Health Centers Archives - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(5):226-232
DOI 10.1590/S0100-72032013000500007
PURPOSE: To determine the HPV prevalence and genotypes and to identify factors associated with infection in pregnant and non-pregnant women with positive or negative HIV-1, treated in Gynecology and Obstetrics Ambulatories and in Health Primary Units, in Rio Grande, Rio Grande do Sul State, Brazil. METHODS: Cervical cells samples from 302 patients were analyzed for HPV presence and genotypes were determined by nested and sequencing polymerase chain reaction. We calculated prevalence ratios associated with the studied variables by Fisher's exact or χ² tests, and Poisson's regression. Women with insufficient material were excluded from the study. RESULTS: HPV was detected in 55 of the 302 women included in the study (18.2%); of these, 31 were pregnant, showing a significant association for HPV (p=0.04) when compared to non-pregnant ones. Risk factors for the infection were: patients aged <20 years-old (p=0.04), early initiation of sexual life (p=0.04), absence of cytological test (p=0.01), diagnosis of altered cytology (p=0.001), and counting <349 cells/mm³ (p=0.05). However, multi-parity was found to be a protective factor for the infection (p=0.01). Multivariate analysis showed that age <20 years-old (PR=2.8; 95%CI 1.0 - 7.7, p=0.04) and an altered cytological result (PR=11.1; 95%CI 3.0 - 4.1, p=0.001) were significantly associated with infection. HPV genotype was determined in 47 samples (85.4%) presenting one genotype per infection: eight HPV 16 and 58; six HPV 6; four HPV 18 and 33; three HPV 53 and 82; two HPV 83 and 61; one HPV 31, 35, 45, 64, 68, 71 and 85. CONCLUSIONS: The prevalence of HPV detection was 18.2%, the most frequent genotypes were 16 and 58, and sociodemographic and gynecological factors were associated with viral infection.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(5):226-232
DOI 10.1590/S0100-72032013000500007
PURPOSE: To determine the HPV prevalence and genotypes and to identify factors associated with infection in pregnant and non-pregnant women with positive or negative HIV-1, treated in Gynecology and Obstetrics Ambulatories and in Health Primary Units, in Rio Grande, Rio Grande do Sul State, Brazil. METHODS: Cervical cells samples from 302 patients were analyzed for HPV presence and genotypes were determined by nested and sequencing polymerase chain reaction. We calculated prevalence ratios associated with the studied variables by Fisher's exact or χ² tests, and Poisson's regression. Women with insufficient material were excluded from the study. RESULTS: HPV was detected in 55 of the 302 women included in the study (18.2%); of these, 31 were pregnant, showing a significant association for HPV (p=0.04) when compared to non-pregnant ones. Risk factors for the infection were: patients aged <20 years-old (p=0.04), early initiation of sexual life (p=0.04), absence of cytological test (p=0.01), diagnosis of altered cytology (p=0.001), and counting <349 cells/mm³ (p=0.05). However, multi-parity was found to be a protective factor for the infection (p=0.01). Multivariate analysis showed that age <20 years-old (PR=2.8; 95%CI 1.0 - 7.7, p=0.04) and an altered cytological result (PR=11.1; 95%CI 3.0 - 4.1, p=0.001) were significantly associated with infection. HPV genotype was determined in 47 samples (85.4%) presenting one genotype per infection: eight HPV 16 and 58; six HPV 6; four HPV 18 and 33; three HPV 53 and 82; two HPV 83 and 61; one HPV 31, 35, 45, 64, 68, 71 and 85. CONCLUSIONS: The prevalence of HPV detection was 18.2%, the most frequent genotypes were 16 and 58, and sociodemographic and gynecological factors were associated with viral infection.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(9):258-263
DOI 10.1590/S0100-72032011000900007
PURPOSE: To evaluate the coverage of Pap smear cytology at Basic Family Health Units (BFHU) and to describe the characteristics of non-performance of this test in the last three years. METHODS: A cross-sectional study was conducted in Rio Grande (RS), Brazil, in areas covered by the Family Health Teams Family (FHT). The interviews were conducted by students participating in the Health-PET, at women’s home. Crude analysis was performed using SPSS software to calculate prevalence ratio, 95% confidence intervals and p value. Multivariate analysis was performed by Poisson regression using Stata 9.0 software, which were included the variables with p value of up to 0.20 in the crude analysis. At the first level, the variables were age, having a partner, and literacy. At the second level, the variables were number of visits and offer of a Pap smear. RESULTS: The prevalence of Pap cytology performed 36 months ago or less was 66.3%. In adjusted analysis, women aged 19 years or less (p<0.001), without a partner (p<0.001), illiterate (p= 0.01), who had never consulted at the basic unit (p=0.02) and who had not been offered the examination during the visit (p=0.006), were more likely not to have had a cytopathology exam in the last 36 months. CONCLUSION: The local health proved to be ineffective and inequitable. Ineffective because it covers fewer women than indicated by the World Health Organization and uneven because access to this test varied according to some characteristics of the users.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(9):258-263
DOI 10.1590/S0100-72032011000900007
PURPOSE: To evaluate the coverage of Pap smear cytology at Basic Family Health Units (BFHU) and to describe the characteristics of non-performance of this test in the last three years. METHODS: A cross-sectional study was conducted in Rio Grande (RS), Brazil, in areas covered by the Family Health Teams Family (FHT). The interviews were conducted by students participating in the Health-PET, at women’s home. Crude analysis was performed using SPSS software to calculate prevalence ratio, 95% confidence intervals and p value. Multivariate analysis was performed by Poisson regression using Stata 9.0 software, which were included the variables with p value of up to 0.20 in the crude analysis. At the first level, the variables were age, having a partner, and literacy. At the second level, the variables were number of visits and offer of a Pap smear. RESULTS: The prevalence of Pap cytology performed 36 months ago or less was 66.3%. In adjusted analysis, women aged 19 years or less (p<0.001), without a partner (p<0.001), illiterate (p= 0.01), who had never consulted at the basic unit (p=0.02) and who had not been offered the examination during the visit (p=0.006), were more likely not to have had a cytopathology exam in the last 36 months. CONCLUSION: The local health proved to be ineffective and inequitable. Ineffective because it covers fewer women than indicated by the World Health Organization and uneven because access to this test varied according to some characteristics of the users.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(10):486-493
DOI 10.1590/S0100-72032008001000002
PURPOSE: to investigate factors accountable for macrosomia incidence in a study with mothers and progeny attended at a Basic Unity of Health in Rio de Janeiro, Brazil. METHODS: a prospective study, with 195 pairs of mothers and progeny, in which the dependent variable was macrosomia (weight at delivery >4,000 g - independent of the gestational age or of other demographic variables), and socioeconomic, previous pregnancies/gestation course, biochemical, behavioral and anthropometric, the independent variables. Statistical analysis has been done by multiple logistic regression. Relative risk (RR) values have been estimated, based on the simple form: RR=OR/ (1 - I0) + (I0 versus OR), in which I0 is the macrosomia incidence in non-exposed people. RESULTS: Macrosomia incidence was 6.7%, the highest value being found in the progeny of women >30 years old (12.8%), white (10.4%), with two or more children (16.7%), with male newborns (9.6%), with height >1,6 m (12.5%), with overweight or obesity as a nutritional pre-gestational state (13.6%), and with excessive gestational gain of weight (12.7%). The final model has shown that having two or more children (RR=3.7; CI95%=1.1-9.9), and having a male newborn (RR=7.5; CI95%=1.0-37.6) were the variables linked to the macrosomia occurrence. CONCLUSIONS: macrosomia incidence was higher than the one observed in Brazil as a whole, but inferior to the one reported in studies from developed countries. Having two or more children and a newborn male were the factors accountable for the occurrence of macrosomia.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(10):486-493
DOI 10.1590/S0100-72032008001000002
PURPOSE: to investigate factors accountable for macrosomia incidence in a study with mothers and progeny attended at a Basic Unity of Health in Rio de Janeiro, Brazil. METHODS: a prospective study, with 195 pairs of mothers and progeny, in which the dependent variable was macrosomia (weight at delivery >4,000 g - independent of the gestational age or of other demographic variables), and socioeconomic, previous pregnancies/gestation course, biochemical, behavioral and anthropometric, the independent variables. Statistical analysis has been done by multiple logistic regression. Relative risk (RR) values have been estimated, based on the simple form: RR=OR/ (1 - I0) + (I0 versus OR), in which I0 is the macrosomia incidence in non-exposed people. RESULTS: Macrosomia incidence was 6.7%, the highest value being found in the progeny of women >30 years old (12.8%), white (10.4%), with two or more children (16.7%), with male newborns (9.6%), with height >1,6 m (12.5%), with overweight or obesity as a nutritional pre-gestational state (13.6%), and with excessive gestational gain of weight (12.7%). The final model has shown that having two or more children (RR=3.7; CI95%=1.1-9.9), and having a male newborn (RR=7.5; CI95%=1.0-37.6) were the variables linked to the macrosomia occurrence. CONCLUSIONS: macrosomia incidence was higher than the one observed in Brazil as a whole, but inferior to the one reported in studies from developed countries. Having two or more children and a newborn male were the factors accountable for the occurrence of macrosomia.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(7):349-354
DOI 10.1590/S0100-72032008000700005
PURPOSE: to describe the prevalence and behavioral profile of genital infections in women attended at a Primary Health Unit in Vitoria, ES. METHODS: a transversal study including 14 to 49-year-old women attended by the Family Health Program (FHP). Exclusion criteria were: having been submitted to gynecological examination in less than one year before, and history of recent treatment (in the last three months) for genital infections. An interview including socio-demographic, clinical and behavioral data was applied. Genital specimens were collected for cytology, GRAM bacterioscopy and culture, and urine sample for molecular biological test for Chlamydia trachomatis. RESULTS: two hundred and ninety-nine women took part in the study. The median age was 30.0 (interquartile interval: 24;38) years old; the average age of the first intercourse was 17.3 (sd=3.6) years old. The first pregnancy average age was 19.2 (3.9) years old. About 70% reported up to 8 years of schooling; 5% reported previous Sexually Transmitted Diseases (STD), and 8%, the use of illicit drugs. Only 23.7% reported consistent use of condoms. Clinical complaints were: genital ulcer (3%); dysuria (7.7%); vaginal discharge (46.6%): pruritus (20%) and pelvic pain (18%). Prevalence rates were: Chlamydia trachomatis 7.4%; gonorrhea 2%; trichomoniasis 2%; bacterial vaginosis 21.3%; candidiasis 9.3%; and cytological changes suggestive of HPV 3.3%. In the final logistic regression model, the factors independently associated to genital infections were: abnormal cervical mucus, OR=9.7 (CI95%=5.6-13.7), previous HIV testing, OR=6.5 (CI95%=4.0-8.9), having more than one partner during the previous year, OR=3.9 (CI95%=2.7-5.0), and having more than one partner in life, OR=4.7 (CI95%=2.4-6.8). CONCLUSIONS: results show a high rate of genital infections and the need of preventive measures, such as STD surveys and risk reduction programs for women that look for routine gynecological service.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(7):349-354
DOI 10.1590/S0100-72032008000700005
PURPOSE: to describe the prevalence and behavioral profile of genital infections in women attended at a Primary Health Unit in Vitoria, ES. METHODS: a transversal study including 14 to 49-year-old women attended by the Family Health Program (FHP). Exclusion criteria were: having been submitted to gynecological examination in less than one year before, and history of recent treatment (in the last three months) for genital infections. An interview including socio-demographic, clinical and behavioral data was applied. Genital specimens were collected for cytology, GRAM bacterioscopy and culture, and urine sample for molecular biological test for Chlamydia trachomatis. RESULTS: two hundred and ninety-nine women took part in the study. The median age was 30.0 (interquartile interval: 24;38) years old; the average age of the first intercourse was 17.3 (sd=3.6) years old. The first pregnancy average age was 19.2 (3.9) years old. About 70% reported up to 8 years of schooling; 5% reported previous Sexually Transmitted Diseases (STD), and 8%, the use of illicit drugs. Only 23.7% reported consistent use of condoms. Clinical complaints were: genital ulcer (3%); dysuria (7.7%); vaginal discharge (46.6%): pruritus (20%) and pelvic pain (18%). Prevalence rates were: Chlamydia trachomatis 7.4%; gonorrhea 2%; trichomoniasis 2%; bacterial vaginosis 21.3%; candidiasis 9.3%; and cytological changes suggestive of HPV 3.3%. In the final logistic regression model, the factors independently associated to genital infections were: abnormal cervical mucus, OR=9.7 (CI95%=5.6-13.7), previous HIV testing, OR=6.5 (CI95%=4.0-8.9), having more than one partner during the previous year, OR=3.9 (CI95%=2.7-5.0), and having more than one partner in life, OR=4.7 (CI95%=2.4-6.8). CONCLUSIONS: results show a high rate of genital infections and the need of preventive measures, such as STD surveys and risk reduction programs for women that look for routine gynecological service.