ABSTRACT
This study aimed to identify the seroprevalence of chikungunya and its associated factors in the city of Quixadá, Ceará, Brazil. We also aimed to identify the spatial distribution patterns of positive cases. A cross-sectional survey was conducted with a questionnaire about clinical symptoms, socioeconomic and demographic factors, and a 10 ml blood sample was collected and analysed by ELISA. For the bivariate analysis, we use the chi-square test, a prevalence ratio and its 95% confidence interval. A robust Poisson hierarchical regression was used to adjust for confounders. The Kernel density was performed for the spatial analysis. A total of 409 samples were analysed; of them, 70.7% were seropositive for previous exposure to chikungunya virus (CHIKV). High seropositivity for CHIKV was higher in female participants (75.5%; PR = 1.23; 95% CI: 1.06-1.43), those aged 31 years or more (74.3%; PR = 1.62; 95% CI: 1.04-2.52), and those with elementary education level (75.0%; PR = 1.30; 95% CI: 1.06-1.60). There were also high seroprevalence in those with less than a minimum wage per month (89.5%; PR = 1.59; 95% CI: 1.11-2.30), housewives (87.5%; PR = 1.64; 95% CI: 1.24-2.18) and unemployed (80.0%; PR = 1.50; 95% CI: 1.10-2.06). After adjusting for age, morning stiffness was the only chikungunya symptom that remained associated (PR = 1.20; 95% CI: 1.06-1.37; p < .001). There was an area of high density of cases in the downtown and two areas of medium density in nearby regions. Otherwise, the higher seroprevalence rates were in the peripherical neighbourhoods. There is a hyperendemicity of CHIKV in Quixadá, and most cases are spatially contiguous. The main associated clinical sign is morning stiffness, but other factors such as low income and spending a longer time at home were significantly associated with higher seroprevalence.
Subject(s)
Arboviruses , Chikungunya Fever , Animals , Antibodies, Viral , Brazil/epidemiology , Chikungunya Fever/epidemiology , Chikungunya Fever/veterinary , Cross-Sectional Studies , Female , Humans , Seroepidemiologic Studies , Surveys and QuestionnairesABSTRACT
O câncer é uma doença de alta prevalência global com elevada taxa de mortalidade a partir dos trinta anos de idade, em especial, na população geriátrica. Os principais objetivos do diagnóstico de câncer e do programa de tratamento é curar ou prolongar a vida consideravelmente, e garantir a melhor qualidade de vida (QV) possível aos sobreviventes do câncer. Garantir boa QV tem sido um dos desafios das políticas públicas na área da gerontologia no mundo e no Brasil. Objetivo: revisar dados da literatura sobre a QV do idoso em tratamento oncológico. Metodologia: o método de pesquisa utilizado foi a revisão integrativa da literatura, que se fundamenta na prática baseada em evidências, utilizando como fonte de levantamento as bases de dados: LILACS, Scielo e MEDLINE/PubMed e os seguintes descritores: qualidade de vida (quality of life), câncer (neoplasms ou cancer), idosos (aged ou elderly) e tratamento (treatment). Foram incluídos artigos com resumos disponíveis que retratam a QV do paciente idoso com câncer e excluídos artigos que não tinha como enfoque principal o paciente idoso. Resultados: fatores como função emocional, social, cognitiva, dificuldades financeiras, assim como fatores relacionados aos efeitos colaterais dos tratamentos, interferem diretamente na qualidade de vida do idoso com câncer. Conclusão: vê-se a necessidade de uma avaliação global do paciente, realizada em conjunto entre as áreas de geriatria, oncologia e equipe multiprofissional, visando a um monitoramento para que o idoso consiga receber e seguir o tratamento sem complicações, possibilitando, assim, uma melhora da qualidade de vida.
Cancer is a global high-prevalence disease with high mortality rate from thirty years of age, especially in the geriatric population. The main goals of cancer diagnosis and treatment program is to cure or prolong life considerably, and ensure the best quality of life (QL) possible for cancer survivors. Ensure good QL has been one of the challenges of public policies in the field of gerontology in the world and in Brazil. Objective: to review the literature on QL of the elderly in cancer treatment. Methodology: the research method was an integrative literature review, which is based on evidence-based practice, using as a source of raising three databases: LILACS, Scielo and MEDLINE/PubMed and the following descriptors: quality of life, cancer, elderly and treatment. They included articles with abstracts available that depict the elderly patient QL with cancer and excluded articles that had as its main focus the elderly. Results: the results showed that factors such as emotional function, social, cognitive, financial difficulties, as well as factors related to the side effects of treatments, directly affect the quality of life of the elderly with cancer. Conclusion: it is necessary a comprehensive patient assessment, carried out jointly between the areas of geriatrics, oncology and multidisciplinary team, aiming to monitoring so that the elderly can receive and follow the treatment without complications, allowing a better quality of life.
