Análisis de la integridad y consistencia de los registros de violencia contra mujeres indígenas en la macrorregión de Dourados, Mato Grosso do Sul, Brasil, 2009-2020

Freitas, Glênio Alves de; Marcon, Gláucia Elisete Barbosa; Welch, James Robert; Silva, Cosme Marcelo Furtado Passos da

doi:10.1590/S2237-96222024V33E20231075.EN

Brasil

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ORIGINAL ARTICLE • Epidemiol. Serv. Saúde 33 • 2024 • https://doi.org/10.1590/S2237-96222024V33E20231075.EN linkcopiar

Análisis de la integridad y consistencia de los registros de violencia contra mujeres indígenas en la macrorregión de Dourados, Mato Grosso do Sul, Brasil, 2009-2020

Autoría SCIMAGO INSTITUTIONS RANKINGS

Resumen

Objetivo: Analizar la tendencia temporal en el grado de completitud y consistencia de los datos de notificación sobre violencia contra mujeres indígenas en la macrorregión sanitaria de Dourados, Mato Grosso do Sul, Brasil, entre los años 2009-2020.

Métodos: Estudio de series de tiempo ecológicas con datos del Sistema de Información de Enfermedades de Declaración Obligatoria; se utilizó la regresión de Prais-Winsten para analizar la tendencia de completitud; para mantener la coherencia, se utilizó la proporción de campos completados y coherentes.

Resultados: Se notificaron 2.630 casos; la exhaustividad fue muy pobre en la variable ocupación (48,9%) y pobre en las variables educación (68,3%) y tiempo de ocurrencia (67,9%); en el análisis de tendencia temporal, sólo la variable ocupación mostró una tendencia decreciente (p = 0,045).

Conclusión: Los datos analizados demuestran la necesidad de mejorar la completitud de las variables educación, ocupación y tiempo de ocurrencia del acto violento.

Palabras-clave: Violencia Contra las Mujeres Indígenas; Notificación; Notificación de Sistemas de Información en Salud; Series de Tiempo

Age (years)	2009-2010 (N = 54)	2011-2012 (N = 127)	2013-2014 (N = 500)	2015-2016 (N = 438)	2017-2018 (N = 678)	2019-2020 (N = 833)	Total (N = 2.630)
Age (years)	N (%)	N (%)	N (%)	N (%)	N (%)	N (%)	N (%)
10-19	15 (27.8)	36 (28.3)	171(34.2)	149 (34.0)	257 (37.9)	241 (28.9)	869 (33.0)
20-29	15 (27.8)	35 (27.6)	108 (21.6)	104 (23.7)	180 (26.5)	265 (31.8)	707 (26.9)
30-39	7 (13.0)	30 (26.6)	103 (20.6)	100 (22.8)	130 (19.2)	156 (18.7)	526 (20.0)
40-49	4 (7.4)	15 (11.8)	58 (11.6)	39 (8.9)	56 (8.3)	94 (11.3)	266 (10.1)
≥ 50	13 (24.0)	11 (8.7)	60 (12.0)	46 (10.6)	55 (8.1)	77 (9.3)	262 (10.0)

Variables	2009-2010 (N = 54)	2011-2012 (N = 127)	2013-2014 (N = 500)	2015-2016 (N = 438)	2017-2018 (N = 678)	2019-2020 (N = 833)	Completeness (%)	Degree of completeness	APC^a (_95%CI^b)	p-value^c	Trend
Variables	N %	N %	N %	N %	N %	N %	Completeness (%)	Degree of completeness	APC^a (_95%CI^b)	p-value^c	Trend
Data on the individual assisted
Schooling	35 63.0	73 57.5	306 61.2	256 58.4	507 74.8	621 74.5	68.3	Poor	3.18 (-0.32;6.69)	0.065	Stability
Marital status	42 77.8	109 85.8	448 89.6	339 77.4	529 78.0	703 84.4	82.5	Regular	0.29 (-3.77;3.18)	0.826	Stability
Occupation	37 68.5	104 81.9	416 83.2	136 31.1	257 37.9	335 40.2	48.9	Very poor	-10.23 (-20.11;-0.35)	0.045	Decreasing
Pregnancy status	45 83.3	94 74.0	414 82.8	369 84.2	606 89.4	783 94.0	87.9	Regular	3.20 (1.24;5.17)	0.010	Increasing
Disability	44 81.5	108 85.0	438 87.6	334 76.3	540 79.6	742 89.1	83.9	Regular	0.00 (-3.12;3.12)	0.998	Stability
Incident data
Place of occurence	43 79.6	108 85.0	433 86.6	356 81.3	588 86.7	739 88.7	86.2	Regular	1.13 (-0.38;2.65)	0.106	Stability
Time of occurrence	35 64.8	67 52.8	328 65.6	263 60.0	488 72.0	596 71.5	67.6	Poor	3.05 (1.18;4.92)	0.016	Increasing
Previous occurrence	40 74.1	81 63.8	355 71.0	254 58.0	519 76.5	640 76.8	71.8	Regular	1.30 (-2.72;5.43)	0.418	Stability
Physical violence	51 94.4	122 96.1	487 97.4	402 91.8	625 92.2	771 92.6	93.5	Good	0,83 (-1.99;0.32)	0.115	Stability
Sexual violence	46 85.2	92 72.4	433 86.6	370 84.5	606 89.4	771 92.6	88.1	Regular	2.99 (1.35;4.64)	0.007	Increasing
Psychological violence	44 81.5	93 73.2	427 85.4	371 84.7	596 87.9	769 92.3	87.5	Regular	3.13 (1.93;4.34)	0.001	Increasing
Torture	43 79.6	86 67.7	418 83.6	366 83.6	593 87.5	769 92.3	86.5	Regular	4.04 (2.29;5.79)	0.003	Increasing
Neglect/abandonment	43 79.6	86 67.7	422 84.4	368 84.0	593 87.5	769 92.3	86.7	Regular	4.03 (2.27;5.08)	0.003	Increasing
Human trafficking	43 79.6	85 66.9	424 84.8	368 84.0	594 87.6	771 92.6	86.9	Regular	4.17 (2.03;6.04)	0.003	Increasing
Use of body force/beating	48 88.9	108 85.0	443 88.6	388 88.6	609 89.8	760 91.2	89.6	Regular	0.91 (0.28;1.54)	0.015	Increasing
Hanging	42 77.8	87 68.5	414 82.8	360 82.2	589 86.9	762 91.5	85.7	Regular	3.96 (2.60;5.31)	0.001	Increasing
Use of blunt object	42 77.8	88 69.3	417 83.4	364 83.1	594 87.6	762 91.5	86.2	Regular	3.93 (2.66;5.25)	0.001	Increasing
Use of sharp object	43 79.6	91 71.7	435 87.0	369 84.2	598 88.2	761 91.4	87.3	Regular	3.41 (2.08;4.74)	0.002	Increasing
Use of hot substance/object	42 77.8	88 69.3	411 82.2	363 82.9	589 86.9	762 91.5	85.7	Regular	3.89 (2.54;5.24)	0.001	Increasing
Poisoning/intoxication	42 77.8	88 69.3	408 81.6	362 82.6	588 86.7	762 91.5	85.6	Regular	3.87 (2.49;5.25)	0.001	Increasing
Use of firearms	42 77.8	87 68.5	409 81.8	360 82.2	588 86.7	761 91.4	85.4	Regular	3.95 (2.51;5.38)	0.001	Increasing
Threat	45 83.3	86 67.7	406 81.2	355 81.1	590 87.0	760 91.2	85.2	Regular	3.35 (0.82;5.88)	0.021	Increasing
Data on the perpetrator
Number of individuals involved	50 86.2	121 93.8	493 94.1	387 92.1	642 94.8	642 94.8	93.6	Good	1.12 (-0.26;2.52)	0.088	Stability
Father	46 79.3	94 72.9	436 3.2	354 84.3	604 89.2	604 89.2	84.5	Regular	3.33 (2.22;4.44)	0.001	Increasing
Mother	46 79.3	92 71.3	440 4.0	356 84.8	604 89.2	604 89.2	85.0	Regular	3.53 (2.12;4.93)	0.002	Increasing
Stepfather	46 79.3	93 72.1	431 82.3	354 84.3	604 89.2	604 89.2	84.5	Regular	3.44 (2.10;4.77)	0.002	Increasing
Spouse	46 79.3	102 79.1	457 87.2	364 86.7	619 91.4	619 91.4	87.8	Regular	3.00 (2.36;3.63)	< 0.001	Increasing
Former-spouse	46 79.3	93 72.1	433 2.6	348 2.9	606 89.5	606 89.5	84.4	Regular	3.47 (2.34;4.60)	0.001	Increasing
Boyfriend	45 77.6	92 71.3	429 1.9	348 2.9	604 89.2	604 89.2	83.9	Regular	3.73 (2.66;4.81)	< 0.001	Increasing
Ex-boyfriend	45 77.6	94 72.9	429 1.9	348 2.9	604 89.2	604 89.2	84.0	Regular	3.52 (2.67;4.38)	< 0.001	Increasing
Acquaintance	45 77.6	94 72.9	443 4.5	349 83.1	610 90.1	610 90.1	85.2	Regular	3.69 (3.05;4.34)	< 0.001	Increasing
Stranger	45 77.6	94 72.9	437 3.4	362 86.2	606 89.5	606 89.5	85.4	Regular	3.62 (2.24;4.99)	0.001	Increasing
Caregiver	45 77.6	91 70.5	434 2.8	351 83.6	602 88.9	602 88.9	84.2	Regular	3.75 (2.53;5.00)	0.001	Increasing
Employer/boss	45 77.6	92 71.3	433 2.6	351 83.6	602 88.9	602 88.9	84.2	Regular	3.67 (2.54;4.79)	< 0.001	Increasing
Institutional relationship person	45 77.6	92 71.3	433 82.6	352 83.8	607 89.1	607 89.1	84.5	Regular	3.67 (2.54;4.79)	< 0.001	Increasing
Sex	51 94.4	112 88.2	466 93.2	382 87.2	620 91.4	754 90.5	90.5	Good	-0.25 (-1.02;0.51)	0.405	Stability
Suspected alcohol use	40 69.0	92 71.3	426 81.3	328 78.1	582 86.0	582 86.0	81.2	Regular	3.72 (2.81;4.63)	< 0.001	Increasing
In cases of sexual violence
STD^d prophylaxis	50 92.6	111 87.4	424 84.8	398 90.9	616 90.9	768 92.2	90.0	Good	0.43 (-1.70;2.58)	0.600	Stability
HIV^e prophylaxis	49 90.7	110 86.6	422 84.4	398 90.9	616 90.9	768 92.2	89.8	Regular	0.81 (-1.09;2.71)	0.302	Stability
Hepatitis B prophylaxis	49 90.7	111 87.4	422 84.4	399 91.1	616 90.9	768 92.2	89.9	Regular	0.75 (-1.08;2.58)	0.318	Stability
Blood collection	49 90.7	112 88.2	422 84.4	400 91.3	616 90.9	768 92.2	90.0	Good	0.69 (-1.07;2.46)	0.336	Stability
Semen collection	49 90.7	110 86.6	423 84.6	396 90.4	616 90.9	767 92.1	89.8	Regular	0.75 (-1.13;2.63)	0.330	Stability
Vaginal secretion collection	40 74.1	108 85.0	416 83.2	378 86.3	586 86.4	732 87.9	85.9	Regular	1.94 (0.47;3.42)	0.021	Increasing
Emergency contraception	40 74.1	108 85.0	416 83.2	377 86.1	586 86.4	735 88.2	86.0	Regular	1.97 (0.53;3.41)	0.018	Increasing
Lawful abortion	40 74.1	108 85.0	416 83.2	374 85.4	585 86.3	732 87.9	85.7	Regular	1.90 (0.45;3.34)	0.021	Increasing
Case progression and referral
Women’s police station	41 75.9	66 52.0	345 69.0	301 68.7	549 81.0	768 92.2	78.0	Regular	5.37 (-0.01;10.77)	0.051	Stability
Other police stations	43 79.6	70 55.1	348 69.6	300 68.5	548 80.8	768 92.2	79.0	Regular	4.40 (-1.51;10.39)	0.107	Stability
Public Prosecutor’s office	42 77.8	64 50.4	334 66.8	302 68.9	545 80.4	768 92.2	78.1	Regular	5.28 (-1.03;11.60)	0.080	Stability
CRAS^f	42 77.8	61 48.0	334 66.8	303 69.2	547 80.7	768 92.2	78.0	Regular	5.66 (-0.72;12.06)	0.069	Stability
IML^g	42 77.8	63 49.6	338 67.6	303 69.2	551 81.3	768 92.2	78.0	Regular	5.51 (-0.66;11.68)	0.068	Stability

Variables	2009-2010	2011-2012	2013-2014	2015-2016	2017-2018	2019-2020	Total percentage of consistency	Classification
Variables	N (%)	N (%)	N (%)	N (%)	N (%)	N (%)	N (%)	Classification
Reproductive age (10-49 years old) versus Pregnancy status (not applicable);	25/38 (65.8)	85/96 (88.5)	350/393 (89.1)	285/34 (82.6)	514/585 (87.9)	630/727 (86.7)	1,889 (86.5)	Regular
Disability/disorder (no) versus Type of disability/disorder (yes)	53 (100.0)	123 (100.0)	490 (100.0)	431 (100.0)	667 (100.0)	812 (100.0)	2,576 (100.0)	Excellent
Psychological violence (yes) versus Type of aggression (excluding threats)		1 (100.0)	2 (100.0)	1/3 (33.33)	7/9 (77.8)	9/12 (75.0)	20 (74.1)	Regular
Sexual violence (yes) versus Type of sexual violence (unknown)	8/8 (100.0)	20/23 (87.0)	93/94 (98.9)	73/81 (90.1)	94/105 (89.5)	92/96 (95.8)	380 (93.4)	Excellent
Sex of the perpetrator of the aggression (male) versus Relationship (mother)		1 (100.0)	2 (100.0)	4 (100.0)	8 (88.9)	1 (50.0)	16 (88.6)	Regular

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[TFN1] Source: Notifiable Health Conditions Information System (Sistema de Informação de Agravos de Notificação - SINAN).