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Master's Dissertation
DOI
10.11606/D.6.2006.tde-08032007-110521
Document
Author
Full name
Maria Lucia Vieira da Silva Cesar
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2006
Supervisor
Committee
Waldman, Eliseu Alves (President)
Eduardo, Maria Bernadete de Paula
Matte, Maria Helena
Title in Portuguese
Doença diarréica aguda: aspectos epidemiológicos e vigilância no município de Avaré, interior do Estado de São Paulo
Keywords in Portuguese
Diarréia
Surtos de diarréia
Vigilância epidemiológica
Vigilância sindrômica
Abstract in Portuguese
INTRODUÇÃO: A doença diarréica aguda é ainda importante causa de morbidade no mundo. Sua elevada incidência e a aceitação de sua ocorrência como fato "normal" impõem desafios para seu registro e implantação de seus sistemas de vigilância. OBJETIVOS: Conhecer as características epidemiológicas da diarréia aguda e avaliar a capacidade de detecção de surtos pelo Programa de Monitorização da Doença Diarréica Aguda, no município de Avaré. MÉTODOS: De 27 de fevereiro a 16 de julho 2005, realizou-se estudo prospectivo da diarréia em unidade sentinela do programa. Os surtos identificados foram investigados por estudos descritivos e analíticos. Amostras de fezes foram coletadas para os casos envolvidos nos surtos. A avaliação dos propósitos do programa embasou-se em indicadores de utilidade, sensibilidade e oportunidade. RESULTADOS: Foram identificados 408 casos (Coeficiente de Incidência = 4,7/1000 habitantes); idade mediana de 7 anos (variação de 1 mês a 89 anos) e 54% do sexo masculino. Dos quatro surtos de diarréia confirmados, dois ocorreram em uma creche e em um orfanato, devido à Giárdia lamblia e Cryptosporidum spp.; um intradomiciliar de origem alimentar, sem identificação do agente, e uma epidemia na comunidade associada ao rotavírus. Dos casos atendidos, 63 (15,5%) pertenciam a surtos, identificando-se mais 56 casos, em um total de 119 casos (Coeficiente de Incidência de Surtos=1,4/1000 habitantes). CONCLUSÕES: O estudo mostrou que o programa responde ao seu principal propósito, respeitando-se as condições de regularidade na informação, análises dos padrões da diarréia e investigação criteriosa. Intensificar treinamentos para aumentar a habilidade das equipes locais nas avaliações e investigações é uma das principais recomendações deste estudo.
Title in English
Acute diarrheal illness: epidemiologic aspects and surveillance in Avaré City, inland of State of São Paulo
Keywords in English
Diarrhea
Diarrhea outbreak
Epidemiologic surveillance
Syndromic surveillance
Abstract in English
BACKGROUND: Acute diarrheal illness remains an important cause of morbidity worldwide. Its high incidence and the acceptance of its occurrence as “normal” fact impose challenges for its report and implantation of its surveillance systems. OBJECTIVES: To describe the epidemiologic characteristics of the acute diarrhea and to evaluate the capacity of the Monitoring Program of the Acute Diarrheal Illness for early detection of outbreaks, in the city of Avaré, State of São Paulo, Brazil. METHODS: From February 16 to July 28, 2005, was a prospective study of the diarrhea in a sentinel health service of the program. Descriptive and analytical studies were developed to investigate the potential outbreaks identified in this period. Stool samples were collected from the involved cases in the outbreaks. The evaluation of purpose of the program was based on indicators of usefulness, sensitivity and timeliness. RESULTS: A total of 408 cases were identified (incidence rate=4.7/1000 inhabitants). The median age was 7 years (range 1-89 years) and 54% were male. Among four confirmed diarrhea outbreaks, two occurred in a day nursery and orphanage, due to Giardia lamblia and Cryptosporidum spp., respectively; one was caused by food in dwelling-house, without identification of the agent, and one caused by rotavirus spread citywide. Of all monitored cases, 63 (15.5%) were involved in outbreaks, linked to more 56 cases, in a total of 119 cases (outbreaks incidence rate=1.4/1000 inhabitants). CONCLUSIONS: The study showed that the program enables prompt detection and investigation of outbreaks, respected the conditions of reliability of the information, evaluation of the acute diarrhea trends and careful inquiry. To intensify training to increase the ability of local professionals to recognize patterns of possible outbreaks and for suitable investigations is one of the major recommendations of this study.
 
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MLuciaCesar.pdf (448.82 Kbytes)
Publishing Date
2007-03-15
 
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