2026-11-092026-11-092024ALVES, Taiana Moita Koury. Associação da doença renal crônica dialítica e hepatite C, Pará, Amazônia, Brasil: análise espacial e epidemiológica. Orientador: Nelson Veiga Gonçalves. 2024. 74 f. Tese (Doutorado em Biologia Parasitária na Amazônia) - Centro de Ciência Biológicas e da Saúde, Universidade do Estado do Pará, Belém, 2024.https://portaldaposgraduacao.uepa.br/handle/riuepa/438AbertoHepatite CHemodiáliseInsuficiência renal crônicaEpidemiologiaAnálise espacialHepatitis CHemodialysisChronic renal insufficiencyEpidemiologySpatial analysisTeseCiências da SaúdeCiências da Saúde::Saúde ColetivaCiências da Saúde::Saúde Coletiva::EpidemiologiaCiências da Saúde::Medicina::Clínica Médica::NefrologiaChronic Kidney Disease (CKD) and Hepatitis C represent significant public health issues in Brazil, linked to weaknesses in health policies that are sensitive to primary health care and epidemiological surveillance, as well as the socioeconomic conditions of municipalities in the state of Pará. The association of these diseases results in poorer prognoses for patients, such as an increased risk of mortality from cardiovascular diseases. Therefore, this study aimed to analyze the spatial distribution of the association between Hepatitis C and CKD, along with their risk factors, in relation to socioeconomic variables and public policy, in the state of Pará from 2021 to 2023. This descriptive, cross-sectional, and ecological study utilized secondary data from the Municipal Health Secretariat of Belém, the State Health Secretariat of Pará, the Amazon Foundation for Research and Studies, the Ministry of Health, and the Brazilian Institute of Geography and Statistics. Descriptive and spatial statistical analyses were conducted using Bioestat 5.4 and ArcGIS 10.5.1 software. A total of 82 cases of the association in question were analyzed, with a higher prevalence observed among economically active males. Considering the Average Human Development Index (AHDI) and primary health care coverage across the 13 health regions of the state, cases were identified in the 1st health region, which had a very high AHDI and low primary health care coverage. In contrast, the 7th, 8th, and 13th Health Regions showed no recorded cases of Hepatitis C/CKD, associated with very low AHDI and primary health care coverage, which may indicate a potential epidemiological silence in these regions. The flow of patients seeking specialized treatment followed a convergence pattern toward the 1st Health Region; however, a movement toward the decentralization of dialysis services in the state of Pará was observed. This shift allowed patients from the 5th, 9th, 10th, 11th, and 12th Health Regions to utilize health services available in their respective regions. Additionally, in the 1st Health Region, a specific epidemiological scenario was identified, characterized by a high number of cases of the studied association (51). A detailed analysis revealed a clinical-epidemiological profile of predominantly male adults with low educational attainment and income, with hypertension (HTN) and/or diabetes mellitus (DM) as primary causes of CKD. Risk factors for Hepatitis C included blood transfusions and an average dialysis duration of approximately five years. Regarding the spatial distribution of the flow of cases in the municipalities that comprise the Belém health region, it was noted that a minority of patients receive dialysis treatment in their own municipalities, resulting in significant movement of SUS users from Ananindeua and Marituba to the capital via the Treatment of Distances (TFD) program. This research contributed to the creation and updating of the epidemiological memory of this association and its impacts on society, facilitating the generation of informational resources for decision-making processes related to the occurrence of Hepatitis C virus (HCV) infection in the dialysis population in Pará municipalities. It aims to inform the planning of public policies by managers, legislators, and organized civil society.PPG-BPA - Epidemiologia de microrganismos e parasitos