1
|
de Lima LV, Pavinati G, de Oliveira RR, Couto RDM, Alves KBA, Magnabosco GT. Temporal trend in the incidence of tuberculosis-HIV coinfection in Brazil, by macro-region, Federative Unit, sex and age group, 2010-2021. EPIDEMIOLOGIA E SERVIÇOS DE SAÚDE 2024; 33:e2023522. [PMID: 38381874 PMCID: PMC10880441 DOI: 10.1590/s2237-96222024v33e2023522.en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 11/22/2023] [Indexed: 02/23/2024] Open
Abstract
OBJECTIVE To analyze the temporal trend in the incidence of tuberculosis-HIV coinfection in Brazil, by macro-region, Federative Unit, sex and age group, from 2010 to 2021. METHODS This was a time series study using surveillance data to estimate average annual percentage changes (AAPC), and 95% confidence intervals (95%CI) via joinpoint regression. RESULTS 122,211 cases of tuberculosis-HIV coinfection were analyzed; a falling trend was identified for Brazil as a whole (AAPC = -4.3; 95%CI -5.1;-3.7), and in the country's Southern (AAPC = -6.2; 95%CI -6.9;-5.5) and Southeast (AAPC = -4.6; 95%CI -5.6;-3.8) regions, even more so during the COVID-19 pandemic (2020-2021); the greatest falling trend was seen in Santa Catarina (AAPC = -9.3; 95%CI -10.1;-8.5), while the greatest rising trend was found in Tocantins (AAPC = 4.1; 95%CI 0.1;8.6); there was a rising trend among males, especially in Sergipe (AAPC = 3.9; 95%CI 0.4;7.9), and those aged 18 to 34 years, especially in Amapá (AAPC = 7.9; 95%CI 5.1;11.5). CONCLUSION The burden and trends of tuberculosis-HIV coinfection were geographically and demographically disparate.
Collapse
Affiliation(s)
- Lucas Vinícius de Lima
- Universidade Estadual de Maringá, Programa de Pós-Graduação em
Enfermagem, Maringá, PR, Brazil
| | - Gabriel Pavinati
- Universidade Estadual de Maringá, Programa de Pós-Graduação em
Enfermagem, Maringá, PR, Brazil
| | | | | | - Kleydson Bonfim Andrade Alves
- Organização Pan-Americana da Saúde, Departamento de Doenças
Transmissíveis e Determinantes Ambientais da Saúde, Brasília, DF, Brazil
| | | |
Collapse
|
2
|
Santos BNSD, Araújo FG, Paula TFD, Matozinhos FP, Felisbino-Mendes MS. Prevalence of preconception health indicators among Brazilian women of reproductive age. CIENCIA & SAUDE COLETIVA 2023; 28:3367-3381. [PMID: 37971017 DOI: 10.1590/1413-812320232811.16282022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 02/13/2023] [Indexed: 11/19/2023] Open
Abstract
This article aims to evaluate the performance of preconception health indicators according to sociodemographic characteristics among Brazilian women of reproductive age. We conducted a descriptive epidemiological study using data from 21,645 and 25,228 women, respectively, who responded the 2013 and 2019 national health surveys, and data for the period 2010 to 2020 derived from the national health system's Department of Informatics (DATASUS). We calculated the prevalence of indicators according to sociodemographic characteristics and statistical significance of differences was measured using Pearson's chi-squared test. Syphilis and HIV incidence rates were also calculated. There was an increase in the prevalence of access to health service indicators (medical and dental consultations and recent Pap smear). However, there was an increase in the prevalence of hypertension, alcohol use, and obesity. The prevalence of use of contraceptive methods and fertility treatment remained stable. Syphilis incidence increased sevenfold between 2010 and 2020. Black/brown women with a low level of education, higher parity, and living in the North or Northeast performed worse for preconception health indicators. Despite the increase in access to health services, performance on preconception health indicators declined and health inequities continued.
Collapse
Affiliation(s)
- Bruna Nicole Soares Dos Santos
- Programa de Pós-Graduação em Enfermagem, Departamento de Enfermagem Materno-Infantil e Saúde Pública, Escola de Enfermagem, Universidade Federal de Minas Gerais. Av. Alfredo Balena 190, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
| | - Fernanda Gontijo Araújo
- Programa de Pós-Graduação em Enfermagem, Departamento de Enfermagem Materno-Infantil e Saúde Pública, Escola de Enfermagem, Universidade Federal de Minas Gerais. Av. Alfredo Balena 190, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
| | - Thayane Fraga de Paula
- Programa de Pós-Graduação em Enfermagem, Departamento de Enfermagem Materno-Infantil e Saúde Pública, Escola de Enfermagem, Universidade Federal de Minas Gerais. Av. Alfredo Balena 190, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
| | - Fernanda Penido Matozinhos
- Programa de Pós-Graduação em Enfermagem, Departamento de Enfermagem Materno-Infantil e Saúde Pública, Escola de Enfermagem, Universidade Federal de Minas Gerais. Av. Alfredo Balena 190, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
| | - Mariana Santos Felisbino-Mendes
- Programa de Pós-Graduação em Enfermagem, Departamento de Enfermagem Materno-Infantil e Saúde Pública, Escola de Enfermagem, Universidade Federal de Minas Gerais. Av. Alfredo Balena 190, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
| |
Collapse
|
3
|
Miranda WDD, Silva GDMD, Fernandes LDMM, Silveira F, Sousa RPD. Health inequalities in Brazil: proposed prioritization to achieve the Sustainable Development Goals. CAD SAUDE PUBLICA 2023; 39:e00119022. [PMID: 37132719 DOI: 10.1590/0102-311xpt119022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 02/13/2023] [Indexed: 05/04/2023] Open
Abstract
This study aimed to develop a prioritization index to speed up the achievement of national health targets proposed in the 2030 Agenda. This is an ecological study that addressed the Health Regions in Brazil. The index incorporated 25 indicators with analytical proximity to the official indicators of the 2030 Agenda whose data are available from public municipal sources for the period of 2015-2019. According to our study, the index was a powerful method to support health management decisions. The results showed the most vulnerable territories are located in the North Region of the country, and therefore, these are priority areas for resource allocation. The analysis of subindices highlighted local health bottlenecks, reinforcing the need for municipalities in each region to set their own priorities while making decisions for health resource allocation. By indicating Health Regions and priority themes for more investments, this investigation shows paths to support the implementation of the 2030 Agenda, from the local to the national level, in addition to providing elements that can be used by policy makers to minimize the effects of social inequalities on health, prioritizing territories with worse indices.
Collapse
Affiliation(s)
| | | | | | - Fabrício Silveira
- Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Brasil
| | | |
Collapse
|
4
|
Pinto LF, Caldas ALFR. Primary child health care: the largest population-based assessment in the history of Brazilian National Health System. CIENCIA & SAUDE COLETIVA 2022. [DOI: 10.1590/1413-81232022278.06092022en] [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
Abstract The IBGE has been playing a leading role in the public policy evaluation in Brazil since 2019. After the National Health Survey (PNS) evaluated primary care services in the Unified Health System (SUS) provided to adults, in 2022, the Continuous National Household Sample Survey (PNAD-C) investigated child health. To this end, it adopted one version of the Primary Care Assessment Tool (PCAT), developed and disseminated by Starfield and Shi to assess the existence and extent of the attributes of PHC services. The target audience surveyed included children under 13 years of age, and the questionnaires were answered by their guardians/caregivers. It included all the 27 federative units of the country in random probabilistic samples, also unfolding in the Brazilian metropolitan regions and capitals. This is the largest household survey on child health assessment ever conducted in Brazil. With the PNS-2019 and the PNAD-C in 2022, IBGE inaugurates its greatest legacy for Brazilian primary health care regarding the evaluation of SUS users, with all federative units recognizing and understanding how Brazilian society evaluates health services at the first level of care.
Collapse
Affiliation(s)
- Luiz Felipe Pinto
- Universidade Federal do Rio de Janeiro, Brazil; Secretaria Municipal de Saúde do Rio de Janeiro, Brazil
| | | |
Collapse
|
5
|
Pinto LF, Caldas ALFR. Primary child health care: the largest population-based assessment in the history of Brazilian National Health System. CIENCIA & SAUDE COLETIVA 2022; 27:3153-3156. [PMID: 35894326 DOI: 10.1590/1413-81232022278.06092022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 04/15/2022] [Indexed: 11/22/2022] Open
Abstract
The IBGE has been playing a leading role in the public policy evaluation in Brazil since 2019. After the National Health Survey (PNS) evaluated primary care services in the Unified Health System (SUS) provided to adults, in 2022, the Continuous National Household Sample Survey (PNAD-C) investigated child health. To this end, it adopted one version of the Primary Care Assessment Tool (PCAT), developed and disseminated by Starfield and Shi to assess the existence and extent of the attributes of PHC services. The target audience surveyed included children under 13 years of age, and the questionnaires were answered by their guardians/caregivers. It included all the 27 federative units of the country in random probabilistic samples, also unfolding in the Brazilian metropolitan regions and capitals. This is the largest household survey on child health assessment ever conducted in Brazil. With the PNS-2019 and the PNAD-C in 2022, IBGE inaugurates its greatest legacy for Brazilian primary health care regarding the evaluation of SUS users, with all federative units recognizing and understanding how Brazilian society evaluates health services at the first level of care.
Collapse
Affiliation(s)
- Luiz Felipe Pinto
- Departamento de Medicina em Atenção Primária à Saúde, Faculdade de Medicina, Universidade Federal do Rio de Janeiro. R. Laura de Araújo 36/2º parte, Cidade Nova. 20211-170 Rio de Janeiro RJ Brasil. .,Secretaria Municipal de Saúde do Rio de Janeiro (SMS-Rio). Rio de Janeiro RJ Brasil
| | | |
Collapse
|
6
|
Meira KC, Magnago C, Mendonça AB, Duarte SFS, de Freitas PHO, dos Santos J, de Souza DLB, Simões TC. Inequalities in Temporal Effects on Cervical Cancer Mortality in States in Different Geographic Regions of Brazil: An Ecological Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5591. [PMID: 35564986 PMCID: PMC9105639 DOI: 10.3390/ijerph19095591] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 04/06/2022] [Accepted: 04/13/2022] [Indexed: 02/01/2023]
Abstract
Cervical cancer is a public health issue with high disease burden and mortality in Brazil. The objectives of the present study were, firstly, to analyze age, period, and cohort effects on cervical cancer mortality in women 20 years old or older from 1980 to 2019 in the North, South, and Southeast Regions of Brazil; and secondly, to evaluate whether the implementation of a national screening program and the expansion of access to public health services impacted the examined period and reduced the risk of death compared with previous years and among younger cohorts. The effects were estimated by applying Poisson regression models with estimable functions. The highest mortality rate per 100,000 women was found in Amazonas (24.13), and the lowest in São Paulo (10.56). A positive gradient was obtained for death rates as women's age increased. The states in the most developed regions (South and Southeast) showed a reduction in the risk of death in the period that followed the implementation of the screening program and in the cohort from the 1960s onwards. The North Region showed a decreased risk of death only in Amapá (2000-2004) and Tocantins (1995-2004; 2010-2019). The findings indicate that health inequities remain in Brazil and suggest that the health system has limitations in terms of decreasing mortality associated with this type of cancer in regions of lower socioeconomic development.
Collapse
Affiliation(s)
- Karina Cardoso Meira
- Health School, Federal University of Rio Grande do Norte, Natal 59078-970, Brazil
| | - Carinne Magnago
- School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil;
| | - Angelo Braga Mendonça
- Brazilian National Cancer Institute, Rio de Janeiro 20230-130, Brazil; (A.B.M.); (J.d.S.)
| | - Stephane Fernanda Soares Duarte
- Department of Demography and Actuarial Sciences, Federal University of Rio Grande Norte, Natal 59078-970, Brazil; (S.F.S.D.); (P.H.O.d.F.)
| | - Pedro Henrique Oliveira de Freitas
- Department of Demography and Actuarial Sciences, Federal University of Rio Grande Norte, Natal 59078-970, Brazil; (S.F.S.D.); (P.H.O.d.F.)
| | - Juliano dos Santos
- Brazilian National Cancer Institute, Rio de Janeiro 20230-130, Brazil; (A.B.M.); (J.d.S.)
| | | | - Taynãna César Simões
- René Rachou Institute, Oswaldo Cruz Foundation, Belo Horizonte 30190-002, Brazil;
| |
Collapse
|
7
|
Carvalho FCD, Bernal RTI, Perillo RD, Malta DC. Associação entre avaliação positiva da atenção primária à saúde e características sociodemográficas e comorbidades no Brasil. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2022; 25:e220023. [DOI: 10.1590/1980-549720220023.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 07/04/2022] [Indexed: 12/23/2022] Open
Abstract
RESUMO Objetivo: Descrever a avaliação positiva da atenção primária à saúde (APS) no Brasil na ótica dos usuários e sua associação com as características sociodemográficas e comorbidades. Métodos: Análise da Pesquisa Nacional de Saúde 2019, com amostra de 9.562 adultos que responderam ao primary care assessment tool (PCATool). Foi testada a associação entre avaliação positiva da APS (escore geral ≥6,6) e características individuais, sendo utilizadas as razões de prevalência (RP) calculadas por meio de regressão de Poisson. Resultados: Menos de 40% dos brasileiros avaliaram a APS com escore alto. No que se refere à associação das variáveis sociodemográficas com a avaliação elevada da APS, ajustada por sexo e idade, encontrou-se que a melhor avaliação da APS ocorreu entre mulheres [RPaj 1,10 (intervalo de confiança de 95% — IC95% 1,00–1,21)]; idosos (60 anos ou mais) [RPaj 1,27 (IC95% 1,09–1,48)]; pessoas com renda per capita de um a três salários mínimos (SM) [RPaj 1,14 (IC95% 1,03–1,27)] e ≥5 SM [RPaj 1,75 (IC95% 1,39–2,21)] quando comparadas com renda até um SM; e moradores das regiões Sul, Sudeste e Centro-Oeste em relação à Região Norte. Considerando as variáveis de comorbidades, avaliaram bem a APS indivíduos com hipertensão [RPaj 1,29 (IC95% 1,17–1,43)]; diabetes [RPaj 1,21 (IC95% 1,08–1,36)]; doença cardíaca [RPaj 1,23 (IC95% 1,07–1,41)]; distúrbio osteomuscular [RPaj 1,36 (IC95% 1,10–1,69)]; doença do pulmão [RPaj 1,48 (IC95% 1,13–1,95)] e obesidade [RPaj 1,15 (IC95% 1,03–1,28)] em comparação com pessoas eutróficas. Conclusão: Usuários que avaliaram bem a APS são mulheres, idosos, com prevalências elevadas de doenças crônicas não transmissíveis. A avaliação positiva da APS, em geral, resulta da maior utilização dos serviços de saúde.
Collapse
|
8
|
Carvalho FCD, Bernal RTI, Perillo RD, Malta DC. Association between positive assessment of Primary Health Care, sociodemographic characteristics and comorbidities in Brazil. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2022. [DOI: 10.1590/1980-549720220023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
ABSTRACT Objective: To describe positive evaluations of Primary Health Care (PHC) in Brazil from the perspective of users and their association with sociodemographic characteristics and comorbidities. Methods: Analysis of the 2019 National Health Survey, in which 9,562 adults responded to the Primary Care Assessment Tool (PCATool). The association between positive PHC assessment (overall score ≥6.6) and individual characteristics was tested using Prevalence Ratios (PR) calculated by Poisson Regression. Results: Less than 40% of Brazilians rated PHC with a high score. Regarding the association of sociodemographic variables with high PHC assessment, adjusted for sex and age, the best PHC assessments were made by women [PRaj 1.10 (95%CI 1.00–1.21)]; elderly (60 years and over) [PRaj 1.27 (95%CI 1.09–1.48); people with a per capita income of 1 to 3 minimum wages (MW) PRaj 1.14 (95%CI 1.03–1.27) and ≥5 MW PRaj 1.75 (95%CI 1.39–2.21) when comparing with income up to 1 MW; residents of the South, Southeast and Midwest regions, compared to the North Region. Considering comorbidities, individuals with hypertension PRaj1,29 (95%CI 1.17–1.43); diabetes PRaj 1.21 (95%CI 1.08–1.36); heart disease PRaj 1.23 (95%CI 1.07–1.41); musculoskeletal disorders PRaj 1.36 (95%CI 1.10–1.69); lung disease PRaj 1.48 (95%CI 1.13–1.95) and obesity PRaj 1.15 (95%CI 1.03–1.28) rated PHC better when compared to normal weight people. Conclusion: Users who evaluate PHC well are usually women, elderly, with high prevalence of chronic non-communicable diseases. A positive evaluation of PHC, in general, results from greater use of health services.
Collapse
|