Risco e vulnerabilidade socioambiental à diarreia aguda em Manaus-AM

Abstract

This study identified the indicators that confer risk and vulnerability to acute diarrhea in Manaus, considering its heterogeneity regarding the socio-environmental and socio-cultural conditions of the population in Manaus. In general, the results show that diarrhea is characterized by little annual variability and peak hospitalizations between January and April. For statistical purposes, the results of Pearson's Correlation indicated that the variable humidity, minimum and average temperature are the ones that showed the best correlations, although weak (r = <0.3 or -0.3). Only the minimum temperature and humidity were significant (p. = 0.001 and 0.000). As for the explanatory power, humidity had a greater value and significance (R2 = 7.7%; p = 0.000), followed by the average quota (R2 = 0.047 = 4.7%) and flooding (R2 = 0.013 = 1.3 %), although both without statistical significance (p. = 0.130 and 0.296, respectively). It was found that the northern and eastern areas of Manaus were the ones with the highest percentage of households with no literacy, poorer strata, households without access to a sewerage or septic tank and households with a garbage deposit buried in the property. In the mapping of alternative water supply sources, it was found that, due to the irregular supply of the water supply service through the city's general network, the population of Manaus opts to use other water supply sources. The mapping of irregular occupations predominated both in the north, east as well as in the west, south and center-south areas of the city. Regarding the flooding events in 2007 and 2008, these predominated in the north, east and some neighborhoods in the south. In 2009 and 2013 there was a considerable decrease in these events. In the remaining years, 2010 to 2017, flooding events predominated again in the north, east and some neighborhoods in the west. The highest incidence of acute diarrhea occurred in the age group above ten years of age. As for the spatial incidence of acute diarrhea, it was noted that the southern zone was the least critical. It was possible to address the cultural factors that result in different health perceptions and treatment practices for acute diarrhea used by the population of Manaus. In the last chapter of the dissertation, on the synthesis maps: IVS and socio-environmental risk. The analyzes carried out in the previous chapters allowed the use of several indicators associated with the perspectives of risk and vulnerability in this study, allowing the integration of different and irreducible dimensions and contexts of the reality in Manaus. In the map of IVS to acute diarrhea in Manaus, areas with low and medium to low vulnerability were identified and are located in the central-west direction and in the territorial limits of the west and south of the city. The areas of medium to high vulnerability, are specific and located in the central part of the city, which allowed us to conclude that the socio-environmental vulnerability to acute diarrhea in Manaus is much clearer and marked by degrees of high and very high vulnerability. Thus, in the summary map of Socio-Environmental Risk, areas with high risk continued to predominate in areas of territorial expansion in the city: north and east. The medium risk was concentrated in the central part and bordering neighborhoods of the west zone towards the north and south of the city; and low risk predominated in a few neighborhoods. It can be said that the city's territory expands in parallel with the risk of the disease, since the north and east areas already show this reality.