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Rebouças P, Paixão ES, Ramos D, Pescarini J, Pinto-Junior EP, Falcão IR, Ichihara MY, Sena S, Veiga R, Ribeiro R, Rodrigues LC, Barreto ML, Goes EF. Ethno-racial inequalities on adverse birth and neonatal outcomes: a nationwide, retrospective cohort study of 21 million Brazilian newborns. LANCET REGIONAL HEALTH. AMERICAS 2024; 37:100833. [PMID: 39070074 PMCID: PMC11269955 DOI: 10.1016/j.lana.2024.100833] [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: 11/07/2023] [Revised: 04/30/2024] [Accepted: 06/18/2024] [Indexed: 07/30/2024]
Abstract
Background Ethno-racial inequalities are critical determinants of health outcomes. We quantified ethnic-racial inequalities on adverse birth outcomes and early neonatal mortality in Brazil. Methods We conducted a cohort study in Brazil using administrative linked data between 2012 and 2019. Estimated the attributable fractions for the entire population (PAF) and specific groups (AF), as the proportion of each adverse outcome that would have been avoided if all women had the same baseline conditions as White women, both unadjusted and adjusted for socioeconomics and maternal risk factors. AF was also calculated by comparing women from each maternal race/skin colour group in different groups of mothers' schooling, with White women with 8 or more years of education as the reference group and by year. Findings 21,261,936 newborns were studied. If all women experienced the same rate as White women, 1.7% of preterm births, 7.2% of low birth weight (LBW), 10.8% of small for gestational age (SGA) and 11.8% of early neonatal deaths would have been prevented. Percentages preventable were higher among Indigenous (22.2% of preterm births, 17.9% of LBW, 20.5% of SGA and 19.6% of early neonatal deaths) and Black women (6% of preterm births, 21.4% of LBW, 22.8% of SGA births and 20.1% of early neonatal deaths). AF was higher in groups with fewer years of education among Indigenous, Black and Parda for all outcomes. AF increased over time, especially among Indigenous populations. Interpretation A considerable portion of adverse birth outcomes and neonatal deaths could be avoided if ethnic-racial inequalities were non-existent in Brazil. Acting on the causes of these inequalities must be central in maternal and child health policies. Funding Bill & Melinda Gates Foundation and Wellcome Trust.
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Affiliation(s)
- Poliana Rebouças
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil
| | - Enny S. Paixão
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil
- Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Dandara Ramos
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil
- Instituto de Saúde Coletiva, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Julia Pescarini
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil
| | - Elzo Pereira Pinto-Junior
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil
| | - Ila R. Falcão
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil
| | - Maria Yury Ichihara
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil
| | - Samila Sena
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil
| | - Rafael Veiga
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil
| | - Rita Ribeiro
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil
- Faculdade de Nutrição, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Laura C. Rodrigues
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Maurício L. Barreto
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil
- Instituto de Saúde Coletiva, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Emanuelle F. Goes
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil
- Instituto de Saúde Coletiva, Federal University of Bahia, Salvador, Bahia, Brazil
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Yu P, Xu R, Wu Y, Huang W, Coelho MSZS, Saldiva PHN, Ye T, Wen B, Liu Y, Yang Z, Li S, Abramson MJ, Guo Y. Cancer mortality risk from short-term PM 2.5 exposure and temporal variations in Brazil. JOURNAL OF HAZARDOUS MATERIALS 2024; 473:134606. [PMID: 38788590 DOI: 10.1016/j.jhazmat.2024.134606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 04/30/2024] [Accepted: 05/11/2024] [Indexed: 05/26/2024]
Abstract
Although some studies have found that short-term PM2.5 exposure is associated with lung cancer deaths, its impact on other cancer sites is unclear. To answer this research question, this time-stratified case-crossover study used individual cancer death data between January 1, 2000, and December 31, 2019, extracted from the Brazilian mortality information system to quantify the associations between short-term PM2.5 exposure and cancer mortality from 25 common cancer sites. Daily PM2.5 concentration was aggregated at the municipality level as the key exposure. The study included a total of 34,516,120 individual death records, with the national daily mean PM2.5 exposure 15.3 (SD 4.3) μg/m3. For every 10-μg/m3 increase in three-day average PM2.5 exposure, the odds ratio (OR) for all-cancer mortality was 1.04 (95% CI 1.03-1.04). Apart from all-cancer deaths, PM2.5 exposure may impact cancers of oesophagus (1.04, 1.00-1.08), stomach (1.05, 1.02-1.08), colon-rectum (1.04, 1.01-1.06), lung (1.04, 1.02-1.06), breast (1.03, 1.00-1.06), prostate (1.07, 1.04-1.10), and leukaemia (1.05, 1.01-1.09). During the study period, acute PM2.5 exposure contributed to an estimated 1,917,994 cancer deaths, ranging from 0 to 6,054 cases in each municipality. Though there has been a consistent downward trend in PM2.5-related all-cancer mortality risks from 2000 to 2019, the impact remains significant, indicating the continued importance of cancer patients avoiding PM2.5 exposure. This nationwide study revealed a notable association between acute PM2.5 exposure and heightened overall and site-specific cancer mortality for the first time to our best knowledge. The findings suggest the importance of considering strategies to minimize such exposure in cancer care guidelines. ENVIRONMENTAL IMPLICATION: The 20-year analysis of nationwide death records in Brazil revealed that heightened short-term exposure to PM2.5 is associated with increased cancer mortality at various sites, although this association has gradually decreased over time. Despite the declining impact, the research highlights the persistent adverse effects of PM2.5 on cancer mortality, emphasizing the importance of continued research and preventive measures to address the ongoing public health challenges posed by air pollution.
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Affiliation(s)
- Pei Yu
- Climate Air quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Rongbin Xu
- Climate Air quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Yao Wu
- Climate Air quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Wenzhong Huang
- Climate Air quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Micheline S Z S Coelho
- Laboratory of Urban Health Insper/Faculty of Medicine of the University of São Paulo, Brazil
| | - Paulo H N Saldiva
- Laboratory of Urban Health Insper/Faculty of Medicine of the University of São Paulo, Brazil
| | - Tingting Ye
- Climate Air quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Bo Wen
- Climate Air quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Yanming Liu
- Climate Air quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Zhengyu Yang
- Climate Air quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Shanshan Li
- Climate Air quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Michael J Abramson
- Climate Air quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Yuming Guo
- Climate Air quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
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Yu P, Xu R, Huang W, Yang Z, Coelho MSZS, Saldiva PHN, Wen B, Wu Y, Ye T, Zhang Y, Sun HZ, Abramson MJ, Li S, Guo Y. Short-term ozone exposure and cancer mortality in Brazil: A nationwide case-crossover study. Int J Cancer 2024. [PMID: 38985095 DOI: 10.1002/ijc.35069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 05/24/2024] [Accepted: 06/06/2024] [Indexed: 07/11/2024]
Abstract
Exposure to ambient ozone (O3) is linked to increased mortality risks from various diseases, but epidemiological investigations delving into its potential implications for cancer mortality are limited. We aimed to examine the association between short-term O3 exposure and site-specific cancer mortality and investigate vulnerable subgroups in Brazil. In total 3,459,826 cancer death records from 5570 Brazilian municipalities between 2000 and 2019, were included. Municipal average daily O3 concentration was calculated from a global estimation at 0.25°×0.25° spatial resolution. The time-stratified case-crossover design was applied to assess the O3-cancer mortality association. Subgroup analyses by age, sex, season, time-period, region, urban hierarchy, climate classification, quantiles of GDP per capita and illiteracy rates were performed. A linear and non-threshold exposure-response relationship was observed for short-term exposure to O3 with cancer mortality, with a 1.00% (95% CI: 0.79%-1.20%) increase in all-cancer mortality risks for each 10-μg/m3 increment of three-day average O3. Kidney cancer was most strongly with O3 exposure, followed by cancers of the prostate, stomach, breast, lymphoma, brain and lung. The associated cancer risks were relatively higher in the warm season and in southern Brazil, with a decreasing trend over time. When restricting O3 concentration to the national minimum value during 2000-2019, a total of 147,074 (116,690-177,451) cancer deaths could be avoided in Brazil, which included 17,836 (7014-28,653) lung cancer deaths. Notably, these associations persisted despite observed adaptation within the Brazilian population, highlighting the need for a focus on incorporating specific measures to mitigate O3 exposure into cancer care recommendations.
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Affiliation(s)
- Pei Yu
- Climate Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Rongbin Xu
- Climate Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Wenzhong Huang
- Climate Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Zhengyu Yang
- Climate Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Micheline S Z S Coelho
- Laboratory of Urban Health Insper/ Faculty of Medicine of the University of São Paulo, Sao Paulo, Brazil
| | - Paulo H N Saldiva
- Laboratory of Urban Health Insper/ Faculty of Medicine of the University of São Paulo, Sao Paulo, Brazil
| | - Bo Wen
- Climate Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Yao Wu
- Climate Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Tingting Ye
- Climate Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Yiwen Zhang
- Climate Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Haitong Z Sun
- Centre for Sustainable Medicine (CoSM), Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Michael J Abramson
- Climate Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Shanshan Li
- Climate Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Yuming Guo
- Climate Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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de Mattos Russo Rafael R, da Silva KP, de Souza Santos HG, Depret DG, Caravaca-Morera JA, Breda KML. Accuracy, potential, and limitations of probabilistic record linkage in identifying deaths by gender identity and sexual orientation in the state of Rio De Janeiro, Brazil. BMC Public Health 2024; 24:1475. [PMID: 38824562 PMCID: PMC11144332 DOI: 10.1186/s12889-024-19002-x] [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: 02/02/2024] [Accepted: 05/29/2024] [Indexed: 06/03/2024] Open
Abstract
BACKGROUND Globally, the counting of deaths based on gender identity and sexual orientation has been a challenge for health systems. In most cases, non-governmental organizations have dedicated themselves to this work. Despite these efforts in generating information, the scarcity of official data presents significant limitations in policy formulation and actions guided by population needs. Therefore, this manuscript aims to evaluate the accuracy, potential, and limits of probabilistic data relationships to yield information on deaths according to gender identity and sexual orientation in the State of Rio de Janeiro. METHODS This study evaluated the accuracy of the probabilistic record linkage to obtain information on deaths according to gender and sexual orientation. Data from two information systems were used from June 15, 2015 to December 31, 2020. We constructed nine probabilistic data relationship strategies and identified the performance and cutoff points of the best strategy. RESULTS The best data blocking strategy was established through logical blocks with the first and last names, birthdate, and mother's name in the pairing strategy. With a population base of 80,178 records, 1556 deaths were retrieved. With an area under the curve of 0.979, this strategy presented 93.26% accuracy, 98.46% sensitivity, and 90.04% specificity for the cutoff point ≥ 17.9 of the data relationship score. The adoption of the cutoff point optimized the manual review phase, identifying 2259 (90.04%) of the 2509 false pairs and identifying 1532 (98.46%) of the 1556 true pairs. CONCLUSION With the identification of possible strategies for determining probabilistic data relationships, the retrieval of information on mortality according to sexual and gender markers has become feasible. Based on information from the daily routine of health services, the formulation of public policies that consider the LGBTQ + population more closely reflects the reality experienced by these population groups.
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Affiliation(s)
| | - Kleison Pereira da Silva
- School of Nursing, Public Health Nursing Department, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Davi Gomes Depret
- School of Nursing, Public Health Nursing Department, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Karen Marie Lucas Breda
- Department of Nursing, College of Education, University of Hartford, Nursing & Health Professions. West Hartford, Connecticut, United States of America
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Gao Y, Huang W, Yu P, Xu R, Gasevic D, Yue X, Coêlho MDSZS, Saldiva PHN, Guo Y, Li S. Wildfire-related PM 2.5 and cardiovascular mortality: A difference-in-differences analysis in Brazil. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 347:123810. [PMID: 38493867 DOI: 10.1016/j.envpol.2024.123810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 03/14/2024] [Accepted: 03/15/2024] [Indexed: 03/19/2024]
Abstract
Brazil has experienced unprecedented wildfires recently. We aimed to investigate the association of wildfire-related fine particulate matter (PM2.5) with cause-specific cardiovascular mortality, and to estimate the attributable mortality burden. Exposure to wildfire-related PM2.5 was defined as exposure to annual mean wildfire-related PM2.5 concentrations in the 1-year prior to death. The variant difference-in-differences method was employed to explore the wildfire-related PM2.5-cardiovascular mortality association. We found that, in Brazil, compared with the population in the first quartile (Q1: ≤1.82 μg/m3) of wildfire-related PM2.5 exposure, those in the fourth quartile (Q4: 4.22-17.12 μg/m3) of wildfire-related PM2.5 exposure had a 2.2% (RR: 1.022, 95% CI: 1.013-1.032) higher risk for total cardiovascular mortality, 3.1% (RR: 1.031, 95% CI: 1.014-1.048) for ischaemic heart disease mortality, and 2.0% (RR: 1.020, 95% CI: 1.002-1.038) for stroke mortality. From 2010 to 2018, an estimation of 35,847 (95% CI: 22,424-49,177) cardiovascular deaths, representing 17.77 (95% CI: 11.12-24.38) per 100,000 population, were attributable to wildfire-related PM2.5 exposure. Targeted health promotion strategies should be developed for local governments to protect the public from the risk of wildfire-related cardiovascular premature deaths.
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Affiliation(s)
- Yuan Gao
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Wenzhong Huang
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Pei Yu
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Rongbin Xu
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Danijela Gasevic
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia; Centre for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Xu Yue
- Jiangsu Key Laboratory of Atmospheric Environment Monitoring and Pollution Control, Collaborative Innovation Center of Atmospheric Environment and Equipment Technology, School of Environmental Science and Engineering, Nanjing University of Information Science and Technology, Nanjing, China
| | | | | | - Yuming Guo
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Shanshan Li
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia.
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Wen B, Ademi Z, Wu Y, Xu R, Yu P, Ye T, Coêlho MDSZS, Saldiva PHN, Guo Y, Li S. Ambient PM 2.5 and productivity-adjusted life years lost in Brazil: a national population-based study. JOURNAL OF HAZARDOUS MATERIALS 2024; 467:133676. [PMID: 38354440 DOI: 10.1016/j.jhazmat.2024.133676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 01/28/2024] [Accepted: 01/29/2024] [Indexed: 02/16/2024]
Abstract
Enormous health burden has been associated with air pollution and its effects continue to grow. However, the impact of air pollution on labour productivity at the population level is still unknown. This study assessed the association between premature death due to PM2.5 exposure and the loss of productivity-adjusted life years (PALYs), in Brazil. We applied a novel variant of the difference-in-difference (DID) approach to assess the association. Daily all-cause mortality data in Brazil were collected from 2000-2019. The PALYs lost increased by 5.11% (95% CI: 4.10-6.13%), for every 10 µg/m3 increase in the 2-day moving average of PM2.5. A total of 9,219,995 (95% CI: 7,491,634-10,921,141) PALYs lost and US$ 268.05 (95% CI: 217.82-317.50) billion economic costs were attributed to PM2.5 exposure, corresponding to 7.37% (95% CI: 5.99-8.73%) of the total PALYs lost due to premature death. This study also found that 5,005,306 PALYs could be avoided if the World Health Organization (WHO) air quality guideline (AQG) level was met. In conclusion, this study demonstrates that ambient PM2.5 exposure is associated with a considerable labour productivity burden relating to premature death in Brazil, while over half of the burden could be prevented if the WHO AQG was met. The findings highlight the need to reduce ambient PM2.5 levels and provide strong evidence for the development of strategies to mitigate the economic impacts of air pollution.
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Affiliation(s)
- Bo Wen
- Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | - Zanfina Ademi
- Health Economics and Policy Evaluation Research (HEPER) Group, Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, 381 Royal Parade, Parkville, VIC 3052, Australia; School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia; School of Pharmacy, Faculty of Health Sciences, Kuopio Campus, University of Eastern Finland, FI-70211 Kuopio, Finland
| | - Yao Wu
- Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | - Rongbin Xu
- Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | - Pei Yu
- Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | - Tingting Ye
- Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | | | | | - Yuming Guo
- Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | - Shanshan Li
- Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia.
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Figueirôa BDQ, Lira PICD, Vanderlei LCDM, Vidal SA, Frias PGD. [Evaluation of the effectiveness of the intervention to improve the Brazilian Mortality Information System in Pernambuco, Brazil: a quasi-experimental study]. CAD SAUDE PUBLICA 2024; 40:e00077523. [PMID: 38198385 PMCID: PMC10775963 DOI: 10.1590/0102-311xpt077523] [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: 04/25/2023] [Revised: 08/12/2023] [Accepted: 09/01/2023] [Indexed: 01/12/2024] Open
Abstract
This study evaluated the influence of the variation in the implementation of the Brazilian Mortality Information System (SIM) on the results, before and after the intervention to improve the system in Pernambuco, Brazil. The SIM logical model and matrix of indicators and assessment were described, primary data were collected from the 184 municipalities and secondary data were collected from the system database. The degree of implementation (DI) was obtained from the indicators of structure and process, and then related to result indicators, based on the model. The intervention was directed at the shortcomings identified, and developed using strategic stages. The percentage of annual variation of the DI and the results before and after the intervention were calculated. The SIM was classified as partially implemented in the pre- (70.6%) and post-intervention (73.1%) evaluations, with increments in all components. The Health Regions followed the same classification of the state level, except for XII (80.3%), regarding implemented score after the intervention. The coverage of the system; deaths with a defined underlying cause; monthly transfer; and timely submission of data were above 90% in both evaluations. There was an improvement in the completeness of infant Death Certificates and in the timely recording of notifiable events. Strengthening the management and operationalization of the SIM with interventions applied to data registration can improve the system's results.
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Affiliation(s)
- Barbara de Queiroz Figueirôa
- Programa de Pós-graduação em Saúde da Criança e do Adolescente, Universidade Federal de Pernambuco, Recife, Brasil
- Secretaria Estadual de Saúde de Pernambuco, Recife, Brasil
| | - Pedro Israel Cabral de Lira
- Programa de Pós-graduação em Saúde da Criança e do Adolescente, Universidade Federal de Pernambuco, Recife, Brasil
| | | | - Suely Arruda Vidal
- Programa de Pós-graduação em Avaliação em Saúde, Instituto de Medicina Integral Prof. Fernando Figueira, Recife, Brasil
| | - Paulo Germano de Frias
- Programa de Pós-graduação em Avaliação em Saúde, Instituto de Medicina Integral Prof. Fernando Figueira, Recife, Brasil
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Huang W, Yang Z, Zhang Y, Vogt T, Armstrong B, Yu W, Xu R, Yu P, Liu Y, Gasparrini A, Hundessa S, Lavigne E, Molina T, Geiger T, Guo YL, Otto C, Hales S, Pourzand F, Pan SC, Ju K, Ritchie EA, Li S, Guo Y. Tropical cyclone-specific mortality risks and the periods of concern: A multicountry time-series study. PLoS Med 2024; 21:e1004341. [PMID: 38252630 PMCID: PMC10843109 DOI: 10.1371/journal.pmed.1004341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 02/05/2024] [Accepted: 01/03/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND More intense tropical cyclones (TCs) are expected in the future under a warming climate scenario, but little is known about their mortality effect pattern across countries and over decades. We aim to evaluate the TC-specific mortality risks, periods of concern (POC) and characterize the spatiotemporal pattern and exposure-response (ER) relationships on a multicountry scale. METHODS AND FINDINGS Daily all-cause, cardiovascular, and respiratory mortality among the general population were collected from 494 locations in 18 countries or territories during 1980 to 2019. Daily TC exposures were defined when the maximum sustained windspeed associated with a TC was ≥34 knots using a parametric wind field model at a 0.5° × 0.5° resolution. We first estimated the TC-specific mortality risks and POC using an advanced flexible statistical framework of mixed Poisson model, accounting for the population changes, natural variation, seasonal and day of the week effects. Then, a mixed meta-regression model was used to pool the TC-specific mortality risks to estimate the overall and country-specific ER relationships of TC characteristics (windspeed, rainfall, and year) with mortality. Overall, 47.7 million all-cause, 15.5 million cardiovascular, and 4.9 million respiratory deaths and 382 TCs were included in our analyses. An overall average POC of around 20 days was observed for TC-related all-cause and cardiopulmonary mortality, with relatively longer POC for the United States of America, Brazil, and Taiwan (>30 days). The TC-specific relative risks (RR) varied substantially, ranging from 1.04 to 1.42, 1.07 to 1.77, and 1.12 to 1.92 among the top 100 TCs with highest RRs for all-cause, cardiovascular, and respiratory mortality, respectively. At country level, relatively higher TC-related mortality risks were observed in Guatemala, Brazil, and New Zealand for all-cause, cardiovascular, and respiratory mortality, respectively. We found an overall monotonically increasing and approximately linear ER curve of TC-related maximum sustained windspeed and cumulative rainfall with mortality, with heterogeneous patterns across countries and regions. The TC-related mortality risks were generally decreasing from 1980 to 2019, especially for the Philippines, Taiwan, and the USA, whereas potentially increasing trends in TC-related all-cause and cardiovascular mortality risks were observed for Japan. CONCLUSIONS The TC mortality risks and POC varied greatly across TC events, locations, and countries. To minimize the TC-related health burdens, targeted strategies are particularly needed for different countries and regions, integrating epidemiological evidence on region-specific POC and ER curves that consider across-TC variability.
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Affiliation(s)
- Wenzhong Huang
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Zhengyu Yang
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Yiwen Zhang
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Thomas Vogt
- Potsdam Institute for Climate Impact Research, Potsdam, Germany
| | - Ben Armstrong
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Wenhua Yu
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Rongbin Xu
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Pei Yu
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Yanming Liu
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Antonio Gasparrini
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Centre on Climate Change & Planetary Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Centre for Statistical Methodology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Samuel Hundessa
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Eric Lavigne
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Tomas Molina
- Department Applied Physics, Universitat de Barcelona, Barcelona, Spain
| | - Tobias Geiger
- Deutscher Wetterdienst (DWD), Regional Climate Office Potsdam, Potsdam, Germany
| | - Yue Leon Guo
- Department of Environmental and Occupational Medicine, National Taiwan University (NTU) and NTU Hospital, Taipei, Taiwan
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan
- Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Christian Otto
- Potsdam Institute for Climate Impact Research, Potsdam, Germany
| | - Simon Hales
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Farnaz Pourzand
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Shih-Chun Pan
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Ke Ju
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Elizabeth A. Ritchie
- School of Earth Atmosphere and Environment, Monash University, Melbourne, Australia
- Department of Civil Engineering, Monash University, Melbourne, Australia
| | - Shanshan Li
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Yuming Guo
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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9
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Degli Esposti M, Coll CVN, Murray J, Carter PM, Goldstick JE. The Leading Causes of Death in Children and Adolescents in Brazil, 2000-2020. Am J Prev Med 2023; 65:716-720. [PMID: 36963471 DOI: 10.1016/j.amepre.2023.03.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/17/2023] [Accepted: 03/17/2023] [Indexed: 03/26/2023]
Abstract
INTRODUCTION Despite promising reductions in mortality from infectious diseases, premature death is a still major public health problem in Brazil. However, little is known about which diseases and injury mechanisms are the main causes of premature death. This paper aimed to detail the trends in leading causes of death among children and adolescents in Brazil. METHODS Data were extracted from medical death certificates from the Brazilian Mortality Information System for children and adolescents aged 1-19 years for 2000-2020. The 10 leading causes of death for children and adolescents were defined using primary cause of death codes, grouped by death for diseases and mechanism for injury, according to the ICD-10. All analyses were completed in 2022. RESULTS From 2000 through 2020, there was a total of 772,729 child and adolescent deaths in Brazil. Despite an overall 34% reduction in child and adolescent mortality from 2000 to 2020, improvements were less pronounced for injury-related deaths than for communicable diseases. Therefore, by 2020, over half of deaths were from injury-related causes. Firearm-related injury was by far the leading cause, accounting for 21% of all deaths. There was a 38% reduction in firearm deaths in the last 4 years against a previously increasing trend, and homicide accounted for over 90% of all firearm deaths because suicide by firearm was rare. CONCLUSIONS Injury-related deaths among children and adolescents are a growing concern in Brazil, and firearms are the current leading cause of child and adolescent death.
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Affiliation(s)
- Michelle Degli Esposti
- Human Development and Violence Research Centre, Federal University of Pelotas, Pelotas, Brazil; Department of Social Policy & Intervention, University of Oxford, Oxford, United Kingdom; Injury Prevention Center, Department of Emergency Medicine, University of Michigan Medical School, Ann Arbor, Michigan.
| | - Carolina V N Coll
- Human Development and Violence Research Centre, Federal University of Pelotas, Pelotas, Brazil
| | - Joseph Murray
- Human Development and Violence Research Centre, Federal University of Pelotas, Pelotas, Brazil
| | - Patrick M Carter
- Injury Prevention Center, Department of Emergency Medicine, University of Michigan Medical School, Ann Arbor, Michigan; Institute for Firearm Injury Prevention, University of Michigan, Ann Arbor, Michigan; Department of Emergency Medicine, University of Michigan Medical School, Ann Arbor, Michigan; Youth Violence Prevention Center, University of Michigan School of Public Health, Ann Arbor, Michigan; Department of Health Behavior & Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Jason E Goldstick
- Injury Prevention Center, Department of Emergency Medicine, University of Michigan Medical School, Ann Arbor, Michigan; Institute for Firearm Injury Prevention, University of Michigan, Ann Arbor, Michigan; Department of Emergency Medicine, University of Michigan Medical School, Ann Arbor, Michigan
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10
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Chávez-Penha R, Bustamante-Teixeira MT, Nogueira MC. Age-Period-Cohort Study of Breast Cancer Mortality in Brazil in State Capitals and in Non-Capital Municipalities from 1980 to 2019. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6505. [PMID: 37569045 PMCID: PMC10418483 DOI: 10.3390/ijerph20156505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/17/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023]
Abstract
Breast cancer was identified as the cancer with the highest mortality rate among women in Brazil. This study analyzed the effects of age, period and birth cohort on the breast cancer mortality rate for Brazilian women, comparing state capitals and non-capital municipalities. Population and deaths data were extracted from the Brazilian Unified Health System database for women aged 30 years or older, for the years between 1980 and 2019. The effects were analyzed using the age-period-cohort model. Age effect on breast cancer mortality is observed in the model through higher mortality rates at older ages. Period effect is similar in all regions in the form of a marked increase in the rate ratio (RR) in non-capital municipalities by period than in state capitals. The RR of birth cohorts in the state capitals remained stable (north, northeast and central-west regions) or decreased followed by an increase in the most recent cohorts (Brazil as a whole and the southeast and south regions). The RR for the other municipalities, however, showed a progressive increase in the cohorts for all regions. Policies and actions focused on breast cancer in women should consider these differences among Brazilian regions, state capitals and other municipalities.
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Affiliation(s)
- Rodrigo Chávez-Penha
- Post-Graduation Program in Collective Health, Faculty of Medicine, Federal University of Juiz de Fora, Juiz de Fora 36036-900, Minas Gerais, Brazil;
| | | | - Mário Círio Nogueira
- Post-Graduation Program in Collective Health, Faculty of Medicine, Federal University of Juiz de Fora, Juiz de Fora 36036-900, Minas Gerais, Brazil;
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11
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Festa L, Prado MDF, Jesuino ACS, Balda RDCX, Tayra Â, Sañudo A, Tancredi MV, Silva MAD, Pinto VM, Costa-Nobre DT, Kiffer CRV, Luppi CG. Underreporting of unfavorable outcomes of congenital syphilis on the Notifiable Health Conditions Information System in the state of São Paulo, Brazil, 2007-2018. EPIDEMIOLOGIA E SERVIÇOS DE SAÚDE 2023; 32:e2022664. [PMID: 37466564 PMCID: PMC10355990 DOI: 10.1590/s2237-96222023000200007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 03/20/2023] [Indexed: 07/20/2023] Open
Abstract
OBJECTIVE to describe the frequency of underreporting of unfavorable outcomes of congenital syphilis in the state of São Paulo, Brazil, 2007-2018. METHODS this was a descriptive study of cases of abortion, fetal and non-fetal deaths due to congenital syphilis reported on the Notifiable Health Conditions Information System (Sistema de Informação de Agravos de Notificação - SINAN), and those of congenital syphilis registered in any line in the Death Certificate, on the Mortality Information System (Sistema de Informações sobre Mortalidade - SIM), by means of probabilistic and deterministic linkage. RESULTS of the 27,713 cases of congenital syphilis reported, 1,320 progressed to death (871 fetal deaths, 449 infant deaths) and were matched to the SIM; 355 deaths (259 fetal deaths, 96 infant deaths) were not included on SINAN; there was an increase in unfavorable outcomes,11.4% for infant deaths due to congenital syphilis, 3.0% for fetal deaths and 1.9% for abortions. CONCLUSION the use of different relationship techniques proved to be adequate to identify the frequency of underreporting of unfavorable outcomes of congenital syphilis in the state of São Paulo.
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Affiliation(s)
- Larissa Festa
- Universidade de São Paulo, Faculdade de Medicina, São Paulo, SP, Brazil
| | - Marli de Fátima Prado
- Secretaria de Estado da Saúde de São Paulo, Centro de Referência e Treinamento em DST/Aids, São Paulo, SP, Brazil
| | | | | | - Ângela Tayra
- Secretaria de Estado da Saúde de São Paulo, Centro de Referência e Treinamento em DST/Aids, São Paulo, SP, Brazil
| | - Adriana Sañudo
- Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, SP, Brazil
| | - Mariza Vono Tancredi
- Secretaria de Estado da Saúde de São Paulo, Centro de Referência e Treinamento em DST/Aids, São Paulo, SP, Brazil
| | - Maria Aparecida da Silva
- Secretaria de Estado da Saúde de São Paulo, Centro de Referência e Treinamento em DST/Aids, São Paulo, SP, Brazil
| | - Valdir Monteiro Pinto
- Secretaria de Estado da Saúde de São Paulo, Centro de Referência e Treinamento em DST/Aids, São Paulo, SP, Brazil
| | | | | | - Carla Gianna Luppi
- Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, SP, Brazil
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12
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Wen B, Ademi Z, Wu Y, Xu R, Yu P, Ye T, Coêlho MDSZS, Saldiva PHN, Guo Y, Li S. Productivity-adjusted life years lost due to non-optimum temperatures in Brazil: A nationwide time-series study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 873:162368. [PMID: 36828065 DOI: 10.1016/j.scitotenv.2023.162368] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 02/12/2023] [Accepted: 02/17/2023] [Indexed: 06/18/2023]
Abstract
Non-optimal temperatures are associated with premature deaths globally. However, the evidence is limited in low- and middle-income countries, and the productivity losses due to non-optimal temperatures have not been quantified. We aimed to estimate the work-related impacts and economic losses attributable to non-optimal temperatures in Brazil. We collected daily mortality data from 510 immediate regions in Brazil during 2000 and 2019. A two-stage time-series analysis was applied to evaluate the association between non-optimum temperatures and the Productivity-Adjusted Life-Years (PALYs) lost. The temperature-PALYs association was fitted for each location in the first stage and then we applied meta-analyses to obtain the national estimations. The attributable fraction (AF) of PALY lost due to ambient temperatures and the corresponding economic costs were calculated for different subgroups of the working-age population. A total of 3,629,661 of PALYs lost were attributed to non-optimal temperatures during 2000-2019 in Brazil, corresponding to 2.90 % (95 % CI: 1.82 %, 3.95 %) of the total PALYs lost. Non-optimal temperatures have led to US$104.86 billion (95 % CI: 65.95, 142.70) of economic costs related to PALYs lost and the economic burden was more substantial in males and the population aged 15-44 years. Higher risks of extreme cold temperatures were observed in the South region in Brazil while extreme hot temperatures were observed in the Central West and Northeast regions. In conclusion, non-optimal temperatures are associated with considerable labour losses as well as economic costs in Brazil. Tailored policies and adaptation strategies should be proposed to mitigate the impacts of non-optimal temperatures on the labour supply in a changing climate.
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Affiliation(s)
- Bo Wen
- Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | - Zanfina Ademi
- Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, 381 Royal Parade, Parkville, VIC, 3052, Australia
| | - Yao Wu
- Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | - Rongbin Xu
- Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | - Pei Yu
- Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | - Tingting Ye
- Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | | | | | - Yuming Guo
- Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | - Shanshan Li
- Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia.
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13
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Carvalho-Sauer R, Flores-Ortiz R, Costa MDCN, Teixeira MG, Saavedra R, Niag M, Paixao ES. Fetal death as an outcome of acute respiratory distress in pregnancy, during the COVID-19 pandemic: a population-based cohort study in Bahia, Brazil. BMC Pregnancy Childbirth 2023; 23:320. [PMID: 37147605 PMCID: PMC10161155 DOI: 10.1186/s12884-023-05601-w] [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: 01/28/2023] [Accepted: 04/12/2023] [Indexed: 05/07/2023] Open
Abstract
BACKGROUND Fetal loss is one of the most serious adverse outcomes of pregnancy. Since the onset of the COVID-19 pandemic, Brazil has recorded an unprecedented number of hospitalizations of pregnant women due to acute respiratory distress (ARD), thereby, we aimed to assess the risk of fetal deaths associated to ARD during pregnancy in Bahia state, Brazil, in the context of the COVID-19 pandemic. METHODS This is an observational population-based retrospective cohort study, developed with women at or after 20 weeks of pregnancy, residents in Bahia, Brazil. Women who had acute respiratory distress (ARD) in pregnancy during the COVID-19 pandemic (Jan 2020 to Jun 2021) were considered 'exposed'. Women who did not have ARD in pregnancy, and whose pregnancy occurred before the onset of the COVID-19 pandemic (Jan 2019 to Dec 2019) were considered 'non-exposed'. The main outcome was fetal death. We linked administrative data (under mandatory registration) on live births, fetal deaths, and acute respiratory syndrome, using a probabilistic linkage method, and analyzed them with multivariable logistic regression models. RESULTS 200,979 pregnant women participated in this study, 765 exposed and 200,214 unexposed. We found four times higher chance of fetal death in women with ARD during pregnancy, of all etiologies (adjusted odds ratio [aOR] 4.06 confidence interval [CI] 95% 2.66; 6.21), and due to SARS-CoV-2 (aOR 4.45 CI 95% 2.41; 8.20). The risk of fetal death increased more when ARD in pregnancy was accompanied by vaginal delivery (aOR 7.06 CI 95% 4.21; 11.83), or admission to Intensive Care Unit (aOR 8.79 CI 95% 4.96; 15.58), or use of invasive mechanical ventilation (aOR 21.22 CI 95% 9.93; 45.36). CONCLUSION Our findings can contribute to expanding the understanding of health professionals and managers about the harmful effects of SARS-CoV-2 on maternal-fetal health and alerts the need to prioritize pregnant women in preventive actions against SARS-CoV-2 and other respiratory viruses. It also suggests that pregnant women, infected with SARS-CoV-2, need to be monitored to prevent complications of ARD, including a careful assessment of the risks and benefits of early delivery to prevent fetal death.
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Affiliation(s)
- Rita Carvalho-Sauer
- Bahia State Health Department, Núcleo Regional de Saúde Leste, Avenida Esperança, 406. Maria Preta. Santo Antônio de Jesus., 44435-500 Bahia, Brazil
- Institute of Collective Health, Federal University of Bahia, Bahia, Brazil
| | - Renzo Flores-Ortiz
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Bahia, Brazil
| | | | | | - Ramon Saavedra
- Institute of Collective Health, Federal University of Bahia, Bahia, Brazil
| | - Marla Niag
- School of Medicine, Federal University of Recôncavo of Bahia, Bahia, Brazil
| | - Enny S. Paixao
- London School of Hygiene and Tropical Medicine, London, UK
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14
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Wu Y, Li S, Xu R, Chen G, Yue X, Yu P, Ye T, Wen B, de Sousa Zanotti Stagliorio Coêlho M, Saldiva PHN, Guo Y. Wildfire-related PM 2.5 and health economic loss of mortality in Brazil. ENVIRONMENT INTERNATIONAL 2023; 174:107906. [PMID: 37030285 DOI: 10.1016/j.envint.2023.107906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/19/2023] [Accepted: 03/27/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Wildfire imposes a high mortality burden on Brazil. However, there is a limited assessment of the health economic losses attributable to wildfire-related fine particulate matter (PM2.5). METHODS We collected daily time-series data on all-cause, cardiovascular, and respiratory mortality from 510 immediate regions in Brazil during 2000-2016. The chemical transport model GEOS-Chem driven with Global Fire Emissions Database (GFED), in combination with ground monitored data and machine learning was used to estimate wildfire-related PM2.5 data at a resolution of 0.25° × 0.25°. A time-series design was applied in each immediate region to assess the association between economic losses due to mortality and wildfire-related PM2.5 and the estimates were pooled at the national level using a random-effect meta-analysis. We used a meta-regression model to explore the modification effect of GDP and its sectors (agriculture, industry, and service) on economic losses. RESULTS During 2000-2016, a total of US$81.08 billion economic losses (US$5.07 billion per year) due to mortality were attributable to wildfire-related PM2.5 in Brazil, accounting for 0.68% of economic losses and equivalent to approximately 0.14% of Brazil's GDP. The attributable fraction (AF) of economic losses due to wildfire-related PM2.5 was positively associated with the proportion of GDP from agriculture, while negatively associated with the proportion of GDP from service. CONCLUSION Substantial economic losses due to mortality were associated with wildfires, which could be influenced by the agriculture and services share of GDP per capita. Our estimates of the economic losses of mortality could be used to determine optimal levels of investment and resources to mitigate the adverse health impacts of wildfires.
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Affiliation(s)
- Yao Wu
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Shanshan Li
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
| | - Rongbin Xu
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Gongbo Chen
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Xu Yue
- Jiangsu Key Laboratory of Atmospheric Environment Monitoring and Pollution Control, Collaborative Innovation Center of Atmospheric Environment and Equipment Technology, School of Environmental Science and Engineering, Nanjing University of Information Science and Technology, Nanjing, China
| | - Pei Yu
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Tingting Ye
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Bo Wen
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | | | | | - Yuming Guo
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
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15
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Ye T, Xu R, Yue X, Chen G, Yu P, Coêlho MSZS, Saldiva PHN, Abramson MJ, Guo Y, Li S. Short-term exposure to wildfire-related PM 2.5 increases mortality risks and burdens in Brazil. Nat Commun 2022; 13:7651. [PMID: 36496479 PMCID: PMC9741581 DOI: 10.1038/s41467-022-35326-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 11/29/2022] [Indexed: 12/13/2022] Open
Abstract
To assess mortality risks and burdens associated with short-term exposure to wildfire-related fine particulate matter with diameter ≤ 2.5 μm (PM2.5), we collect daily mortality data from 2000 to 2016 for 510 immediate regions in Brazil, the most wildfire-prone area. We integrate data from multiple sources with a chemical transport model at the global scale to isolate daily concentrations of wildfire-related PM2.5 at a 0.25 × 0.25 resolution. With a two-stage time-series approach, we estimate (i) an increase of 3.1% (95% confidence interval [CI]: 2.4, 3.9%) in all-cause mortality, 2.6% (95%CI: 1.5, 3.8%) in cardiovascular mortality, and 7.7% (95%CI: 5.9, 9.5) in respiratory mortality over 0-14 days with each 10 μg/m3 increase in daily wildfire-related PM2.5; (ii) 0.65% of all-cause, 0.56% of cardiovascular, and 1.60% of respiratory mortality attributable to acute exposure to wildfire-related PM2.5, corresponding to 121,351 all-cause deaths, 29,510 cardiovascular deaths, and 31,287 respiratory deaths during the study period. In this study, we find stronger associations in females and adults aged ≥ 60 years, and geographic difference in the mortality risks and burdens.
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Affiliation(s)
- Tingting Ye
- grid.1002.30000 0004 1936 7857Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004 Australia
| | - Rongbin Xu
- grid.1002.30000 0004 1936 7857Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004 Australia
| | - Xu Yue
- grid.260478.f0000 0000 9249 2313Jiangsu Key Laboratory of Atmospheric Environment Monitoring and Pollution Control, Collaborative Innovation Center of Atmospheric Environment and Equipment Technology, School of Environmental Science and Engineering, Nanjing University of Information Science & Technology (NUIST), Nanjing, 210044 China
| | - Gongbo Chen
- grid.1002.30000 0004 1936 7857Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004 Australia
| | - Pei Yu
- grid.1002.30000 0004 1936 7857Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004 Australia
| | - Micheline S. Z. S. Coêlho
- grid.11899.380000 0004 1937 0722Urban Health Laboratory University of São Paulo, Faculty of Medicine/INSPER, São Paulo, 01246-903 Brazil
| | - Paulo H. N. Saldiva
- grid.11899.380000 0004 1937 0722Urban Health Laboratory University of São Paulo, Faculty of Medicine/INSPER, São Paulo, 01246-903 Brazil
| | - Michael J. Abramson
- grid.1002.30000 0004 1936 7857Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004 Australia
| | - Yuming Guo
- grid.1002.30000 0004 1936 7857Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004 Australia
| | - Shanshan Li
- grid.1002.30000 0004 1936 7857Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004 Australia
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Affonso MVDG, Souza IG, de Rocha ES, Goloni-Bertollo EM, Gomes FDC, do Nascimento LS, de Melo-Neto JS. Association between Sociodemographic Factors, Coverage and Offer of Health Services with Mortality Due to Oral and Oropharyngeal Cancer in Brazil: A 20-Year Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13208. [PMID: 36293789 PMCID: PMC9603184 DOI: 10.3390/ijerph192013208] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 07/19/2022] [Accepted: 07/23/2022] [Indexed: 06/16/2023]
Abstract
To investigate the association between sociodemographic factors and variables related to oral health services in oral and oropharyngeal cancer mortality in Brazil, between 2000 and 2019. This study had an ecological design. Standardized mortality rates were compared between age group, sex, and regions. Age-Period-Cohort analysis was applied. Oral health services variables were analyzed in correlation tests. Survival analysis included Kaplan-Meier estimators, log-rank tests, and Cox regression. The mortality rate increased with age and was higher in men. Southeast and south regions had the highest rates for men, and the northeast and southeast had it for women. Age-Period-Cohort analysis showed a slight increase in female deaths and an increasing trend in the annual percent change in mortality for men over age 55. In survival analysis, males, Black individuals and southern residents were more strongly associated with death. The correlation between oral health teams' coverage was high and negative, while the number of dental specialty centers and soft tissue biopsies had a high and positive correlation. Mortality and survival patterns were dependent on sex, age, geographic region and race/ethnicity. It was observed that preventive and diagnostic procedures were not being performed, which may be related to the increase in mortality.
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Affiliation(s)
| | - Igor Gonçalves Souza
- Institute of Health Sciences, Federal University of Pará (UFPA), Belem 66075-110, Brazil
| | - Emerson Souza de Rocha
- Institute of Health Sciences, Federal University of Pará (UFPA), Belem 66075-110, Brazil
| | | | - Fabiana de Campos Gomes
- Faculty of Medicine of São José do Rio Preto (FAMERP), Sao Jose do Rio Preto 15090-000, Brazil
| | | | - João Simão de Melo-Neto
- Institute of Health Sciences, Federal University of Pará (UFPA), Belem 66075-110, Brazil
- School of Physiotherapy and Occupational Therapy, Federal University of Pará (UFPA), Street Augusto Corrêa, 01, Belem 66075-110, Brazil
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17
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Rebouças P, Goes E, Pescarini J, Ramos D, Ichihara MY, Sena S, Veiga R, Rodrigues LC, Barreto ML, Paixão ES. Ethnoracial inequalities and child mortality in Brazil: a nationwide longitudinal study of 19 million newborn babies. Lancet Glob Health 2022; 10:e1453-e1462. [PMID: 36113530 PMCID: PMC9638038 DOI: 10.1016/s2214-109x(22)00333-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 07/15/2022] [Accepted: 07/18/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Racism is a social determinant of health inequities. In Brazil, racial injustices lead to poor outcomes in maternal and child health for Black and Indigenous populations, including greater risks of pregnancy-related complications; decreased access to antenatal, delivery, and postnatal care; and higher childhood mortality rates. In this study, we aimed to estimate inequalities in childhood mortality rates by maternal race and skin colour in a cohort of more than 19 million newborns in Brazil. METHODS We did a nationwide population-based, retrospective cohort study using linked data on all births and deaths in Brazil between Jan 1, 2012, and Dec 31, 2018. The data consisted of livebirths followed up to age 5 years, death, or Dec 31, 2018. Data for livebirths were extracted from the National Information System for livebirths, SINASC, and for deaths from the Mortality Information System, SIM. The final sample consisted of complete data for all cases regarding maternal race and skin colour, and no inconsistencies were present between date of birth and death after linkage. We fitted Cox proportional hazard regression models to calculate the crude and adjusted hazard ratios (HRs) and 95% CIs for the association between maternal race and skin colour and all-cause and cause-specific younger than age 5 mortality rates, by age subgroups. We calculated the trend of HRs (and 95% CI) by time of observation (calendar year) to indicate trends in inequalities. FINDINGS From the 20 526 714 livebirths registered in SINASC between Jan 1, 2012, and Dec 31, 2018, 238 436 were linked to death records identified from SIM. After linkage, 1 010 871 records were excluded due to missing data on maternal race or skin colour or inconsistent date of death. 19 515 843 livebirths were classified by mother's race, of which 224 213 died. Compared with children of White mothers, mortality risk for children younger than age 5 years was higher among children of Indigenous (HR 1·98 [95% CI 1·92-2·06]), Black (HR 1·39 [1·36-1·41]), and Brown or Mixed race (HR 1·19 [1·18-1·20]) mothers. The highest hazard ratios were observed during the post-neonatal period (Indigenous, HR 2·78 [95% CI 2·64-2·95], Black, HR 1·54 [1·48-1·59]), and Brown or Mixed race, HR 1·25 [1·23-1·27]) and between the ages of 1 year and 4 years (Indigenous, HR 3·82 [95% CI 3·52-4·15]), Black, HR 1·51 [1·42-1·60], and Brown or Mixed race, HR 1·30 [1·26-1·35]). Children of Indigenous (HR 16·39 [95% CI 12·88-20·85]), Black (HR 2·34 [1·78-3·06]), and Brown or Mixed race mothers (HR 2·05 [1·71-2·45]) had a higher risk of death from malnutrition than did children of White mothers. Similar patterns were observed for death from diarrhoea (Indigenous, HR 14·28 [95% CI 12·25-16·65]; Black, HR 1·72 [1·44-2·05]; and Brown or Mixed race mothers, HR 1·78 [1·61-1·98]) and influenza and pneumonia (Indigenous, HR 6·49 [95% CI 5·78-7·27]; Black, HR 1·78 [1·62-1·96]; and Brown or Mixed race mothers, HR 1·60 [1·51-1·69]). INTERPRETATION Substantial ethnoracial inequalities were observed in child mortality in Brazil, especially among the Indigenous and Black populations. These findings demonstrate the importance of regular racial inequality assessments and monitoring. We suggest implementing policies to promote ethnoracial equity to reduce the impact of racism on child health. FUNDING MCTI/CNPq/MS/SCTIE/Decit/Bill & Melinda Gates Foundation's Grandes Desafios Brasil, Desenvolvimento Saudável para Todas as Crianças, and Wellcome Trust core support grant awarded to CIDACS-Center for Data and Knowledge Integration for Health.
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Affiliation(s)
- Poliana Rebouças
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil.
| | - Emanuelle Goes
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil; Iyaleta Research Association-Research, Science and Humanities, Salvador, Bahia, Brazil
| | - Julia Pescarini
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil; Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Dandara Ramos
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil; Instituto de Saude Coletiva, Federal University of Bahia, Salvador, Bahia, Brazil; Iyaleta Research Association-Research, Science and Humanities, Salvador, Bahia, Brazil
| | - Maria Yury Ichihara
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil
| | - Samila Sena
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil
| | - Rafael Veiga
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil
| | - Laura C Rodrigues
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil; Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Maurício L Barreto
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil; Instituto de Saude Coletiva, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Enny S Paixão
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil; Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
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Impact of sociodemographic factors and screening, diagnosis, and treatment strategies on colorectal cancer mortality in Brazil: A 20-year ecological study. PLoS One 2022; 17:e0274572. [PMID: 36107976 PMCID: PMC9477339 DOI: 10.1371/journal.pone.0274572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 08/30/2022] [Indexed: 11/19/2022] Open
Abstract
Colorectal cancer (CRC) caused 261,060 deaths in Brazil over a 20-year period, with a tendency to increase over time. This study aimed to verify the sociodemographic factors predicting higher mortality caused by CRC and survival rates. Moreover, we aimed to verify whether the performance of screening, diagnostic and treatment procedures had an impact on mortality. Ecological observational study of mortality due to CRC was conducted in Brazil from 2000–2019. The adjustment variable was age, which was used to calculate the age-standardized mortality rate (ASMR). The exposure variables were number of deaths and ASMR. Outcome variables were age-period-cohort, race classification, marital status, geographic region, and screening, diagnostic, and treatment procedures. Age-period-cohort analysis was performed. ANOVA and Kruskal-Wallis test with post hoc tests were used to assess differences in race classification, marital status, and geographic region. Multinomial logistic regression was used to test for interaction among sociodemographic factors. Survival analysis included Kaplan-Meier plot and Cox regression analysis were performed. Multivariate linear regression was used to test prediction using screening, diagnosis, and treatment procedures. In Brazil, mortality from CRC increased after age 45 years. The highest adjusted mortality rates were found among white individuals and in the South of the country (p < 0.05). Single, married, and widowed northern and northeastern persons had a higher risk of death than legally separated southern persons (p < 0.05). Lower survival rates were observed in brown and legally separated individuals and residents from the North (p < 0.05). An increase in first-line chemotherapy and a decrease in second-line chemotherapy were associated with high mortality in the north (p<0.05). In the south, second-line chemotherapy and abdominoperineal rectal resection were associated with high mortality (p < 0.05). Regional differences in sociodemographic factors and clinical procedures can serve as guidelines for adjusting public health policies.
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Yu P, Xu R, Li S, Yue X, Chen G, Ye T, Coêlho MSZS, Saldiva PHN, Sim MR, Abramson MJ, Guo Y. Exposure to wildfire-related PM2.5 and site-specific cancer mortality in Brazil from 2010 to 2016: A retrospective study. PLoS Med 2022; 19:e1004103. [PMID: 36121854 PMCID: PMC9529133 DOI: 10.1371/journal.pmed.1004103] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 10/03/2022] [Accepted: 08/25/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Long-term exposure to fine particles ≤2.5 μm in diameter (PM2.5) has been linked to cancer mortality. However, the effect of wildfire-related PM2.5 exposure on cancer mortality risk is unknown. This study evaluates the association between wildfire-related PM2.5 and site-specific cancer mortality in Brazil, from 2010 to 2016. METHODS AND FINDINGS Nationwide cancer death records were collected during 2010-2016 from the Brazilian Mortality Information System. Death records were linked with municipal-level wildfire- and non-wildfire-related PM2.5 concentrations, at a resolution of 2.0° latitude by 2.5° longitude. We applied a variant difference-in-differences approach with quasi-Poisson regression, adjusting for seasonal temperature and gross domestic product (GDP) per capita. Relative risks (RRs) and 95% confidence intervals (CIs) for the exposure for specific cancer sites were estimated. Attributable fractions and cancer deaths were also calculated. In total, 1,332,526 adult cancer deaths (age ≥ 20 years), from 5,565 Brazilian municipalities, covering 136 million adults were included. The mean annual wildfire-related PM2.5 concentration was 2.38 μg/m3, and the annual non-wildfire-related PM2.5 concentration was 8.20 μg/m3. The RR for mortality from all cancers was 1.02 (95% CI 1.01-1.03, p < 0.001) per 1-μg/m3 increase of wildfire-related PM2.5 concentration, which was higher than the RR per 1-μg/m3 increase of non-wildfire-related PM2.5 (1.01 [95% CI 1.00-1.01], p = 0.007, with p for difference = 0.003). Wildfire-related PM2.5 was associated with mortality from cancers of the nasopharynx (1.10 [95% CI 1.04-1.16], p = 0.002), esophagus (1.05 [95% CI 1.01-1.08], p = 0.012), stomach (1.03 [95% CI 1.01-1.06], p = 0.017), colon/rectum (1.08 [95% CI 1.05-1.11], p < 0.001), larynx (1.06 [95% CI 1.02-1.11], p = 0.003), skin (1.06 [95% CI 1.00-1.12], p = 0.003), breast (1.04 [95% CI 1.01-1.06], p = 0.007), prostate (1.03 [95% CI 1.01-1.06], p = 0.019), and testis (1.10 [95% CI 1.03-1.17], p = 0.002). For all cancers combined, the attributable deaths were 37 per 100,000 population and ranged from 18/100,000 in the Northeast Region of Brazil to 71/100,000 in the Central-West Region. Study limitations included a potential lack of assessment of the joint effects of gaseous pollutants, an inability to capture the migration of residents, and an inability to adjust for some potential confounders. CONCLUSIONS Exposure to wildfire-related PM2.5 can increase the risks of cancer mortality for many cancer sites, and the effect for wildfire-related PM2.5 was higher than for PM2.5 from non-wildfire sources.
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Affiliation(s)
- Pei Yu
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Rongbin Xu
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Shanshan Li
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Xu Yue
- Jiangsu Key Laboratory of Atmospheric Environment Monitoring and Pollution Control, Collaborative Innovation Center of Atmospheric Environment and Equipment Technology, School of Environmental Sciences and Engineering, Nanjing University of Information Science & Technology, Nanjing, China
| | - Gongbo Chen
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Tingting Ye
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Micheline S. Z. S. Coêlho
- Laboratory of Urban Health, Insper, São Paulo, Brazil
- Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Paulo H. N. Saldiva
- Laboratory of Urban Health, Insper, São Paulo, Brazil
- Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Malcolm R. Sim
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Michael J. Abramson
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Yuming Guo
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- * E-mail:
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Braga LLBC, Ferreira AF, Pinheiro FAS, Benigno TGDS, Heukelbach J, de Castro DB, Queiroz DMM, Miyajima F, Ramos AN. Temporal trends and spatial clusters of gastric cancer mortality in Brazil. Rev Panam Salud Publica 2022; 46:e101. [PMID: 36016835 PMCID: PMC9395278 DOI: 10.26633/rpsp.2022.101] [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: 10/13/2021] [Accepted: 05/02/2022] [Indexed: 12/24/2022] Open
Abstract
Objective To identify nationwide temporal trends and spatial patterns of gastric cancer-related mortality in Brazil. Methods An ecological study was performed using death certificates registered from 2000 to 2019 in which gastric cancer was recorded as any cause of death (an underlying or associated cause). Trends over time were assessed using joinpoint regression models. Spatial and spatiotemporal clusters were identified by Kulldorff's space-time scan statistics to identify high-risk areas. Results In 276 897/22 663 091 (1.22%) death certificates gastric cancer was recorded as any cause of death. Age-adjusted gastric cancer-related mortality increased significantly over time (annual percentage change [APC]: 0.7, 95% confidence interval [CI]: 0.5 to 0.8). The increase in mortality was more pronounced in the less-developed North and Northeast Regions (North Region, APC: 3.1, 95% CI: 2.7 to 3.5; Northeast Region, APC: 3.1, 95% CI: 2.5 to 3.7). Eight spatiotemporally associated high-risk clusters of gastric cancer-related mortality were identified in the North, South, Northeast and Central-West Regions, as well as a major cluster covering a wide geographical range in the South and Southeast Regions of Brazil during the first years of the study period (2000 to 2009). Conclusions More recently, during 2010 to 2019, clusters of gastric cancer have been identified in the Northeast Region. The nationwide increase in mortality in this analysis of 20 years of data highlights the persistently high burden of gastric cancer in Brazil, especially in socioeconomically disadvantaged regions. The identification of these areas where the population is at high risk for gastric cancer-related mortality emphasizes the need to develop effective and intersectoral control measures.
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Affiliation(s)
- Lucia Libanez Bessa Campelo Braga
- Department of Internal Medicine School of Medicine Federal University of Ceará Fortaleza Brazil Department of Internal Medicine, School of Medicine, Federal University of Ceará, Fortaleza, Brazil
| | - Anderson Fuentes Ferreira
- Postgraduate Program of Public Health School of Medicine Federal University of Ceará Fortaleza Brazil Postgraduate Program of Public Health, School of Medicine, Federal University of Ceará, Fortaleza, Brazil
| | - Fernando Antônio Siqueira Pinheiro
- Department of Surgery School of Medicine Federal University of Ceará Fortaleza Brazil Department of Surgery, School of Medicine, Federal University of Ceará, Fortaleza, Brazil
| | - Tiago Gomes da Silva Benigno
- Postgraduate Program of Medical-Surgical Sciences School of Medicine Federal University of Ceará Fortaleza Brazil Postgraduate Program of Medical-Surgical Sciences, School of Medicine, Federal University of Ceará, Fortaleza, Brazil
| | - Jorg Heukelbach
- Postgraduate Program of Public Health School of Medicine Federal University of Ceará Fortaleza Brazil Postgraduate Program of Public Health, School of Medicine, Federal University of Ceará, Fortaleza, Brazil
| | - Daniel Barros de Castro
- Health Surveillance Foundation AmazonasManaus Brazil Health Surveillance Foundation, Amazonas, Manaus, Brazil
| | - Dulciene Maria Magalhães Queiroz
- Laboratory of Research in Bacteriology School of Medicine Federal University of Minas Gerais Belo Horizonte Brazil Laboratory of Research in Bacteriology, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Fábio Miyajima
- Oswaldo Cruz Foundation Ceará Campus FIOCRUZ-CE Eusebio Brazil Oswaldo Cruz Foundation, Ceará Campus, FIOCRUZ-CE, Eusebio, Brazil
| | - Alberto Novaes Ramos
- Department of Community Health School of Medicine Federal University of Ceará Fortaleza Brazil Department of Community Health, School of Medicine, Federal University of Ceará, Fortaleza, Brazil
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Moroskoski M, Brito FAMD, Oliveira RRD. Time trend and spatial distribution of the cases of lethal violence against women in Brazil. Rev Lat Am Enfermagem 2022; 30:e3609. [PMID: 35858008 DOI: 10.1590/1518-8345.5613.3609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 03/10/2022] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE to analyze the time trend and the spatial distribution of the cases of lethal violence against women in Brazil, according to age group and to race/skin color. METHOD an ecological study of time series, with spatial distribution of the deaths of women victims of aggression, registered in the Mortality Information System, resident in Brazil, Brazilian geographic regions and states. Due to underreporting of deaths in some states, correction factors of the mortality rates were employed. For the trend analysis, we adopted the polynomial regression model. In addition to that, the mean rates and annual upward/downward trends were distributed considering the Brazilian federative units as analysis units. RESULTS the mean rate was 6.24 cases of lethal violence per 100,000 women, with a significant variation across the Brazilian regions and states. The main victims of violent death in Brazil are young, black-/brown-skinned and indigenous women, with a growing trend in these population segments. The North and Northeast regions stood out with the most significant mean annual increases (0.33; r2= 0.96 and 0.26; r2= 0.92, respectively). CONCLUSION there was a stable trend regarding lethal violence against women, with significant regional differences. Young, black-/brown-skinned and indigenous women are more vulnerable to violent death in Brazil.
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Affiliation(s)
- Márcia Moroskoski
- Universidade Estadual de Maringá, Maringá, PR, Brasil.,Bolsista da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brasil
| | - Franciele Aline Machado de Brito
- Universidade Estadual de Maringá, Maringá, PR, Brasil.,Bolsista da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brasil
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Yu P, Xu R, Li S, Coelho MSZS, Saldiva PHN, Sim MR, Abramson MJ, Guo Y. Associations between long-term exposure to PM 2.5 and site-specific cancer mortality: A nationwide study in Brazil between 2010 and 2018. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 302:119070. [PMID: 35231538 DOI: 10.1016/j.envpol.2022.119070] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 02/22/2022] [Accepted: 02/25/2022] [Indexed: 05/21/2023]
Abstract
Long-term exposure to PM2.5 has been linked to lung cancer incidence and mortality, but limited evidence existed for other cancers. This study aimed to assess the association between PM2.5 on cancer specific mortality. An ecological study based on the cancer mortality data collected from 5,565 Brazilian cities during 2010-2018 using a difference-in-differences approach with quasi-Poisson regression, was applied to examine PM2.5-cancer mortality associations. Globally gridded annual average surface PM2.5 concentration was extracted and linked with the residential municipality of participants in this study. Sex, age stratified and exposure-response estimations were also conducted. Totalling 1,768,668 adult cancer deaths records of about 208 million population living across 5,565 municipalities were included in this study. The average PM2.5 concentration was 7.63 μg/m3 (standard deviation 3.32) with range from 2.95 μg/m3 to 28.5 μg/m3. With each 10 μg/m3 increase in three-year-average (current year and previous two years) concentrations of PM2.5, the relative risks (RR) of cancer mortality were 1.16 (95% confidence interval [CI]: 1.11-1.20) for all-site cancers. The PM2.5 exposure was significantly associated with several cancer-specific mortalities including oral, nasopharynx, oesophagus, and stomach, colon rectum, liver, gallbladder, larynx, lung, bone, skin, female breast, cervix, prostate, brain and leukaemia. No safe level of PM2.5 exposure was observed in the exposure-response curve for all types of cancer. In conclusion, with nationwide cancer death records in Brazil, we found that long-term exposure to ambient PM2.5 increased risks of mortality for many cancer types. Even low level PM2.5 concentrations had significant impacts on cancer mortality.
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Affiliation(s)
- Pei Yu
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Rongbin Xu
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Shanshan Li
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | | | | | - Malcolm R Sim
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Michael J Abramson
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Yuming Guo
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
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Moroskoski M, Brito FAMD, Oliveira RRD. Time trend and spatial distribution of the cases of lethal violence against women in Brazil. Rev Lat Am Enfermagem 2022. [PMID: 35858008 PMCID: PMC9285200 DOI: 10.1590/1518-8345.5613.3547] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective: to analyze the time trend and the spatial distribution of the cases of lethal violence against women in Brazil, according to age group and to race/skin color. Method: an ecological study of time series, with spatial distribution of the deaths of women victims of aggression, registered in the Mortality Information System, resident in Brazil, Brazilian geographic regions and states. Due to underreporting of deaths in some states, correction factors of the mortality rates were employed. For the trend analysis, we adopted the polynomial regression model. In addition to that, the mean rates and annual upward/downward trends were distributed considering the Brazilian federative units as analysis units. Results: the mean rate was 6.24 cases of lethal violence per 100,000 women, with a significant variation across the Brazilian regions and states. The main victims of violent death in Brazil are young, black-/brown-skinned and indigenous women, with a growing trend in these population segments. The North and Northeast regions stood out with the most significant mean annual increases (0.33; r2= 0.96 and 0.26; r2= 0.92, respectively). Conclusion: there was a stable trend regarding lethal violence against women, with significant regional differences. Young, black-/brown-skinned and indigenous women are more vulnerable to violent death in Brazil.
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Affiliation(s)
- Márcia Moroskoski
- Universidade Estadual de Maringá, Brazil; Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brasil
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Moroskoski M, Brito FAMD, Oliveira RRD. Tendencia temporal y distribución espacial de los casos de violencia letal contra la mujer en Brasil. Rev Lat Am Enfermagem 2022. [DOI: 10.1590/1518-8345.5613.3608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumen Objetivo: analizar la tendencia temporal y la distribución espacial de los casos de violencia letal contra la mujer en Brasil, según la franja etaria y la raza/color. Método: estudio ecológico, de las series temporales, con distribución espacial de las muertes de mujeres víctimas de agresión, registradas en el Sistema de Información de Mortalidad, residentes en Brasil, regiones geográficas y estados brasileños. Debido a que hay subregistro de las muertes en algunos estados, se utilizaron factores de corrección para las tasas de mortalidad. Para el análisis de tendencias, adoptamos el modelo de regresión polinomial. Además, las tasas medias y las tendencias anuales de aumento/disminución fueron distribuidas considerando como unidad de análisis las unidades federativas de Brasil. Resultados: la tasa promedio fue de 6,24 casos de violencia letal por cada 100.000 mujeres, con variación significativa entre regiones y estados brasileños. Las principales víctimas de muerte violenta en Brasil son mujeres jóvenes, negras/morenas e indígenas y la tendencia es creciente en estas poblaciones. Las regiones Norte y Noreste presentaron los aumentos medios anuales más significativos (0,33; r2 = 0,96 y 0,26; r2 = 0,92, respectivamente). Conclusión: hubo una tendencia a la estabilidad de la violencia letal contra la mujer, con diferencias regionales significativas. Las mujeres jóvenes, negras/morenas e indígenas son más vulnerables a la muerte violenta en Brasil.
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Affiliation(s)
- Márcia Moroskoski
- Universidade Estadual de Maringá, Brazil; Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brasil
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Rodrigues BLS, Silva RND, Arruda RGD, Silva PBC, Feitosa DKDS, Guarda FRBD. Impact of the Health Gym Program on mortality from Systemic Arterial Hypertension in Pernambuco state, Brazil. CIENCIA & SAUDE COLETIVA 2021; 26:6199-6210. [PMID: 34910010 DOI: 10.1590/1413-812320212612.32802020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 10/19/2020] [Indexed: 11/21/2022] Open
Abstract
The aim of this paper was to analyze the impact of the Health Gym Program (HGP) on the Systemic Arterial Hypertension mortality rate in Pernambuco state, Brazil. This public policy impact analysis used a quasi-experimental approach which consisted of the application of Propensity Score Matching in the years 2010 and 2017. Socioeconomic, demographic, and epidemiological data of 89 municipalities that implemented HGP (treated) and 54 that did not (controls) were collected from the Brazilian Health Data Department, Brazilian Institute of Geography and Statistics, and other databases. The impact of HGP on hypertension mortality rate was estimated through a logit model using the Kernel algorithm. Treated municipalities presented a decrease of 12.8% in global hypertension mortality rate, 12.5% in brown-skinned people and 13.1% in those over 80 years of age. The balancing test attests to the robustness of the estimated model to explain the impact of the program on mortality due to hypertension. The implementation of the program proved to be effective in decreasing the mortality rate in the treated municipalities, indicating that it seems to contribute to controlling the progress of chronic non-communicable diseases.
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Affiliation(s)
- Bárbara Letícia Silvestre Rodrigues
- Centro Acadêmico de Vitória, Universidade Federal de Pernambuco. R. Alto do Reservatório s/n, Alto José Leal. 55608-680 Vitória de Santo Antão PE
| | | | | | - Paloma Beatriz Costa Silva
- Centro Acadêmico de Vitória, Universidade Federal de Pernambuco. R. Alto do Reservatório s/n, Alto José Leal. 55608-680 Vitória de Santo Antão PE
| | - Daíze Kelly da Silva Feitosa
- Centro Acadêmico de Vitória, Universidade Federal de Pernambuco. R. Alto do Reservatório s/n, Alto José Leal. 55608-680 Vitória de Santo Antão PE
| | - Flávio Renato Barros da Guarda
- Centro Acadêmico de Vitória, Universidade Federal de Pernambuco. R. Alto do Reservatório s/n, Alto José Leal. 55608-680 Vitória de Santo Antão PE
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Silva PJDC, Feitosa RA, Machado MF, Quirino TRL, Correia DS, Wanderley RDA, Souza CDFD. Perfil epidemiológico e tendência temporal da mortalidade por suicício em adolescentes. JORNAL BRASILEIRO DE PSIQUIATRIA 2021. [DOI: 10.1590/0047-2085000000338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
RESUMO Objetivo Descrever o perfil epidemiológico e analisar a tendência temporal da mortalidade por suicídio entre adolescentes (10-19 anos) do Nordeste brasileiro, no período de 2001 a 2015. Métodos Trata-se de estudo observacional, que teve como cenário a região Nordeste do Brasil. O período de estudo foi de 2001 a 2015. Consideraram-se as mortes por lesão autoprovocada intencionalmente (X60 a X84), intoxicação exógena de intenção indeterminada (Y10 a Y19) e sequela de lesões autoprovocadas intencionalmente (Y87.0), de acordo com a 10ª Revisão da Classificação Internacional de Doenças (CID-10), de adolescentes de 10 a 19 anos. As variáveis analisadas foram: sexo, faixa etária, raça/cor, CID específico, estado de residência e taxa de mortalidade por suicídio/100.000 habitantes. Resultados Foram registrados 3.194 óbitos em decorrência de suicídio na faixa etária estudada, com predomínio do sexo masculino (62,1%; n = 1.984), faixa etária de 15 a 19 anos (84,8%; n = 2.707), raça/cor parda (65,4%; n = 2.090); entre quatro e sete anos de escolaridade (31,7%; n = 1.011) e no CID X70 (47,8%; n = 1.528). A tendência temporal de mortalidade foi crescente de 2001 a 2015 (APC: 2,4%; p < 0,01), com maiores taxas no sexo masculino. Observou-se tendência crescente da taxa de suicídios, no sexo masculino, em todo o período (AAPC: 2,9%; p < 0,01). No sexo feminino, identificou-se tendência decrescente a partir de 2004 (APC: -2,2%; p < 0,01). Conclusão O perfil epidemiológico foi caracterizado pelo sexo masculino, faixa etária de 15-19 anos, cor/raça parda e escolaridade média. A tendência apresentou padrão de crescimento no sexo masculino e declínio no feminino. Recomenda-se que políticas públicas sejam voltadas para a população adolescente.
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Nóbrega Barbosa KG, Walker BB, Vieira da Silva A, Procópio Gonzaga GL, Maio de Brum EH, Ribeiro MC. Spatial-temporal patterns of homicide in socioeconomically deprived settings: violence in Alagoas, Brazil, 2006‒2015. Glob Health Action 2021; 14:1952752. [PMID: 34334101 PMCID: PMC8330714 DOI: 10.1080/16549716.2021.1952752] [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] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND Homicide presents a significant health burden globally, but geographical differences in homicide rates necessitate focussed analyses of spatial and temporal patterns, particularly in affected areas. The highest rates are concentrated in regions in Central and South America, but analyses of sub-regional patterns and sex-specific differences may yield important information for addressing the upstream causes of homicide at the community level. OBJECTIVE This study examines and presents spatial and temporal patterns of homicide victims from 2006 to 2015 in the state of Alagoas, Brazil, focussing on the municipality scale and differentiated by victims' sex. METHODS Data comprising victims' age, sex, the date, time, and the municipality of the homicide incident were acquired from the Brazilian National Mortality Information System. These data were aggregated by municipality, and we made quantitative comparisons of sex-specific homicide rates between the capital city of Macieó metropolitan region and the peripheral, predominantly rural regions. Empirical Local Bayes methods were used to adjust per-capita homicide risk estimates and map the results. RESULTS A total of 19,560 homicides occurred during the study period, with an average of 60.4 per 100,000 inhabitants; the metropolitan region rate was 81.8, compared to 46.5 for the remaining regions. The male homicide rate was 115.9 per 100,000, compared to 7.1 for females. Empirical Local Bayes mapping showed strong clustering of male homicide risk in specific cities near the capital, while female risk was more dispersed throughout the region. CONCLUSIONS The risk of male victim homicide observed for the metropolitan region of Alagoas was amongst the highest globally, particularly during the period 2012-2014. Geographical differences in male and female risk may indicate differences in risk factors and highlight a need for prevention programmes that take into account gender-specific pathways of violence.
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Affiliation(s)
| | | | | | | | | | - Mara Cristina Ribeiro
- Mestrado Profissional Pesquisa Em Saúde, Centro Universitário Cesmac, Maceió, Alagoas, Brazil
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Baptista GC, Poton WL. Evolution of neonatal mortality by preventable causes over the past ten years in Espírito Santo State. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2021. [DOI: 10.1590/1806-93042021000100003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Abstract Objectives: analyze neonatal mortality causes, highlighting the pteventable ones from 2008 to 2017, in Espírito Santo State and health regions. Methods: ecological study of temporal series on neonatal mortality using data from Mortality Information System and from Live Birth Information System. The death causes were classified based on the List of Avoidable Causes of Deaths due to Interventions of the Brazilian Health System. The temporal tendency was analyzed using linear regression. Results: the neonatal mortality rate reduced, approximately 5%, with a reduction of almost 27% in the late neonatal component. Approximately, 70% of neonatal deaths were preventable, with a higher frequency of reducible causes by adequate care at pregnancy, childbirth and to the newborn. The reduction was significant for adequate care for pregnant women in Espírito Santo and in Metropolitan Region and due to adequate care to the newborn in the South Region. Conclusions: the main causes of neonatal deaths were due inadequate care for women during pregnancy, at childbirth and to the newborn, despite the reduction in neonatal mortality over the past 10 years. This study may contribute to the planning of health policies to improve care for pregnant women, parturient and to the newborn.
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Nogueira VD, Xavier-Gomes LM, Barbosa TLDA. Homicide mortality in border regions in the State of Paraná, Brazil. CIENCIA & SAUDE COLETIVA 2020; 25:3107-3118. [PMID: 32785546 DOI: 10.1590/1413-81232020258.28522018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 11/05/2018] [Indexed: 11/22/2022] Open
Abstract
A time series analysis was conducted to identify trends in homicide mortality in border regions in the State of Paraná, Brazil between 2002 and 2012. Homicide mortality rates were analyzed by sex, age group, region (border regions, non-border regions, and the state as a whole), and type of assault. Trend analysis was performed using polynomial regression. The findings showed that mortality rates were higher in the border regions; however the growth in homicide rates was greater in the non-border regions and in the state as a whole, with these states showing an upward trend in homicide rates (p < 0.001) and border regions showing a downward trend, although the latter was not significant. Mortality rates were higher among men across all regions and highest in the 20 to 29 age group. The findings regarding homicide rates in border regions provide compelling evidence of the urgent need for intersectoral prevention policies targeting the most affected groups.
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Affiliation(s)
- Vinícius Denepotti Nogueira
- Instituto Latino-Americano de Ciências da Vida e da Natureza, Universidade Federal da Integração Latino-Americana. Av. Tarquínio Joslin dos Santos 1000, Bairro Polo Universitário. 85870-901 Foz do Iguaçu PR Brasil.
| | - Ludmila Mourão Xavier-Gomes
- Instituto Latino-Americano de Ciências da Vida e da Natureza, Universidade Federal da Integração Latino-Americana. Av. Tarquínio Joslin dos Santos 1000, Bairro Polo Universitário. 85870-901 Foz do Iguaçu PR Brasil.
| | - Thiago Luis de Andrade Barbosa
- Instituto Latino-Americano de Ciências da Vida e da Natureza, Universidade Federal da Integração Latino-Americana. Av. Tarquínio Joslin dos Santos 1000, Bairro Polo Universitário. 85870-901 Foz do Iguaçu PR Brasil.
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Lower respiratory infections mortality among Brazilians under-five before and after national pneumococcal conjugate vaccine implementation. Vaccine 2020; 38:2559-2565. [DOI: 10.1016/j.vaccine.2020.01.084] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 01/23/2020] [Accepted: 01/28/2020] [Indexed: 11/17/2022]
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Beluzo CE, Silva E, Alves LC, Bresan RC, Arruda NM, Sovat R, Carvalho T. Towards neonatal mortality risk classification: A data-driven approach using neonatal, maternal, and social factors. INFORMATICS IN MEDICINE UNLOCKED 2020; 20:100398. [PMID: 33102685 PMCID: PMC7568208 DOI: 10.1016/j.imu.2020.100398] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 07/13/2020] [Accepted: 07/14/2020] [Indexed: 11/16/2022] Open
Abstract
Infant mortality is an important health measure in a population as a crude indicator of the poverty and socioeconomic level. It also shows the availability and quality of health services and medical technology in a specific region. Although improvements have been observed in the last decades, the implementation of actions to reduce infant mortality is still a concern in many countries. To address such an important problem, this paper proposes a new support decision approach to classify newborns according to their neonatal mortality risk. Using features related to mother, newborn, and socio-demographic, we model the problem using a data-driven classification model able to provide the probability of a newborn dying until 28 t h days of life. More than a theoretical study, decision support tools as the one proposed here is relevant in countries in development as Brazil, because it aims at identifying risky neonates that may die to raise the attention of medical practitioners so that they can work harder to reduce the overall neonatal mortality. Overcoming an AUC of 96%, the proposed method is able to provide not just the probability of death risk but also an explicable interpretation of most important features for model decision, which is paramount in public health applications. Furthermore, we provide an extensive analysis across different rounds of experiments, including an analysis of pre and post partum features influence over data-driven model. Finally, different from previously conducted studies which rely on databases with less than 100,000 samples, our model takes advantage from a new proposed database, constructed using more than 1,400,000 samples comprising births and deaths extracted from public records in São Paulo-Brazil from 2012 to 2018.
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Affiliation(s)
| | - Everton Silva
- Federal Institute of São Paulo, Campinas, SP, Brazil
| | | | | | | | - Ricardo Sovat
- Federal Institute of São Paulo, Campinas, SP, Brazil
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Ribeiro TS, Ramalho AA, Vasconcelos SP, Opitz SP, Koifman RJ. Tendência temporal da mortalidade em idosos em municípios no estado do Acre. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2020. [DOI: 10.1590/1981-22562020023.200018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivo Analisar a tendência temporal da mortalidade na população de idosos em municípios selecionados das cinco regionais de desenvolvimento no estado do Acre, Brasil. Método Estudo descritivo, ecológico de séries temporais, que utilizou dados do Sistema de Informações sobre Mortalidade (SIM), no qual foi selecionado o universo de óbitos ocorridos em idosos, registrados nos municípios acreanos de 1996 a 2015. Foram calculadas as taxas de mortalidade brutas e ajustadas por idade, utilizando o método direto e a população mundial como referência. Para a análise das tendências, foi realizada a estimativa da variação percentual anual da mortalidade com nível de confiança de 95% pelo software Joinpoint Regression Program. Resultados A tendência da mortalidade geral apresentou-se decrescente em Rio Branco e com oscilações nos demais municípios investigados. As principais causas de óbito foram as doenças do aparelho circulatório, respiratório e neoplasias. Em Rio Branco, as taxas de mortalidade padronizadas por idade nas doenças do aparelho circulatório reduziram 2,26% (p<0,001) ao ano e as neoplasias apresentaram tendência crescente e constante com uma variação anual de 1,02% (p=0,010). Conclusão O estudo mostrou evidências de polarização epidemiológica, geográfica e social no comportamento das tendências da mortalidade. Rio Branco, a capital do estado, apresentou padrões semelhantes aos das regiões desenvolvidas brasileiras. Por outro lado, os demais municípios apresentaram consideráveis oscilações nas tendências que podem estar relacionadas à elevada proporção de causas mal definidas. Esses achados podem auxiliar no planejamento de ações estratégicas e sugestões de hipóteses para novos estudos.
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Bezerra PCDL, Monteiro GTR. Trends in overall mortality and from diseases of the circulatory system in elderly individuals in Rio Branco, Acre, 1980-2012. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2018. [DOI: 10.1590/1981-22562018021.170128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Abstract Objective: To analyze trends in general mortality and circulatory system disease mortality among elderly persons living in the city of Rio Branco, Acre, Brazil, from 1980 to 2012. Method: A study of the cause of death of elderly people was carried out from the data available in the Brazilian Mortality Information System. Crude and age-based overall and circulatory system mortality rates were calculated. The trend analyses of these rates were performed using the JoinPoint Regression program. Results: Despite the reductions in mortality rates, diseases of the circulatory system remained the main cause of death of the elderly in Rio Branco. The decrease in overall mortality rates was higher among elderly women and those aged 70 years or older. There was a tendency for death rates due to diseases of the circulatory system to decline among elderly men and grow among elderly women. Conclusion: The mortality rate among the elderly in Rio Branco revealed a declining trend. Deaths from diseases of the circulatory system were the leading cause of death, suggesting that research should be carried out to assess the need for investment to ensure that increased longevity is accompanied by good quality of life.
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