Epidemiologia da paralisia cerebral em crianças e adolescentes e associação com a vulnerabilidade em saúde

• Ano de defesa: 2018
• Autor(a) principal: Peixoto, Marcus Valerius da Silva
• Orientador(a): Nunes, Marco Antônio Prado
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Programa de Pós-Graduação: Pós-Graduação em Ciências da Saúde
• Palavras-chave em Português: Paralisia cerebral; Epidemiologia; Determinantes sociais; Sistemas de informação em saúde; Análise espacial em saúde
• Palavras-chave em Inglês: Cerebral palsy; Epidemiology; Social determinants; Health information systems
• Área do conhecimento CNPq: CIENCIAS DA SAUDE
• Link de acesso: http://ri.ufs.br/jspui/handle/riufs/10531

Introduction: Cerebral Palsy (CP) is the main cause of physical disability in childhood, however many aspects of the CP are still inconclusive. The association of CP with areas of vulnerability can be considered a knowledge gap. Did not are find population epidemiological studies and information systems on CP in Brazil. Objective: To analyze the epidemiological characteristics of Cerebral Palsy in children and adolescents and the association with health vulnerability. Methods: The study was divided into five stages that involved four designs of epidemiological research and a technological production. The first step was a study of the methodological type of construction and validation of a synthetic indicator of health vulnerability (VIHealth). In the second stage, a cross-sectional epidemiological study was carried out through a primary care survey on CP in children and adolescents in the city of Aracaju. In the third step, an ecological study was performed with spatial analysis of the PC with data produced from the survey and added with secondary data. In the fourth stage, a casecontrol study was carried out with prenatal and birth information of the cases and controls collected in the Records of the Live Birth Information System of the Brazilian Ministry of Health (SINASC). The fifth stage consisted of the production of an Information System for the Epidemiological Monitoring of Cerebral Palsy. Were used descriptive analyzes, main component analysis, exploratory spatial data analysis, multiple linear regression and multiple logistic regression. Results: A consensus was obtained for the composition of the synthetic indicator of vulnerability, statistical validation and applicability in Aracaju territory. The prevalence of CP among children and adolescents in Aracaju was 1.64 / 1000, with a higher frequency in males (56.25%), race / color brown or black (67.50%), the most common bilateral spastic subtype 45.42%), with higher comorbidities of epilepsy (48.33%) and intellectual disability (30%). Fifty-eight percent of families have family incomes of up to 1 minimum wage. Associations of prevalence of CP with areas of vulnerability in health were found. The associated factors were low birth weight, prematurity, low Apgar score, advanced maternal age and congenital anomalies. The information system for PC registration has met the needs of storage, database, intuitive interface, simple layout, access with different levels and generation of reports. Conclusion: Cerebral palsy in children and adolescents in Aracaju presents as a characteristic the bilateral spastic subtype, low prevalence, despite disparities within the city, higher frequency in social minority groups of race/color brown or black and in families living in extreme poverty. The prevalence of CP is associated with contextual social inequities and has a relation of spatial dependence with the areas of greatest vulnerability in health. The most important associated factors were congenital anomalies, low Apgar scores, low birth weight and prematurity. The information system in the situation room model can be considered large by the amount of information available that applies to research, surveillance, planning and evaluation of services for the CP.