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Huang HN, Li X, Peng Z, Liao YF, Li L, Nardocci AC, Ou CQ, Yang Z. Mortality risk and burden of aortic aneurysm and dissection attributable to low temperatures: A nationwide case-crossover analysis in Brazil, a predominantly tropical country. ENVIRONMENT INTERNATIONAL 2024; 190:108895. [PMID: 39059022 DOI: 10.1016/j.envint.2024.108895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 06/05/2024] [Accepted: 07/17/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND Low temperatures are adverse contributors to cardiovascular diseases, but the associations between short-term exposure to cold and the risk of death from aortic dissection and aneurysm remain unclear, particularly in tropical regions. OBJECTIVE This study was conducted based on 123,951 records of deaths caused by aortic dissection and aneurysms extracted from the national Mortality Information System in Brazil between 2000 and 2019. METHODS Relative risks and 95 % confidence intervals (CI) for the aortic-related deaths associated with low ambient temperatures were estimated using the conditional logistic model combined with the distributed lag nonlinear model. Subgroup analyses were performed by age group, sex, race, education level, and residential region. Furthermore, this study calculated the number and fraction of aortic-related deaths attributed to temperatures below the temperature threshold to quantify the cold-related mortality burden of aortic diseases. RESULTS During the study period, aortic-related deaths and mortality rates in Brazil exhibited a steady increase, rising from 4419 (2.66/100,000) in 2000 to 8152 (3.88/100,000) in 2019. Under the identified temperature threshold (26 °C), per 1 °C decrease in daily mean temperature was associated with a 4.77 % (95 % CI: 4.35, 5.19) increase in mortality risk of aortic-related diseases over lag 0-3 days. Females, individuals aged 50 years or older, Asian and Black race, and northern residents were more susceptible to low temperatures. Low temperatures were responsible for 19.10 % (95 % CI: 17.71, 20.45) of aortic-related deaths in Brazil. CONCLUSION This study highlights that low temperatures were associated with an increased risk of aortic-related deaths, with a remarkable burden even in this predominantly tropical country.
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Affiliation(s)
- Hao-Neng Huang
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Xin Li
- Department of Emergency Medicine, Guangdong Provincial People's Hospital, (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Zhen Peng
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Yi-Fu Liao
- Department of Neurology, Guangdong Provincial People's Hospital, (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Li Li
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Adelaide C Nardocci
- Department of Environmental Health, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Chun-Quan Ou
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou 510515, China; Department of Emergency Medicine, Guangdong Provincial People's Hospital, (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.
| | - Zhou Yang
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou 510515, China.
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Lopes da Silva J, Gomes SA, Costa de Oliveira L, Zanetti de Albuquerque L, Moura LM, Santos Thuler LC, Cristina de Melo A. Exploring factors and trends in place of death by cancer: a population-based study in Brazil. LANCET REGIONAL HEALTH. AMERICAS 2024; 34:100764. [PMID: 38779656 PMCID: PMC11109465 DOI: 10.1016/j.lana.2024.100764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 04/12/2024] [Accepted: 04/26/2024] [Indexed: 05/25/2024]
Abstract
Background The place of death profoundly affects end-of-life care quality, particularly in cancer. Assisting individuals at home enhances support, privacy, and control, reducing healthcare costs. This study seeks to elucidate factors associated and trends in place of death by cancer in Brazil. Methods Using data obtained from the National Mortality Information System, this study extracted tumour topography, sociodemographic characteristics, and the place of death (outcome classified into hospital or home death) by cancer in Brazil from 2002 to 2021. Findings The analysis included 3,677,415 cases, with 82.3% of deaths occurring in hospitals and 17.7% at home. Most participants were male (53.1%), had gastrointestinal tumours (32.2%), and resided in the Southeastern region (48.7%). Home deaths were more frequent in the Northeastern (30.2%) and Northern (24.8%) regions compared to the Southern (17.1%) and Southeastern (12.2%) regions. A strong inverse correlation was found between home deaths and the Human Development Index of the region. Over the years, there was a reduction in home deaths, followed by a recent increase. Individuals with no formal education, indigenous individuals, and patients from the North, Northeast, and Central-West regions had higher rates of home deaths, while patients with haematological malignancies had lower rates compared to those with gastrointestinal tumours. Interpretation The minority of deaths by cancer in Brazil occur at home, with distinct trends over time. Home death was associated with regional, racial and educational level differences. Funding No funding.
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Affiliation(s)
- Jessé Lopes da Silva
- Division of Clinical Research and Technological Development, Brazilian National Cancer Institute, Rio de Janeiro, Brazil
| | - Sarah Ananda Gomes
- Oncoclinicas&Co– Medica Scientia Innovation Research (MEDSIR)/MedSir, Sao Paulo, Brazil
| | | | - Lucas Zanetti de Albuquerque
- Division of Clinical Research and Technological Development, Brazilian National Cancer Institute, Rio de Janeiro, Brazil
| | | | - Luiz Claudio Santos Thuler
- Division of Clinical Research and Technological Development, Brazilian National Cancer Institute, Rio de Janeiro, Brazil
| | - Andréia Cristina de Melo
- Division of Clinical Research and Technological Development, Brazilian National Cancer Institute, Rio de Janeiro, Brazil
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Marques LJP, Silva ZPD, Alencar GP, Paixão ESD, Blencowe H, de Almeida MF. Prevalence and risk of stillbirth according to biologic vulnerability phenotypes in the municipality of São Paulo, Brazil: A population-based cohort study. Int J Gynaecol Obstet 2024; 165:442-452. [PMID: 37712560 DOI: 10.1002/ijgo.15102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 07/28/2023] [Accepted: 08/22/2023] [Indexed: 09/16/2023]
Abstract
OBJECTIVE To estimate the prevalence and risk of stillbirths by biologic vulnerability phenotypes in a cohort of pregnant women in the municipality of São Paulo, Brazil, 2017-2019. METHODS Retrospective population-based cohort study. Fetuses were assessed as small for gestational age (SGA), large for gestational age (LGA), adequate for gestational age (AGA), preterm (PT) as less than 37 weeks of gestation, non-PT (NPT) as 37 weeks of gestation or more, low birth weight (LBW) as less than 2500 g, and non-LBW (NLBW) as 2500 g or more. Relative risks (RR) with robust variance were estimated using Poisson regression. RESULTS In all 442 782 pregnancies, including 2321 (0.5%) stillbirths, were included. About 85% (n = 1983) of stillbirths had at least one characteristic of vulnerability, compared with 21% (n = 92524) of live births. Fetuses with all three markers of vulnerability had the highest adjusted RR of stillbirth-SGA + LBW + PT (RR 155.00; 95% confidence interval [CI] 136.29-176.30) and LGA + LBW + PT (RR 262.04; 95% CI 206.10-333.16) when compared with AGA + NLBW + NPT. CONCLUSION Our findings show that the simultaneous presence of prematurity, low birth weight, and abnormal intrauterine growth presented a higher risk of stillbirths. To accelerate progress towards reducing preventable stillbirths, one must identify the circumstances of greatest biologic vulnerability.
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Affiliation(s)
| | - Zilda Pereira da Silva
- Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo, Brazil
| | | | - Enny Santos da Paixão
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Bahia, Salvador, Brazil
- Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Hannah Blencowe
- Maternal Adolescent Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK
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Oliveira Alves FJ, Fialho E, Paiva de Araújo JA, Naslund JA, Barreto ML, Patel V, Machado DB. The rising trends of self-harm in Brazil: an ecological analysis of notifications, hospitalisations, and mortality between 2011 and 2022. LANCET REGIONAL HEALTH. AMERICAS 2024; 31:100691. [PMID: 38500959 PMCID: PMC10945432 DOI: 10.1016/j.lana.2024.100691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 01/16/2024] [Accepted: 01/22/2024] [Indexed: 03/20/2024]
Abstract
Background Self-harm is considered an important public health issue and is comprised by a wide range of definitions and behaviours. It is estimated that suicide affects more than 700,000 individuals every year, although, globally, there is a lack of evidence on other self-harm behaviour, such as attempted suicide. The objective of this study is to report and examine temporal trends of notifications, hospitalisations related to self-harm and suicide rates in Brazil between 2011 and 2022, as well as investigating differences in sociodemographic characteristics, methods, and region. Methods This ecological study used secondary, Brazilian Health Information System data between 2011 and 2022. Self-harm notifications were collected from the Notifiable Diseases Information System (SINAN); self-harm hospitalisations from the Hospital Information System (SIH), and suicide data from the Mortality Information System (SIM). We calculated self-harm notifications, hospitalisations, and suicide rates by sex, age, race, region, and overall. We assessed time-related trends using Joinpoint regression analyses. Findings From 2011 to 2022, 720,480 self-harm notifications, 104,458 self-harm hospitalisations, and 147,698 suicides were recorded in Brazil. In this period, self-harm notifications (AAPC: 21.13 (CI: 17.50, 25.33)) and suicide (AAPC: 3.70 (CI: 3.05, 4.38)) have increased in the country. Male adults (25-59 years old) and the elderly (>60 years old) continue to be the groups most affected by suicide, with respective rates of 9.59 and 8.60/100,000 in 2022. However, the largest percentage increases have been seen in young people (AAPC: 6.14 (CI: 4.57, 7.88)). The Indigenous population had the highest self-harm notification (103.72, 10,000) and suicide (16.58/100,000) rates, but the lowest hospitalisation rates (1.14/100,000) in 2022), compared to the overall population (70.06, 7.27, and 4.69/100,000, respectively, in 2022). Interpretation The observed trend of increased self-harm notifications and suicide rates suggests the need for a greater allocation of resources to strategies to prevent self-harm and suicide. The Indigenous population seems to be the group with less access to healthcare. Funding Research reported in this publication was supported by the National Institute of Mental Health of the National Institutes of Health under award number R01MH128911-01. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
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Affiliation(s)
- Flávia Jôse Oliveira Alves
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
- Center of Data and Knowledge Integration for Health (CIDACS), Instituto Gonçalo Moniz, Fundação Oswaldo Cruz (FIOCRUZ), Salvador, Brazil
| | - Erika Fialho
- Center of Data and Knowledge Integration for Health (CIDACS), Instituto Gonçalo Moniz, Fundação Oswaldo Cruz (FIOCRUZ), Salvador, Brazil
| | - Jacyra Azevedo Paiva de Araújo
- Center of Data and Knowledge Integration for Health (CIDACS), Instituto Gonçalo Moniz, Fundação Oswaldo Cruz (FIOCRUZ), Salvador, Brazil
| | - John A. Naslund
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Maurício L. Barreto
- Center of Data and Knowledge Integration for Health (CIDACS), Instituto Gonçalo Moniz, Fundação Oswaldo Cruz (FIOCRUZ), Salvador, Brazil
| | - Vikram Patel
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Daiane Borges Machado
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
- Center of Data and Knowledge Integration for Health (CIDACS), Instituto Gonçalo Moniz, Fundação Oswaldo Cruz (FIOCRUZ), Salvador, Brazil
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Wu XN, Xue F, Zhang N, Zhang W, Hou JJ, Lv Y, Xiang JX, Zhang XF. Global burden of liver cirrhosis and other chronic liver diseases caused by specific etiologies from 1990 to 2019. BMC Public Health 2024; 24:363. [PMID: 38310221 PMCID: PMC10837876 DOI: 10.1186/s12889-024-17948-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 02/01/2024] [Indexed: 02/05/2024] Open
Abstract
BACKGROUND This study aimed to assess the global, regional, and national burden of liver cirrhosis and other chronic liver diseases between 1990 and 2019, considering five etiologies (hepatitis B, hepatitis C, alcohol use, NAFLD and other causes), age, gender, and sociodemographic index (SDI). METHODS Data on liver cirrhosis and other chronic liver diseases mortality, incidence, and disability-adjusted life years (DALYs) were collected from the Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study 2019. RESULTS In 2019, liver cirrhosis and other chronic liver diseases accounted for 1,472,011 (95% UI 1,374,608-1,578,731) deaths worldwide, compared to 1,012,975 (948,941-1,073,877) deaths in 1990. Despite an increase in absolute deaths, the age-standardized death rate declined from 24.43 (22.93-25.73) per 100,000 population in 1990 to 18.00 (19.31-16.80) per 100,000 population in 2019. Eastern sub-Saharan Africa exhibited the highest age-standardized death rate (44.15 [38.47-51.91] per 100,000 population), while Australasia had the lowest rate (5.48 [5.05-5.93] deaths per 100,000 population in 2019). The age-standardized incidence rate of liver cirrhosis and other chronic liver diseases attributed to hepatitis B virus has declined since 1990, but incidence rates for other etiologies have increased. Age-standardized death and DALYs rates progressively decreased with higher SDI across different GBD regions and countries. Mortality due to liver cirrhosis and other chronic liver diseases increased with age in 2019, and the death rate among males was estimated 1.51 times higher than that among females globally. CONCLUSION Liver cirrhosis and other chronic liver diseases continues to pose a significant global public health challenge. Effective disease control, prevention, and treatment strategies should account for variations in risk factors, age, gender, and regional disparities.
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Affiliation(s)
- Xiao-Ning Wu
- Department of Hepatobiliary Surgery, Institute of Advanced Surgical Technology and Engineering, The First Affiliated Hospital of Xi'an Jiaotong University, 710061, Xi'an, Shaanxi Province, China
- National-Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi Province, China
| | - Feng Xue
- Department of Hepatobiliary Surgery, Institute of Advanced Surgical Technology and Engineering, The First Affiliated Hospital of Xi'an Jiaotong University, 710061, Xi'an, Shaanxi Province, China
| | - Nan Zhang
- Department of Hepatobiliary Surgery, Institute of Advanced Surgical Technology and Engineering, The First Affiliated Hospital of Xi'an Jiaotong University, 710061, Xi'an, Shaanxi Province, China
- National-Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi Province, China
| | - Wei Zhang
- Department of Hepatobiliary Surgery, Institute of Advanced Surgical Technology and Engineering, The First Affiliated Hospital of Xi'an Jiaotong University, 710061, Xi'an, Shaanxi Province, China
- National-Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi Province, China
| | - Jing-Jing Hou
- Department of Hepatobiliary Surgery, Institute of Advanced Surgical Technology and Engineering, The First Affiliated Hospital of Xi'an Jiaotong University, 710061, Xi'an, Shaanxi Province, China
- National-Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi Province, China
| | - Yi Lv
- Department of Hepatobiliary Surgery, Institute of Advanced Surgical Technology and Engineering, The First Affiliated Hospital of Xi'an Jiaotong University, 710061, Xi'an, Shaanxi Province, China
- National-Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi Province, China
| | - Jun-Xi Xiang
- Department of Hepatobiliary Surgery, Institute of Advanced Surgical Technology and Engineering, The First Affiliated Hospital of Xi'an Jiaotong University, 710061, Xi'an, Shaanxi Province, China.
- National-Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.
| | - Xu-Feng Zhang
- Department of Hepatobiliary Surgery, Institute of Advanced Surgical Technology and Engineering, The First Affiliated Hospital of Xi'an Jiaotong University, 710061, Xi'an, Shaanxi Province, China.
- National-Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.
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Gouvêa EDCDP, Ribeiro AM, de Aquino EC, Stopa SR. Mortality trend due to chronic kidney disease in Brazil: an ecological study. EPIDEMIOLOGIA E SERVIÇOS DE SAÚDE 2023; 32:e2023313. [PMID: 38018647 PMCID: PMC10684131 DOI: 10.1590/s2237-96222023000300010.en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 09/04/2023] [Indexed: 11/30/2023] Open
Abstract
OBJECTIVE To analyze chronic kidney disease mortality in Brazil according to sex, age group and region of residence, from 2009 to 2020. METHODS This was a time series study having deaths as its unit of analysis, based on Mortality Information System data. The mortality rate was standardized using the direct method and the temporal trend was analyzed using the Prais-Winsten method. RESULTS There was a rising trend in chronic kidney disease mortality, ranging from 2.82, in 2009, to 3.24 in 2020 (average annual increase 1.29%; 95%CI 0.73;1.85), with a greater increase in males (1.14% per year; 95%CI 0.52;1.76), those aged 75 years and over (2.23% per year; 95%CI 1.87; 2.60) and in the Northern Region (3.86% per year; 95%CI 1.86;5.90) and Northeast Region (3.36% per year; 95%CI 2.24;4.50). CONCLUSION Chronic kidney disease mortality showed a rising trend in the period, with sociodemographic disparities. MAIN RESULTS A rising mortality trend was found for both sexes, with a greater increase in males, those aged over 75 years and in the North and Northeast regions of Brazil; mortality was highest in the Midwest region throughout the entire period. IMPLICATIONS FOR SERVICES The results point to the need to implement public policies with guidelines for addressing chronic kidney disease, focused on strengthening Primary Health Care (PHC). PERSPECTIVES Expanding access to health services, health education and integration between PHC, health surveillance and specialized care are strategies that would possibly prove to be efficient in managing this chronic health condition.
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Affiliation(s)
| | - Alex Mussoi Ribeiro
- Universidade Federal de Santa Catarina, Programa de Pós-Graduação em Controle de Gestão, Florianópolis, SC, Brazil
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Zimeo Morais GA, Miraglia JL, de Oliveira BZ, Mistro S, Hisatugu WH, Greffin D, Marques CB, Reis EP, de Lima HM, Szlejf C. Factors associated with the quality of death certification in Brazilian municipalities: A data-driven non-linear model. PLoS One 2023; 18:e0290814. [PMID: 37651355 PMCID: PMC10470916 DOI: 10.1371/journal.pone.0290814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 08/16/2023] [Indexed: 09/02/2023] Open
Abstract
Studies evaluating the local quality of death certification in Brazil focused on completeness of death reporting or inappropriate coding of causes of death, with few investigating missing data. We aimed to use missing and unexpected values in core topics to assess the quality of death certification in Brazilian municipalities, to evaluate its correlation with the percentage of garbage codes, and to employ a data-driven approach with non-linear models to investigate the association of the socioeconomic and health infrastructure context with quality of death statistics among municipalities. This retrospective study used data from the Mortality Information System (2010-2017), and municipal data regarding healthcare infrastructure, socioeconomic characteristics, and death rates. Quality of death certification was assessed by missing or unexpected values in the following core topics: dates of occurrence, registration, and birth, place of occurrence, certifier, sex, and marital status. Models were fit to classify municipalities according to the quality of death certification (poor quality defined as death records with missing or unexpected values in core topics ≥ 80%). Municipalities with poor quality of death certification (43.9%) presented larger populations, lower death rates, lower socioeconomic index, healthcare infrastructure with fewer beds and physicians, and higher proportion of public healthcare facilities. The correlation coefficients between quality of death certification assessed by missing or unexpected values and the proportion of garbage codes were weak (0.11-0.49), but stronger for municipalities with lower socioeconomic scores. The model that best fitted the data was the random forest classifier (ROC AUC = 0.76; precision-recall AUC = 0.78). This innovative way of assessing the quality of death certification could help quality improvement initiatives to include the correctness of essential fields, in addition to garbage coding or completeness of records, especially in municipalities with lower socioeconomic status where garbage coding and the correctness of core topics appear to be related issues.
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Affiliation(s)
| | - João Luiz Miraglia
- Department of Big Data, Hospital Israelita Albert Einstein, São Paulo, São Paulo, Brazil
| | - Bruno Zoca de Oliveira
- Department of Big Data, Hospital Israelita Albert Einstein, São Paulo, São Paulo, Brazil
| | - Sóstenes Mistro
- Multidisciplinary Institute of Health, Federal University of Bahia, Vitoria da Conquista, Bahia, Brazil
| | - Wilian Hiroshi Hisatugu
- Department of Computing and Electronics, Federal University of Espirito Santo, Vitoria, Espírito Santo, Brazil
| | | | | | - Eduardo Pontes Reis
- Department of Big Data, Hospital Israelita Albert Einstein, São Paulo, São Paulo, Brazil
| | | | - Claudia Szlejf
- Department of Big Data, Hospital Israelita Albert Einstein, São Paulo, São Paulo, Brazil
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Guedes R, Dutra GJ, Machado C, Palma MA. Avaliação dos dados de mortes por COVID-19 nas bases dos cartórios do RC-Arpen, SIVEP-Gripe e SIM no Brasil em 2020. CAD SAUDE PUBLICA 2023; 39:e00077222. [PMID: 37018774 DOI: 10.1590/0102-311xpt077222] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 12/12/2022] [Indexed: 04/05/2023] Open
Abstract
Este estudo compara os registros de óbitos por COVID-19 em 2020 para todo o território nacional. Utilizamos três bases distintas: Registro Civil (RC-Arpen), Sistema de Informação sobre Mortalidade (SIM) e Sistema de Informação da Vigilância Epidemiológica da Gripe (SIVEP-Gripe). Há discordâncias entre os números de mortes por COVID-19 divulgados pelas diversas bases e essas diferenças variam em cada Unidade da Federação. A base do RC-Arpen é atualizada mais rapidamente que as outras duas bases do Departamento de Informática do Sistema Único de Saúde - DATASUS (SIM e SIVEP-Gripe), além de ser mais indicada para monitoramentos e pesquisas que abrangem períodos mais recentes. Apesar da atualização mais lenta, as bases do DATASUS apresentam números geograficamente similares e divulgam dados mais detalhados sobre as mortes. Esse detalhamento das informações torna as bases do DATASUS mais adequadas para pesquisas que demandam mais informações sobre o paciente e o tratamento.
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Affiliation(s)
- Ricardo Guedes
- FGV EPGE Escola Brasileira de Economia e Finanças, Brazil
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Diógenes VHD, Pinto EP, Gonzaga MR, Queiroz BL, Lima EEC, da Costa LCC, Rocha AS, Ferreira AJF, Teixeira CSS, Alves FJO, Rameh L, Flores-Ortiz R, Leyland A, Dundas R, Barreto ML, Ichihara MYT. Differentials in death count records by databases in Brazil in 2010. Rev Saude Publica 2022; 56:92. [PMID: 36287489 PMCID: PMC9586519 DOI: 10.11606/s1518-8787.2022056004282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 12/07/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To compare the death counts from three sources of information on mortality available in Brazil in 2010, the Mortality Information System (SIM - Sistema de Informações sobre Mortalidade ), Civil Registration Statistic System (RC - Sistema de Estatísticas de Resgistro Civil ), and the 2010 Demographic Census at various geographical levels, and to confirm the association between municipal socioeconomic characteristics and the source which showed the highest death count. METHODS This is a descriptive and comparative study of raw data on deaths in the SIM, RC and 2010 Census databases, the latter held in Brazilian states and municipalities between August 2009 and July 2010. The percentage of municipalities was confirmed by the database showing the highest death count. The association between the source of the highest death count and socioeconomic indicators - the Índice de Privação Brasileiro (IBP - Brazilian Deprivation Index) and Índice de Desenvolvimento Humano Municipal (IHDM - Municipal Human Development Index) - was performed by bivariate choropleth and Moran Local Index of Spatial Association (LISA) cluster maps. RESULTS Confirmed that the SIM is the database with the highest number of deaths counted for all Brazilian macroregions, except the North, in which the highest coverage was from the 2010 Census. Based on the indicators proposed, in general, the Census showed a higher coverage of deaths than the SIM and the RC in the most deprived (highest IBP values) and less developed municipalities (lowest IDHM values) in the country. CONCLUSION The results highlight regional inequalities in how the databases chosen for this study cover death records, and the importance of maintaining the issue of mortality on the basic census questionnaire.
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Affiliation(s)
- Victor Hugo Dias Diógenes
- Universidade Federal do Rio Grande do NorteCentro de Ciências Exatas e da TerraPrograma de Pós-Graduação em DemografiaNatalRNBrasil Universidade Federal do Rio Grande do Norte . Centro de Ciências Exatas e da Terra . Programa de Pós-Graduação em Demografia . Natal , RN , Brasil ,Universidade Federal da ParaíbaCentro de Ciências Sociais AplicadasDepartamento de Finanças e ContabilidadeJoão PessoaPBBrasil Universidade Federal da Paraíba . Centro de Ciências Sociais Aplicadas . Departamento de Finanças e Contabilidade . João Pessoa , PB , Brasil
| | - Elzo Pereira Pinto
- Fundação Oswaldo CruzCentro de Integração de Dados e Conhecimentos para SaúdeSalvadorBABrasil Fundação Oswaldo Cruz . Centro de Integração de Dados e Conhecimentos para Saúde . Salvador , BA , Brasil
| | - Marcos Roberto Gonzaga
- Universidade Federal do Rio Grande do NorteCentro de Ciências Exatas e da TerraPrograma de Pós-Graduação em DemografiaNatalRNBrasil Universidade Federal do Rio Grande do Norte . Centro de Ciências Exatas e da Terra . Programa de Pós-Graduação em Demografia . Natal , RN , Brasil ,Universidade Federal do Rio Grande do NorteCentro de Ciências Exatas e da TerraDepartamento de Demografia e Ciências AtuariaisNatalRNBrasil Universidade Federal do Rio Grande do Norte . Centro de Ciências Exatas e da Terra . Departamento de Demografia e Ciências Atuariais . Natal , RN , Brasil
| | - Bernardo Lanza Queiroz
- Universidade Federal de Minas GeraisFaculdade de Ciências EconômicasCentro de Desenvolvimento e Planejamento RegionalBelo HorizonteMGBrasil Universidade Federal de Minas Gerais . Faculdade de Ciências Econômicas . Centro de Desenvolvimento e Planejamento Regional . Belo Horizonte , MG , Brasil
| | - Everton E. C. Lima
- Universidade Estadual de CampinasInstituto de Filosofia e Ciências HumanasNúcleo de Estudos de PopulaçãoCampinasSPBrasil Universidade Estadual de Campinas . Instituto de Filosofia e Ciências Humanas e Núcleo de Estudos de População . Campinas , SP , Brasil
| | - Lilia Carolina C. da Costa
- Universidade Federal da BahiaInstituto de Matemática e EstatísticaDepartamento de EstatísticaSalvadorBABrasil Universidade Federal da Bahia . Instituto de Matemática e Estatística . Departamento de Estatística . Salvador , BA , Brasil
| | - Aline S. Rocha
- Fundação Oswaldo CruzCentro de Integração de Dados e Conhecimentos para SaúdeSalvadorBABrasil Fundação Oswaldo Cruz . Centro de Integração de Dados e Conhecimentos para Saúde . Salvador , BA , Brasil ,Universidade Federal da BahiaEscola de NutriçãoPrograma de Pós-Graduação em Alimento, Nutrição e SaúdeSalvadorBABrasil Universidade Federal da Bahia . Escola de Nutrição . Programa de Pós-Graduação em Alimento, Nutrição e Saúde . Salvador , BA , Brasil
| | - Andrêa J. F. Ferreira
- Fundação Oswaldo CruzCentro de Integração de Dados e Conhecimentos para SaúdeSalvadorBABrasil Fundação Oswaldo Cruz . Centro de Integração de Dados e Conhecimentos para Saúde . Salvador , BA , Brasil ,Universidade Federal da BahiaInstituto de Saúde ColetivaPrograma de Pós-Graduação em Saúde ColetivaSalvadorBABrasil Universidade Federal da Bahia . Instituto de Saúde Coletiva . Programa de Pós-Graduação em Saúde Coletiva . Salvador , BA , Brasil
| | - Camila S. S. Teixeira
- Fundação Oswaldo CruzCentro de Integração de Dados e Conhecimentos para SaúdeSalvadorBABrasil Fundação Oswaldo Cruz . Centro de Integração de Dados e Conhecimentos para Saúde . Salvador , BA , Brasil ,Universidade Federal da BahiaInstituto de Saúde ColetivaPrograma de Pós-Graduação em Saúde ColetivaSalvadorBABrasil Universidade Federal da Bahia . Instituto de Saúde Coletiva . Programa de Pós-Graduação em Saúde Coletiva . Salvador , BA , Brasil
| | - Flávia Jôse O Alves
- Fundação Oswaldo CruzCentro de Integração de Dados e Conhecimentos para SaúdeSalvadorBABrasil Fundação Oswaldo Cruz . Centro de Integração de Dados e Conhecimentos para Saúde . Salvador , BA , Brasil ,Universidade Federal da BahiaInstituto de Saúde ColetivaPrograma de Pós-Graduação em Saúde ColetivaSalvadorBABrasil Universidade Federal da Bahia . Instituto de Saúde Coletiva . Programa de Pós-Graduação em Saúde Coletiva . Salvador , BA , Brasil
| | - Leila Rameh
- Fundação Oswaldo CruzCentro de Integração de Dados e Conhecimentos para SaúdeSalvadorBABrasil Fundação Oswaldo Cruz . Centro de Integração de Dados e Conhecimentos para Saúde . Salvador , BA , Brasil
| | - Renzo Flores-Ortiz
- Fundação Oswaldo CruzCentro de Integração de Dados e Conhecimentos para SaúdeSalvadorBABrasil Fundação Oswaldo Cruz . Centro de Integração de Dados e Conhecimentos para Saúde . Salvador , BA , Brasil
| | - Alastair Leyland
- University of GlasgowMedical Research CouncilGlasgowScotland University of Glasgow . Medical Research Council . Glasgow , Scotland
| | - Ruth Dundas
- University of GlasgowMedical Research CouncilGlasgowScotland University of Glasgow . Medical Research Council . Glasgow , Scotland
| | - Maurício L. Barreto
- Fundação Oswaldo CruzCentro de Integração de Dados e Conhecimentos para SaúdeSalvadorBABrasil Fundação Oswaldo Cruz . Centro de Integração de Dados e Conhecimentos para Saúde . Salvador , BA , Brasil ,Universidade Federal da BahiaInstituto de Saúde ColetivaPrograma de Pós-Graduação em Saúde ColetivaSalvadorBABrasil Universidade Federal da Bahia . Instituto de Saúde Coletiva . Programa de Pós-Graduação em Saúde Coletiva . Salvador , BA , Brasil
| | - Maria Yury Travassos Ichihara
- Fundação Oswaldo CruzCentro de Integração de Dados e Conhecimentos para SaúdeSalvadorBABrasil Fundação Oswaldo Cruz . Centro de Integração de Dados e Conhecimentos para Saúde . Salvador , BA , Brasil
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10
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Pescarini JM, Campbell D, Amorim LD, Falcão IR, Ferreira AJF, Allik M, Shaw RJ, Malta DC, Ali MS, Smeeth L, Barreto ML, Leyland A, Craig P, Aquino EML, Katikireddi SV. Impact of Brazil's Bolsa Família Programme on cardiovascular and all-cause mortality: a natural experiment study using the 100 Million Brazilian Cohort. Int J Epidemiol 2022; 51:1847-1861. [PMID: 36172959 PMCID: PMC9749722 DOI: 10.1093/ije/dyac188] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 09/13/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) has a disproportionate effect on mortality among the poorest people. We assessed the impact on CVD and all-cause mortality of the world's largest conditional cash transfer, Brazil's Bolsa Família Programme (BFP). METHODS We linked administrative data from the 100 Million Brazilian Cohort with BFP receipt and national mortality data. We followed individuals who applied for BFP between 1 January 2011 and 31 December 2015, until 31 December 2015. We used marginal structural models to estimate the effect of BFP on all-age and premature (30-69 years) CVD and all-cause mortality. We conducted stratified analyses by levels of material deprivation and access to healthcare. We checked the robustness of our findings by restricting the analysis to municipalities with better mortality data and by using alternative statistical methods. RESULTS We studied 17 981 582 individuals, of whom 4 855 324 were aged 30-69 years. Three-quarters (76.2%) received BFP, with a mean follow-up post-award of 2.6 years. We detected 106 807 deaths by all causes, of which 60 893 were premature; and 23 389 CVD deaths, of which 15 292 were premature. BFP was associated with reductions in premature all-cause mortality [hazard ratio (HR) = 0.96, 95% CI = 0.94-0.98], premature CVD (HR = 0.96, 95% CI = 0.92-1.00) and all-age CVD (HR = 0.96, 95% CI = 0.93-1.00) but not all-age all-cause mortality (HR = 1.00, 95% CI = 0.98-1.02). In stratified and robustness analyses, BFP was consistently associated with mortality reductions for individuals living in the two most deprived quintiles. CONCLUSIONS BFP appears to have a small to null effect on premature CVD and all-cause mortality in the short term; the long-term impact remains unknown.
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Affiliation(s)
- Julia M Pescarini
- Corresponding author. London School of Hygiene & Tropical Medicine, Keppel St, London, WC1E 7HT, UK. E-mail:
| | - Desmond Campbell
- MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Leila D Amorim
- Departamento de Estatística, Instituto de Matemática e Estatística, Universidade Federal da Bahia, Salvador, Brazil
| | - Ila R Falcão
- Centre for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
| | - Andrêa J F Ferreira
- Centre for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
| | - Mirjam Allik
- MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Richard J Shaw
- MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Deborah C Malta
- Departamento materno infantil e saude pública, Universidade Federal de Minas gerais (UFMG), Belo Horizonte, Brazil
| | - M Sanni Ali
- Departments of Infectious Disease Epidemiology (JMP) and Epidemiology and Population Health (LS), Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Liam Smeeth
- Departments of Infectious Disease Epidemiology (JMP) and Epidemiology and Population Health (LS), Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK,Health Data Research (HDR), London, UK
| | - Mauricio L Barreto
- Centre for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil,Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brazil
| | - Alastair Leyland
- MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, Glasgow, UK
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11
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da Fonsêca JR, de Oliveira CM, de Castro CCL, da Costa HVV, Galvão PVM, da Costa Ceballos AG, do Bonfim CV. Analysis of the completeness of self-harm and suicide records in Pernambuco, Brazil, 2014-2016. BMC Public Health 2022; 22:1154. [PMID: 35681172 PMCID: PMC9178859 DOI: 10.1186/s12889-022-13455-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 05/18/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Suicides and suicide attempts are major public health problems, and coping strategies are hampered by insufficient or inadequate notifications. Data accuracy influences the formulation of public and mental health policies and suicide prevention strategies. The objective of this study was to analyze the completeness of self-harm and suicide records in the state of Pernambuco, Brazil, 2014-2016. METHODS This is an evaluative study with a descriptive design. The data were collected from suicide attempt records from the Notifiable Diseases Information System and suicide records from the Mortality Information System. Probabilistic linkage was used to relate these databases, and the degree of completeness of the variables was calculated. Completeness was classified into the following categories: good (≥ 75.1%), regular (50.1%-75.0%), low (25.1%-50.0%), and very low (≤ 25.0%). RESULTS In the analyzed period, 1,404 notifications of self-harm were studied, with an overall mean completeness of 86.2%. In addition, 1,050 suicide records were analyzed, with an overall mean completeness of 95.8%. Most variables referring to suicide attempts had good completeness, with the exception of the variables "occupation" and "education." The completeness of all suicide-related variables was rated as good. After linkage, a significant improvement was observed in the degree of completeness of the variable "occupation". CONCLUSION The results of this study showed that the completeness of self-harm and suicide variables improved from the first to the last year. The integration of data from different information systems provides an opportunity to improve suicide prevention programs and the quality of available information. Continuous efforts to increase the completeness and reliability of suicide surveillance systems are fundamental to describe the epidemiological profile and, consequently, plan preventive actions, in addition to contributing to the development and reformulation of strategies aimed at reducing morbidity and mortality related to suicidal behavior.
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Affiliation(s)
| | | | | | | | | | | | - Cristine Vieira do Bonfim
- Directorate of Social Research, Joaquim Nabuco Foundation, Rua Dois Irmãos, 92 - Ed. Anexo Anísio Teixeira - Apipucos, Recife, PE, CEP 52071-440, Brazil.
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12
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Teixeira RA, Vasconcelos AMN, Torens A, França EB, Ishitani L, Bierrenbach AL, de Abreu DMX, Marinho F. Excess Mortality due to natural causes among whites and blacks during the COVID-19 pandemic in Brazil. Rev Soc Bras Med Trop 2022; 55:e0283. [PMID: 35107533 PMCID: PMC9009425 DOI: 10.1590/0037-8682-0283-2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 08/09/2021] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION Excess Mortality by all causes considers deaths directly related to COVID-19 and those attributed to conditions caused by the pandemic. When stratified by social dimensions, such as race/color, it allows for the evaluation of more vulnerable populations. The study estimated the excess mortality by natural causes, separating the white and black populations in 2020. METHODS Public civil registration data on deaths observed in 2020, corrected for under registration, were used. The expected number of deaths was estimated based on the mortality rates observed in 2019, applied to the estimated population in 2020. The difference between the values expected and observed and the proportion of excess was considered the excess mortality. RESULTS The present study found an excess of 270,321 deaths (22.2% above the expected) in 2020. Every state of Brazil reported deaths above the corresponding expected figure. The excess was higher for men (25.2%) than for women (19.0%). Blacks showed an excess of 27.8%, as compared to whites at 17.6%. In both sexes and all age groups, excess was higher in the black population, especially in the South, Southeast, and Midwest regions. São Paulo, the largest in population number, had twice as much excess death in the black population (25.1%) than in the white population (11.5%). CONCLUSIONS The present study showed racial disparities in excess mortality during the COVID-19 pandemic in Brazil. The higher excess found for the black suggests an intrinsic relationship with the socioeconomic situation, further exposing the Brazilian reality, in which social and structural inequality is evident.
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Affiliation(s)
- Renato Azeredo Teixeira
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Programa de Pós-Graduação em Saúde Pública, Belo Horizonte, MG, Brasil
- Vital Strategies, New York, United States of America
| | | | - Ana Torens
- Vital Strategies, New York, United States of America
| | - Elisabeth Barboza França
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Programa de Pós-Graduação em Saúde Pública, Belo Horizonte, MG, Brasil
| | - Lenice Ishitani
- Universidade Federal de Minas Gerais, Grupo de Pesquisas em Epidemiologia e Avaliação em Saúde, Belo Horizonte, MG, Brasil
| | | | - Daisy Maria Xavier de Abreu
- Universidade Federal de Minas Gerais, Grupo de Pesquisas em Epidemiologia e Avaliação em Saúde, Belo Horizonte, MG, Brasil
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13
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Shaw RJ, Harron KL, Pescarini JM, Pinto Junior EP, Allik M, Siroky AN, Campbell D, Dundas R, Ichihara MY, Leyland AH, Barreto ML, Katikireddi SV. Biases arising from linked administrative data for epidemiological research: a conceptual framework from registration to analyses. Eur J Epidemiol 2022; 37:1215-1224. [PMID: 36333542 PMCID: PMC9792414 DOI: 10.1007/s10654-022-00934-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 10/16/2022] [Indexed: 11/08/2022]
Abstract
Linked administrative data offer a rich source of information that can be harnessed to describe patterns of disease, understand their causes and evaluate interventions. However, administrative data are primarily collected for operational reasons such as recording vital events for legal purposes, and planning, provision and monitoring of services. The processes involved in generating and linking administrative datasets may generate sources of bias that are often not adequately considered by researchers. We provide a framework describing these biases, drawing on our experiences of using the 100 Million Brazilian Cohort (100MCohort) which contains records of more than 131 million people whose families applied for social assistance between 2001 and 2018. Datasets for epidemiological research were derived by linking the 100MCohort to health-related databases such as the Mortality Information System and the Hospital Information System. Using the framework, we demonstrate how selection and misclassification biases may be introduced in three different stages: registering and recording of people's life events and use of services, linkage across administrative databases, and cleaning and coding of variables from derived datasets. Finally, we suggest eight recommendations which may reduce biases when analysing data from administrative sources.
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Affiliation(s)
- Richard J Shaw
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Berkeley Square, 99 Berkeley Street, Glasgow, G3 7HR, UK.
| | - Katie L Harron
- UCL Great Ormond Street Institute of Child Health, UCL, London, UK
| | - Julia M Pescarini
- Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Fundação Oswaldo Cruz, Salvador, Brazil
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Elzo Pereira Pinto Junior
- Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Fundação Oswaldo Cruz, Salvador, Brazil
| | - Mirjam Allik
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Berkeley Square, 99 Berkeley Street, Glasgow, G3 7HR, UK
| | - Andressa N Siroky
- Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Fundação Oswaldo Cruz, Salvador, Brazil
- Departamento de Estatística, Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | - Desmond Campbell
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Berkeley Square, 99 Berkeley Street, Glasgow, G3 7HR, UK
| | - Ruth Dundas
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Berkeley Square, 99 Berkeley Street, Glasgow, G3 7HR, UK
| | - Maria Yury Ichihara
- Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Fundação Oswaldo Cruz, Salvador, Brazil
| | - Alastair H Leyland
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Berkeley Square, 99 Berkeley Street, Glasgow, G3 7HR, UK
| | - Mauricio L Barreto
- Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Fundação Oswaldo Cruz, Salvador, Brazil
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brazil
| | - Srinivasa Vittal Katikireddi
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Berkeley Square, 99 Berkeley Street, Glasgow, G3 7HR, UK
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Costa ACDO, Ferreira BH, Souza MDR, Costa Filho AM, Souza AAD. Análise da qualidade da informação sobre óbitos por neoplasias no Brasil, entre 2009 e 2019. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2022; 25:e220022. [DOI: 10.1590/1980-549720220022.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 06/08/2022] [Indexed: 12/23/2022] Open
Abstract
RESUMO Objetivo: Avaliar a qualidade das informações sobre mortalidade por neoplasias no âmbito do Sistema de Informação sobre Mortalidade. Métodos: Estudo descritivo observacional com avaliação da qualidade do Sistema de Informação sobre Mortalidade, com desfecho referente aos dados de óbitos por neoplasias ocorridos entre os anos de 2009 e 2019 na população brasileira (≥15 anos). A qualidade da informação (QI) foi mensurada para o Brasil e para as Unidades Federativas por meio das dimensões: cobertura, especificidade e completude dos dados. Resultados: A qualidade da dimensão cobertura variou entre “boa” e “excelente” nas abrangências nacional e estadual. A dimensão especificidade foi classificada como inadequada predominantemente nos Estados das Regiões Norte e Nordeste. A proporção de causas mal definidas foi classificada como de “baixa” qualidade na maioria das unidades de análise ao longo da série. A completude dos dados variou de acordo com o indicador utilizado, os indicadores sexo e idade mostraram-se “excelentes” para todo o período e unidades de análise, a escolaridade apresentou variação de qualidade tanto nas unidades como nos períodos e o estado civil apresentou melhoria da qualidade de seu registro ao longo do período, assim como o indicador raça/cor. Conclusões: A qualidade dos dados de mortalidade por neoplasias na população brasileira (≥15 anos) é, em sua maioria, adequada, mas há lacunas importantes que merecem ser preenchidas, pois a ampliação da QI busca dar visibilidade à condição de saúde da população brasileira, bem como propor ações públicas para sua melhoria.
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15
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Costa ACDO, Ferreira BH, Souza MDR, Costa Filho AM, Souza AAD. Analysis of quality of information about deaths from neoplasms in Brazil between 2009 and 2019. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2022. [DOI: 10.1590/1980-549720220022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
ABSTRACT Objective To assess the quality of information about mortality from neoplasm within the Mortality Information System. Methods: Descriptive observational study evaluating the quality of the Mortality Information System, with an outcome referring to data on deaths from neoplasm between 2009 and 2019 in the Brazilian population (≥15 years). Information Quality (IQ) was measured through coverage, specificity and completeness of data, at national and state level. Results: The quality of the coverage dimension ranged from “good” to “excellent” in the national and state coverages. Specificity was classified as inadequate mainly in the states of the North and Northeast regions. The proportion of ill-defined causes was classified as “poor” quality in most units of analysis throughout the series. Data completeness varied according to indicator. Gender and age indicators were proven “excellent” for the entire period and units of analysis, while educational level varied in quality across units and periods, marital status had its quality improved over the period, as well as ethnicity/skin color. Conclusions: The quality of data on mortality from neoplasm in the Brazilian population (≥15 years) is mostly adequate, but there are important gaps to be filled, as the expansion of IQ seeks to give visibility to the health condition of the Brazilian population and to propose public actions for its improvement.
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16
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Calais-Ferreira L, Barreto ME, Mendonça E, Dite GS, Hickey M, Ferreira PH, Scurrah KJ, Hopper JL. Birthweight, gestational age and familial confounding in sex differences in infant mortality: a matched co-twin control study of Brazilian male-female twin pairs identified by population data linkage. Int J Epidemiol 2021; 51:1502-1510. [PMID: 34849953 PMCID: PMC9557851 DOI: 10.1093/ije/dyab242] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 11/03/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In infancy, males are at higher risk of dying than females. Birthweight and gestational age are potential confounders or mediators but are also familial and correlated, posing epidemiological challenges that can be addressed by studying male-female twin pairs. METHODS We studied 28 558 male-female twin pairs born in Brazil between 2012 and 2016, by linking their birth and death records. Using a co-twin control study matched for gestational age and familial factors, we applied logistic regression with random effects (to account for paired data) to study the association between male sex and infant death, adjusting for: birthweight, within- and between-pair effects of birthweight, birth order and gestational age, including interactions. The main outcome was infant mortality (0-365 days) stratified by neonatal (early and late) and postneonatal deaths. RESULTS Males were 100 g heavier and more at risk of infant death than their female co-twins before [odds ratio (OR) = 1.28, 95% confidence interval (CI): 1.11-1.49, P = 0.001] and after (OR = 1.60, 95% CI: 1.39-1.83, P <0.001) adjusting for birthweight and birth order. When adjusting for birthweight within-pair difference and mean separately, the OR attenuated to 1.40 (95% CI: 1.21-1.61, P <0.001), with evidence of familial confounding (likelihood ratio test, P <0.001). We found evidence of interaction (P = 0.001) between male sex and gestational age for early neonatal death. CONCLUSIONS After matching for gestational age and familial factors by design and controlling for birthweight and birth order, males remain at greater risk of infant death than their female co-twins. Birthweight's role as a confounder can be partially explained by familial factors.
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Affiliation(s)
- Lucas Calais-Ferreira
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Marcos E Barreto
- AtyImoLab, Computer Science Department, Federal University of Bahia, Salvador, Brazil.,Department of Statistics, London School of Economics and Political Science, London, UK
| | - Everton Mendonça
- AtyImoLab, Computer Science Department, Federal University of Bahia, Salvador, Brazil
| | - Gillian S Dite
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.,Genetic Technologies Ltd., Melbourne, VIC, Australia
| | - Martha Hickey
- Royal Women's Hospital, Melbourne, VIC, Australia.,Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, VIC, Australia
| | - Paulo H Ferreira
- Charles Perkins Centre Musculoskeletal Hub, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Katrina J Scurrah
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - John L Hopper
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
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17
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Sempé L, Lloyd-Sherlock P, Martínez R, Ebrahim S, McKee M, Acosta E. Estimation of all-cause excess mortality by age-specific mortality patterns for countries with incomplete vital statistics: a population-based study of the case of Peru during the first wave of the COVID-19 pandemic. LANCET REGIONAL HEALTH. AMERICAS 2021; 2:None. [PMID: 34693394 PMCID: PMC8507430 DOI: 10.1016/j.lana.2021.100039] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 07/21/2021] [Accepted: 07/21/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND All-cause excess mortality is a comprehensive measure of the combined direct and indirect effects of COVID-19 on mortality. Estimates are usually derived from Civil Registration and Vital Statistics (CRVS) systems, but these do not include non-registered deaths, which may be affected by changes in vital registration coverage over time. METHODS Our analytical framework and empirical strategy account for registered mortality and under-registration. This provides a better estimate of the actual mortality impact of the first wave of the COVID-19 pandemic in Peru. We use population and crude mortality rate projections from Peru's National Institute of Statistics and Information (INEI, in Spanish), individual-level registered COVID-19 deaths from the Ministry of Health (MoH), and individual-level registered deaths by region and age since 2017 from the National Electronic Deaths Register (SINADEF, in Spanish).We develop a novel framework combining different estimates and using quasi-Poisson models to estimate total excess mortality across regions and age groups. Also, we use logistic mixed-effects models to estimate the coverage of the new SINADEF system. FINDINGS We estimate that registered mortality underestimates national mortality by 37•1% (95% CI 23% - 48•5%) across 26 regions and nine age groups. We estimate total all-cause excess mortality during the period of analysis at 173,099 (95% CI 153,669 - 187,488) of which 108,943 (95% CI 96,507 - 118,261) were captured by the vital registration system. Deaths at age 60 and over accounted for 74•1% (95% CI 73•9% - 74•7%) of total excess deaths, and there were fewer deaths than expected in younger age groups. Lima region, on the Pacific coast and including the national capital, accounts for the highest share of excess deaths, 87,781 (95% CI 82,294 - 92,504), while in the opposite side regions of Apurimac and Huancavelica account for less than 300 excess deaths. INTERPRETATION Estimating excess mortality in low- and middle-income countries (LMICs) such as Peru must take under-registration of mortality into account. Combining demographic trends with data from administrative registries reduces uncertainty and measurement errors. In countries like Peru, this is likely to produce significantly higher estimates of excess mortality than studies that do not take these effects into account. FUNDING None.
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Affiliation(s)
- Lucas Sempé
- University of East Anglia, Norwich, UK & Universidad Católica San Pablo, Arequipa, Peru
| | | | | | - Shah Ebrahim
- London School of Hygiene and Tropical Medicine, London, UK
| | - Martin McKee
- London School of Hygiene and Tropical Medicine, London, UK
| | - Enrique Acosta
- Max Planck Institute for Demographic Research, Rostock, Germany
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Marinho MF, Torrens A, Teixeira R, Brant LCC, Malta DC, Nascimento BR, Ribeiro ALP, Delaney R, Paula PCB, Setel P, Sampaio JM, Nogales-Vasconcelos AM. Racial disparity in excess mortality in Brazil during COVID-19 times. Eur J Public Health 2021; 32:24-26. [PMID: 34142119 PMCID: PMC8807077 DOI: 10.1093/eurpub/ckab097] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
We evaluated the impact of the COVID-19 pandemic on excess mortality by race/skin color in Brazil, between epidemiological weeks 12 and 50 of 2020. We compared the 2020-point estimate and the expected point-estimate applying 2019 mortality rates to the 2020 population. There was an excess of 187,002 deaths (+20.2%) compared to the expected. Excess mortality was 26.3% (23.3%-29.3%) among blacks/browns compared to 15.1% (14.1%-16.1%) among whites (58.9% of excess among black/browns). Age-standardized rates increased from 377 to 419/100,000 among blacks/browns compared to 328 to 398/100,000 in whites, resulting in 9% relative risk. Excess mortality in Brazil depicts a considerable gap, with increased mortality in all age-groups in the black/brown population.
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Affiliation(s)
| | | | | | - Luisa Campos Caldeira Brant
- Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.,Serviço de Cardiologia e Cirurgia Cardiovascular e Centro de Telessaúde, Hospital das Clínicas da Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Deborah Carvalho Malta
- Escola de Enfermagem, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Bruno Ramos Nascimento
- Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.,Serviço de Cardiologia e Cirurgia Cardiovascular e Centro de Telessaúde, Hospital das Clínicas da Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Antonio Luiz Pinho Ribeiro
- Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.,Serviço de Cardiologia e Cirurgia Cardiovascular e Centro de Telessaúde, Hospital das Clínicas da Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
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Adair T, Lopez AD. Generating age-specific mortality statistics from incomplete death registration data: two applications of the empirical completeness method. Popul Health Metr 2021; 19:29. [PMID: 34098975 PMCID: PMC8186206 DOI: 10.1186/s12963-021-00262-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 05/24/2021] [Indexed: 11/18/2022] Open
Abstract
Background The study aims to assess two approaches that apply the empirical completeness method to generate age-specific mortality statistics from incomplete death registration systems. Methods We use the empirical completeness method to calculate all-age death registration completeness, which is used with a model life table to generate mortality statistics and age-specific completeness using (1) the conventional method and (2) the equivalent deaths method. The results are compared with a capture-recapture (C-RC) study and three alternative mortality estimates for Brazilian states, and C-RC studies in Thailand, Oman and Vietnam, which independently estimate the level and age pattern of mortality or completeness. Results The empirical completeness method produces similar estimates of all-age completeness of registration to the C-RC studies. Compared with C-RC studies, at 15-59 years, the conventional method’s estimates of mortality and completeness are more concordant, while at 60-84 years the equivalent death method’s estimates are closer. Estimates of life expectancy from the two approaches each have similar concordance with the C-RC studies. For male adult mortality in Brazilian states, there is relatively strong average correlation of this study's estimates with three alternative estimates. Conclusions The two approaches produce mortality statistics from incomplete data that are mostly concordant with C-RC studies, and can be most usefully applied to subnational populations. Supplementary Information The online version contains supplementary material available at 10.1186/s12963-021-00262-3.
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Affiliation(s)
- Tim Adair
- Melbourne School of Population and Global Health, The University of Melbourne, Level 5, Building 379, 207 Bouverie Street, Carlton, Victoria, 3010, Australia.
| | - Alan D Lopez
- Institute for Health Metrics and Evaluation, University of Washington, 2301 5th Ave, Seattle, WA, 98121, USA
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