a surdez em são tomé e príncipe - imvf.org · 180 44 16 19 17 40 0 50 100 150 200 controlo...

ASurdezemSãoToméePríncipeOpresenteeofuturo…

CristinaCaroça,JoãoPaço

Opresenteeofuturo…

Fala

Cognição Psicosocial

Família ComunidadeFala

Cognição Psicosocial

Família Comunidade

Surdez(n=644)GraudePerdadeaudiçãoTipodeSurdez

Moderada(41-60dB)

Ligeira(26-40dB)

Severa(61-80dB)

Profunda(≥81dB)

2012-2014

SurdezNeurosensorial

SurdezdeCondução

SurdezMista

Normal

UnilateralHL

Normal

180

44

16 19 17 40

0 50 100 150 200

Controlo

Surdez

Unilateral

Surdez

Bilateral

GRUPOCASO/CONTROLOPORGRAUDESURDEZ

Normal Ligeira Moderada Severa Profunda

Idades(n=298) Género(n=298)

DistritodeResidência(n=298)

HistóriaFamiliar(n=292)

Co-sanguinidade(n=287)

250

Hz

500

Hz

1000

Hz

2000

Hz

4000

Hz

LeftEar(dB) 20.36 19.78 19.36 14.01 13.18

RightEar(dB) 19.96 20.57 19.97 14.27 13.66

0102030405060708090100

dB

CurvaAudiométrica–grupocontrolo

250

Hz

500

Hz

1000

Hz

2000

Hz

4000

Hz

LeftEar(dB) 55.49 60.8 61.6 61.81 63.41

RightEar(dB) 56.76 60.75 62.71 59.26 61.7

0102030405060708090

100

dB

CurvaAudiométrica–grupocaso

AUDIOGRAMATONAL–MÉDIAS

LinguagemOral(n=275)

HistóriadeinfeçãoporMalária(n=289)

Hb(n=298)

WT wB(376A)

Var

wA+(376G)

wA-(202A+376G)

wHeterozygousgroup*

G6PD202G>A(n=298) G6PD376A>G(n=298)

VarianteG6PD(n=298)

SemdelecçõesGJB6identificadas

RegiãocodificanteGJB2(n=298)

RubéolaIgG(n=298)

Surdez

Anemia

Genética

DoençasInfecciosas

27

Table2-Binary Logistic Regressi betwee independent variables a HL without

a with ris factors a interactions

Cases

129(43.3%)

Controls

169(56.7%)

P-

valueCrudeOR(95%CI) P-value AdjustedOR(95%CI)

GenderGroup

Female

Male

54(41.9%)

75(58.1%)

80(47.3%)

89(52.7%)

0.347

Reference

0.801[0.505-1.272]

0.024

Reference

0.312[0.113-0.860]

Agegroup

[2-14]:

[15-35]:

67(51.9%)

62(48.1%)

77(45.6%)

92(54.4%)

0.275

Reference

0.774[0.489-1.226]

0.130

Reference

2.047[0.809-5.181]

Malaria

infection

No:

Yes:

86(66.7%)

39(30.2%)

98(58%)

66(40.2%)

0.114

Reference

1.485[0.909-2.425]

0.053

Reference

2.885[0.987-8.435]

HbS

AA:

AS:

SS:

106(82.2%)

21(16.3%)

2(1.6%)

133(78.7%)

35(20.7%)

1(0.6%)

0.475

0.352

0.455

Reference

0.753[0.414-1.369]

2.509[0.224-28.051]

0.768

0.939

0.523

Reference

0.931[0.266-3.403]

2.470[0.154-39.633]

G6PDvariants

B

Non-B

66(51.2%)

63(48.8%)

86(50.9%)

83(49.1%)

0.962

Reference

0.989[0.625-1.564]

0.884

Reference

1.079[0.388-3.004]

RubellaIgG

Neg:

Pos:

36(27.9%)

93(72.1%)

64(37.4%)

107(62.6%)

0.111

Reference

1.497[0.912-2.458]

0.023

Reference

1.986[1.100-3.585]

Malaria

infection&Age

groups

0.084 0.0001

No&[2-14] Reference Reference

0.658[0.409-1.059] 0.123[0.039-0.385]

Malaria

infection&

Gender

0.168 0.046

No&Fem Reference Reference

1.448[0.856-2.451] 3.001[1.021-8.817]

G6PDvariants

&Gender

0.672 0.258


1.141[0.620-2.101] 1.804[0.649-5.014]

G6PDvariants

&Malaria

infection

0.844 0.459

B&No Reference Reference

1.051[0.639-1.729] 0.669[0.230-1.942]

G6PDvariants

&HbS*

0.436 0.643

B&HbAA Reference Reference

0.749[0.362-1.550] 0.738[0.204-2.668]

HbS*&Malaria

infection

0.960

0.506

HbAA&No Reference Reference

0.982[0.481-2.005] 1.264[0.634-2.522]

HL:Normalhearing 0 ReferenceCategoryisaresponsevariable;independentvariables:GenderGroup(0 Female,1

Male),agegroups(0 [2-14]years,1 [15-35]years),historyofMalariainfection(0 no,1 yes),ImmunityRubella(0

Negative,1 Positive),HbS(0 HbAAwildtype,1-HbAStrait,2 HbSShomozygotic),G6PDvariants(0 G6PDB,1

G6PDA/G6PDA-/202G>A)andHbS*(0 HbAA,1 HbAS/HbSS)

27



Cases

129(43.3%)

Controls

169(56.7%)

P-


GenderGroup

Female

Male

54(41.9%)

75(58.1%)

80(47.3%)

89(52.7%)

0.347

Reference

0.801[0.505-1.272]

0.024

Reference

0.312[0.113-0.860]

Agegroup

[2-14]:

[15-35]:

67(51.9%)

62(48.1%)

77(45.6%)

92(54.4%)

0.275

Reference

0.774[0.489-1.226]

0.130

Reference

2.047[0.809-5.181]

Malaria

infection

No:

Yes:

86(66.7%)

39(30.2%)

98(58%)

66(40.2%)

0.114

Reference

1.485[0.909-2.425]

0.053

Reference

2.885[0.987-8.435]

HbS

AA:

AS:

SS:

106(82.2%)

21(16.3%)

2(1.6%)

133(78.7%)

35(20.7%)

1(0.6%)

0.475

0.352

0.455

Reference

0.753[0.414-1.369]

2.509[0.224-28.051]

0.768

0.939

0.523

Reference

0.931[0.266-3.403]

2.470[0.154-39.633]

G6PDvariants

B

Non-B

66(51.2%)

63(48.8%)

86(50.9%)

83(49.1%)

0.962

Reference

0.989[0.625-1.564]

0.884

Reference

1.079[0.388-3.004]

RubellaIgG

Neg:

Pos:

36(27.9%)

93(72.1%)

64(37.4%)

107(62.6%)

0.111

Reference

1.497[0.912-2.458]

0.023

Reference

1.986[1.100-3.585]

Malaria

infection&Age

groups

0.084 0.0001


0.658[0.409-1.059] 0.123[0.039-0.385]

Malaria

infection&

Gender

0.168 0.046


1.448[0.856-2.451] 3.001[1.021-8.817]

G6PDvariants

&Gender

0.672 0.258


1.141[0.620-2.101] 1.804[0.649-5.014]

G6PDvariants

&Malaria

infection

0.844 0.459


1.051[0.639-1.729] 0.669[0.230-1.942]

G6PDvariants

&HbS*

0.436 0.643


0.749[0.362-1.550] 0.738[0.204-2.668]

HbS*&Malaria

infection

0.960

0.506


0.982[0.481-2.005] 1.264[0.634-2.522]

HL:Normalhearing–0–ReferenceCategoryisaresponsevariable;independentvariables:GenderGroup(0–Female,1

–Male),agegroups(0–[2-14]years,1–[15-35]years),historyofMalariainfection(0–no,1–yes),ImmunityRubella(0

–Negative,1–Positive),HbS(0–HbAAwildtype,1-HbAStrait,2–HbSShomozygotic),G6PDvariants(0–G6PDB,1–

G6PDA/G6PDA-/202G>A)andHbS*(0–HbAA,1–HbAS/HbSS)

Ogéneromasculinotemmenorriscodedesenvolversurdezemrelaçãoaogénerofeminino.Provavelmenteporqueosexo

femininotemmaisanemia.

REGRESSÃOLOGÍSTICABINÁRIAMÚLTIPLASENTRETODOSOSFACTORESDERISCOESURDEZ

ARubéolaéumadoençaevitávelquepodelevarasurdez

(períodogestacional).Representaumriscoelevado– duplicao

riscodesurdez

27



Cases

129(43.3%)

Controls

169(56.7%)

P-


GenderGroup

Female

Male

54(41.9%)

75(58.1%)

80(47.3%)

89(52.7%)

0.347

Reference

0.801[0.505-1.272]

0.024

Reference

0.312[0.113-0.860]

Agegroup

[2-14]:

[15-35]:

67(51.9%)

62(48.1%)

77(45.6%)

92(54.4%)

0.275

Reference

0.774[0.489-1.226]

0.130

Reference

2.047[0.809-5.181]

Malaria

infection

No:

Yes:

86(66.7%)

39(30.2%)

98(58%)

66(40.2%)

0.114

Reference

1.485[0.909-2.425]

0.053

Reference

2.885[0.987-8.435]

HbS

AA:

AS:

SS:

106(82.2%)

21(16.3%)

2(1.6%)

133(78.7%)

35(20.7%)

1(0.6%)

0.475

0.352

0.455

Reference

0.753[0.414-1.369]

2.509[0.224-28.051]

0.768

0.939

0.523

Reference

0.931[0.266-3.403]

2.470[0.154-39.633]

G6PDvariants

B

Non-B

66(51.2%)

63(48.8%)

86(50.9%)

83(49.1%)

0.962

Reference

0.989[0.625-1.564]

0.884

Reference

1.079[0.388-3.004]

RubellaIgG

Neg:

Pos:

36(27.9%)

93(72.1%)

64(37.4%)

107(62.6%)

0.111

Reference

1.497[0.912-2.458]

0.023

Reference

1.986[1.100-3.585]

Malaria

infection&Age

groups

0.084 0.0001


0.658[0.409-1.059] 0.123[0.039-0.385]

Malaria

infection&

Gender

0.168 0.046


1.448[0.856-2.451] 3.001[1.021-8.817]

G6PDvariants

&Gender

0.672 0.258


1.141[0.620-2.101] 1.804[0.649-5.014]

G6PDvariants

&Malaria

infection

0.844 0.459


1.051[0.639-1.729] 0.669[0.230-1.942]

G6PDvariants

&HbS*

0.436 0.643


0.749[0.362-1.550] 0.738[0.204-2.668]

HbS*&Malaria

infection

0.960

0.506


0.982[0.481-2.005] 1.264[0.634-2.522]





27



Cases

129(43.3%)

Controls

169(56.7%)

P-


GenderGroup

Female

Male

54(41.9%)

75(58.1%)

80(47.3%)

89(52.7%)

0.347

Reference

0.801[0.505-1.272]

0.024

Reference

0.312[0.113-0.860]

Agegroup

[2-14]:

[15-35]:

67(51.9%)

62(48.1%)

77(45.6%)

92(54.4%)

0.275

Reference

0.774[0.489-1.226]

0.130

Reference

2.047[0.809-5.181]

Malaria

infection

No:

Yes:

86(66.7%)

39(30.2%)

98(58%)

66(40.2%)

0.114

Reference

1.485[0.909-2.425]

0.053

Reference

2.885[0.987-8.435]

HbS

AA:

AS:

SS:

106(82.2%)

21(16.3%)

2(1.6%)

133(78.7%)

35(20.7%)

1(0.6%)

0.475

0.352

0.455

Reference

0.753[0.414-1.369]

2.509[0.224-28.051]

0.768

0.939

0.523

Reference

0.931[0.266-3.403]

2.470[0.154-39.633]

G6PDvariants

B

Non-B

66(51.2%)

63(48.8%)

86(50.9%)

83(49.1%)

0.962

Reference

0.989[0.625-1.564]

0.884

Reference

1.079[0.388-3.004]

RubellaIgG

Neg:

Pos:

36(27.9%)

93(72.1%)

64(37.4%)

107(62.6%)

0.111

Reference

1.497[0.912-2.458]

0.023

Reference

1.986[1.100-3.585]

Malaria

infection&Age

groups

0.084 0.0001


0.658[0.409-1.059] 0.123[0.039-0.385]

Malaria

infection&

Gender

0.168 0.046


1.448[0.856-2.451] 3.001[1.021-8.817]

G6PDvariants

&Gender

0.672 0.258


1.141[0.620-2.101] 1.804[0.649-5.014]

G6PDvariants

&Malaria

infection

0.844 0.459


1.051[0.639-1.729] 0.669[0.230-1.942]

G6PDvariants

&HbS*

0.436 0.643


0.749[0.362-1.550] 0.738[0.204-2.668]

HbS*&Malaria

infection

0.960

0.506


0.982[0.481-2.005] 1.264[0.634-2.522]





AinfeçãoporMalárianogrupomaisvelhoéprotectorparaasurdez,provavelmenteporqueaimaturidade

imunológicaeefeitodaototoxicidadenosmaisnovos

AinfeçãoporMalárianogéneromasculinotemumriscoelevadoparaasurdez(3vezes),provavelmentedevidoà

maiorexposiçãoaPFalciparumoueventualmenteuma

anemiahemolíticamaisagressivanogéneromasculino

quenofeminino.


27



Cases

129(43.3%)

Controls

169(56.7%)

P-


GenderGroup

Female

Male

54(41.9%)

75(58.1%)

80(47.3%)

89(52.7%)

0.347

Reference

0.801[0.505-1.272]

0.024

Reference

0.312[0.113-0.860]

Agegroup

[2-14]:

[15-35]:

67(51.9%)

62(48.1%)

77(45.6%)

92(54.4%)

0.275

Reference

0.774[0.489-1.226]

0.130

Reference

2.047[0.809-5.181]

Malaria

infection

No:

Yes:

86(66.7%)

39(30.2%)

98(58%)

66(40.2%)

0.114

Reference

1.485[0.909-2.425]

0.053

Reference

2.885[0.987-8.435]

HbS

AA:

AS:

SS:

106(82.2%)

21(16.3%)

2(1.6%)

133(78.7%)

35(20.7%)

1(0.6%)

0.475

0.352

0.455

Reference

0.753[0.414-1.369]

2.509[0.224-28.051]

0.768

0.939

0.523

Reference

0.931[0.266-3.403]

2.470[0.154-39.633]

G6PDvariants

B

Non-B

66(51.2%)

63(48.8%)

86(50.9%)

83(49.1%)

0.962

Reference

0.989[0.625-1.564]

0.884

Reference

1.079[0.388-3.004]

RubellaIgG

Neg:

Pos:

36(27.9%)

93(72.1%)

64(37.4%)

107(62.6%)

0.111

Reference

1.497[0.912-2.458]

0.023

Reference

1.986[1.100-3.585]

Malaria

infection&Age

groups

0.084 0.0001


0.658[0.409-1.059] 0.123[0.039-0.385]

Malaria

infection&

Gender

0.168 0.046


1.448[0.856-2.451] 3.001[1.021-8.817]

G6PDvariants

&Gender

0.672 0.258


1.141[0.620-2.101] 1.804[0.649-5.014]

G6PDvariants

&Malaria

infection

0.844 0.459


1.051[0.639-1.729] 0.669[0.230-1.942]

G6PDvariants

&HbS*

0.436 0.643


0.749[0.362-1.550] 0.738[0.204-2.668]

HbS*&Malaria

infection

0.960

0.506


0.982[0.481-2.005] 1.264[0.634-2.522]





HbSéumahemoglobinopatiaquehabitualmenteestá

associadaaproteçãoàmalária.OtraçodeHbSsugerealgumaproteçãoparaasurdez,enquantoqueadoençaHbSpareceaumentaroriscoparaasurdez,quase2,5vezes.

HistóriadeMaláriasugereumaumentoderiscopróximo

de3vezes.

Maláriapodelevaraanemiahemolíticaelibertaçãode

mediadoresinflamatóriosquepodeminduzirasurdez.

Tambématerapêuticaantipalúdicapodedarorigema

surdez.

27



Cases

129(43.3%)

Controls

169(56.7%)

P-


GenderGroup

Female

Male

54(41.9%)

75(58.1%)

80(47.3%)

89(52.7%)

0.347

Reference

0.801[0.505-1.272]

0.024

Reference

0.312[0.113-0.860]

Agegroup

[2-14]:

[15-35]:

67(51.9%)

62(48.1%)

77(45.6%)

92(54.4%)

0.275

Reference

0.774[0.489-1.226]

0.130

Reference

2.047[0.809-5.181]

Malaria

infection

No:

Yes:

86(66.7%)

39(30.2%)

98(58%)

66(40.2%)

0.114

Reference

1.485[0.909-2.425]

0.053

Reference

2.885[0.987-8.435]

HbS

AA:

AS:

SS:

106(82.2%)

21(16.3%)

2(1.6%)

133(78.7%)

35(20.7%)

1(0.6%)

0.475

0.352

0.455

Reference

0.753[0.414-1.369]

2.509[0.224-28.051]

0.768

0.939

0.523

Reference

0.931[0.266-3.403]

2.470[0.154-39.633]

G6PDvariants

B

Non-B

66(51.2%)

63(48.8%)

86(50.9%)

83(49.1%)

0.962

Reference

0.989[0.625-1.564]

0.884

Reference

1.079[0.388-3.004]

RubellaIgG

Neg:

Pos:

36(27.9%)

93(72.1%)

64(37.4%)

107(62.6%)

0.111

Reference

1.497[0.912-2.458]

0.023

Reference

1.986[1.100-3.585]

Malaria

infection&Age

groups

0.084 0.0001


0.658[0.409-1.059] 0.123[0.039-0.385]

Malaria

infection&

Gender

0.168 0.046


1.448[0.856-2.451] 3.001[1.021-8.817]

G6PDvariants

&Gender

0.672 0.258


1.141[0.620-2.101] 1.804[0.649-5.014]

G6PDvariants

&Malaria

infection

0.844 0.459


1.051[0.639-1.729] 0.669[0.230-1.942]

G6PDvariants

&HbS*

0.436 0.643


0.749[0.362-1.550] 0.738[0.204-2.668]

HbS*&Malaria

infection

0.960

0.506


0.982[0.481-2.005] 1.264[0.634-2.522]



–Negative,1–Positive),HbS(0–HbAAwildtype,1-HbAStrait,2–HbSShomozygotic),G6PDvariants(0–G6PDB,1–

G6PDA/G6PDA-/202G>A)andHbS*(0–HbAA,1–HbAS/HbSS)


27



Cases

129(43.3%)

Controls

169(56.7%)

P-


GenderGroup

Female

Male

54(41.9%)

75(58.1%)

80(47.3%)

89(52.7%)

0.347

Reference

0.801[0.505-1.272]

0.024

Reference

0.312[0.113-0.860]

Agegroup

[2-14]:

[15-35]:

67(51.9%)

62(48.1%)

77(45.6%)

92(54.4%)

0.275

Reference

0.774[0.489-1.226]

0.130

Reference

2.047[0.809-5.181]

Malaria

infection

No:

Yes:

86(66.7%)

39(30.2%)

98(58%)

66(40.2%)

0.114

Reference

1.485[0.909-2.425]

0.053

Reference

2.885[0.987-8.435]

HbS

AA:

AS:

SS:

106(82.2%)

21(16.3%)

2(1.6%)

133(78.7%)

35(20.7%)

1(0.6%)

0.475

0.352

0.455

Reference

0.753[0.414-1.369]

2.509[0.224-28.051]

0.768

0.939

0.523

Reference

0.931[0.266-3.403]

2.470[0.154-39.633]

G6PDvariants

B

Non-B

66(51.2%)

63(48.8%)

86(50.9%)

83(49.1%)

0.962

Reference

0.989[0.625-1.564]

0.884

Reference

1.079[0.388-3.004]

RubellaIgG

Neg:

Pos:

36(27.9%)

93(72.1%)

64(37.4%)

107(62.6%)

0.111

Reference

1.497[0.912-2.458]

0.023

Reference

1.986[1.100-3.585]

Malaria

infection&Age

groups

0.084 0.0001


0.658[0.409-1.059] 0.123[0.039-0.385]

Malaria

infection&

Gender

0.168 0.046


1.448[0.856-2.451] 3.001[1.021-8.817]

G6PDvariants

&Gender

0.672 0.258


1.141[0.620-2.101] 1.804[0.649-5.014]

G6PDvariants

&Malaria

infection

0.844 0.459


1.051[0.639-1.729] 0.669[0.230-1.942]

G6PDvariants

&HbS*

0.436 0.643


0.749[0.362-1.550] 0.738[0.204-2.668]

HbS*&Malaria

infection

0.960

0.506


0.982[0.481-2.005] 1.264[0.634-2.522]





27



Cases

129(43.3%)

Controls

169(56.7%)

P-


GenderGroup

Female

Male

54(41.9%)

75(58.1%)

80(47.3%)

89(52.7%)

0.347

Reference

0.801[0.505-1.272]

0.024

Reference

0.312[0.113-0.860]

Agegroup

[2-14]:

[15-35]:

67(51.9%)

62(48.1%)

77(45.6%)

92(54.4%)

0.275

Reference

0.774[0.489-1.226]

0.130

Reference

2.047[0.809-5.181]

Malaria

infection

No:

Yes:

86(66.7%)

39(30.2%)

98(58%)

66(40.2%)

0.114

Reference

1.485[0.909-2.425]

0.053

Reference

2.885[0.987-8.435]

HbS

AA:

AS:

SS:

106(82.2%)

21(16.3%)

2(1.6%)

133(78.7%)

35(20.7%)

1(0.6%)

0.475

0.352

0.455

Reference

0.753[0.414-1.369]

2.509[0.224-28.051]

0.768

0.939

0.523

Reference

0.931[0.266-3.403]

2.470[0.154-39.633]

G6PDvariants

B

Non-B

66(51.2%)

63(48.8%)

86(50.9%)

83(49.1%)

0.962

Reference

0.989[0.625-1.564]

0.884

Reference

1.079[0.388-3.004]

RubellaIgG

Neg:

Pos:

36(27.9%)

93(72.1%)

64(37.4%)

107(62.6%)

0.111

Reference

1.497[0.912-2.458]

0.023

Reference

1.986[1.100-3.585]

Malaria

infection&Age

groups

0.084 0.0001


0.658[0.409-1.059] 0.123[0.039-0.385]

Malaria

infection&

Gender

0.168 0.046


1.448[0.856-2.451] 3.001[1.021-8.817]

G6PDvariants

&Gender

0.672 0.258


1.141[0.620-2.101] 1.804[0.649-5.014]

G6PDvariants

&Malaria

infection

0.844 0.459


1.051[0.639-1.729] 0.669[0.230-1.942]

G6PDvariants

&HbS*

0.436 0.643


0.749[0.362-1.550] 0.738[0.204-2.668]

HbS*&Malaria

infection

0.960

0.506


0.982[0.481-2.005] 1.264[0.634-2.522]






QuemtemavarianteG6PDdefeédogéneromasculino,sugereumaumentoderiscoparaasurdez.G6PDdefémaisprevalentecomodoençanogéneromasculinoporqueéhemizigótica,apresentandomaioranemia

hemolítica,comelevadoriscoparaasurdez.QuemtemavarianteG6PDnão-Betemmalária,sugereumadiminuiçãoderiscoparaasurdez.G6PDdeftemum

efeitoprotectorparaamaláriasevera,nestaamostrater

G6PDvariantenão-BactuacomoprotectorparaasurdezG6PDdefeHbSsugereumefeitoprotectornodesenvolvimentodemaláriasevera.Nestaamostrater

G6PDvariantenão-BeHbSestãoaactuarcomo

protectoresparaasurdezQuemtemHbSemalária,sugereumriscoaumentadodetersurdez.HbStemumefeitoprotectorparao

desenvolvimentodemaláriasevera,mastambémtem

ummecanismoquepodeinduzirsurdeznestaamostra,

aumentadoorisco.

Rubéola Feminino

IdadeJovem

Masculino

FACTORESDERISCOPARAASURDEZ

Malária

OUTROSPROJETOS

•  EducaçãoparaaSaúde

•  AdaptaçãodePróteses

Auditivas

•  TerapiadaFala

•  STP:Desenvolvimentode

LínguaGestual

•  RastreioAuditivoNeonatal

•  ImplementaçãodaVacinada

Rubéola

•  TelemedicinaORL

•  Treinomédicoespecializado

emORL,emespecialpara

médicosdeSTP



Auditivas



LínguaGestual



Rubéola




médicosdeSTP

OUTROSPROJETOS



Auditivas



LínguaGestual



Rubéola




médicosdeSTP

CONSIDERAÇÕESFINAIS

OUTROSPROJETOS

PerspectivasCirúrgicas

•  Follow-updosprojectos

•  TreinomédicoespecializadodeORLamédicosgeneralistasdeSTP

•  Identificaçãoprecocedesurdez,follow-upeidentificaçãodeoutrosfactoresderisco

•  RastreiodeG6PDemSTP

Futuro…

Projetos,

Ideias…

PerspectivasFuturas–G6PDDefeLinguagemOral

Normouvinte

SemOralidadeComOralidade

G6PDVar

ìG6PDA+

ìG6PDA-

PerspectivasFuturas–G6PDDef– Surdez-Hipertensão

G6PDVar

ì Susceptibilidadeàs

infeções

ìHemólise

íOxidoNítrico

ì SurdezNS ìHipertensão

ììMasc

ìFeminino

OxidoNitrico(NO)– Efeitovasodilatadorarteriolar

ArtCoclear

PerspectivasFuturas– Toxoplasmose

Amostra

HipoacusiaNeurosensorialNormouvintebil

IgGToxoplasmose

ìIgGToxop

Osonho…

Inovação

Equipamultidisciplinar

Familiares/Educadores

TerapêutadaFala

Reabilitaçãoauditiva

Audiologistas

Médicos

Psicólogos

ImplanteCoclear

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