ABSTRACT
A tuberculose (TB) é um grande desafio para as autoridades de saúde pública no mundo. O Brasil é um dos 30 países onde a doença ainda está presente e, portanto, fazendo parte da lista e das prioridades nas agendas internacionais para estratégias de controle do agravo (BRASIL, 2020; 2021b). O plano nacional pelo fim da TB como problema de saúde pública 2021-2025 renova as metas a serem atingidas para melhoria das condições da doença, com redução da incidência para 90% e da mortalidade para 95%. Estas metas tomaram como base o resultado do ano de 2015 no país (BRASIL, 2021; 2022). Com a emergência sanitária causada pelo advento da COVID 19 houve piora das condições da tuberculose com queda dos diagnósticos em 2020 e, consequentemente, do registro de notificações, e aumento dos óbitos, causando piora nos indicadores tanto epidemiológicos quanto operacionais (BRASIL, 2022). O estado do Rio de Janeiro dentro deste quadro da TB situa-se em posição de destaque negativo, sendo o 2º em taxa de incidência e o 1º em taxa de mortalidade, segundo dados do último boletim de 2022 do Ministério da Saúde (BRASIL, 2022). Para que a situação da doença seja acompanhada por gestores e programas de saúde, bem como por toda comunidade científica e social é através do cálculo de seus principais indicadores, por meio dos sistemas oficiais de vigilância padronizados nacionalmente. Sendo os indicadores de morbidade extraídos da alimentação do Sistema de Informação de Agravo de Notificação SINAN, com preenchimento da ficha de notificação/investigação da tuberculose. E para os dados de mortalidade o Sistema sobre Mortalidade SIM, por meio do registro da Declaração de Óbitos.
Subject(s)
Tuberculosis/mortality , Tuberculosis/epidemiology , Epidemiology , Health Status Indicators , Brazilian Health Surveillance Agency , Patient Dropouts/statistics & numerical data , Unified Health System , Health Information Systems/classificationABSTRACT
No Brasil, a prevalência de tabagismo ainda é elevada em pessoas portadoras de Condições Crônicas não Transmissíveis (CCNT). A compreensão dos modelos de atenção ao tabagista é essencial para se reduzir o abandono do tratamento. Objetivos: identificar as características sociodemográficas e de saúde dos indivíduos que buscaram o Programa Nacional de Controle do Tabaco (PNCT) em duas Unidades Básicas de Saúde (UBS) do município de Campinas, estimar o percentual de abandono do tratamento e elencar os fatores associados a esse desfecho. Metodologia: coorte histórico cujos dados foram obtidos, entre 2016 e 2019, em grupos de tratamento do PNCT. Para a realização da análise exploratória, a pesquisa incluiu 276 participantes, dos quais foram registradas suas variáveis sociodemográficas, condições de saúde, formas de uso do tabaco e participação no programa. Foram estimados o índice de abandono do tratamento e as possíveis relações com as variáveis significativas através de regressão múltipla. Resultados: a média de idade foi de 50,7 anos, com 60% do sexo feminino, 57,7% brancos, 52,2% com companheiro, 84,7% com filhos, 52,5% com ensino fundamental, 64% com renda entre um e dois salários, 40,1% trabalhando em setor de serviços e 58% católicos. O percentual de abandono do tratamento foi de 31%. A hipertensão se relacionou com o abandono do tratamento (p=0,030), reduzindo-o. Conclusão: o perfil dos indivíduos foi semelhante ao encontrado em outras pesquisas; indivíduos não hipertensos apresentaram maioríndice de abandono. São necessários outros estudos que avaliem fatores associados ao abandono do tratamento
In Brazil, there is still a high prevalence of smoking among people with chronic diseases. The understanding of smoking treatments is essential to a reduction in treatment dropout. Objectives: to identify epidemiological and health aspects of smokers, estimate the dropout rates, and list the factorsassociated with treatment dropouts. Data from PNCT (National Program of Tobacco Control) treatment groups was obtained from a historical cohort between 2016 and 2019. The research included 276 participants with different sociodemographic realities, healthconditions, forms of tobacco use, and participation in the program to conduct an exploratory analysis. The treatment dropout rate and possible relations with significant variables were estimated through multiple regression. Results: The mean age was 50.7 years; 60% female; 57.7% white; 52.2% with a partner; 84.7% with children; 52.5% studied until elementary school; 64% received between one and two salaries; 40.1% worked in the service sector; 58% were Catholic. The percentage of treatment dropouts was 31%. Hypertension was related to treatment dropout (p = 0.030), reducing it. Conclusion: The profiles of individuals were similar to those in other surveys. Non-hypertensive individuals had a higher dropout rate. Further studies are needed to assess the factors associated with treatment dropout.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Patient Dropouts/statistics & numerical data , Tobacco Use Disorder/prevention & control , Smoking Prevention , Health Status , Risk Factors , Sociodemographic FactorsSubject(s)
Humans , Male , Female , Adult , Middle Aged , Body Weight/drug effects , Glucagon-Like Peptides/administration & dosage , Glucagon-Like Peptides/agonists , Overweight/drug therapy , Liraglutide/administration & dosage , Hypoglycemic Agents/administration & dosage , Obesity/drug therapy , Patient Dropouts/statistics & numerical data , Placebos/administration & dosage , United States , Drug Administration Schedule , Weight Loss , Randomized Controlled Trials as Topic , Multicenter Studies as Topic , Treatment Outcome , Clinical Trials, Phase III as Topic , Diabetes Mellitus , Glucagon-Like Peptides/adverse effects , Overweight/therapy , Liraglutide/adverse effects , Hypoglycemic Agents/adverse effects , Injections, Subcutaneous , Obesity/therapyABSTRACT
Objetivo: Analisar os fatores de risco para o abandono do tratamento da tuberculose no município de Porto Velho RO, no período de 2010 a 2015. Método: Estudo descritivo, transversal e quantitativo dos dados coletados no Sistema de Notificação de Agravos Nacional de todos os portadores de tuberculose que abandonaram o tratamento no município. Análise foi realizada através de distribuição de frequência, após atender os preceitos éticos. Resultados: Pertencer ao sexo masculino (73,6%), média de idade de 34,8 anos, cor/raça parda (70,2%), baixa escolaridade (35,1%), desemprego (8,9%), caso novo (64,3%), forma clínica pulmonar (87,4%), raio-x suspeito (75%), baciloscopia de escarro positiva (62,5%), exames de controle mensal não realizados/ em branco, aproximadamente quatro meses de tratamento e não ser acompanhado pelo regime do Tratamento Diretamente Observado, constituíram como fatores de risco para o abandono. Conclusão: Evidencia-se a necessidade de ações sobre estes fatores, para fornecer subsídios para o controle da doença
Objective: to analyze the risk factors for the abandonment of tuberculosis treatment in the municipality of Porto Velho - RO, from 2010 to 2015. Methods: a descriptive, cross-sectional and quantitative study of the data collected in the National Disease Notification System of all tuberculosis patients who abandoned treatment in the municipality. Analysis was performed through frequency distribution, after meeting the ethical precepts. Results: male (73.6%), mean age 34.8 years, brown color/ race (70.2%), low schooling (35.1%), unemployment (8.9%), new case (64.3%), pulmonary clinical form (87.4%), suspected x-ray (75%), sputum smear positive (62.5%), monthly checkups unconcluded/ blank monthly control tests four months of treatment and not being accompanied by the Directly Observed Treatment regimen, were considered as risk factors for abandonment. Conclusion: the need for action on these factors is evidenced, in order to provide subsidies for the control of the disease
Objetivo: analizar los factores de riesgo para el abandono del tratamiento de la tuberculosis en el municipio de Porto Velho - RO, en el período de 2010 a 2015. Método: estudio descriptivo, transversal y cuantitativo de los datos recogidos en el Sistema de Notificación de Agravios Nacional de todos los portadores de tuberculosis que abandonaron el tratamiento en el municipio. El análisis fue realizado a través de la distribución de frecuencia, después de atender los preceptos éticos. Resultados:pertenencia al sexo masculino (73,6%), promedio de edad de 34,8 años, color/ raza parda (70,2%), baja escolaridad (35,1%), desempleo (8,9%), caso nuevo (64,3%), forma clínica pulmonar (87,4%), radiografía sospechosa (75%), baciloscopia de esputo positivo (62,5%), exámenes de control mensual no realizados/ en blanco, aproximadamente cuatro meses de tratamiento y no ser acompañado por el régimen del Tratamiento Directamente Observado, constituyeron como factores de riesgo para el abandono. Conclusión: se evidencia la necesidad de acciones sobre estos factores, a fin de proporcionar subsidios para el control de la enfermedad
Subject(s)
Humans , Male , Female , Patient Dropouts/statistics & numerical data , Tuberculosis/epidemiology , Medication Adherence/statistics & numerical data , Risk FactorsABSTRACT
A epidemia de HIV/aids teve início na década de 1980 e avançou pelo mundo se constituindo hoje como uma infecção que tem grande incidência entre as mulheres. Apesar do progresso no desenvolvimento de medicações eficazes para tratamento e controle da infecção pelo HIV, ainda há um número elevado de novas infecções e mortes registrados todos os anos no Brasil. Esta pesquisa foi desenvolvida com objetivo de conhecer a proporção de mulheres vivendo com HIV que abandonam o tratamento após acompanhamento pré-natal especializado e as questões relacionadas à interrupção. Foram realizados, portanto, dois estudos: uma análise retrospectiva de dados de mulheres que iniciaram pré-natal entre 2016 e 2017 em ambulatório especializado de um hospital público do município do Rio de Janeiro; e um estudo qualitativo de narrativas a partir de entrevistas com mulheres que compareceram ao mesmo ambulatório entre 2019 e 2020. O primeiro analisou dados socioeconômicos, comportamentais, obstétricos, clínicos e laboratoriais utilizando dados do SICLOM e de prontuários do HFSE. Foram analisados dados de 454 mulheres, das quais 18% interromperam o uso da medicação antirretroviral após o final da gestação. O uso de drogas ilícitas durante a gestação e conhecer o diagnóstico do HIV e não estar em uso de ARV quando engravidou foram fatores associados ao abandono do tratamento após a gestação. O estudo de narrativas partiu da análise de entrevistas realizadas com 6 mulheres que interromperam o tratamento após uma gestação e retornaram ao serviço para consultas de puerpério ou pré-natal de uma nova gestação ou consulta de pediatria de algum filho. A análise observou que a vivência de múltiplas vulnerabilidades (social, de gênero e racial) somada à tristeza e ao isolamento relacionados à soropositividade pode constituir uma situação de grande sofrimento psíquico para mulheres vivendo com HIV que são mães. A partir dos resultados obtidos, consideramos imprescindível que os profissionais de saúde tenham formação adequada para acolher mulheres vivendo com HIV tanto em serviços especializados, como na rede básica de saúde. Parte das mulheres soropositivas têm experiência de grande sofrimento e a impossibilidade de acolhê-las em suas individualidades pode se constituir como mais uma barreira ao tratamento do HIV.
The AIDS epidemic began in the 1980s, spread around the world, and is currently an infection with high incidence among women. Despite progress in developing effective medications to treat and control HIV infection, the number of new infections every year is still high in Brazil. This research aimed to determine the proportion of women living with HIV who abandon treatment after specialized prenatal care and the causes of such abandonment. Two studies were conducted: first, a retrospective analysis of data on women who received prenatal care in 2016-2017 at a specialized health clinic at a public hospital in Rio de Janeiro; and second, a qualitative study of narratives based on interviews with women who attended the same outpatient clinic in 2019-2020. The first study analyzed socioeconomic, behavioral, obstetric, clinical and laboratory data using records from SICLOM and medical charts. Data from 454 women were analyzed, 18% of whom interrupted treatment after pregnancy. In the narratives study, interviews were conducted with six women who interrupted treatment after pregnancy but returned to the hospital for postnatal care, prenatal care for a subsequent pregnancy, or pediatric appointments for one of their children. The results indicated that the experience of multiple vulnerabilities (social, gender, racial) in conjunction with sadness and loneliness related to HIV provoke suffering among women living with HIV who are mothers. Considering the results of both studies, it is essential that health professionals have adequate education and training to care for women living with HIV at specialized clinics as well as in primary care. Women living with HIV may experience considerable suffering. Healthcare providers who are not attuned to the individual circumstances of these patients can become another obstacle to HIV treatment.
Subject(s)
Humans , Female , Pregnancy , Patient Dropouts/statistics & numerical data , Prenatal Care , Pregnancy , Acquired Immunodeficiency Syndrome/therapy , Anti-Retroviral Agents/therapeutic use , Socioeconomic Factors , Brazil , Retrospective Studies , Social VulnerabilityABSTRACT
Objetivou-se identificar fatores relacionados, classificar a tendência temporal e identificar áreas com associação espacial do abandono de tratamento para tuberculose em Ribeirão Preto, São Paulo. Estudo ecológico; população composta pelos casos notificados entre 2006 a 2017. Realizou-se o teste qui-quadrado para identificar fatores relacionados. Para a tendência temporal, utilizou-se o método de Prais-Winsten para classificar a tendência temporal do evento e calculada sua porcentagem de variação anual. Para verificar associação espacial, utilizaram-se as técnicas G e Gi*. Foram notificados 146 casos de abandono do tratamento da doença no período; como fatores de risco foi identificado pessoas sem escolaridade, retratamentos pós-abandono e falência prévia; como proteção casos novos identificados pela busca ativa, não ter coinfecção Tuberculose-HIV e não fazer uso de álcool ou drogas. A taxa de abandono apresenta tendência crescente (APC=1,6%; IC95% 0.023.48). O estudo evidencia o aumento do abandono de tratamento, contrariando as políticas direcionadas pelo End TB Strategy.
The objective was to identify related factors, classify the time trend and identify areas with spatial association of abandonment of treatment for tuberculosis in Ribeirão Preto, São Paulo. Ecological study; population composed of the cases notified between 2006 and 2017. The chi-square test was performed to identify related factors. For the time trend, the Prais-Winsten method was used to classify the time trend of the event and calculate its percentage of annual variation. To verify spatial association the G and Gi* techniques were used. In the period, 146 cases of abandonment of the disease treatment were notified; as risk factors, people without education, retreatment after abandonment, and previous failure were identified; as protection, new cases were identified by active search, no Tuberculosis-HIV co-infection, and no alcohol or drug use. The abandonment rate shows an increasing trend (APC=1.6%; 95%CI 0.023.48). The study evidences the increase of abandonment of treatment, contradicting the policies directed by the End TB Strategy.
Subject(s)
Humans , Patient Dropouts , Tuberculosis , Patient Dropouts/statistics & numerical data , Public Health , Treatment Adherence and ComplianceABSTRACT
RESUMO: Objetivo: Este estudo objetivou investigar os fatores associados aos desfechos de cura e abandono na população privada de liberdade com tuberculose. Métodos: Estudo quantitativo, observacional e analítico. Realizado com dados oriundos do Sistema de Informação de Agravos de Notificação (Sinan), de tuberculose da população privada de liberdade nos anos de 2007 a 2016 no estado da Paraíba. Foram incluídas as notificações de indivíduos maiores de 18 anos notificados como "casos novos" e como encerramento por "cura" ou "abandono". Excluíram-se aqueles que até dezembro de 2016 não tinham a situação de encerramento. Realizaram-se estatísticas bivariada e multivariada, por meio de regressão de Poisson. Resultados: Com 614 notificações, a maioria foi do sexo masculino (93,8%). Na análise bivariada, houve associação estaticamente relevante dos desfechos com síndrome da imunodeficiência adquirida (p = 0,044), sorologia para vírus da imunodeficiência humana (p = 0,048) e não realização de baciloscopia de acompanhamento (p = 0,001). Na análise multivariada ajustada, a síndrome da imunodeficiência adquirida (risco relativo - RR = 1,998; intervalo de confiança de 95% - IC95% 1,078 - 3,704; p = 0,028) e a não realização de baciloscopia de acompanhamento (RR = 5,211; IC95% 2,158 - 12,583; p < 0,001*) permaneceram significativamente associadas ao desfecho de abandono. Conclusão: Os desfechos de cura e abandono estão associados principalmente com a realização ou não da baciloscopia de acompanhamento e com a síndrome da imunodeficiência adquirida.
ABSTRACT: Objective: This study aimed to investigate the factors associated with the outcomes of recovery and abandonment in the incarcerated population with tuberculosis. Methods: A quantitative and observational analytical study was performed with data from the Notification Disease Information System (Sinan), tuberculosis data from the incarcerated population in the state of Paraiba from 2007 to 2016; Notifications of individuals over the age of 18, reported as "new cases" and the outcome, "recovery" or "abandonment" status were included. Those people who until December 2016 had no outcome information were excluded. Analyses were performed using bivariate and multivariate statistics from the Poisson regression. Results: Of the 614 notifications, most were male (93.8%). In the bivariate analysis, there was a statistically relevant association of outcomes with Acquired Immunodeficiency Syndrome (p = 0.044), Human Immunodeficiency Virus (HIV) serology (p = 0.048) and lack of completion of follow-up bacilloscopy (p = 0.001). In the adjusted multivariate analysis, Acquired Immunodeficiency Syndrome (RR = 1.998; 95%CI 1.078 - 3.704; p = 0.028) and lack of completion of follow-up bacilloscopy (RR = 5.251; 95%CI 2.158 - 12.583; p <0.001*) remained significantly associated with the dropout outcome. Conclusion: Recovery and abandonment outcomes were mainly associated with whether the follow-up bacilloscopy was performed or not and Acquired Immunodeficiency Syndrome.
Subject(s)
Humans , Male , Female , Adult , Patient Dropouts/statistics & numerical data , Prisoners/statistics & numerical data , Tuberculosis/therapy , Brazil/epidemiology , Follow-Up Studies , Bacteriological Techniques/statistics & numerical data , Acquired Immunodeficiency Syndrome/epidemiology , Treatment OutcomeABSTRACT
Resumen Introducción. En la tuberculosis multirresistente, el abandono del tratamiento constituye un grave problema de salud pública que afecta la calidad de vida de los pacientes, sus familias y la comunidad. El enfrentarlo supone una carga para los sistemas sanitarios debido a que provoca fuentes de transmisión libre en la comunidad e incrementa la prevalencia y la mortalidad. De ahí, la necesidad de investigar los factores asociados con esta situación. Objetivo. Determinar los factores de riesgo asociados con el abandono del tratamiento en pacientes con tuberculosis multirresistente en la región de Callao (Perú). Materiales y métodos. Se hizo un estudio analítico de casos y controles (80 casos y 180 controles) en tratamiento entre el 1° enero del 2010 y el 31 diciembre del 2012. Los factores se determinaron mediante regresión logística, y se calcularon los odds ratios (OR) y los intervalos de confianza (IC) del 95 %. Resultados. En el análisis multivariado se determinaron los siguientes factores de riesgo: no tener conocimiento de la enfermedad (OR=23,10; IC95%: 3,6-36,79; p=0,002); no creer en la curación (OR=117,34; IC95%: 13,57-124,6; p=0,000); no tener apoyo social (OR=19,16; IC95%: 1,32-27,77; p=0,030); no considerar adecuado el horario de atención (OR=78,13; IC95%: 4,84-125,97; p=0,002), y no recibir los resultados de laboratorio (OR=46,13; IC95%: 2,85-74,77; p=0,007). Conclusión. Los servicios de salud deben esforzarse en la determinación precoz de las condiciones que podrían convertirse en factores de riesgo, lo cual ayudaría a implementar preventivamente intervenciones efectivas, rápidas y de alto impacto.
Abstract Introduction: In the context of multidrug-resistant tuberculosis, abandonment of therapy represents a serious public health problem that affects the quality of life of patients, families, and communities. Managing this phenomenon places a burden on health systems since it causes free sources of transmission in the community, thereby increasing prevalence and mortality. Thus, there is a need to study factors associated with this problem. Objective: This study sought to identify risk factors associated with the abandonment of therapy by patients with multidrug-resistant tuberculosis in the Peruvian region of Callao. Materials and methods: We conducted an analytical case-control study (cases=80; controls=180) in patients under treatment from January 1st, 2010, to December 31, 2012. Risk factors were identified using logistic regression; odds ratios (OR) and 95% confidence intervals (CI) were calculated. Results: The multivariate analysis identified the following risk factors: Being unaware of the disease (OR=23.10; 95% CI 3.6-36.79; p=0.002); not believing in healing (OR=117.34; 95% CI 13.57-124.6; p=0.000); not having social support (OR=19.16; 95% CI 1.32-27.77; p=0.030); considering the hours of attention to be inadequate (OR=78.13; 95% CI 4.84-125.97; p=0.002), and not receiving laboratory reports (OR=46.13; 95% CI 2.85-74.77; p=0.007). Conclusion: Health services must focus on the early detection of conditions that may represent risk factors to proactively implement effective, rapid and high-impact interventions.
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Patient Dropouts/psychology , Tuberculosis, Multidrug-Resistant/psychology , Medication Adherence/psychology , Motivation , Antitubercular Agents/therapeutic use , Patient Dropouts/statistics & numerical data , Professional-Patient Relations , Quality of Life , Social Support , Socioeconomic Factors , Attitude to Health , Microbial Sensitivity Tests , Case-Control Studies , Risk Factors , Tuberculosis, Multidrug-Resistant/drug therapy , Culture , Educational Status , Medication Adherence/statistics & numerical data , Precision Medicine , Health Services Accessibility , Life Style , Mycobacterium tuberculosis/isolation & purification , Mycobacterium tuberculosis/drug effects , Antitubercular Agents/pharmacologyABSTRACT
Objetivos: Descrever as características dos casos de abandono do tratamento de tuberculose em pacientes que desenvolveram tuberculose multirresistente (TBMR). Métodos: Estudo descritivo de abordagem quantitativa, desenvolvido em uma instituição terciária de referência para tratamento de TBMR localizada na cidade do Rio de Janeiro. Foi utilizado instrumento estruturado com informações de quarenta prontuários entre os meses de agosto a dezembro de 2016. A análise dos dados foi realizada por meio do software SPSS. Resultados: Dos pacientes estudados, 35% abandonaram tratamento anterior de tuberculose. Conclusão e implicação para a prática: É necessária a identificação precoce de pacientes que apresentam maior risco para abandono do tratamento, bem como a criação de um modelo de assistência voltado ao perfil dos usuários que abandonam o tratamento, com uma prática participativa, com grupos educativos que promovam ações preventivas, identificando e estudando estratégias para a superação de barreiras ligadas à realidade de vida individual e coletiva
Objective: To describe the characteristics of cases of tuberculosis treatment abandonment in patients who developed MDR-TB. Methods: a descriptive study of a quantitative approach developed in a tertiary referral institution for the treatment of MDR-TB, located in the city of Rio de Janeiro. A structured instrument was used with information from forty medical records between August and December 2016. Data analysis was performed using SPSS software. Results: Of the patients studied, 35% abandoned previous treatment of tuberculosis. Conclusion and implication for the practice: early identification of patients who are at greater risk for treatment abandonment is required, as well as the creation of a model of assistance aimed at the profile of users who abandon treatment, with a participatory practice with educational groups That promote preventive actions, identifying, studying strategies for overcoming barriers linked to reality, individual and collective life
Objetivos: Describir las características de los casos de abandono del tratamiento de tuberculosis en pacientes que desarrollaron TBMR. Métodos: estudio descriptivo de abordaje cuantitativo, desarrollado en una institución terciaria de referencia para tratamiento de TBMR, ubicado en la ciudad de Río de Janeiro. Se utilizó instrumento estructurado con informaciones de cuarenta prontuarios entre los meses de agosto a diciembre de 2016. El análisis de los datos fue realizado a través del software SPSS. Resultados: de los pacientes estudiados, el 35% abandonó el tratamiento anterior de la tuberculosis.Conclusión e implicación para la práctica: es necesaria la identificación precoz de pacientes que presentan mayor riesgo para el abandono del tratamiento, así como la creación de un modelo de asistencia orientado al perfil de los usuarios que abandonan el tratamiento, con una práctica participativa, con grupos educativos Que promuevan acciones preventivas, identificando, estudiando estrategias para la superación de barreras ligadas a la realidad, de vida individual y colectiva
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Patient Dropouts/statistics & numerical data , Tuberculosis, Multidrug-Resistant/drug therapy , Tuberculosis, Multidrug-Resistant/therapy , Medication Adherence/statistics & numerical dataABSTRACT
El trastorno obsesivo-compulsivo (TOC) afecta al 2% de la población general, llegando en ocasiones a causar un deterioro funcional severo y de la calidad de vida de las personas afectadas. Entre el 10 y el 30% de los pacientes con este trastorno no responde a los tratamientos recomendados: farmacológicos y terapia cognitivo-conductual. La Food and Drug Administration de los Estados Unidos (FDA) aprobó en el año 2008 la Estimulación cerebral profunda (ECP) para pacientes con TOC resistente a tratamiento. La ECP, utilizada frecuentemente para el tratamiento de la enfermedad de Parkinson refractaria, es una opción viable para los pacientes con TOC resistente, con efectos adversos poco frecuentes y transitorios. (AU)
Obsessive-compulsive disorder (OCD) affects 2% of the general population, sometimes resulting in severe impairment of functional capacity and quality of life of affected people. Between 10 and 30% of these patients do not respond to recommended treatments: pharmacological and cognitive behavioral therapy. In 2008, the FDA approved Deep Brain Stimulation (DBS) for patients with OCD resistant to treatment. DBS, frequently used for the treatment of refractory Parkinson's disease, is a viable option for the treatment of patients with resistant OCD, with infrequent and transient adverse effects. (AU)
Subject(s)
Humans , Deep Brain Stimulation/methods , Obsessive-Compulsive Disorder/therapy , Patient Dropouts/statistics & numerical data , Quality of Life , Signs and Symptoms , Deep Brain Stimulation/adverse effects , Deep Brain Stimulation/trends , Mental Disorders/surgery , Obsessive-Compulsive Disorder/complications , Obsessive-Compulsive Disorder/etiology , Obsessive-Compulsive Disorder/drug therapyABSTRACT
El trastorno por déficit de atención e hiperactividad (TDAH) es un trastorno del neurodesarrollo complejo y heterogéneo, de carácter crónico, de etiología multifactorial, principalmente debida a factores genéticos y ambientales. Realizamos un estudio analítico retrospectivo del tratamiento de niños diagnosticados de TDAH. Se estudió una muestra de 82 niños diagnosticados de TDAH (74.4% niños y 25.6% niñas). El 96.3% de los casos presentaba algún trastorno asociado. El tratamiento farmacológico fue el tratamiento de elección (90.2%). El 46.0% recibía metilfenidato de liberación inmediata, un 51.4% metilfenidato de liberación sostenida y la atomoxetina solo se recetó en un 2.7% de los casos. El 20.3% de la muestra abandonó en algún momento el tratamiento farmacológico. El tratamiento farmacológico fue la opción más utilizada en nuestra muestra, y el metilfenidato de liberación inmediata el fármaco de elección para inicio del tratamiento. Se utilizan poco las alternativas a los estimulantes. No se encontraron diferencias significativas entre el tipo de tratamiento y el subtipo de TDAH o el género, aunque sí en cuanto a la edad de inicio del tratamiento.
Attention deficit hyperactivity disorder (ADHD) is a complex and heterogeneous neurodevelopmental disorder, of a chronic nature, of multifactorial etiology, mainly due to genetic and environmental factors. We conducted a retrospective analytical study of the t herapeutic management of children diagnosed with ADHD. A sample of 82 children diagnosed with ADHD (74.4% children and 25.6% girls) was studied. 96.3% of the cases presented some associated disorder. Pharmacological treatment was the treatment of choice (90.2%). 46.0% received immediate release methylphenidate, 51.4% sustained release methylphenidate and atomoxetine was only prescribed in 2.7% of patients. 20.3% of the sample abandoned pharmacological treatment at some point. Pharmacological treatment was the most frequent option in our sample, and methylphenidate immediate release the drug of choice for treatment initiation. The alternatives to stimulants are used in very low percentage of the patient. No significant differences were found between the type of treatment regarding the subtype of ADHD or gender, but we found significant difference in relation with the age of onset of treatment.
Subject(s)
Humans , Male , Female , Child , Adolescent , Attention Deficit Disorder with Hyperactivity/drug therapy , Adrenergic Uptake Inhibitors/therapeutic use , Atomoxetine Hydrochloride/therapeutic use , Central Nervous System Stimulants/therapeutic use , Methylphenidate/therapeutic use , Patient Dropouts/statistics & numerical data , Psychotherapy , Attention Deficit Disorder with Hyperactivity/classification , Attention Deficit Disorder with Hyperactivity/therapy , Retrospective Studies , Sex Distribution , Age DistributionABSTRACT
Resumo: O objetivo deste estudo foi descrever características clínicas e sociodemográficas, estimar a incidência da tuberculose (TB), além de analisar fatores associados ao abandono e ao óbito na vigência do tratamento dos casos de TB notificados entre crianças e adolescentes indígenas, no Brasil, entre 2006-2016. Realizou-se análise da série histórica de incidência, segundo faixa etária e macrorregião e utilizou-se regressão logística multinomial para elucidar fatores associados ao abandono e ao óbito. Do total de 2.096 casos notificados, 88,2% tiveram cura, 7,2% abandonaram o tratamento e 4,6% evoluíram para óbito. Houve predomínio de casos em meninos de 15-19 anos e maior proporção de óbitos (55,7%) em < 4 anos. Considerando o conjunto de crianças e adolescentes indígenas com TB no Brasil, a incidência média foi 49,1/100 mil, variando de 21,5/100 mil a 97,6/100 mil nas regiões Nordeste e Centro-oeste, respectivamente. Os casos com acompanhamento insuficiente e regular tiveram maiores chances de abandono (OR = 11,1; IC95%: 5,2-24,8/OR = 4,4; IC95%: 1,9-10,3) e óbito (OR = 20,3; IC95%: 4,9-84,9/OR = 5,1; IC95%: 1,2-22,7). Os casos em retratamento (OR = 2,4; IC95%: 2,08-8,55) e com anti-HIV positivo (OR = 8,2; IC95%: 2,2-30,9) também mostraram-se associados ao abandono. As formas clínicas extrapulmonar (OR = 1,8; IC95%: 1,1-3,3) e mista (OR = 5,6; IC95%: 2,8-11,4), os casos em < 4 anos (OR = 3,1; IC95%: 1,5-6,4) e os casos provenientes das regiões Norte (OR = 2,8; IC95%: 1,1-7,1) e Centro-oeste (OR = 2,8; IC95%: 1,1-7,0) mostraram-se associados ao óbito. Acreditamos que o controle da TB em crianças e adolescentes indígenas não poderá ser alcançado sem investimentos em pesquisa e desenvolvimento e sem a redução das desigualdades sociais.
Abstract: The study aimed to describe clinical and sociodemographic characteristics, estimate incidence, and analyze factors associated with dropout and death during treatment of TB cases reported in indigenous children and adolescents in Brazil from 2006 to 2016. A historical case series was performed on incidence according to age bracket and major geographic region, and multinomial logistic regression was used to explain factors associated with treatment dropout and death. Of the 2,096 reported cases, 88.2% evolved to cure, 7.2% dropped out of treatment, and 4.6% evolved to death. There was a predominance of cases in boys 15-19 years of age and a higher proportion of deaths (55.7%) in children < 4 years. Considering indigenous children and adolescents with TB in Brazil as a whole, mean incidence was 49.1/100,000, ranging from 21.5/100,000 to 97.6/100,000 in the Northeast and Central, respectively. Cases with insufficient and irregular follow-up showed higher odds of dropout (OR = 11.1; 95%CI: 5.2-24.8/OR = 4.4; 95%CI: 1.9-10.3) and death (OR = 20.3; 95%CI: 4.9-84.9/OR = 5.1; 95%CI: 1.2-22.7). Cases in retreatment (OR = 2.4; 95%CI: 2.08-8.55) and with HIV coinfection (OR = 8.2; 95%CI: 2.2-30.9) were also associated with dropout. Extrapulmonary (OR = 1.8; 95%CI: 1.1-3.3) and mixed clinical forms (OR = 5.6; 95%CI: 2.8-11.4), age < 4 years (OR = 3.1; 95%CI: 1.5-6.4), and cases from the North (OR = 2.8; 95%CI: 1.1-7.1) and Central (OR = 2.8; 95%CI: 1.1-7.0) were associated with death. TB control in indigenous children and adolescents cannot be achieved without investments in research and development and without reducing social inequalities.
Resumen: El objetivo de este estudio fue describir características clínicas y sociodemográficas, estimar la incidencia de la tuberculosis (TB), además de analizar factores asociados al abandono y al óbito en la vigencia del tratamiento de los casos de TB, notificados entre niños y adolescentes indígenas, en Brasil entre 2006-2016. Se realizó un análisis de la serie histórica de incidencia, según la franja de edad y macrorregión y se utilizó la regresión logística multinomial para elucidar factores asociados al abandono y al óbito. Del total de 2.096 casos notificados, un 88,2% tuvieron cura, un 7,2% abandonaron el tratamiento y un 4,6% evolucionaron hacia óbito. Hubo un predominio de casos en chicos de 15-19 años y mayor proporción de óbitos (55,7%) en < 4 años. Considerando el conjunto de niños y adolescentes indígenas con TB en Brasil, la incidencia media fue 49,1/100.000, variando de 21,5/100.000 a 97,6/100.000 en las regiones Nordeste y Centro-oeste, respectivamente. Los casos con un seguimiento insuficiente y regular tuvieron mayores oportunidades de abandono (OR = 11,1; IC95%: 5,2-24,8/OR = 4,4; IC95%: 1,9-10,3) y óbito (OR = 20,3; IC95%: 4,9-84,9/OR = 5,1; IC95%: 1,2-22,7). Los casos de retorno al tratamiento (OR = 2,4; IC95%: 2,08-8,55) y con anti-VIH positivo (OR = 8,2; IC95%: 2,2-30,9) también se mostraron asociados al abandono. Las formas clínicas extrapulmonares (OR = 1,8; IC95%: 1,1-3,3) y mixta (OR = 5,6; IC95%: 2,8-11,4), los casos en < 4 años (OR = 3,1; IC95%: 1,5-6,4) y los casos procedentes de las regiones Norte (OR = 2,8; IC95%: 1,1-7,1) y Centro-oeste (OR = 2,8; IC95%: 1,1-7,0) se mostraron asociados al óbito. Creemos que el control de la TB en niños y adolescentes indígenas no se podrá alcanzar sin inversiones en investigación y desarrollo y sin la reducción de las desigualdades sociales.
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Young Adult , Patient Dropouts/statistics & numerical data , Tuberculosis/epidemiology , Indians, South American/statistics & numerical data , Disease Notification/statistics & numerical data , Death , Patient Dropouts/ethnology , Socioeconomic Factors , Tuberculosis/diagnosis , Tuberculosis/ethnology , Tuberculosis/mortality , Tuberculosis, Pulmonary/diagnosis , Tuberculosis, Pulmonary/etiology , Tuberculosis, Pulmonary/epidemiology , Brazil/epidemiology , Residence Characteristics/statistics & numerical data , Incidence , Sex Distribution , Age Distribution , Continuity of Patient Care/statistics & numerical dataSubject(s)
Humans , Blood Pressure/drug effects , Cardiovascular Diseases/drug therapy , Hypertension/drug therapy , Antihypertensive Agents/therapeutic use , Patient Dropouts/statistics & numerical data , Reference Values , Systole , Blood Pressure/physiology , Review Literature as Topic , Cardiovascular Diseases/mortality , Randomized Controlled Trials as Topic , Meta-Analysis as Topic , Diastole , GRADE Approach , Systematic Reviews as Topic , Hypertension/complications , Hypertension/mortality , Antihypertensive Agents/adverse effectsABSTRACT
Resumen: Introducción: A 10 años de la fundación del Hospital de Especialidades Pediátricas en Chiapas, México, es importante valorar la sobrevida global a 5 años de los pacientes con leucemia aguda bajo el régimen del Seguro Popular. Métodos: Estudio descriptivo y de sobrevida de 210 casos de leucemia aguda diagnosticados y tratados entre 2008 y 2012. Empleando curvas de Kaplan-Meier se analizó cada variedad de la enfermedad (B, T y mieloide), y para la leucemia B en función del grupo de riesgo, el sexo, la edad, los leucocitos al diagnóstico, los marcadores de superficie, el índice de DNA, el cariotipo y las translocaciones. Resultados: La edad, el sexo y la proporción de tipos de leucemia aguda (B = 85%; M = 10%; T = 5%) fueron similares al resto del país. El 20% de los pacientes estaban vivos a 5 años; el 53% habían fallecido y el 27% abandonaron el tratamiento. La sobrevida global a 5 años fue del 42% (B = 45%; T = 20%; M = 10%) (mediana: 38.8 meses; intervalo de confianza del 95%: 28.9-48.7). La mediana de «muy alto riesgo¼ fue de 7.7 contra 47 meses; no hubo diferencia entre riesgo habitual y alto riesgo. Los leucocitos < 50,000/µl al diagnóstico y CD10 positivo se asociaron con mejor sobrevida. En el momento del deceso, el 29% se encontraba en remisión. Conclusiones: La sobrevida de la leucemia aguda bajo el Seguro Popular fue desfavorable los primeros 5 años del Hospital de Especialidades Pediátricas. Se identificaron como contribuyentes la alta tasa de mortalidad temprana, de pacientes en remisión y el abandono. Además de revisar la atención médica, se requiere el estudio de elementos extrahospitalarios determinantes del abandono para mejorar el programa.
Abstract: Background: At the 10th anniversary of the Hospital de Especialidades Pediátricas in Chiapas, Mexico, it was important to assess the 5-year acute leukemia overall survival under the Seguro Popular program (Popular Insurance). Methods: A descriptive and survival study of 210 acute leukemia patients diagnosed and treated during 2008-2012 was performed. Kaplan-Meier survival curves were developed for all patients, each leukemia type (B, T and myeloid) and for B type related to risk group, age, sex, leukocytes, cell markers, DNA index, karyotype, and translocations. Results: Age, gender and proportion of leukemia types (B = 85%; M = 10%; T = 5%), were similar to other parts of the country. At the end of the 5-year treatment, 20% of the patients were alive, 53% had died and 27% had abandoned the treatment. Global survival was 42% (B = 45%; T = 20%; M = 10%) (median: 38.8 months; confidence interval of 95% = 28.9-48.7). Very high-risk median survival was 7.7 versus 47 months. There was no difference between standard and high-risk groups. The initial leukocyte count < 50,000/µL and CD10 positive were related to better B survival; no other variables were related. At the time of death, 29% of patients were in remission. Conclusions: Global survival of acute leukemia at Hospital de Especialidades Pediátricas under the Seguro Popular during its first 5 years was surprisingly poor given the medical resources available through the insurance. Early mortality, death during remission and high desertion rates contributed to these results. A detailed revision of treatment protocols and reasons for abandoning treatment is mandatory.
Subject(s)
Child , Child, Preschool , Humans , Infant , Leukemia, B-Cell/mortality , Leukemia, Myeloid, Acute/mortality , Leukemia, T-Cell/mortality , Hospital Mortality , Hospitals, Pediatric/statistics & numerical data , Patient Dropouts/statistics & numerical data , Leukemia, B-Cell/genetics , Leukemia, Myeloid, Acute/genetics , Leukemia, T-Cell/genetics , Biomarkers, Tumor/classification , Confidence Intervals , Survival Analysis , Acute Disease , Universal Health Insurance , Kaplan-Meier Estimate , Mexico/epidemiologyABSTRACT
Objective: A large proportion of psychotherapy patients remain untreated, mostly because they drop out. This study compares the short- and long-term outcomes of patients who dropped out of psychotherapy to those of therapy completers. Methods: The sample included 63 patients (23 dropouts and 40 completers) from a controlled clinical trial, which compared narrative therapy vs. cognitive-behavioral therapy for major depressive disorder. Patients were assessed at the eighth session, post-treatment, and at 31-month follow-up. Results: Dropouts improved less than completers by the last session attended, but continued to improve significantly more than completers during the follow-up period. Some dropout patients improved with a small dose of therapy (17% achieved a clinically significant change before abandoning treatment), while others only achieved clinically significant change after a longer period (62% at 31-month follow-up). Conclusion: These results emphasize the importance of dealing effectively with patients at risk of dropping out of therapy.Patients who dropped out also reported improvement of depressive symptoms without therapy, but took much longer to improve than did patients who completed therapy. This might be attributable to natural remission of depression. Further research should use a larger patient database, ideally gathered by meta-analysis.
Subject(s)
Humans , Male , Female , Adult , Patient Dropouts/statistics & numerical data , Cognitive Behavioral Therapy/statistics & numerical data , Depressive Disorder, Major/therapy , Narrative Therapy/statistics & numerical data , Patient Dropouts/psychology , Psychiatric Status Rating Scales , Time Factors , Follow-Up Studies , Patient Compliance , Treatment Outcome , Self ReportABSTRACT
The aim of this study was to evaluate interruption of treatment with biological drugs and tofacitinib due to adverse events in patients with rheumatoid arthritis. A systematic review was performed in the electronic databases MEDLINE, Cochrane, Scopus, CRD, IPA, Lilacs and Scielo. Case reports addressing interruption of treatment due to any adverse event related to abatacept (ABA), adalimumab (ADA), anakinra (ANA), certolizumab pegol (CER), etanercept (ETA), golimumab (GOL), infliximab (IFX), rituximab (RTX), secukinumab (SEC), tocilizumab (TCZ), tofacitinib (TOF) or ustekinumab (UST) in rheumatoid arthritis patients were evaluated. Baseline data, patient profile, previous and current treatments, cause of discontinuation and information on reintroduction of treatment were extracted from the case reports. One hundred and fifty-four studies (154 patients) reported 162 discontinuations of rheumatoid arthritis treatment due to adverse events (ETA = 57; IFX = 46; ADA = 32; TCZ = 13; RTX = 5; ANA = 3; GOL = 2; ABA = 2; TOF = 1; CER = 1; SEC = 0 and UST = 0). The mean age of patients was 56 (± 12.1) years and 82% were female. Seventy-four adverse events were confirmed (related to used drug), and 138 were observed in patients using anti-TNF. The most common adverse events were infections (21%), skin disease (15%), autoimmune disease (13%) and hematological disorders (9%). Case reports are important in the detection of rare adverse events and should be considered in the choice of appropriate therapy for patients.
Subject(s)
Humans , Female , Middle Aged , Aged , Aged, 80 and over , Patient Dropouts/statistics & numerical data , Arthritis, Rheumatoid/drug therapy , Withholding Treatment/statistics & numerical data , Biological Products , Drug-Related Side Effects and Adverse Reactions/classificationABSTRACT
The objective of this study was to develop an agent based modeling (ABM) framework to simulate the behavior of patients who leave a public hospital emergency department (ED) without being seen (LWBS). In doing so, the study complements computer modeling and cellular automata (CA) techniques to simulate the behavior of patients in an ED. After verifying and validating the model by comparing it with data from a real case study, the significance of four preventive policies including increasing number of triage nurses, fast-track treatment, increasing the waiting room capacity and reducing treatment time were investigated by utilizing ordinary least squares regression. After applying the preventing policies in ED, an average of 42.14% reduction in the number of patients who leave without being seen and 6.05% reduction in the average length of stay (LOS) of patients was reported. This study is the first to apply CA in an ED simulation. Comparing the average LOS before and after applying CA with actual times from emergency department information system showed an 11% improvement. The simulation results indicated that the most effective approach to reduce the rate of LWBS is applying fast-track treatment. The ABM approach represents a flexible tool that can be constructed to reflect any given environment. It is also a support system for decision-makers to assess the relative impact of control strategies.
Subject(s)
Humans , Behavior , Emergency Service, Hospital/organization & administration , Patient Dropouts/statistics & numerical data , Triage/statistics & numerical data , Brazil , Computer Simulation , Crowding , Decision Making , Decision Support Techniques , Emergency Service, Hospital/statistics & numerical data , Hospitals, Public , Length of Stay , Models, Theoretical , Patient Dropouts/psychology , Patient-Specific Modeling , Simulation Training , Waiting ListsABSTRACT
OBJETIVO: Identificar e analisar as causas de abandono do tratamento da tuberculose entre pacientes em retratamento, por abandono anterior. MÉTODOS: Estudo descritivo, transversal, constituído por análise qualitativa, realizado por meio de análise de prontuários, entrevistas e aplicação de questionários a pacientes que reingressaram no tratamento de tuberculose após abandono, no período de abril de 2013 a abril de 2014, no município de Belém (PA). RESULTADOS: Os fatores mais citados pelos pacientes como motivadores do abandono do tratamento de tuberculose foram: melhora dos sintomas após o início do uso dos medicamentos (seis respostas), uso de drogas ilícitas (cinco respostas), falta de conhecimento da tuberculose e de seu tratamento (três respostas), uso de bebidas alcoólicas (três respostas), falta de dinheiro para ir ao posto (3 respostas), problemas familiares e falta de apoio familiar (três respostas). Essas causas foram apontadas como os principais motivadores do não seguimento do tratamento, o que correspondeu a 63,9% de todas as respostas. CONCLUSÃO: Diversos fatores ocasionaram o abandono do tratamento da tuberculose. São necessárias mais ações que aumentem a compreensão e conhecimento da doença pelo paciente.(AU)
OBJECTIVE: To identify and analyze the causes of treatment abandonment among tuberculosis patients in retreatment due to previous abandonment. METHODS: A descriptive, cross-sectional study consisting of qualitative analysis, carried out through an analysis of medical records, interviews and questionnaires applied to patients who rejoined treatment of tuberculosis after abandonment, from April 2013 to April 2014, in the city of Belem, state of Para. RESULTS: The factors that are most cited by patients as causes of abandonment of TB treatment were: improvement of symptoms after the start of drug use (six answers), illicit drug use (five answers), lack of knowledge about tuberculosis and its treatment (three answers), the use of alcohol (three answers), lack of money to go to the hospital (three answers), family problems and lack of Family support (three answers). These causes are cited as the main reasons for not following the treatment, which corresponded to 63.9% of all responses. CONCLUSION: There are several factors that cause abandonment of tuberculosis treatment. More actions to increase patient understanding and knowledge of the disease are needed.(AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Young Adult , Patient Care Team , Patient Dropouts/psychology , Patient Dropouts/statistics & numerical data , Tuberculosis/psychology , Treatment FailureABSTRACT
Abstract INTRODUCTION: Bottlenecks still exist during human immunodeficiency virus care that may delay the achievement of better outcomes. METHODS: We established a monitoring system to trace patients throughout the human immunodeficiency virus/acquired immunodeficiency syndrome care process in Juiz de Fora, Brazil, to identify potential bottlenecks. RESULTS: Among 250 patients, 17.6% abandoned follow-up. Our monitoring system tracked 86.4% of patients through the medication logistics control system and 2.3% through the mortality information system. Two percent of patients were not located by our monitoring system. CONCLUSIONS: A pathway care process contributes to a better understanding of the barriers to the treatment cascade.
Subject(s)
Humans , Male , Female , Adult , Patient Dropouts/statistics & numerical data , HIV Infections/drug therapy , Antiretroviral Therapy, Highly Active , Prospective Studies , Risk Factors , CD4 Lymphocyte Count , Viral LoadABSTRACT
OBJETIVO: Verificar o perfil sociodemográfico e a frequência de abandono de tratamento dos portadores de fenilcetonúria atendidos em um serviço de referência. MÉTODOS: Estudo retrospectivo, transverso, descritivo, com abordagem quantitativa, envolvendo todos os prontuários de pacientes fenilcetonúricos, atendidos no Serviço de Referência de Triagem Neonatal do Centro de Saúde-Escola Marco da Universidade do Estado do Pará, até novembro de 2013, com protocolo de autoria própria. RESULTADOS: No total, 36 pacientes compuseram a amostra; 52,77% eram do sexo feminino e 47,23% do sexo masculino. Três quartos não residiam em Belém (75%). Apenas um caso de abandono do tratamento (2,77%) foi confirmado, ou seja, um número ínfimo. Quanto ao diagnóstico da doença, 80,55% foram precoces. CONCLUSÃO: O perfil sociodemográfico traçado no atendimento do Centro de Saúde-Escola da Universidade do Estado do Pará foi: uma criança entre zero a 4 anos, do sexo feminino, diagnosticada precocemente, não residente em Belém, com tratamento efetivo, sem intercorrências que a fizessem abandonar o tratamento.
OBJECTIVE: To check the sociodemographic profile and the frequency of treatment abandon of phenylketonuria patients treated at a reference service. METHODS: Retrospective, cross-sectional, descriptive, quantitative approach study, involving all records of phenylketonuria patients treated at the neonatal screening reference center of the Marco School Health Center of State University of Pará until November 2013, with own protocol. RESULTS: It was counted 36 pacients, 52.77 % were female and 47.23% male. 3/4 doesn't live in Belém (75%). Only one confirmed case of noncompliance (2.77%), small number, however should be eradicated. Regarding the diagnosis of this disease, 80.55% were early. RESULTS: The sample was composed of 36 patients; 52.77 % were female and 47,23% male. Three of each four patients did not live in Belém (75%). We observed only one confirmed case of noncompliance (2.77%), that is a small number. Regarding the diagnosis of this disease, 80.55% were early. CONCLUSION: The sociodemographic profile in stroke care Centro de Saúde-Escola Marco was a child between zero to 4 years old female diagnosed early, non-resident of Belém, with sporadic and effective treatment without complications that made them to abandon treatment.