CONDIÇÕES DE SAÚDE DE AGENTES COMUNITÁRIOS DO MUNICÍPIO DE VITÓRIA (ES)

Abstract

This is a master's dissertation addressing the theme of health conditions of Community Health Agents (CHA) in the city of Vitória/ES. Data from the research entitled “Impact of the Training of Community Health Agents in Food Education - CACEA” were analyzed and the dissertation was structured in two manuscripts (both original). The first aimed to assess the health conditions, care and life habits of CHA active in Vitória/ES and the second aimed to identify the discriminatory power of adiposity indicators for diabetes mellitus (DM) in female CHA. A questionnaire was applied to obtain sociodemographic, lifestyle and health data. Clinical, anthropometric, biochemical tests (fasting glucose and after 75 g dextrose overload, insulin, total cholesterol and fractions, and triglycerides) and hemodynamic tests were performed. Data analysis was performed using the statistical program Statistical Package for the Social Sciences - SPSS 21.0, adopting a significance level of p ≤ 5%. In the first manuscript, descriptive and association analyzes were performed. The sample consisted of 262 CHA (mean age 46.1 ± 9.3 years) mostly female, of mixed race/brown color, with high school, married marital status and belonging to socioeconomic class C. The CHA had high percentages of pre-diabetes, DM, arterial hypertension (AH), obesity, high cholesterol, hypertriglyceridemia, and metabolic syndrome. About 41% have 3 or more associated morbidities, and of those who had a previous diagnosis of DM and/or AH, a fifth did not use medication for such conditions. The use of anxiolytics and/or antidepressants was high and was associated with worse self-perception of health status. In the second manuscript, association analyzes were performed and ROC (Receiver Operational Characteristic) curves were constructed to evaluate the performance models, and the area under the curve (AUC) was used to measure the discriminatory power of DM. At AUC, the ROC curves between the markers were compared using a parametric method, using the GraphROC for Windows software. The sensitivity and specificity values for each adiposity measure were determined by analysis of ROC curves. The ideal cutoff points for Body Mass Index (BMI), Waist circumference (WC), Body Adiposity Index (BAI) and Visceral Adiposity Index (VAI) were established based on the greatest combination of sensitivity and specificity. Using data from 247 female CHAs, a frequency of DM of 17% (95%CI 12.4-22.1). is observed. WC (AUC = 0.79) has greater power to discriminate DM compared to BAI (AUC = 0.66), VAI (AUC = 0.67), and BMI (AUC = 0.74). Considering that the CHA's adherence to the study corresponds to 70% of these professionals in the city of Vitória/ES, it is possible to establish that the results found are representative of the set of professionals.