Prevalência de sintomas do climatério em mulheres dos meios rural e urbano no Rio Grande do Norte, Brasil

OBJETIVO: avaliar a sintomatologia climatérica e fatores relacionados entre mulheres dos meios urbano e rural do Rio Grande do Norte. MÉTODOS: estudo transversal, descritivo, envolvendo casuística de 261 mulheres climatéricas residentes em Natal e Mossoró (grupo urbano; n=130) e Uruaçu, em São Gonçalo do Amarante (grupo rural; n=131). A sintomatologia climatérica foi avaliada pelo Índice Menopausal de Blatt-Kupperman (IMBK) e Escala Climatérica de Greene (ECG). A análise estatística constou de comparações das medianas dos escores entre os grupos e regressão logística. Defi niram-se como “muito sintomáticas” as pacientes com escores ≥20, para ambos instrumentos (variável dependente). As variáveis independentes foram: idade, procedência, alfabetização, obesidade e prática de atividade física. RESULTADOS: o grupo urbano apresentou escores signifi cativamente superiores ao grupo rural, tanto para o IMBK (medianas de 26,0 e 17,0, respectivamente; p<0,0001), quanto para a ECG (medianas de 27,0 e 16,0, respectivamente; p<0,0001). Na amostra total, evidenciou-se que 56,3% (n=147) das mulheres foram classifi cadas como “muito sintomáticas”. Na comparação intergrupos, essa prevalência foi signifi cativamente mais elevada nas mulheres urbanas em relação às rurais (79,2 e 33,6%, respectivamente; p<0,05). Pela análise de regressão logística, evidenciou-se que a chance de pertencer ao grupo defi nido como “muito sintomáticas” foi maior para mulheres do meio urbano [odds ratio ajustado (OR)=7,1; 95% intervalo de confi ança a 95% (IC95%)=3,69-13,66] e alfabetizadas (OR=2,19; IC95%=1,16-4,13). A idade superior a 60 anos associou-se com menor chance de ocorrência de sintomas signifi cativos (OR=0,38; IC95%=0,17-0,87). CONCLUSÕES: a prevalência de sintomas climatéricos signifi cativos é menor em mulheres do meio rural, demonstrando que fatores socioculturais e ambientais estão fortemente relacionados ao surgimento dos sintomas climatéricos em nossa população.___________________________________ABSTRACT PURPOSE: to evaluate climacteric symptoms and related factors in women living in rural and urban areas of Rio Grande do Norte, Brazil. METHODS: a cross-sectional study involving 261 women in the climacteric was performed. A total of 130 women from Natal and Mossoró (urban group) and 131 from Uruaçu, in São Gonçalo do Amarante (rural group), were studied. Climacteric symptoms were assessed by the Blatt-Kupperman Menopausal Index (BKMI) and Greene Climacteric Scale (GCE). Statistical analysis involved comparison of median between groups and logistic regression analysis. Patients were defi ned as “very symptomatic” when the climacteric score was ≥20 for both questionnaires (dependent variable). Independent variables were: age, living area, schooling, obesity and physical activity. RESULTS: the urban group had signifi cantly higher scores than those of the rural group, both for BKMI (median of 26.0 and 17.0, respectively; p<0.0001) and for GCE (median of 27.0 and 16.0, respectively; p<0.0001). For the entire sample, a total of 56.3% (n=147) of the women were classifi ed as “very symptomatic”. This prevalence was signifi cantly higher in urban than in rural women (79.2 and 33.6%, respectively; p<0.05). Logistic regression analysis showed that the likelihood of belonging to the group defi ned as “very symptomatic” was greater for urban women [adjusted odds ratio (OR)=7.1; confi dence interval at 95% (95%CI)=3.69-13.66] who were literate (OR=2.19; 95%CI=1.16- 4.13). Individuals over the age of 60 years had less chance of having signifi cant symptoms (OR=0.38; 95%CI=0.17-0.87). CONCLUSIONS: the prevalence of signifi cant climacteric symptoms is less in women from a rural environment, showing that sociocultural and environmental factors are strongly related to the appearance of climacteric symptoms in our population

O descompasso de uma experiência: avaliação do Programa Habitar Brasil na Comunidade África-Natal/RN

This research deals with the evaluation of the Programa do Governo Federal para Urbanização de Favelas Habitar Brasil(1993) carried out in the Africa slum - Redinha neighbourhood in Natal-Rn. This study carried out in period from 2005 to 2006 searches to identify the effects of the actions proposed by Program in 1993-1994 about the current urbanistic configuration of the Africa community. It analyzes the effectiveness in the process of achievement of the considered objectives to habitation, communitity equipments, infrastructure and agrarian regularization. On the evaluation process, it has been as reference the works developed by Adauto Cardoso (2004), Blaine Worthen (2004), Ronaldo Garcia (2001) and Rosângela Paz (2006). About the Habitational Policy with approach to the Urbanistic Right and the right to the housing, the reflections by Raquel Rolnik, Nabil Bonduki, Ermínia Maricato, Saule Júnior, Betânia de Moraes Alfonsin and Edésio Fernandes are main references. To gauge the execution of the objectives proposed by Habitar Brasil in 1993, it has searched in the documentary data of the time and in information gotten in interviews with technicians that had participated of the program, consistent references on what was considered, what was executed and the process of the intervention of Habitar Brasil in the Africa community. The area analysis in 2005-2006 has developed on the base of the urbanistic survey of the current situation from the four performance lines of the Program: habitation, infrastructure, community equipments and agrarian regularization, with a current urbanistic evaluation of Africa considering the intervention carried out in 1993 and 1994. The study points out the context of Brazilian Habitational Policy where the Programa Habitar Brasil was launched, explaining the main principles of the Program. In terms of local, it empahsizes the administrative-political factors that had contributed so that Natal-Rn city has been pioneering in the resources captation of Habitar Brazil (1993). Considering Habitar Brazil in Africa, the work argues and presents the intervention diagnosis and the proposal, developed by Program in 1993 evidencing the local problem of the time. After that, it makes a current reading of the area, identifying in 2006 representative elements of Habitar Brasil (1993-1994) for the Africa community. It identifies significant advances in the constitution of the institucional apparatus of the plaining system of Habitation of Social Interest for the city of Natal and points the fragilities in the implementation of the urban infrastructure actions and above all in the achievement of the objectives of the agrarian regularization