Fatores determinantes para óbitos por dengue: estudo caso-controle
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2021-07-15
Autores
Santos, Ezequiel Aparecido dos [UNESP]
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Universidade Estadual Paulista (Unesp)
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Introdução: Segundo a Organização Mundial de Saúde (OMS), a dengue apresentou elevada incidência nas últimas décadas, assim como a subnotificação dos casos. Comparando 2008 e 2015, os casos triplicaram nas Américas, no Sudeste Asiático e no Pacífico Ocidental, ultrapassando 3,2 milhões de casos. Destes, registrou-se 2,35 milhões nas Américas, sendo 10.200 os casos classificados como dengue grave e 1.181 os pacientes que morreram. Objetivo: Analisar os casos com sinais e sintomas, sinais de alarme, gravidade e óbitos. Métodos: estudo caso-controle, para identificar os fatores determinantes dos óbitos por dengue, analisando banco de óbitos e casos notificados no Sistema de Informação de Agravos de Notificação (SINAN) em 2019. Resultados: Observou-se que a variável sexo não foi significativa para o óbito, enquanto o estadiamento para dengue no primeiro atendimento age como fator de proteção, Odds Ratio (OR) de (0,03 e p<0,05). Além disso, notou-se que a internação (OR = 9,97), a idade que é considerada uma condição especial (OR = 4,9), diabetes e outras comorbidades (OR = 4,8 e 11,7) se apresentaram como fator de risco com significância estatisca (p<0,05%). Conclusão: Com o estudo caso-controle, conclui-se que: a) Atenção Básica não é a principal porta de entrada dos pacientes com dengue, b) falta de valorização dos sinais de alarme e gravidade da dengue principalmente pelos médicos e enfermeiros, c) necessidade monitoramento da infusão de líquidos a beira leito. Neste sentido a prevenção pode evitar a alta taxa de internação, reduzir custos e principalmente a mortalidade por dengue.
Introduction: According to the World Health Organization (WHO), dengue had a high incidence in recent decades, as well as underreporting of cases. Comparing 2008 and 2015, cases tripled in the Americas, Southeast Asia and the Western Pacific, surpassing 3.2 million cases. Of these, 2.35 million were registered in the Americas, with 10,200 cases classified as severe dengue and 1,181 patients who died. Objective: To analyze cases with signs and symptoms, alarm signs, severity and deaths. Methods: a case-control study to identify the determinants of deaths from dengue, analyzing the database of deaths and cases reported in the Notifiable Diseases Information System (SINAN) in 2019. Results: It was observed that the gender variable was not significant for death, while staging for dengue in the first visit acts as a protective factor, Odds Ratio (OR) of (0.03 and p<0.05). In addition, it was noted that hospitalization (OR = 9.97), age that is considered a special condition (OR = 4.9), diabetes and other comorbidities (OR = 4.8 and 11.7) were present. as a risk factor with statistical significance (p<0.05%). Conclusion: With the case-control study, it is concluded that: a) Primary Care is not the main entry point for patients with dengue, b) lack of appreciation of the alarm signs and severity of dengue, especially by doctors and nurses, c) need to monitor the infusion of liquids at the bedside. In this sense, prevention can avoid the high rate of hospitalization, reduce costs and especially dengue mortality.
Introduction: According to the World Health Organization (WHO), dengue had a high incidence in recent decades, as well as underreporting of cases. Comparing 2008 and 2015, cases tripled in the Americas, Southeast Asia and the Western Pacific, surpassing 3.2 million cases. Of these, 2.35 million were registered in the Americas, with 10,200 cases classified as severe dengue and 1,181 patients who died. Objective: To analyze cases with signs and symptoms, alarm signs, severity and deaths. Methods: a case-control study to identify the determinants of deaths from dengue, analyzing the database of deaths and cases reported in the Notifiable Diseases Information System (SINAN) in 2019. Results: It was observed that the gender variable was not significant for death, while staging for dengue in the first visit acts as a protective factor, Odds Ratio (OR) of (0.03 and p<0.05). In addition, it was noted that hospitalization (OR = 9.97), age that is considered a special condition (OR = 4.9), diabetes and other comorbidities (OR = 4.8 and 11.7) were present. as a risk factor with statistical significance (p<0.05%). Conclusion: With the case-control study, it is concluded that: a) Primary Care is not the main entry point for patients with dengue, b) lack of appreciation of the alarm signs and severity of dengue, especially by doctors and nurses, c) need to monitor the infusion of liquids at the bedside. In this sense, prevention can avoid the high rate of hospitalization, reduce costs and especially dengue mortality.
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Palavras-chave
Dengue, Doenças endemicas, Mortalidade, Epidemias e epidemiologia, Enfermeiras e enfermeiros, Endemic diseases, Mortality