?a. ? necess?rio tamb?m que ocorram melhorias nas a??es de vigil?ncia, o que pode garantir uma representa??o epidemiol?gica fidedigna da doen?a. / Pertussis, an infectious-contagious disease, is currently presenting a reemerging profile. Factors such as decreased immunity years after vaccination, changes in the genotype of the bacteria and increased susceptibility among young and adults are considered to have contributed to increase the disease incidence rate. Therefore, this study aimed to verify the spatial distribution of confirmed pertussis cases between 2007 and 2015; to identify the patterns in the time-series of pertussis incidence rates during the period 2001 to 2015 in Brazil and to verify the association of pertussis vaccine with the occurrence of the disease in the state of Rio Grande do Norte. Thus, the methodological path of the research was divided into three parts. The analysis of the spatial distribution considered the 482 Regions Immediate Urban Articulation as unit of analysis and used the Terraview software to construct the thematic maps. In order to verify the trend in the series we chose to use the adjustment of a polynomial function in time, using polynomial regression models. Regarding the association, the confirmation of the case was established as inclusion criteria in accordance with the criteria established by the Ministry of Health, being excluded those files that were not properly filled or had any uncertainties that could compromise the data collection. The results suggests that the disease has a democratic spatial distribution throughout the country, forming small clusters with high incidence rates in the urban articulation present in the South and Southeast regions. It was also identified in the time-series an increasing tendency of the disease over a period of 15 years. Finally, the results indicate that regardless of vaccination status individuals are being infected with pertussis, which did not generate enough scientific evidence to measure the effectiveness of the vaccine. The findings suggest that aspects related to vaccination need further investigation in order to guarantee disease control. There is also a need for improvements in surveillance actions, which can ensure a reliable epidemiological representation of the disease.
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.ufrn.br:123456789/23965 |
| Date | 17 March 2017 |
| Creators | Medeiros, Ang?lica Teresa Nascimento de |
| Contributors | 39817270459, Cavalcante, Cleonice Andrea Alves, 83751076468, Bonfada, Diego, 04663937411, Gondim, Gr?cia Maria de Miranda, 10657894400, Freitas, Marise Reis de, 30594766320, Ferreira, Maria Angela Fernandes |
| 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/doctoralThesis |
| 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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