Spatiotemporal clustering, social vulnerability and risk of congenital syphilis in northeast Brazil: an ecological study.

BACKGROUND: To investigate the spatial distribution of congenital syphilis (CS) and its association to social vulnerability indexes in northeast Brazil. METHODS: This was an ecological study referring to all cases of CS and CS deaths recorded in the northeast region of Brazil from 2008 to 2015. Data were obtained from three Brazilian information systems. We examined statistical correlations between CS indicators by state and municipality and their socioeconomic and social vulnerability characteristics. We used Bayesian empirical local models to identify fluctuations of the indicators. Spatial statistical tests were used to identify spatial clusters and the municipalities at high risk of CS. RESULTS: The incidence of CS ranged from 2.1 cases/1000 live births (LB) in 2008 to 6.9/1000 LB in 2015, with an annual increase of 19.9% (p < 0.001). The mortality coefficient of CS ranged from 2.9/1000 LB in 2008 to 6.5/1000 LB in 2015, resulting in an annual increase of 15.1% (p < 0.001). Nine spatial clusters were identified. Cases of congenital syphilis occurred in well-defined spatiotemporal clusters and in areas with high levels of social vulnerability. CONCLUSIONS: CS incidence is associated with social vulnerability. CS control programmes should target spatial clusters and populations with high levels of social vulnerability.

Induced abortion: risk factors for adolescent female students, a Brazilian study.

The purpose of this study was to analyze risk factors for abortion among female teenagers from 12 to 19 years of age in the city of Maceió, Brazil. This is a cross-sectional study, conducted in ten schools. The sample was calculated by considering the number of admissions for postabortion curettage, obtained from the Information System of Hospitalization. Data were obtained through a semi-structured questionnaire divided into three basic blocks of data: sociodemographic, sexual life, and pregnancy/abortion. To analyze the data, the logistic regression model was used. The Forward Method was chosen to set the final model that minimizes the number of variables and maximizes the accuracy of the model. The significant analysis between the dichotomous variables provided eight significant variables. Two of them are protective for abortion: the ages 12-14 years and talking with parents about sex. After the logistic regression, the receipt of support for abortion was the most significant variable of all. The adolescent with an active sexual life, a previous pregnancy, who is married, and has received support for an abortion has a 99.74% probability for an abortion. The results of this study, demonstrating the importance of the group in adolescence, and the statistical significance of having a partner to support and approve the pregnancy appears as a preventive factor for abortion. It shows the importance of support and companionship for adolescent women.

Adolescents: contraceptive knowledge and use, a Brazilian study.

The purpose of this study was to identify the knowledge and use of contraceptive methods by female adolescent students. The study was cross-sectional and quantitative, using a semi-structured questionnaire that was administered to 12- to 19-year-old female students in Maceió, Brazil. A representative and randomized sample was calculated, taking into account the number of hospital admissions for curettage. This study was approved by the Human Research Ethics Committee, and Epi Info software was used for data and result evaluation using the mean and chi-square statistical test. Our results show that the majority of students know of some contraceptive methods (95.5%), with the barrier/hormonal methods being the most mentioned (72.4%). Abortion and aborting drugs were inaccurately described as contraceptives, and 37.9% of the sexually active girls did not make use of any method. The barrier methods were the most used (35.85%). A significant association was found in the total sample (2,592) between pregnancy and the use of any contraceptive method. This association was not found, however, in the group having an active sexual life (559). The study points to a knowledge of contraceptive methods, especially by teenagers who have already been pregnant, but contraceptives were not adequately used. The low use of chemical methods of contraception brings the risk of pregnancy. Since abortion and aborting drugs were incorrectly cited as contraceptive methods, this implies a nonpreventive attitude towards pregnancy.

Efeito do stress no grau de inflamação gengival em adolescentes grávidas: estudo piloto / Effect of stress on the degree ofgingival inflammation in pregnant adolescents: pilot study

Objetivo: Avaliar a severidade de inflamação gengival perante duas condições, estresse e gravidez, em um grupo de adolescentes atendidas no serviço público de saúde na cidade de Maceió-AL. Material e métodos: 80 adolescentes grávidas com faixa etária ente 14 e 19 anos, atendidas em centros de referência ao atendimento pré-natal na cidade de Maceió-AL, participaram desse estudo piloto. O estresse social foi avaliado subjetivamente pelo teste de avaliação de estresse e a inflamação gengival foi avaliada pelo índice de inflamação gengival através de um exame clínico utilizando-se 6 dentes índices. A análise estatística foi executada relacionando o estresse social com dados demográficos e de hábitos de higiene oral e com relação a inflamação gengival pelo teste de Mann-Whitney e pelo teste de Fischer para variáveis dicotômicas. Resultados: Na avaliação da relação do estresse com a inflamação gengival e com o índice de placa com controle das variáveis independentes foi utilizada a regressão logística multivariada. Todos os testes foram aplicados com nível de confiança de 95%. O teste de Mann-Whitney demonstrou que as grávidas estressadas apresentavam maior frequência de escovação que as grávidas sem stress (p=0.008). Os outros dados demográficos e de hábitos de higiene oral se distribuíram igualmente entre os grupos. A análise por regressão logística multivariada demonstrou que nenhuma das variáveis independentes influenciou no índice gengival e no índice de placa em mulheres grávidas com ou sem stress. Conclusão: O estresse não causou aumento da severidade da inflamação gengival em adolescentes grávidas.

Objective: Evaluate the severity of gingival inflammation against two conditions, stress and pregnancy, in a group of adolescents treated at a public health service in Maceió-AL. Material and methods: 80 pregnant adolescents aged between 14 to 19 years being treated at referral centers for prenatal care in the city of Maceió-AL, participated in this pilot study. The social stress was subjectively evaluated by assessment of stress test (Lipp test) and gingival inflammation was assessed by the index of gingival inflammation (Loe & Silness) through a clinical examination using six index teeth. Statistical analysis was performed relating the social stress with demographic data and habits regarding oral hygiene and gingival inflammation using the Mann-Whitney and Fischer's test for dichotomous variables. Results: When considering the influence of the stress in gingival inflammation and plaque index with controlled of theindependent variables the multivariate logistic regression was used. All tests were applied with a confidence level of 95%. The Mann-Whitney test demonstrated that pregnant women under stress showed higher frequency of brushing than pregnant women without stress (p = 0.008). The other demographic and oral hygiene habits were equally distributed between the groups. A multivariate logistic regression analysis showed that none of the independent variables influenced the gingival index and plaque index in pregnant women with or without stress. Conclusion:The stress did not increase the severity of gingival inflammation in pregnant adolescents.