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| Author(s): |
Mellina Yamamura Calori
Total Authors: 1
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| Document type: | Doctoral Thesis |
| Press: | Ribeirão Preto. |
| Institution: | Universidade de São Paulo (USP). Escola de Enfermagem de Ribeirão Preto (PCARP/BC) |
| Defense date: | 2016-02-19 |
| Examining board members: |
Ricardo Alexandre Arcêncio;
Francisco Chiaravalloti Neto;
Rosely Moralez de Figueiredo;
Jordana de Almeida Nogueira;
Ione Carvalho Pinto
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| Advisor: | Ricardo Alexandre Arcêncio |
| Abstract | |
Objective: It was proposed to analyze the spatial relation of deaths and avoidable hospitalizations for TB with social indicators in Ribeirão Preto/SP. Methods: It is an ecological study that considered cases of deaths and hospital admissions due to tuberculosis (CID A15.0 to A19.9). They occurred in the urban area of Ribeirão Preto and were recorded, respectively, in the Mortality Information System and Hospital Admission System of the Unified Health System between 2006 and 2012. It was possible to perform the univariate analysis of socio- demographic and occupational variables of the investigated cases. It was used, for social indicators construction, the principal component analysis and data from selected areas of the municipality by considering the Demographic Census of 2010. The cases decoding was processed by TerraView version 4.2.2. It was used the multiple linear regression through the least squares method and spatial regression for relation analysis of spatial dependence between social indicators and death rates and hospitalizations by TB. The autocorrelation in residues of multiple linear regression was tested by the Global Moran test, and analyzes were performed by considering the software Arcgis-version 10.1, Statistica version 12.0, OpenGeoDa version 1.0 and R version 3.2.3. For diagnosis of a better spatial regression model, it was possible to use the Lagrange Multiplier test. In all tests, the alpha significance level was fixed at 5% (p <0.05). Results: There were 50 cases of deaths and 196 cases of hospitalizations by TB. Most cases registered in both systems occurred in males (n=41; 82%/n=146; 74.5%) and with pulmonary clinical form (n=44; 80.0%/n=138; 67.9%). Three new variables emerged, in the construction of social indicators, presenting respectively the total variance of 46.2%, 18.7% and 14.6% and named as indicators of income, social inequality and social equity. In the modeling to verify the spatial relation between deaths and social indicators, it was observed that social equity was the statistically significant indicator (p=0.0013), and with a negative relation to the mortality. Then, the Spatial Lag Model was the best method to test spatial dependence, with a value of ? (rho) estimated at 0.53 and highly significant (p=0.0014). In relation to the modeling of spatial relationship between hospitalizations for tuberculosis and social indicators, income indicator was statistically significant (p=0.015) with a negative relation for hospitalization, and the Spatial Lag Model was also the best method to test spatial dependence, with a value of ? (rho) estimated at 0.80 and highly significant (p<0.0001). Conclusion: The research contributes to knowledge advancement that mortality and hospitalizations for tuberculosis are events socially determined that suggest management investments (AU) | |
| FAPESP's process: | 11/22834-5 - Mortality, hospitalizations for tuberculosis and underreporting of cases in Ribeirão Preto (SP) |
| Grantee: | Mellina Yamamura Calori |
| Support Opportunities: | Scholarships in Brazil - Doctorate |