AVALIAÇÃO DA EXPERIÊNCIA DE CÁRIE E QUALIDADE DE VIDA RELACIONADA À SAÚDE BUCAL DE ESCOLARES

Objetivo: Avaliar a relação entre experiência de cárie, qualidade de vida relacionada à saúde bucal (QVRSB) e fatores socioeconômicos em escolares de rede municipal. Métodos: Este estudo, de corte transversal, realizado em um município paulista a partir de um levantamento de saúde bucal do ano de 2012, incluiu 142 escolares com 12 anos completos para avaliação da QVRSB por meio do Child Perceptions Questionnaire (CPQ11-14) e de fatores socioeconômicos (escolaridade dos pais, renda, número de cômodos e número de pessoas que habitam o domicílio). A experiência de cárie foi avaliada e expressa pelo índice CPOD e ceo-d (número de dentes cariados, perdidos e obturados na dentição permanente e decídua, respectivamente). A análise consistiu de estatística descritiva, uso dos testes Qui-quadrado, Mann-Whitney e correlação de Spearman. Resultados: Do total, 58,5% (n=83) dos escolares apresentaram experiência de cárie (CPOD+ceo-d≥1), os quais também apresentaram maiores escores na percepção global em saúde bucal (2,6±0,9 x 2,1±0,8), na escala total (33,0±22,6 x 21,9±14,5) e nos domínios bem-estar emocional (11,4±8,6 x 6,6±5,8) e bem-estar social (7,7±8,2 x 4,4±4,9) quando comparados àqueles sem experiência de cárie. Observouse também correlação positiva significativa entre o número de pessoas que habitavam o domicílio e o índice CPOD/ceo-d (r=0,2670; p=0,003). Conclusão: A experiência de cárie relacionou-se com uma percepção negativa da saúde bucal, principalmente nos aspectos emocional e social, e com o número de pessoas que habitavam o domicílio.

The revolving door of mental, neurological, and substance use disorders re-hospitalization in rural KwaZulu-Natal Province, South Africa.

Objective: Little is known about the extent of mental, neurological and substance-use (MNS) disorders re-hospitalization in South Africa. We examined the extent of one-year MNS re-hospitalization (MNS-R) in a rural South African primary health care facility (PHCF). Methods: We conducted a retrospective analysis of hospital administrative data from 10,525 adults discharged from a rural PHCF in KwaZulu-Natal Province, South Africa. Chi-squared tests were utilized to describe MNS-R within one year of an index hospital admission in individuals with MNS, with a sub-analysis also being conducted to describe schizophrenia re-hospitalization (S-R). Results: The prevalence of MNS and schizophrenia recorded at an index hospitalization was 5% and 1%, respectively. A total of 44/67 (66%) individuals with a diagnosis of MNS at the index hospitalization were classified as having MNS-R during oneyear follow-up period. Half of those diagnosed with schizophrenia at the index hospitalization (6/12 patients) were classified as having S-R during one-year follow-up period. There was a significant association between re-hospitalization outcomes (MNS-R and S-R) and MNS (p<0.01) or schizophrenia diagnosis (p<0.01) at index baseline hospitalization. Conclusion: The extent of MNS-R and S-R remains relatively high in rural South Africa, and needs further health systems strengthening to prevent revolving door occurrences.

Anthropometric characteristics and the burden of altered nutritional status among neuropsychiatric patients at Zomba Mental Hospital in Zomba, Malawi

Objective To determine the prevalence of overnutrition and undernutrition among neuropsychiatric inpatients and outpatients at Zomba Mental Hospital in Zomba, Malawi. Methods In this analytical cross-sectional study (n = 239), data were collected from psychiatric patients who were either inpatients (n = 181) or outpatients (n = 58) at Zomba Mental Hospital, which is the largest mental health facility in Malawi. Information was collected about patient demographics, anthropometric data, dietary information, and tobacco and alcohol use, among other variables. Data were entered and analysed in SPSS 16.0 (SPSS Inc., Chicago, IL, USA). Means were generated and compared between male and female patients, and between inpatients and outpatients. Results The study recruited 158 male and 81 female patients, with mean ages of 31.24 ± 11.85 years and 33.08 ± 15.18 years (p = 0.328), respectively. Male patients were significantly taller (165.27 ± 7.25 cm) than female patients (155.30 ± 6.56 cm) (p < 0.001); were significantly heavier than females (60.02 ± 10.56 kg versus 55.64 ± 10.53 kg); and had a significantly lower mean body mass index (BMI) than females (21.87 ± 3.21 vs. 23.01 ± 3.78) (p = 0.016). Overweight and obese patients comprised 17.6% of the participants, and 8.8% were underweight. There were no significant differences in the prevalence of overweight, obesity, and underweight between male and female participants, or between inpatients and outpatients. Conclusion Our study—the first one of its kind in Malawi—characterised the anthropometry of neuropsychiatric patients at a major metal health facility in Malawi, and has shown a high proportion of overweight patients and a notable presence of underweight patients among them. Being overweight or obese is a risk factor for metabolic disorders. Being underweight may aggravate mental illness or disturb the effect of medication. There is need, therefore, to include nutrition screening and therapeutic or supplementary feeding as part of a comprehensive care and treatment plan for neuropsychiatric patients.