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Mortalidade prematura por hipertensão arterial sistêmica e diabetes mellitus no Maranhão: análise de tendência (2015-2024) e projeções para 2030

2026-08-28T13:53:52Z

Título: Mortalidade prematura por hipertensão arterial sistêmica e diabetes mellitus no Maranhão: análise de tendência (2015-2024) e projeções para 2030 Autor: SOUZA, Jadeane Medeiros Pereira Primeiro orientador: SANTOS, Elisangela Milhomem dos Abstract: Introduction: Non-Communicable Diseases (NCDs), particularly Systemic Arterial Hypertension (SAH) and Diabetes Mellitus (DM), constitute major causes of premature mortality (ages 30 to 69), posing a significant challenge to Primary Health Care (PHC). In regional contexts such as the state of Maranhão, this scenario is heightened, impacting the organization of care within the territory. Searches in scientific databases reveal that research on premature mortality trends for SAH and DM remains incipient, especially in Maranhão, with no identified studies specifically addressing this issue in the local context. Objective: To analyze the temporal trend of premature mortality from SAH and DM in Maranhão from 2015 to 2024, with projections for the epidemiological scenario through 2030. Methodology: An ecological time-series study was conducted using secondary data from the Mortality Information System (SIM) and population estimates from the Brazilian Institute of Geography and Statistics (IBGE) for the 2015–2024 period, with projections for 2025–2030. Underlying causes of death were classified according to ICD-10, considering codes I10 to I15 (SAH) and E10 to E14 (DM). The premature mortality rate for SAH and DM was calculated as the ratio between the number of deaths in the 30–69 age group and the corresponding resident population, multiplied by 100,000 inhabitants. Statistical analysis employed stochastic modeling using the M6 Model, adjusted via Bayesian inference in R software, with validation performed through cross-validation techniques. Results: A total of 3,624 deaths were recorded during the analyzed period. The premature mortality rate for SAH and DM remained stable among younger age groups and showed a progressive increase starting at age 50, reaching peak values between 65 and 69 years. An overall declining trend was observed throughout the period, interrupted by an increase in 2020, followed by a resumption of the downward trend. Estimates of the kt2 parameter from the M6 model indicated an upward trajectory, suggesting an increase in the mortality slope over time. Projections for the 2025–2030 period indicated rising mortality rates, particularly in the 60–69 age group, while younger groups showed little variation. Conclusions: Premature mortality from SAH and DM in Maranhão exhibits a pattern associated with population aging and intensified risk after age 50, with a projected growth trend through 2030. These findings indicate a risk of failing to meet Target 3.4 of the Sustainable Development Goals and reinforce the need to strengthen Primary Health Care, utilizing epidemiological tools to improve the planning and organization of health actions within the territory. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação

EFEITOS DE UMA INTERVENÇÃO EDUCATIVA NA PREVENÇÃO E CONTROLE DE DOENÇAS PARASITÁRIAS EM CRIANÇAS ESCOLARES NO INTERIOR DO MARANHÃO: ESTUDO QUASE-EXPERIMENTAL

2026-08-07T14:24:11Z

Título: EFEITOS DE UMA INTERVENÇÃO EDUCATIVA NA PREVENÇÃO E CONTROLE DE DOENÇAS PARASITÁRIAS EM CRIANÇAS ESCOLARES NO INTERIOR DO MARANHÃO: ESTUDO QUASE-EXPERIMENTAL Autor: OLIVEIRA, Scarlett Costa de Primeiro orientador: COSTA, Ana Cristina Pereira de Jesus Abstract: Parasitic disease is a globally prevalent public health problem affecting the health of children in developing countries. It is associated with clinical morbidities that, in more severe cases, can affect child growth and development. Considering the effects of an intervention in the prevention and control of parasitic diseases in school-aged children, in this context, Primary Health Care, especially through the Family Health Strategy, is a strategic space for the development of educational actions for health promotion and prevention in the territory. The study has a quasi-experimental, self-controlled, beforeand-after, longitudinal research design with a quantitative approach. It was conducted in 2025 in an elementary school in the interior of Maranhão, with a sample of 26 children aged 7 to 8 years. Data collection occurred in three stages: 1. Pre-intervention, with the collection of social, demographic, economic information and knowledge about the topic; 2. Educational intervention; 3. Post-intervention, with a new survey of knowledge on the subject, 90 days after the end of the intervention, to evaluate its long-term effect. Data were collected after approval from the Ethics and Research Committee. Analyses were conducted using complete pairs available for each outcome, where categorical variables were compared between pre- and postintervention using McNemar's test. For statistical inference of the differences in scores between the pre- and post-intervention moments, the Wilcoxon test for paired samples was used. All analyses were processed using the open-source software JAMOVI version 1.6 and JASPER version 1.0, adopting a significance level of 5%. The results showed a majority of brown-skinned children living with their father or mother in a house with at least four people. With parents who were farmers, an income of up to half the minimum monthly wage, and approximately 6-9 years of schooling. Following the educational intervention, there was a statistically significant increase in knowledge about what parasites are (p<0.001), symptoms of intestinal parasitosis (p<0.001), and ways to prevent parasitosis (p<0.001), as well as in the domain of prevention habits (p=0.021). In percentage terms, the increase in knowledge ranged from 23.5% to 40.2%, and the effect size was considered high (rb=0.98) and significant. Considering the participants' sex, the percentage variation in the increase in correct answers was greater in females, ranging from 28.6% to 50% (girls) versus 21.4% to 42.9% (boys) (p=0.037). It is concluded that, after an educational intervention, there was an increase in knowledge regarding parasitosis, encompassing the identification of symptoms and means of prevention; there was also an increase in personal hygiene habits. It is expected that the proposed intervention in the territory of the family health strategy will contribute to the acquisition and maintenance of knowledge and healthy lifestyle habits in the children participating in the study, with the aim of preventing and controlling parasitic diseases. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação

MORTALIDADE MATERNA E DETERMINANTES DOS MUNICÍPIOS NORDESTINOS: ANÁLISE ESPACIAL ANTES E DURANTE A PANDEMIA DE COVID-19

2026-07-14T12:34:58Z

Título: MORTALIDADE MATERNA E DETERMINANTES DOS MUNICÍPIOS NORDESTINOS: ANÁLISE ESPACIAL ANTES E DURANTE A PANDEMIA DE COVID-19 Autor: FILGUEIRAS, Ellen Rose Santos Primeiro orientador: QUEIROZ, Rejane Christine de Sousa Abstract: Objective: To analyze the spatial distribution of maternal mortality in Northeast Brazil before and during the COVID-19 pandemic, correlating the Maternal Mortality Ratio (MMR) with social vulnerability and maternal healthcare indicators. Methods: This is an ecological and analytical study based on secondary data from 2017 to 2022. Global and Local Moran spatial autocorrelation indices were applied to identify territorial patterns and risk clusters. Correlation analyses were also conducted between the Maternal Mortality Ratio (MMR), social vulnerability indicators, Primary Health Care coverage, and adequacy of prenatal care. Analyses were performed for all municipalities in Northeast Brazil. Results: At the regional level, positive spatial autocorrelation of MMR was observed in all analyzed periods. Before the pandemic, the Global Moran’s I was 0.140, increasing to 0.234 during the pandemic period (2020–2022), indicating that maternal mortality is not randomly distributed across the territory. Low–Low clusters predominated, representing municipalities with lower mortality rates. However, during the COVID-19 pandemic, changes in the spatial configuration of these clusters were observed, with increased inequalities and greater territorial heterogeneity. In Maranhão, spatial patterns showed greater instability during the pandemic, with more pronounced changes in cluster distribution and stronger associations between maternal mortality, social vulnerability, lower Primary Health Care coverage, and inadequate prenatal care. Conclusion: Despite the challenges imposed by the COVID-19 pandemic, some municipalities in Northeast Brazil maintained more favorable maternal mortality patterns, possibly related to better healthcare infrastructure and more organized Primary Health Care systems. In Maranhão, however, territorial inequalities were more pronounced, reinforcing the need to strengthen maternal health policies, improve maternal death surveillance, and enhance healthcare networks with a territorial and equity-focused approach. Instituição: Universidade Federal do Maranhão Tipo do documento: Tese

Qualidade de vida e laboral dos agentes comunitários de saúde em um município do Maranhão

2026-07-09T19:26:43Z

Título: Qualidade de vida e laboral dos agentes comunitários de saúde em um município do Maranhão Autor: ABREU, Lillia Michely Nunes Primeiro orientador: MONTEIRO, Sally Cristina Moutinho Abstract: Community Health Workers (CHWs) play a central role in the Family Health Strategy. However, they are often exposed to adverse working conditions and occupational stressors, which may compromise their quality of life and the effectiveness of Primary Health Care. This study aimed to analyze the quality of life and quality of work life of Community Health Workers in São José de Ribamar, Maranhão, as well as their associated factors. This is a cross-sectional, quantitative study with 155 participants, whose data were collected through a semi-structured questionnaire covering sociodemographic characteristics, lifestyle habits, and health conditions, as well as validated instruments to assess quality of life and quality of work life. Data were analyzed using descriptive and inferential statistics. Qualitative variables were expressed as absolute and relative frequencies, while quantitative variables, after the Shapiro–Wilk normality test, were presented as medians and percentiles. A predominance of females was observed, with a higher proportion aged over 50 years (56.1%) and a long professional trajectory (median of 25 years). Regarding lifestyle habits, most participants were non-smokers (95.5%) and did not consume alcoholic beverages (78.6%), while 45.2% reported engaging in regular physical activity. A high prevalence of overweight (83.3%) and chronic conditions such as hypertension (32.9%), diabetes (17.4%), and dyslipidemia (24.0%) was identified. Quality of life scores were higher in the psychological and social relationships domains (median of 75.0), intermediate in the physical domain (67.9), and lower in the environment domain (60.7). Quality of work life showed a median of 76.0, indicating an overall satisfactory perception. A negative association was observed between the physical domain and age, number of children, and number of families followed, while a positive association was found between the psychological domain and years of professional experience. The environment domain was negatively correlated with the number of children, with no significant associations identified for the social relationships domain or quality of work life. In multivariate analysis, the number of families followed and family burden showed a negative impact on the physical and environmental domains. It is concluded that, although CHWs perceive their work-related quality of life as satisfactory, factors such as age, family burden, and the number of families followed may negatively impact the physical and environmental domains of their quality of life. These findings highlight the need for policies focused on workload management, occupational health promotion, and family and psychosocial support strategies for this professional group. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação