EPIDEMIOLOGY OF VIOLENCE INVOLVING CHILD AND ADOLESCENTS IN FORTALEZA

A violÃncia envolvendo crianÃas e adolescentes à um fenÃmeno de natureza multicausal e vem tomando os centros das discussÃes no campo da saÃde pÃblica devido aos impactos dos elevados Ãndices, mesmo sua real prevalÃncia sendo pouco conhecida. Objetivou-se neste estudo caracterizar a violÃncia envolvendo crianÃas e adolescentes no municÃpio de Fortaleza. Tratou-se de estudo seccional analÃtico realizado a partir dos processos de crianÃas e adolescentes vÃtimas e promotores de violÃncia nos seis Conselhos Tutelares de Fortaleza em 2011. Tomou-se uma amostra aleatÃria e valor amostral de 840 (a partir de 3.926 processos erro de 3% e IC 95%) . Construiu-se formulÃrio com variÃveis de caracterÃsticas da violÃncia, tipologia da violÃncia, vÃtima, agressor, da famÃlia, crianÃas e adolescentes, e medidas de proteÃÃo, pertinentes aos pais ou responsÃveis. A coleta foi realizada entre fevereiro e marÃo de 2013 e apÃs as perdas, resultaram 780. Digitados e analisados atravÃs do EPIINFO 7. Utilizou-se as anÃlises descritiva (valores absolutos e percentuais), univariada (prevalÃncias) e bivariada (razÃo de prevalÃncia â RP, razÃo de Chances â OR e o qui-quadrado), cÃlculo do risco atribuÃvel e regressÃo logÃstica. Seguiu-se os princÃpios Ãticos da pesquisa. Os principais achados deste estudo: alta prevalÃncia de violÃncia psicolÃgica contra crianÃas e adolescentes (66,5%) e promovidas por elas (81,4%); alta prevalÃncia de violÃncia domÃstica sofrida em 72,3% e promovida em 49,0%dos casos; risco elevado por uso de substÃncias quÃmicas tanto pelas crianÃas e adolescente (reduziria em 23,24%), quanto pelos agressores (preveniria em 22,61%) e pelos familiares (reduziria em 31,31%). Foram encontradas associaÃÃes com fatores que possibilitam crianÃas e adolescentes promoverem violÃncia domÃstica: sofrer ameaÃas (OR=0,15: 0,04-0,57); situaÃÃo dos pais usuÃrios de drogas(OR=19,05: 2,24-161,89). AssociaÃÃo com sofrer violÃncia domÃstica: ser mÃe (OR=0,05: 0,02-0,19) e/ou pai agressor (OR=0,04: 0,01-0,17); presenciar violÃncia anterior (OR=0,52: 0,33-0,83); crianÃa/adolescente frequentando escola (OR=0,48: 0,29-0,76); crianÃa/adolescente trabalhando (OR=3,23: 1,47-7,07); crianÃa/adolescente usuÃrios de droga (OR=3,34: 1,56-7,13). Evidencia-se que a violÃncia envolvendo as crianÃas e adolescentes mostra-se como um problema que possui raÃzes sociais e culturais e deve ser enfrentada como uma questÃo de cidadania, de direitos humanos e sociais, alertando a articulaÃÃo intersetorial e abordagem multiprofissional e interdisciplinar.Violence involving children and adolescents is a multi-causal phenomenon. It has been the focus of the discussions in the public health field due to the impacts of high rates and its prevalence unfamiliar. The objective of this study was to characterize violence involving children and adolescents in the city of Fortaleza. It is an analytical sectional study from the children and adolescent victims and promoters of violence processes in the six Guardianship Councils in the city of Fortaleza in 2011. It took a random sample and value of 840 from 3,926 processes using margin of error of 3% and confidence interval of 95%. Data collection form is composed of characteristics of violence, typology of violence, victim, offender, family, children and adolescents, and protective measures, relevant to parents or guardians. The data were collected between February and March 2013. It resulted in 780 after losses. It was entered and analyzed by EPIINFO 7. We used the descriptive analysis (absolute and percentage), univariate analysis (prevalence) and bivariate analysis (prevalence ratio - PR, odds ratio - OR and chi-square), attributable risk calculus and logistic regression. There followed the ethical principles of research. The main findings of this study: high prevalence of psychological violence against children and adolescents (66.5%) and promoted by them (81.4%); High prevalence of domestic violence suffered in 72.3% and promoted in 49.0% of cases; high risk for substance use by both children and adolescents (decrease by 23,24%) and by the aggressors (would prevent in 22.61%) and family (reduce by 31.31%). Associations were found with factors that enable children and adolescents to promote domestic violence: suffer threats (OR = 0.15: 0.04 to 0.57); situation of drug users parents (OR = 19.05: 2.24 to 161.89). Association with experience domestic violence: being a mother (OR = 0.05: 0.02 to .19); abusive father (OR = 0.04: 0.01 to 0.17); previous witness violence (OR = 0.52: 0.33 to 0.83); children and adolescents attending school (OR = 0.48: 0.29 to 0.76); child and adolescent working (OR = 3.23: 1.47 to 7.07); child and adolescent drug users (OR = 3.34: 1.56 to 7.13). Finally, violence shows up as a problem with social and cultural roots. It must be tackled as a matter of citizenship, human and social rights, and it will be solved only using intersectoral and interdisciplinary approach and coordination