ABSTRACT
O câncer do colo uterino é um importante problema de saúde pública no Brasil e sua identificação precoce aumenta consideravelmente a probabilidade de cura. O principal instrumento utilizado na detecção precoce deste câncer é o exame Papanicolau. O objetivo deste estudo foi analisar fatores biopsicossociais que interferem na realização do exame preventivo do câncer do colo do útero entre mulheres do Município de Porto Velho, Estado de Rondônia, com ênfase na prática religiosa. Aplicou-se questionário individual mediante visita domiciliar e realizaram-se entrevistas semiestruturadas em igrejas locais onde são realizados exames preventivos mensalmente. A amostra foi de 227 mulheres, dentre as quais 82,8 por cento declararam já ter realizado alguma vez o exame. A etnia, o estado civil, o grau de instrução, a profissão e a religião não foram detectados como significativos para a não realização do exame preventivo. Há preferência entre as participantes pela realização do exame preventivo nas igrejas, pois estas oferecem um espaço físico e social de acolhimento. Políticas intersetoriais neste sentido podem ser desenvolvidas para aumentar as taxas de cobertura do exame.
Cervical cancer is a major public health problem in Brazil, and its early detection greatly increases the likelihood of cure. The main tool for the early detection of cervical cancer is the Papanicolaou smear (Pap smear). The aim of the present study was to analyze the biopsychosocial factors that affect the performance of cervical cancer screening tests among women in the municipality of Porto Velho, Rondônia State, Brazil, with an emphasis on religious practices. An individual questionnaire was applied during home visits, and semi-structured interviews were conducted in local churches where preventive screening is performed monthly. The sample consisted of 227 women of whom 82.8 per cent had previously undergone the test. Ethnicity,marital status, schooling, occupation and religion were not considered significant factors for the execution of preventive screening in the women. There was a preference among the participants towards performing the screening tests at the churches because they offer a physically and socially welcoming space. Therefore, intersectoral policies can be developed to increase the tests coverage rates.
Subject(s)
Female , Humans , Adult , Uterine Cervical Neoplasms , Vaginal Smears , Brazil , Public Health , Risk Factors , Women's HealthABSTRACT
A critical role has been proposed for the switch from non-cytophilic IgG2 to cytophilic antibodies of IgG1 and IgG3 subclasses observed in the humoral immune responses to Plasmodium falciparum of some Africans. These Africans have acquired clinically immunity naturally, after several years of exposure to holo-endemic malaria. In the present study, the possibility that life-long exposure to low levels of malarial endemicity may be associated with changes in the IgG-subclass composition of antibodies to P. falciparum was investigated in a native Amazonian community. The subjects were 138 malaria-exposed but non-infected Karitiana Indians. In a separate investigation, the concentrations of IgG-subclass antibodies in acutely ill patients with severe malaria (N = 22) were compared with those in age- and sex-matched controls who had uncomplicated malaria (N = 44). Plasma concentrations of IgG against a detergent-soluble extract of P. falciparum schizonts were measured by quantitative ELISA, using indirect standardization. Among the Karitiana, the concentrations of anti-parasite antibodies of all subclasses increased with age, and there was no correlation between age and the proportion of such antibodies which was cytophilic. The predominance of cytophilic IgG1 and non-cytophilic IgG2 antibodies in all age-groups of the Karitiana provides an example of an intermediate pattern of immune responses to P. falciparum which contrasts with those previously described in both clinically immune and non-immune populations. Although mean concentrations of cytophilic IgG1 against P. falciparum were significantly higher in the controls than in the patients with severe malaria, there were no significant differences in other IgG subclasses. Lack of exposure to malaria in the past was associated with disease severity (odds ratio = 4.75; 95% confidence interval = 1.31-17.42), and may explain, at least partially, the occurrence of defective, low-IgG1 antibody responses to P. falciparum in those subjects who had severe malaria.
Subject(s)
Male , Female , Humans , Plasmodium falciparum , Enzyme-Linked Immunosorbent AssayABSTRACT
Proposta para a assistência à saúde de populaçöes indígenas, tomando por base a problemática de saúde dos índios Karitiana de Rondônia. Leva em consideraçäo as condiçöes de saúde/doença do grupo indígena em questäo através do levantamento sistemático dos dados epidemiológicos, assim como a compreensäo do processo que proporciona a saúde ou que leva a doença no imaginário da comunidade. Associa números e dados de Epidemiologia às questöes culturais e ao sistema de representaçöes sociais da própria comunidade e, a partir desse complexo de informaçöes, elabora o conjunto das açöes de saúde que deveräo ser dirigidas para melhorar a qualidade e aumentar a quantidade de vida dos indivíduos e do grupo social. Os índios, atores sociais envolvidos num processo cultural que lhes é próprio e único e com regras muito particulares, requerem açöes de saúde específicas
