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PREVALENCE OF CHILDREN WITH SPECIAL HEALTHCARE NEEDS: AN EPIDEMIOLOGICAL SURVEY IN BRAZIL
Author
Affilliation
Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sérgio Arouca. Rio de Janeiro, RJ, Brasil / Instituto Federal do Paraná. Paranavaí, PR, Brasil.
Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sérgio Arouca. Rio de Janeiro, RJ, Brasil.
Universidade Federal de Santa Maria. Santa Maria, RS, Brasil.
Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sérgio Arouca. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Universidade Federal de São Carlos. São Carlos, SP, Brasil.
Universidade Federal do Rio de Janeiro. Escola de Enfermagem Anna Nery. Rio de Janeiro, RJ, Brasil / Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.
Universidade de São Paulo. Escola de Enfermagem de Ribeirão Preto. Ribeirão Preto, SP, Brasil.
Universidade Federal de Santa Maria. Santa Maria, RS, Brasil.
Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sérgio Arouca. Rio de Janeiro, RJ, Brasil.
Universidade Federal de Santa Maria. Santa Maria, RS, Brasil.
Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sérgio Arouca. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Universidade Federal de São Carlos. São Carlos, SP, Brasil.
Universidade Federal do Rio de Janeiro. Escola de Enfermagem Anna Nery. Rio de Janeiro, RJ, Brasil / Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.
Universidade de São Paulo. Escola de Enfermagem de Ribeirão Preto. Ribeirão Preto, SP, Brasil.
Universidade Federal de Santa Maria. Santa Maria, RS, Brasil.
Abstract
Purpose: We aimed to estimate the prevalence and delineate the profile of children with special healthcare needs (CSHCN) in the three municipalities of Brazil's southern and southeastern regions from 2015 to 2017.
Design and methods: This cross-sectional study included 6853 children aged 0-11 years. Participants were selected through complex sampling in 32 primary healthcare units. The Brazilian version of the Children with Special Healthcare Needs Screener© and a questionnaire were used to identify sociodemographic and family characteristics, health status, and health services utilization. Simple and multiple logistic regression models were used to evaluate the association between family and child characteristics and prevalence (P < 0.05).
Results: The prevalence of CSHCN was 25.3% (95% confidence interval: 21.0-30.0). Most participants required health services or were on long-term medication for a current chronic condition; approximately 53% of CSHCN had no formally recorded diagnoses. The most frequent health problems were respiratory conditions, asthma, and allergies. Approximately 60% of the CSHCN patients underwent follow-up examinations of the specialties pneumology, pediatrics, otorhinolaryngology, speech therapy, neurology, and psychology. Children of school age, of male sex, with premature birth, with a history of recurrent hospitalization, from non-nuclear families, and from underprivileged social classes were identified as risk factors for classification as CSHCN.
Practice implication: These results contribute to the unprecedented mapping of these children in healthcare networks in Brazil.
Conclusion: The high prevalence of CSHCN in medium and large municipalities in the southern and southeastern regions was associated with the child's previous health conditions and family structure.
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