THE RESULTS

CHATS

      There were realized seven chat reunions during the eleven weeks of the traineeship related to the followed subjects:

  • 1º. PRENATAL AND GINECOLOGIC PREVENTION PROGRAMS:

    The method used was expositive, with not much participation of the women, because they couldn't understand the methodology. The expositive chat is a quite far from the daily of the community. In this chat mothers didn't allowed their adolescent daughters to attempt.
  • 2º. BREAST-FEEDING:

    Initially the chat conductor, a man, had intention of doing an expositive chat, what arouse an astonishment reaction and also not acceptance by them, because this is a female subject and a man broached it. Since this, the chat turned into an interactive way conducted by a woman.
  • 3º. SCABIES AND LOUSES:

    This was an interactive chat teaching how to make artisan soap with sulfur 10% in the practice.
  • 4º. INTRAUTERINE DEVICE AND GINECLOGIC CANCER PREVENTION:

    The subject was opened to arguments. In fact, the women themselves proposed the subject sequence. The method was interactive.
  • 5º. CONTRACEPTIVE METHODS AND FAMILY PLANNING:

    It was used once more the method interactive with a quite participation of the women, that made many questions showing great interest by the subject.
  • 6º. BREAST CANCER:

    There was an auto breast exam demonstration and answer to many daunts.
  • 7º. ADOLESCENCE:

    It was tried to use the interactive method, asking them to make questions about anatomy, physiology, pregnancy, sexual relations and menstruation. Because the taboos and prejudice against this subject there was no participation of them, and so an expositive chat was done.

    •       Relative to the attempting to the women to the chat reunions, there was a significant increase rate with the pass of the work, as shown in table 1.
     
     

    TABLE 1 - Attending number to Chat Reunions
    CHAT REUNION ATTENDING NUMBER Total
    Ilha Rasa  Almeida Ponta do Lanço
    1º 0 9 0 9
    2º ? ? ? 15
    3º 2 4 0 6
    4º 8 4 1 13
    5º 6 26 0 32
    6º 0 12 1 13
    7º 0 8* 0 8
    * Total of addolescent women in Almeida
        ? means that it wasn't separated by locality.
     

    QUESTION FORMS

          The question forms analysis reveled that there are 93 women older than 13 years old, which 28 reside in Ilha Rasa, 53 in Almeida and 11 in Ponta do Lanço. 75 women are in fertile age and 18 in menopause period. The age mean is 31.8±16.1 years old and table 2 represents the age zone distribution.

    TABLE 2 - Age Zone Distribution
    Age Zone (years old) Number of Women
    10 to 15 6
    16 to 20 17
    21 to 30 21
    31 to 40 13
    41 to 50 12
    Older than 51 11
     
     
     

          Among the 76 women that have any school knowledge, this was not over primary. There are 17 illiterate women. The school knowledge in the age zone distribution (table 3) shows that these illiterate women have more elevated ages. A qualitative data it can be perceived is that many women, in despite of having any school knowledge, were illiterate.

    TABLE 3 - Age Zone and School Knowledge Distribution
    Age Zone (years old)
    School Knowledge
     
    Illiterate
    1º
    2º
    3º
    4º
    5º
    6º
    7º
    8º
    10 to 15
    0
    0
    0
    0
    0
    0
    0
    1
    0
    16 to 20
    0
    0
    1
    3
    5
    6
    0
    3
    0
    21 to 30
    0
    1
    3
    2
    10
    7
    0
    0
    0
    31 to 40
    3
    0
    1
    1
    5
    3
    0
    1
    2
    41 to 50
    5
    0
    1
    1
    2
    0
    0
    1
    0
    Older than 51
    5
    0
    1
    1
    0
    0
    0
    0
    0

          The gynecologic cancer (breast and uterus) was availed through the presence or not of STDs, age of beginning of sexual activities, number of sexual partners, vaginal deliveries, number of sex relations at week, hygiene, smoking and hormonal oral contraceptive use.

          Related to STDs, 48.38% of women confirmed vaginal purulent secretions in the moment of interview. This fact doesn't make the STDs presence or not, but it gives an idea of its prevalence.

          From the total of women, 66 (70.97%) are sexually active.

          The age of beginning of the sexual activity was earlier in older women, as can show the table 4.
    TABLE 4 - Sexual Activity begin in the Different Age Zones
    AGE
    Sexual Activity Begin
    ZONE
    10 to 15
    16 to 20
    21 to 30
    Older than 31
    10 to 15
    0
    -
    -
    -
    16 to 20
    3
    5
    -
    -
    21 to 30
    8
    8
    1
    -
    Older than 31
    3
    26
    2
    0

          The great part of women related just one sexual partner, but there is a significant quantity of women that had more than one partner, as shown in table 5.

    TABLE 5 - Number of Sexual Partners per Women
    Nº of Sexual Partners
    Nº of Women
    1
    61
    2
    11
    3
    2
    4
    1
    More than 4
    2

          The mean of vaginal deliveries by woman is 3.5.

          The mean of sexual relations at week was 3.42±2.4.

          Related to the increased risk to uterus cervix cancer, from the 93 women, 30 (32.26%) had sexual activity begin before 20 years old, more than 1 vaginal delivery, the first pregnancy before 20 years old and vaginal purulent secretion present; 5 of them (5,37%) had these factors and STDs evidenced in the cytology (Gardnerella vaginalis, Trichomonas vaginalis and Human Papilomavirus infection). One woman had all these factors and the two first cited germs simultaneously.

          The hygiene conditions are failing because, principally, the miss of treated water in Ilha Rasa, making difficult the baths, that are taken using a basin. These data are culturally difficult to be taken because the shame the women fell related to their hygiene conditions, comparing their standards with that they imagine the doctor have.

          Related to smoke, only 9,7% of women do it. The mean of smoking time is 29.5±19.3 years, with the rage 21.4 years. They smoke predominating straw cigarettes and pipes.

          The use o contraceptives are very common (also see table 6). Adding the actual to the past, all women made use of this method.

          The mean of past use is 4.3±4.3 years. The correct use in the past is 54.39%. The actual use mean is 3.35±4.3 years and the correct use is 56.59%. There is no significant difference between the correct use rate in the past and actual.

          Related to family planning, the great part of women doesn't use any contraceptive method. The best used was the hormonal oral contraceptive and tubarian interruption. Curiously, the third most used contraceptive method was the interrupted sexual act.

    TABLE 6 - Contraceptive Method Rate Between Women
    Used Method
    Number of Women
    Intra-uterine Device
    3
    Tubarian Interruption
    13
    Condon
    3
    Interrupted Sexual Act
    7
    AHO
    15
    Não Usa
    35

          Related to prenatal program, from the 93 women 64 were pregnant, in a total rate of 379 pregnancies, which 229 (60,42%) were not campaigned to prenatal program. From the total of pregnancies, there were 19 miscarriages and 15 fetal deaths.

          The number of life sons per woman is 3.71 and the number of pregnancies per woman is 4.07. The total fertility rate is 8.61.

          The age of the first pregnancy is 17.53±2.67 years old (table 7).

          The table 8 shows the frequencies of domiciliary and hospital deliveries distributed in the age zones.

    TABLE 7 - The First Pregnancy in the Different Age Zones
    Age
    1º Pregnancy
    10 to 15
    4
    15 to 20
    44
    20 to 30
    8
    Older than 30
    0

    TABLE 8 - Domiciliar and Hospital Deliveries in Different Age Zones
    Age Zone (years old)
    Domiciliar Deliveries
    Hospital Deliveries
    10 to 15
    0
    0
    16 to 20
    0
    6
    21 to 30
    12
    38
    31 to 40
    27
    41
    41 to 50
    75
    8
    Older than 51
    106
    7
    There are 8 (8.6%) pregnant women in Ilha Rasa actually, 7 in Almeida and 1 in Ilha Rasa. Half of the women were integrated to the prenatal program. The pregnant time of prenatal initiation mean was 11±2 weeks. The mean of prenatal consults was 3.3±1.5. 2 women were considered of high risk, though none was directed to third attention. Only 3 (37.5%) were up to date with anti-tetanic vaccination and 5 (62.5%) had prenatal card.

    THE RUBBING UTERUS CERVIX CITOLOGY SAMPLES

          It was collected 61 rubbing samples to uterus cervix cytology exam. It was not collected samples from virgins (16 women) and from those didn't want to do the exam (16), women over 5 months of pregnant time (4) because the bad technical conditions.

          The result of the samples shows that 29 women (47.5%) had discreet inflammation, 28 (45.90%) have moderate inflammation, 32 (52.46%) with presence of flake methaplasy and 21± (34.43%) with presence of mist bacterial flora. 2 of the collected samples had compatible changes with Human Papilomavirus infection, 5 (8.20%) with Gardnerella vaginalis and one (1.07%) with Trichomonas vaginalis, totaling 7 (11.7%) with STDs compatible changes (remembering that there was one women with both Trichomonas vaginalis and Gardnerella vaginalis infection).

    1