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Resumen Objetivo: Describir la convergencia de fuerzas biosociales que interactúan para producir y exacerbar la mortalidad materna en el departamento de Chocó. Materiales y métodos: Estudio descriptivo, retrospectivo de la mortalidad materna y los factores asociados en el Chocó. Se solicitó autorización para revisión de fichas de vigilancia epidemiológica de todos los casos de muertes maternas entre 2013 y 2019. Se garantizó la confidencialidad usando códigos y número de historia clínica, para identificación. Además, se revisó la Encuesta Nacional de Demografía y Salud ENDS 2015 y los informes de control prenatal en el departamento del Chocó para identificar factores asociados a la mortalidad materna. Resultados: Se registró un total de 96 muertes maternas durante el período 2013-2019. El grupo comprendido entre 30-34 años de edad aportó el mayor número de casos de muerte materna (17 muertes). El 90% de los fallecimientos maternos pertenecían al Sistema General de Seguridad Social, 10% correspondía a población pobre no asegurada. El 94% (68) de los fallecimientos obstétricos corresponde a mujeres que desempeñaban labores en el hogar y 6% (4) empleadas del sector público. La principal causa de mortalidad materna se relacionó con trastornos hipertensivos en el embarazo. Se evidenció que solo el 72% de las gestantes recibieron control prenatal por médico en Chocó y el 6.6% de los controles fue realizado por enfermeras. En 2020, se reportó que el porcentaje máximo de nacidos vivos con más de 4 consultas de control prenatal fue 79.49%. Conclusiones: La situación observada sugiere la implementación de estrategias que mejoren el acceso a servicios de salud integrales de calidad. Se debe garantizar una articulación entre las autoridades de salud, actores de prestación de servicios del sistema de salud, actores comunitarios locales y la academia.
Abstract Objective: To describe the convergence of biosocial forces that interact to produce and exacerbate maternal mortality in the department of Chocó. Materials and methods: This is a descriptive, retrospective study of maternal mortality and its associated factors in Chocó. Authorization was requested to review the epidemiological surveillance files of all cases of maternal deaths between 2013 and 2019. Confidentiality was guaranteed by using codes and medical record numbers for identification. In addition, the National Survey of Demography and Health (NSDH) 2015 and prenatal control reports from the department of Chocó were reviewed to identify factors associated with maternal mortality. Results: A total of 96 maternal deaths were registered during the 2013-2019 period. The group between 30-34 years of age contributed with the highest number of cases of maternal death (17 deaths). 90% of maternal deaths (65) were affiliated with the General Social Security System, 10% (7) corresponded to the uninsured population. Finally, 94% of obstetric deaths (68) correspond to women who performed household chores, and 6% (4) to public sector employees. The main cause of maternal mortality was related to hypertensive disorders during pregnancy. It was evidenced that only 72% of pregnant women received prenatal check-ups by a doctor in Chocó and that the nurses attended 6.6% of them. In 2020, it was reported that the maximum percentage of live births with more than 4 prenatal check-ups was 79.49%. Conclusions: The observed situation suggests the implementation of strategies that improve access to quality integral health services. Thus, an articulation between health authorities, health system service providers, local community actors, and academia must be guaranteed.
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Introducción: La historia de la lactancia materna es tan antigua como la historia de la humanidad. La leche materna ha sido durante toda la existencia del ser humano el único alimento que el recién nacido y el lactante pequeño podían recibir para sobrevivir. En Cuba en 2014 se pudo apreciar que 33,2 por ciento de los infantes menores de 6 meses eran amamantados con lactancia materna exclusiva. Objetivo: Caracterizar el comportamiento de la lactancia materna exclusiva, según factores biosociales en el Policlínico Docente Aleida Fernández Chardiet del municipio La Lisa, en 2015. Material y Métodos: Se realizó un estudio observacional descriptivo, de corte transversal. El universo de estudio lo constituyeron 182 madres de niños nacidos durante esa etapa en el área de salud. Se realizaron distribuciones de frecuencia y cálculos porcentuales. Resultados: El 49,5 por ciento de madres mantuvo lactancia materna exclusiva por 6 meses. Solo 34,2 por ciento de madres con nivel de escolaridad de secundaria, mantuvo la lactancia materna exclusiva por 6 meses. Conclusiones: Casi la mitad de las madres mantuvieron la lactancia materna exclusiva por 6 meses. En las madres en que la lactancia materna exclusiva duró menos de 6 meses, predominaron los siguientes factores biosociales: edad menor de 20 años, nivel de escolaridad de secundaria, estudiantes, primíparas, solteras y las de familia severamente disfuncionales. La insuficiente disponibilidad de leche en las mamas fue la la causa más frecuente de supresión de la lactancia materna exclusiva(AU)
Introduction: The history of breastfeeding is as old as the history of mankind. Breast milk has been the only food that the newborn and the small infant could receive to survive during all the existence of the human being. It was observed that 33,2 percent of the infants younger than 6 months received exclusive breastfeeding in Cuba, in 2014. Objective: To characterize exclusive breastfeeding behavior according to biosocial factors in Aleida Fernández Chardiet Teaching Polyclinic, La Lisa Municipality, in the year 2015. Material and Methods: A cross-sectional descriptive observational study was conducted. The universe of study was composed of 182 mothers of children who were born in the health area during the study period. Distribution of frequencies, and percentage calculations were carried out. Results: 49,5 percent of mothers maintained exclusive breastfeeding for 6 months. Only 34,2 percent of mothers with secondary school education maintained exclusive breastfeeding for 6 months. Conclusions:Almost half the mothers maintained exclusive breastfeeding for 6 months. The following biosocial factors predominate in those mothers in whom exclusive breastfeeding lasted less than 6 months: younger than 20 years of age, secondary school education, students, primiparas, single, and mothers from severe dysfunctional families. Insufficient milk availability in the breasts was the most frequent cause of breastfeeding suppression(AU)
Subject(s)
Humans , Female , Breast Feeding/methods , Sociological Factors , Health Behavior/ethics , Epidemiology, Descriptive , Cross-Sectional Studies , Observational StudyABSTRACT
Background: Type 2 diabetes mellitus is a multi-factoral medical condition that aggregates in the family and has implications for family health. Research analyses of determinants of type 2 diabetes mellitus have demonstrated the interactions and clustering of family biosocial factors in its epidemiology. Aim: To determine the prevalence of type 2 diabetes mellitus and describe the associated family biosocial factors in ambulatory adult type 2 diabetic Nigerians in a primary care clinic in Southeastern Nigeria. Study Design: This was a cross-sectional study. Seven hundred and fifty patients were screened for diabetes mellitus and thirty five of them who had diabetes mellitus were age and sex matched with thirty five non-diabetic, non-hypertensive patients for the determination of the association with family biosocial factors. Place and Duration of Study: The study was carried out at a primary care clinic in Umuahia, South-eastern Nigeria in May 2011. Methodology: Data on family biosocial factors were obtained using pretested, structured and interviewer-administered questionnaire. Diabetes mellitus was defined using American Diabetes Association criterion. Results: The prevalence of type 2 diabetes mellitus was 4.7%. Eleven (1.5%) of the diabetic patients were newly diagnosed in the hospital. There were fourteen (40.0%) males and twenty one (60.0%) females with sex ratio of 1:1.5. The age ranged from 28-82 years with mean age of 47±11.2 years. The middle aged adults were predominantly affected. Family biosocial factors significantly associated with type 2 diabetes were family history of hypertension (P=.006) and diabetes mellitus (P=.048). A significantly higher proportion of the diabetic patients had family history of hypertension compared to the non-diabetic and non-hypertensive subjects. The diabetic patients were one and half times more likely to have family history of hypertension compared to their non-diabetic and non-hypertensive counterparts. Conclusion: The study has shown the prevalence of type 2 diabetes mellitus with predilection for middle aged adult Nigerians. The associated family biosocial factors were family history of hypertension and diabetes mellitus. Screening adult Nigerians with family history of hypertension and diabetes mellitus for diabetes mellitus is recommended in primary care setting for familycentred preventive care.
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Introducción: el bruxismo se define como el acto parafuncional de apretar los dientes, relacionado con factores locales, sistémicos, psíquicos y ocupacionales, generadores de una morbilidad que puede llegar a ser muy alta. Objetivo: determinar la asociación del bruxismo con factores bio-sociales. Método: se realizó una investigación analítica de casos-controles, de enero a junio de 2012, en la Clínica Estomatológica de Bayamo, Provincia Granma. El universo fue de 435 pacientes de 35-54 años ingresados durante el período, la muestra de 80 pacientes, 40 para cada grupo. Las variables estudiadas fueron: bruxismo, nivel de escolaridad, vínculo laboral, interferencias oclusales, necesidad de rehabilitación protésica por desdentamiento y trastornos en la articulación temporomandibular, que clasificaron como cualitativa nominal dicotómica. A partir de sus frecuencias absolutas se determinó la asociación entre estas por la prueba X2 cuando p<0,05 y el Odds Ratio (OR), con intervalos de confianza del 95 % (IC). Resultados: mostraron la relación causal entre el bruxismo y el alto nivel de escolaridad (OR=6,40; IC=2,35-17,15), el vínculo laboral (OR=10,50; IC=3,39-32,52), las interferencias oclusales (OR=7,86; IC=2,79-22,16), la necesidad de rehabilitación protésica (OR=16,24; IC=5,39-48,91) y los trastornos de la articulación temporomandibular (OR=4,27; IC=1,53-11,88). Conclusiones: el vínculo laboral como elemento generador de estrés, la necesidad de rehabilitación protésica y los trastornos sobre la articulación temporomandibular por su influencia en la relación de oclusión fueron los factores causales que más influyeron.
Introduction: bruxism is defined as the functional act of pressing the teeth, which is related with local, systemic, psychic and occupation factors that may cause a very high morbidity. Objective: to determine the bruxism association with biosocial factors. Method: an analytic control cases research was carried out, from January to June of 2012, at Dental Clinic of Bayamo, Granma Province. The universe comprised 435 patients between 35-54 years admitted during the period, and the sample was represented by 80 patients (40 for each group). The studied variables were: bruxism, education level, labor bond, occlusal interferences, necessity of rehabilitation denture for toothless and dysfunctions in the temporomandibular joint, classified as nominal qualitative dichotomy, considering the absolute frequencies, the association was determined among them by the test X2 when p < 0.05 and Odds Ratio (OR), with confidence intervals of 95 %. Results: the results showed the causal relationship between bruxism with education level (OR = 6.40) IC [2,35 - 17,15], labor bond (OR = 10,50) IC [3,39-32,52], occlusal interferences (OR = 7,86) IC [2,79-22,16], the necessity of denture rehabilitation (OR=16 ,24) IC [5,39. 48,91] and the temporomandibular joint dysfunctions (OR=4 ,27) IC [1,53. 11,88]. Conclusions: the labor bond as factor that causes stress, the necessity of rehabilitation denture were the causal factors of most influence due to its influence on the occlusion relationship.