Marilia de Souza Araujo

Malaria is a parasitosis conditioned by several factors. This study sought to analyze the spatial distribution of malaria considering environmental, socioeconomic, and political variables in São Félix do Xingu, Pará, Brazil, from 2014 to 2020. Epidemiological, cartographic, and environmental data were obtained from the Ministry of Health, Brazilian Geographical and Statistical Institute, and National Space Research Institute. Statistical and spatial distribution analyses were performed using chi-squared tests of expected equal proportions and the kernel and bivariate global Moran’s techniques with Bioestat 5.0 and ArcGIS 10.5.1. The highest percentage of cases occurred in adult males with brown skin color, mainly placer miners, with a primary education level, living in rural areas, who were infected with Plasmodium vivax and with parasitemia of two or three crosses as diagnosed by the thick drop/smear test. The disease had a non-homogeneous distribution, with distinct annual parasite indices associated with administrative districts and clusters of cases in locations with deforestation, mining, and pastures close to Conservation Units and Indigenous Lands. Thus, a direct relationship between areas with cases and environmental degradation associated with land use was demonstrated, along with the precarious availability of health services. Pressure on protected areas and epidemiological silence in Indigenous Lands were also noted. Environmental and socioeconomic circuits were identified for development of diseases associated with precarious health services in the municipality. These findings highlight the need to intensify malaria surveillance and contribute to the systematic knowledge of malaria’s epidemiology by considering the complexity of its conditioning factors.

Objetivo:Avaliar o consumo alimentar de macronutrientes e o estado nutricional de pessoas com estomia no contexto amazônico. Método: Estudo transversal quantitativo realizado na unidade de referência especializada às pessoas com estomia, no período de janeiro a março de 2020. A amostra foi constituída de 77 pessoas com estomias, com idade de 21 a 88 anos, de ambos os sexos. Foram utilizados informações sociodemográficas, aspectos clínicos e comportamentais, medidas antropométricas e recordatório 24 h. A análise estatística foi realizada por meio dos softwares BioEstat 5.0 e EpiInfo 3.5.1. Resultados: A maioria era do sexo masculino, com faixa etária entre 35 e 50 anos. Os tipos mais frequentes de estomia foram: colostomia (69%) e ileostomia (21%), com caráter temporário (43%), tendo em ambos os sexos a etiologia neoplásica (60%). Quanto ao estado nutricional, a maioria apresentou eutrofia segundo o índice de massa corporal, no entanto a circunferência da cintura demonstrou risco metabólico aumentado no sexo feminino, e a prega cutânea tricipital indicou obesidade no sexo masculino e eutrofia no sexo feminino (<0,0001). Com relação ao consumo alimentar, observou-se inadequação de energia e de macronutrientes. Conclusão: Os hábitos alimentares no contexto amazônico podem estar relacionados ao consumo alimentar inadequado e às alterações no estado nutricional.

Objective: To evaluate the food intake of macronutrients and nutritional status of people with ostomy in the Amazonian context. Method: Quantitative cross-sectional study carried out in the specialized reference unit for people with ostomy, in the period from January to March 2020. The sample consisted of 77 people with ostomies, aged 21 to 88 years old, of both genders. We used sociodemographic information, clinical and behavioral aspects, anthropometric measurements and 24-hour recall. Statistical analysis was performed using BioEstat 5.0 and EpiInfo 3.5.1 software. Results: Most were male, aged between 35 and 50 years old. The most frequent types of ostomy were: colostomy (69%) and ileostomy (21%), with a temporary nature (43%), with neoplastic etiology in both sexes (60%). As for the nutritional status, most presented eutrophy according to the body mass index, but waist circumference showed increased metabolic risk in females, and the triceps skinfold thickness indicated excess adiposity in males (<0.0001). Regarding food consumption, there was inadequacy of energy and macronutrients. Conclusion: Eating habits in the Amazonian context may be related to inadequate food consumption and changes in nutritional status.

As estomias são resultadas de um ato cirúrgico para exteriorização de algum órgão oco do corpo com a finalidade de eliminar dejetos. Essa nova fisiologia influência nas relações interpessoais, imagem corporal, questões emocionais e no seu comportamento alimentar. O presente trabalho tem como finalidade avaliar a correlação entre a frequência alimentar e o estado nutricional em pessoas com Estomia de eliminação (colostomia, ileostomia e urostomia). Trata-se de um estudo transversal e descritivo, com abordagem quantitativa, realizado com 77 estomizados (temporários e definitivos) no período de janeiro a março de 2020, na Unidade de Referência Especializada - URE’s. Para a realização da coleta de dados foram utilizadas informações sócio-demográficas, aspectos clínicos, medidas antropométricas e questionário de frequência alimentar. Como resultado, observou-se alta frequência de consumo de alimentos processados/ultraprocessados e um baixo ingesta de fibras, além disso, houve correlações estatísticas significativas entre a frequência alimentar e algumas variáveis antropométricas, caracterizando hábitos alimentares disfuncionais, os quais a longo prazo podem contribuir para a gênese de doenças crônicas transmissíveis que favorecer agravos à saúde da pessoa com estomia, tais como obesidade, diabete, entre outros; assim como facilitar para o risco de prolapso, hérnia paraestomal, retração e necrose do estoma. Portanto, faz-se necessário que o paciente estomizado realize acompanhamento nutricional de forma periódica de modo a fornecer informações em relação a uma alimentação saudável considerando a características individuas dos pacientes e, assim, garantir sua saúde, qualidade de vida e diminuir probabilidades de sintomatologias intestinais desagradáveis.

The increase in chronic diseases in recent years has rise the need for placement of ostomy bags. Changes occur in their lives, and food is impacted, through the food taboo people stop consuming certain foods, out of fear and as an attempt to prevent embarrassing situations. This study sought to verify the food taboos of people with ostomy, make a nutritional assessment and establish if there are correlations. This is a cross-sectional, descriptive and quantitative research, seventy seven individuals with intestinal and urinary ostomy were interviewed at the specialized referral unit, the data collected through the sociodemographic questionnaire verifying the type and character of ostomy and etiology, anthropometric evaluation (body mass index, arm circumference, arm muscle circumference and tritrital skinfold) in addition to the question "do you have a taboo/food belief?” In the case of an affirmative answer, which ones were asked. The results showed that 66% of the participants had food taboo, both men and women presented for shrimp and pork, even without a significant percentage of intolerances and allergies, these foods are part of culinary dishes in the region thus affecting socialization, but there was no significant correlation with nutritional status when evaluating body mass index (p=0.13), adequacy of Tritriital Skinfold (p=0.26) and arm circumference (p=0.59), and arm muscle circumference (p=0.74), demonstrating how much individual belief and society influence people's dietary choices, this can cause damage.

Introduction: Malaria cases in Brazil are concentrated in the Amazon region. In the state of Pará, malaria is considered an endemic disease, and the population has different levels of exposure, which contributes to different types of occurrence in the municipalities. Methodology: A descriptive, cross-sectional, and ecological study was conducted using data from the Malaria Epidemiological Surveillance System of the municipalities of Cametá and Tucuruí, PA, Brazil, from 2014 to 2018; the Brazilian Institute of Geography and Statistics; and the National Registry of Health Institutions of the Ministry of Health. Statistical and spatial analyses of epidemiological, laboratory and public health service coverage variables were performed using the Bioestat 5.0 and ArcGis 10.5 software. Results: 11,381 Malaria cases were reported in the two municipalities. The highest percentage of case notifications was reported in brown-skinned men aged from 19 and 59 years, and who had primary education levels. The predominant occupations were farming and livestock in Cametá and domestic activity in Tucuruí. The most common diagnostic examination used was a thick blood smear, and Plasmodium vivax was the species most often encountered. The percentage of primary care coverage increased during the study period. The spatial distribution of the disease was not homogeneous, and there were clusters of cases with different densities in Cametá and Tucuruí. Conclusions: Malaria is a public health problem in the municipalities of Cametá and Tucuruí, because of its transmission dynamics and variable spatial distribution as well as the coexistence of factors that favor the exposure of resident populations to epidemiological situations, thus reflecting health inequities.