Dinâmica da cobertura vacinal da BCG, poliomielite e tríplice viral no estado do Paraná: análise espaço-temporal, 2006 a 2022
| Ano de defesa: | 2023 |
|---|---|
| Autor(a) principal: |
Veiga, Carolina Pires
 |
| Orientador(a): |
Arcoverde, Marcos Augusto Moraes
|
| Banca de defesa: |
Nihei, Oscar Kenji
,
Pieri, Flávia Meneguetti
|
| Tipo de documento: | Dissertação |
| Tipo de acesso: | Acesso aberto |
| Idioma: | por |
| Instituição de defesa: |
Universidade Estadual do Oeste do Paraná
Foz do Iguaçu |
| Programa de Pós-Graduação: |
Programa de Pós-Graduação em Saúde Pública em Região de Fronteira
|
| Departamento: |
Centro de Educação Letras e Saúde
|
| País: |
Brasil
|
| Palavras-chave em Português: | |
| Palavras-chave em Inglês: | |
| Palavras-chave em Espanhol: | |
| Área do conhecimento CNPq: | |
| Link de acesso: | https://tede.unioeste.br/handle/tede/7459 |
Resumo: | Vaccination plays a central role in preventing disease and promoting public health. Compliance with the Vaccination Calendar in Brazil has been a reference for other countries, with effective strategies and high success rates since the creation of the National Immunization Program (PNI) in 1973. Despite this history, immunization targets have faced obstacles in recent years, resulting in unsatisfactory vaccination coverage rates, especially in children. This work aimed to carry out a spatio-temporal analysis of vaccination coverage in the state of Paraná, focusing on BCG, Polio and MMR vaccines between the years 2006 and 2022. To this end, a retrospective epidemiological study was carried out, with an approach ecological, analyzing vaccination coverage in 399 municipalities in Paraná. This approach is fundamental to understanding geographic and temporal variations in vaccination coverage, considering border dynamics and interaction with neighboring countries. Vaccination coverage data was collected in DATASUS. The analysis variable was the coverage of vaccines applied (BCG, Polio and MMR). The following analyzes were performed: descriptive statistics (mean, median, standard deviation and normality test), comparison of means (Mann-Whitney test), spatial analysis (spatial autocorrelation test Moran's Global Index and Gi* test for local association) , and temporal regression analysis. During the study period, it was observed that the average vaccination coverage for immunizers varied between 94.57% and 99.27%. However, the 3 immunizers showed downward trends throughout the study, with MMR maintaining a constant regression (APC = -1.0). The years 2013 and 2014 marked the beginning of a decline in coverage for Polio and BCG, as indicated in the joinpoint temporal regression. The spatial analysis showed that BCG vaccination coverage showed an increase in the number of municipalities that did not reach the 90% target, with emphasis on the Cascavel and Maringá Health Regions. However, in the period from 2018 to 2022, the COVID-19 pandemic may have affected vaccination coverage. In relation to Polio, more municipalities did not reach the 95% target over time. Triple Viral also faced challenges, with the majority of municipalities not reaching the target (95%) in the last period (2018- 2022). Spatial dependence was assessed with the Global Moran Index, showing a weak but consistent spatial dependence for BCG and Polio coverage, while MMR coverage showed notable spatial dispersion. Local spatial autocorrelation analysis identified specific areas with clusters of high (hostspots) and low (coldspots) coverage rates for the three immunizers. The analysis of border areas revealed that the majority of municipalities, both in the border area and beyond, did not reach vaccination coverage targets, pointing to significant challenges throughout the state of Paraná. In short, vaccination coverage in Paraná has declined over time, with persistent regional challenges. The spatial and temporal analysis highlighted numerous areas with low coverage and emphasized the need for targeted strategies to improve vaccination uptake. |