RESUMO
Abstract To estimate the prevalence of leprosy among Brazilian female prisoners and identify factors associated with the disease. Cross-sectional study conducted between 2014 and 2015 in 15 Brazilian female prisons. The data of 1,327 women were collected using Audio Computer-Assisted Self-Interviewing and dermatological and neurological examination to identify suspicious lesions of leprosy. The average age was 33.4 years. Suspicion of leprosy was identified in 5.1% of women in prison, and lifetime self-reported prevalence was 7.5%. The variables that were associated with lifetime self-reported leprosy were: women in prison once being twice as likely to have leprosy; white women were 1.4 time more likely to have leprosy than non-white women; women who knew someone with leprosy was 1.9 time more likely to have leprosy; and women who shared a cell with 11 or more women were 2.5 times more likely to have leprosy than women who shared a cell with two or fewer people. The leprosy prevalence among female prisoners in Brazil were greater than that found in a Brazilian woman of the general population and show the extremely high vulnerability of this population generated through pre-incarceration poverty, as well as potential transmission in prison.
Resumo Objetivou-se estimar a prevalência de hanseníase entre presidiárias brasileiras e identificar fatores associados à doença. Estudo transversal realizado entre 2014 e 2015 em 15 presídios femininos brasileiros. Os dados de 1.327 mulheres foram coletados por meio de autoentrevista assistida por computador e exame dermatológico e neurológico para identificar lesões suspeitas de hanseníase. A idade média foi de 33,4 anos. A suspeita de hanseníase foi identificada em 5,1% das mulheres na prisão, e a prevalência autorreferida ao longo da vida foi de 7,5%. As variáveis que se associaram à hanseníase autorrelatada ao longo da vida foram: mulheres presas uma vez com duas vezes mais chance de ter hanseníase; mulheres brancas tinham 1,4 vez mais chance de ter hanseníase do que mulheres não brancas; mulheres que conheciam alguém com hanseníase tinham 1,9 vez mais chance de ter hanseníase; e mulheres que compartilhavam uma cela com 11 ou mais mulheres tinham 2,5 vezes mais chance de ter hanseníase do que mulheres que compartilhavam uma cela com duas ou menos pessoas. A prevalencia de hanseníase entre presidiárias no Brasil foi maior do que a encontrada entre mulheres da população geral e evidencia a vulnerabilidade dessa população gerada pela pobreza pré-reclusão, bem como o potencial de transmissão na prisão.
RESUMO
To estimate the prevalence of leprosy among Brazilian female prisoners and identify factors associated with the disease. Cross-sectional study conducted between 2014 and 2015 in 15 Brazilian female prisons. The data of 1,327 women were collected using Audio Computer-Assisted Self-Interviewing and dermatological and neurological examination to identify suspicious lesions of leprosy. The average age was 33.4 years. Suspicion of leprosy was identified in 5.1% of women in prison, and lifetime self-reported prevalence was 7.5%. The variables that were associated with lifetime self-reported leprosy were: women in prison once being twice as likely to have leprosy; white women were 1.4 time more likely to have leprosy than non-white women; women who knew someone with leprosy was 1.9 time more likely to have leprosy; and women who shared a cell with 11 or more women were 2.5 times more likely to have leprosy than women who shared a cell with two or fewer people. The leprosy prevalence among female prisoners in Brazil were greater than that found in a Brazilian woman of the general population and show the extremely high vulnerability of this population generated through pre-incarceration poverty, as well as potential transmission in prison.
Assuntos
Hanseníase , Prisioneiros , Feminino , Humanos , Adulto , Brasil/epidemiologia , Estudos Transversais , Prisões , Prevalência , Hanseníase/epidemiologiaRESUMO
Neste artigo reflete-se acerca dos maus-tratos contra crianças e adolescentes; o discurso oficial e a prática da notificação pelos profissionais de saúde. Buscou-se, ainda, descrever o papel do setor saúde na notificação dos maus-tratos constatados. O Estatuto da Criança e do Adolescente tem uma formulação clara sobre o papel do setor saúde, tratando-o como esfera pública privilegiada, no sentido de identificar, notificar a situação de maus-tratos e buscar formas para proteger a vítima e apoiar a família. Mesmo assim, observa-se que os profissionais necessitam de esclarecimento e de noções de legalidade sobre maus-tratos, bem como da concepção de suspeita, adquirindo, assim, segurança para notificar os casos que forem constatados.
This article contemplates child and adolescent maltreatment, the official discourse on the issue, and reporting practice by health professionals. It also aims at describing the role of the health department on the reporting process of maltreatment. The Child and Adolescent Statute (SCA) has clear provisions on the role of the health department, as the privileged state sphere when it comes to identifying, reporting, and offering protection to the victim and support to the his/her family. Even so, it is observed that professionals need further instruction both on legal provisions on maltreatment and on the notion of suspicious cases to ensure full reporting on cases identified.
En este artículo se reflexiona sobre los malos tratos contra niños y adolescentes; el discurso oficial y la práctica de la notificación por los profesionales de salud. Se buscó, además, describir el papel del sector salud en la notificación de los malos tratos constatados. El Estatuto del Niño y del Adolescente (ECA) tiene una formulación clara sobre el papel del sector salud, tratándolo como esfera pública privilegiada, en el sentido de identificar, notificar la situación de malos tratos y buscar formas para proteger a la víctima y apoyar a la familia. Aún así, se observa que los profesionales necesitan aclaraciones y nociones de legalidad sobre malos tratos, así como del concepto de sospecha, adquiriendo, de esta forma, seguridad para notificar los casos que fueren constatados.
