Acesso da população ao diagnóstico e tratamento da esquistossomose em área endêmica no Município de Jequitinhonha, Minas Gerais

AUTOR(ES)
DATA DE PUBLICAÇÃO

2009

RESUMO

This study examines the relationship between demographic, social, economic, geographic and health service patterns and the utilization of health-care by a population in diagnostic and treatment of schistosomiasis in City of São Pedro do Jequitinhonha, State of Minas Gerais, Brazil. This study enrolled 1,228 subjects, including 935 residents of the central village, and 293 in rural area. Data collection consisted of a questionnaire with demographic, socioeconomic, cultural information and access and utilization of health services related to diagnosis and treatment of schistosomiasis in 2002 (active case findings), in addition to the period between 2002 and 2006 (passive demand). Three stool test samples were taken from each subject, analyzed using the Kato-Katz method and subjects testing positive for S. mansoni were treated with praziquantel. Focal groups were conducted with 30 residents and interviews with health professionals to collect information regarding access to public health services and schistosomiasis control. Data analysis involved the following: descriptive analysis according to residence, univariate and multivariate logistic regression with a Generalized Estimation Equation (GEE). The interviews and focus groups were analyzed according to the analysis of Bardin. Results pointed to an inequity to access and the utilization of health care by the target population in the diagnostic and treatment of schistosomiasis. The main barriers associated with low utilization rate at the individual level were poor economic conditions, lack of knowledge by subjects regarding schistosomiasis and a high rate of home medication consumption. At the health services level, the main barriers were lack of routine stool-sample collection testing at local health services, the centralization of praziquantel in Jequitinhonha Municipality and the lack of health education programs. Access to the ongoing cases by the health service, in 2002, differed between central village and rural residents, and this strategy for schistosomiasis control does not occur as directed according to protocol procedures by the Brazilian Ministry of Health. The large distances between the rural residences, in addition to the geographical barrier caused by the Jequitinhonha River, a lack of public transportation, are such factors that may have contributed to low rate of health-care utilization for diagnostic and treatment of schistosomiasis. These barriers associated with lack of sanitation conditions have contributed to high disease prevalence and lack of control of schistosomiasis in this study area. Our results showed major differences in perception and knowledge of schistosomiasis control between users and health services providers. Results suggest the need to accelerate the dissemination of schistosomiasis control program at primary health services in order to make them more accessible to the at-risk population in the Sao Pedro District. This must include a health education program that will focus on health promotion and active participation of the community.

ASSUNTO(S)

enfermagem decs humanos decs esquistossomose mansoni/terapia decs pesquisa qualitativa decs acesso aos serviços de saúde decs questionários decs esquistossomose mansoni/diagnóstico decs enfermagem teses desigualdade em saúde decs população rural decs brasil decs fatores socioeconômicos decs

ACESSO AO ARTIGO

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