ABSTRACT
RESUMEN Fundamento: la fecundidad cubana se encuentra por debajo del reemplazo, condición mantenida por más de cuatro décadas. Los valores de las tasas de fecundidad adolescente, no se corresponden con el nivel de fecundidad del país. La provincia Granma en el 2020 presentó la tasa de fecundidad adolescente más elevada del país, comportamiento que persiste por varios años. Objetivo: describir el comportamiento de la fecundidad adolescente en Granma y sus territorios para el período 2015-2020. Métodos: estudio descriptivo transversal sobre las madres menores de 20 años en la provincia Granma para el período 2015-2020. Se tuvieron en cuenta las tasas específicas para este grupo etario, peso relativo de la fecundidad adolescente, según zona de residencia y se analizaron los nacidos con bajo peso de madres adolescentes. Resultados: la provincia Granma y sus municipios presentan elevados valores de fecundidad adolescente, por encima de la media nacional. Existió un aumento de los valores de las tasas y pesos relativos en el período de análisis, así como de los porcentajes de niños bajo peso al nacer de madres adolescentes. En las zonas rurales fueron mayores los valores de los indicadores seleccionados. Conclusiones: deben integrarse acciones para disminuir la fecundidad y el embarazo adolescente en la provincia. Aunque existen programas de educación en salud sexual y reproductiva, debe integrarse el trabajo de las instituciones para reducir este comportamiento en las adolescentes.
ABSTRACT Background: Cuban fertility is below replacement, a condition that has been maintained for more than four decades. The values of the adolescent fertility rates do not correspond to the fertility level of the country. Granma province in 2020 had the highest adolescent fertility rate in the country, a behavior that persists for several years. Objective: to describe the behavior of adolescent fertility in Granma and its territories during 2015-2020. Methods: a descriptive cross-sectional study on mothers under 20 years of age in Granma province during 2015-2020. The specific rates for this age group, relative weight of adolescent fertility, according to the area of residence, were taken into account, and those born with low weight from adolescent mothers were analyzed. Results: Granma province and its municipalities show high adolescent fertility values, above the national average. There was an increase in the values of the relative rates and weights in the period of analysis, as well as in the percentages of low birth weight children of adolescent mothers. In rural areas, the values of the selected indicators were higher. Conclusions: actions should be integrated to reduce fertility and adolescent pregnancy in the province. Although there are sexual and reproductive health education programs, the work of the institutions must be integrated to reduce this behavior in adolescent girls.
ABSTRACT
Objective: To evaluate and compare sensitivity and specificity of ANB, Wits, APDI and AF-BF to diagnose sagittal skeletal malocclusions, in children between 6 to 12 years old, using ROC curves, a widely accepted method for the analysis and evaluation of diagnostic tests. Material and Methods: A descriptive-comparative study of diagnostic tests was conducted. From a population of 3,000 children, a non-probabilistic sample of 209 was selected. The clinical classification of the patients as class I, II or III, made by a group of experts based on the visual inspection of models and photographs, was chosen as the gold standard. After calibration (ICC>0.94) the variables were measured in cephalograms. Eight ROC curves were plotted (I vs II, and I vs III for each one of the variables). The area under the curve was measured and compared (Ji-square test). Cut points were established. Results: To discriminate Class I from II, ANB showed the largest area under the curve (AUC) (0.876) and the cut point (best sensitivity and specificity) was at 5.75°. To discriminate class I from III, Wits showed the largest AUC (0.874) with a cut point of -3.25 mm. There were no statistical differences between the AUC for the four variables (p=0.48 y p=0.38 for class I-II and I-III). Conclusion: ANB and Wits performed better for the diagnosis of class II and III, respectively. Cut points in children were different from those reported in adults.