1
|
Filho AMS, França GVAD, Malta DC. Tripla carga de doenças no Brasil, 1990-2021. REME Rev Min Enferm 2022. [DOI: 10.35699/2316-9389.2022.39410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023] Open
Abstract
Objetivo: descrever a evolução temporal pela tripla carga de doenças no Brasil, comparando a mortalidade do Sistema de Informação de Mortalidade (SIM) e estudo de Carga Global de Doenças (GBD). Método: estudo descritivo e exploratório sobre a evolução temporal das taxas e a distribuição proporcional de óbitos para doenças infecciosas, crônicas não transmissíveis (DCNT) e causas externas usando duas fontes de dados, 1990 a 2021. As taxas no SIM foram ajustadas pelo método direto por idade e suavizadas por média móvel. As estimativas do GBD corrigem subregistro e causas garbage. Resultados: o Brasil registrou 817.284 óbitos (1990) e 1.349.801 (2019) no SIM, corrigidos em 17,7% e 1,9% no GBD para os respectivos anos. Neste período, as taxas de mortalidade diminuíram nas duas fontes, respectivamente: DCNT -16,8% (433,7 a 360,7) e -34% (720,5 a 474,6); infeciosas -20,2% (86 para 68,6) e -57,2% (198,5 para 84,9); causas externas -17,3% (77,4 para 64) e -27% (100,9 para 73,7). O SIM mostrou redução -79,2% (138,6 para 28,8) para as taxas de causas mal definidas (CMD). Os fatores de correção do GBD foram maiores nos anos anteriores a 2005. Após 2019, as taxas de infeciosas e CMD no SIM aumentaram respectivamente 207% (68,6 para 210,7) e 30,2% (28,8 para 37,5). Conclusão: o avanço da transição epidemiológica da carga de doenças e melhoria da qualidade do dado de óbito no Brasil foram interrompidos pela COVID-19, aumentando a carga das doenças infecciosas.
Collapse
|
2
|
Gondim FSS, Campos MO, Flores TR, de França GVA, de Medeiros AC. 2019 National Health Survey: progress in monitoring the health of the Brazilian people. Epidemiol Serv Saude 2022; 31:e2021309. [PMID: 35946668 PMCID: PMC9897813 DOI: 10.1590/ss2237-9622202200001.especial] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Affiliation(s)
| | | | - Thaynã Ramos Flores
- Ministério da Saúde, Secretaria de Vigilância em Saúde, Brasília, DF, Brazil
| | | | | |
Collapse
|
3
|
Leal LF, Malta DC, Souza MDFM, Vasconcelos AMN, Teixeira RA, Veloso GA, Lansky S, Ribeiro ALP, de França GVA, Naghavi M. Maternal Mortality in Brazil, 1990 to 2019: a systematic analysis of the Global Burden of Disease Study 2019. Rev Soc Bras Med Trop 2022; 55:e0279. [PMID: 35107531 PMCID: PMC9009438 DOI: 10.1590/0037-8682-0279-2021] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 09/23/2021] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Maternal death continues to be one of the most challenging public health problems that needs to be addressed in low and middle-income countries. The objective of this study was to describe the problem of maternal death in Brazil, using estimates from the Global Burden of Disease Study (GBD). METHODS This study used data from the GBD 2019 to show the numbers of deaths and the Maternal Mortality Ratio (MMR) - number of deaths/100,000 live births - in Brazil and its 27 Federated Units (FU), for ages 10 to 54 years, from 1990 to 2019. The annual variation of the MMR was estimated in 1990, 2010, and 2019. The MMR were shown for specific causes as well as for five-year age groups. The estimates were presented with 95% uncertainty intervals (UI). RESULTS The number of maternal deaths, as well as the MMR showed a 49% reduction from 1990 to 2019. This reduction occurred heterogeneously throughout the country, and the profile of the MMR for specific causes changed between 1990 and 2019: from hypertensive gestation diseases, to indirect maternal deaths, followed by hypertensive gestation diseases. In the extreme age groups, the MMR is higher, with mortality increasing exponentially in direct proportion with age. CONCLUSIONS Maternal deaths in Brazil have decreased substantially since 1990; however, the numbers still fall short of what was established by the World Health Organization (WHO). Indirect causes are the greatest problem in more than 60% of the FU, especially for hypertensive pregnancy diseases.
Collapse
Affiliation(s)
- Lisiane Freitas Leal
- McGill University, Department of Epidemiology, Biostatistics and Occupational Health, Montreal, QC, Canada
| | - Deborah Carvalho Malta
- Universidade Federal de Minas Gerais, Escola de Enfermagem, Departamento de Enfermagem Materno-Infantil e Saúde Pública, Belo Horizonte, MG, Brasil
| | - Maria de Fatima Marinho Souza
- Ministério da Saúde, Secretaria de Vigilância em Saúde, Departamento de Análise da Situação de Saúde, Brasília, DF, Brasil
| | - Ana Maria Nogales Vasconcelos
- Universidade de Brasília - Campus Darcy Ribeiro, Departamento de Estatística, Instituto de Ciências Exatas, Brasília, DF, Brasil
| | - Renato Azeredo Teixeira
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Programa de Pós-Graduação em Saúde Pública, Belo Horizonte, MG, Brasil
| | - Guilherme Augusto Veloso
- Universidade Federal de Minas Gerais, Departamento de Estatística, Programa de Pós-graduação em Estatística, Belo Horizonte, MG, Brasil
| | - Sônia Lansky
- Secretaria Municipal de Saúde Belo Horizonte, Belo Horizonte, MG, Brasil
| | - Antonio Luiz Pinho Ribeiro
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Clínica Médica, Belo Horizonte, MG, Brasil
| | | | - Mohsen Naghavi
- Institute for Health Metrics and Evaluation, Seattle, WA, United States of America
| |
Collapse
|
4
|
Nobrega AAD, Mendes YMMBE, Miranda MJD, Santos ACCD, Lobo ADP, Porto DL, França GVAD. Mortalidade perinatal no Brasil em 2018: análise epidemiológica segundo a classificação de Wiggleworth modificada. CAD SAUDE PUBLICA 2022; 38:e00003121. [DOI: 10.1590/0102-311x00003121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 07/15/2021] [Indexed: 11/21/2022] Open
Abstract
Resumo: A mortalidade perinatal engloba a mortalidade fetal e a neonatal precoce (0 a 6 dias). Este estudo descreveu os óbitos perinatais ocorridos no Brasil em 2018, segundo a classificação de Wigglesworth modificada. As fontes de dados foram os Sistemas de Informações sobre Mortalidade e sobre Nascidos Vivos. Foram calculadas as taxas de mortalidade fetal e perinatal por mil nascimentos totais (nascidos vivos mais natimortos) e a taxa de mortalidade neonatal precoce por mil nascidos vivos, e comparadas usando seus respectivos intervalos de 95% de confiança (IC95%). Os óbitos perinatais foram classificados nos grupos de causas anteparto, anomalias congênitas, prematuridade, asfixia e causas específicas. Foi calculado, para cada grupo de causas, o número de óbitos por faixa de peso, além das taxas de mortalidade e os respectivos IC95%, e feita a distribuição espacial das taxas de mortalidade por Unidade da Federação (UF). Foram registrados 35.857 óbitos infantis, sendo 18.866 (52,6%) neonatais precoces; os natimortos somaram 27.009. Os óbitos perinatais totalizaram 45.875, perfazendo uma taxa de mortalidade de 15,5‰ nascimentos. A maior taxa de mortalidade (7,6‰; 7,5‰-7,7‰) foi observada no grupo anteparto, seguido da prematuridade (3,6‰; 3,6‰-3,7‰). No grupo anteparto, 14 das 27 UFs (sendo oito na Região Nordeste e quatro na Região Norte) apresentaram as taxas de mortalidade perinatal acima da nacional. A taxa de mortalidade perinatal no Brasil mostrou-se elevada, e a maioria dos óbitos poderia ser prevenida com investimento em cuidados pré-natais e ao nascimento.
Collapse
|
5
|
Cardoso-Dos-Santos AC, Alves RSDM, Medeiros-de-Souza AC, Bremm JM, Gomes JDA, Alves RFS, Araujo VEMD, França GVAD. National congenital anomaly registers in the world: historical and operational aspects. Epidemiol Serv Saude 2021; 30:e2021075. [PMID: 34755811 DOI: 10.1590/s1679-49742021000400015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 05/24/2021] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To identify registers of congenital anomalies with national coverage currently available around the world, highlighting their main historical and operational characteristics. METHODS This was a documentary study by means of a Medline database search (via PubMed) and searches involving reports, official documents and websites. Studies reporting at least one national registry were included. RESULTS 40 registers of national congenital anomalies were identified in 39 different countries. All registers included in the study were concentrated in upper-middle or high-income countries located in Europe. Most of the registers were population-based, compulsory notification and with a time limit for notification of up to 1 year of age. The Brazilian register showed the highest annual coverage. CONCLUSION The registers analyzed showed different characteristics, related to the reality of each country. The results presented provide support for the theme of congenital anomalies surveillance, especially in places where such activity is intended to be implemented.
Collapse
Affiliation(s)
| | | | | | - João Matheus Bremm
- Ministério da Saúde, Secretaria de Vigilância em Saúde, Brasília, DF, Brasil
| | | | | | | | | |
Collapse
|
6
|
Cardoso-Dos-Santos AC, Medeiros-de-Souza AC, Bremm JM, Alves RFS, Araújo VEMD, Leite JCL, Schuler-Faccini L, Sanseverino MTV, Karam SDM, Félix TM, Leal MB, Macário EM, Medeiros ACD, França GVAD. List of priority congenital anomalies for surveillance under the Brazilian Live Birth Information System. ACTA ACUST UNITED AC 2021; 30:e2020835. [PMID: 33886939 DOI: 10.1590/s1679-49742021000100030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 02/11/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To define the list of priority congenital anomalies for improving their recording on the Brazilian Live Birth Information System (Sinasc). METHODS Based on the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10), international protocols and meetings with specialists, the list of priority anomalies was built considering two main criteria: being diagnosable at birth and having intervention available at different levels. The list was submitted for consideration by the Brazilian Medical Genetics and Genomics Society. RESULTS The list comprised eight groups of congenital anomalies distributed according to the type of related anomaly, as well as the affected part of the body and its corresponding code in ICD-10 Chapter XVII. CONCLUSION The list of priority congenital anomalies for notification provides a basis for improving case recording on Sinasc.
Collapse
Affiliation(s)
| | | | - João Matheus Bremm
- Ministério da Saúde, Secretaria de Vigilância em Saúde, Brasília, DF, Brasil
| | | | | | | | | | | | | | - Têmis Maria Félix
- Hospital de Clínicas de Porto Alegre, Serviço de Genética Médica, Porto Alegre, RS, Brasil
| | - Mariana Bertol Leal
- Ministério da Saúde, Secretaria de Ciência, Tecnologia e Insumos Estratégicos, Brasília, DF, Brasil
| | | | | | | |
Collapse
|
7
|
Morris J, Orioli IM, Benavides-Lara A, de la Paz Barboza-Arguello M, Tapia MAC, de França GVA, Groisman B, Holguin J, Hurtado-Villa PM, Ibarra Ramirez M, Mellado C, Pardo R, Pastora Bucardo DM, Rodríguez C, Zarante I, Limb E, Dolk H. Prevalence of microcephaly: the Latin American Network of Congenital Malformations 2010-2017. BMJ Paediatr Open 2021; 5:e001235. [PMID: 34901471 PMCID: PMC8611451 DOI: 10.1136/bmjpo-2021-001235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 10/25/2021] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE The Latin American Network of Congenital Malformations: ReLAMC was established in 2017 to provide accurate congenital anomaly surveillance. This study used data from ReLAMC registries to quantify the prevalence of microcephaly from 2010 to 2017 (before, during and after the Zika virus epidemic). DESIGN Nine ReLAMC congenital anomaly registries provided case-level data or aggregate data for any live births, still births or terminations of pregnancy with microcephaly. Births to pregnant women infected with Zika virus first occurred in Brazil in 2015, and in the remaining registry areas in 2016 with the exception of Chile that did not experience Zika virus. Therefore the prevalence of microcephaly for 2010-2014 and individual years 2015, 2016 and 2017 was estimated using multilevel random effect Poisson models. Clinical classification and characteristics of the cases were compared pre and post Zika for all centres providing individual case-level data. RESULTS The prevalence of microcephaly for all registries excluding Brazil was 2.3 per 10 000 (95% CI 2.0 to 2.6) for 2010-2014 rising to 5.4 (95% CI 4.8 to 6.0) in 2016 and 5.9 (95% CI 5.3 to 6.6) in 2017. Brazil had a prevalence of 0.6 per 10 000 (95% CI 0.5 to 0.6) in 2010-2014, rising to 5.8 (95% CI 5.6 to 6.1) in 2015, 8.0 (95% CI 7.6 to 8.3) in 2016 and then falling in 2017. Only 29 out of 687 cases of microcephaly were reported as congenital Zika syndrome in countries excluding Brazil. CONCLUSIONS The prevalence of microcephaly was influenced both by Zika causing congenital Zika syndrome and by increased reporting awareness.
Collapse
Affiliation(s)
- Joan Morris
- Population Health Research Institute, St George's University of London, London, UK
| | - Ieda M Orioli
- ReLAMC (Latin American Network of Congenital Malformations) at Department of Genetics, Institute of Biology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.,ECLAMC (Latin American Collaborative Study of Congenital Malformations), Instituto Nacional de Genética Médica Populacional INAGEMP, Porto Alegre, Brazil
| | - Adriana Benavides-Lara
- Centro de Registro de Enfermedades Congénitas (CREC), Unidad de Enfermedades Congénitas, Instituto Costarricense de Investigación y Enseñanza en Nutrición y Salud-INCIENSA, Cartago, Costa Rica
| | - María de la Paz Barboza-Arguello
- Centro de Registro de Enfermedades Congénitas (CREC), Unidad de Enfermedades Congénitas, Instituto Costarricense de Investigación y Enseñanza en Nutrición y Salud-INCIENSA, Cartago, Costa Rica
| | | | | | - Boris Groisman
- National Network of Congenital Anomalies of Argentina (RENAC), National Center of Medical Genetics (CNGM), National Administration of Laboratories and Health Institutes (ANLIS), National Ministry of Health, Buenos Aires, Argentina
| | - Jorge Holguin
- Secretaria de Salud Publica Municipal de Cali, Cali, Colombia
| | | | - Marisol Ibarra Ramirez
- Departamento de Genética, Universidad Autónoma de Nuevo León Facultad de Medicina, Monterrey, Nuevo León, Mexico
| | - Cecilia Mellado
- Genetics Unit, Division of Pediatrics, Pontificia Universidad Católica de Chile, Santiago, Chile.,Genetics Section, Department of Medicine, Servicio de Salud Metropolitano Sur Oriente, Santiago, Chile
| | - Rosa Pardo
- Genetics Section, Department of Medicine, Hospital Clinico Universidad de Chile, Santiago, Chile.,Complejo Asistencial Dr. Sótero del Río, Servicio de Salud Metropolitano Sur Oriente, Santiago, Chile
| | | | | | - Ignacio Zarante
- Instituto de Genetica Humana, Pontificia Universidad Javeriana Bogota, Bogota, Colombia
| | - Elizabeth Limb
- Population Health Research Institute, St George's University of London, London, UK
| | - Helen Dolk
- Maternal Fetal and Infant Research Centre, Institute of Nursing and Health Research, Ulster University, Newtownabbey, Northern Ireland, UK
| |
Collapse
|
8
|
Orioli IM, Dolk H, Lopez-Camelo J, Groisman B, Benavides-Lara A, Gimenez LG, Correa DM, Ascurra M, de Aquino Bonilha E, Canessa-Tapia MA, de França GVA, Hurtado-Villa P, Ibarra-Ramírez M, Pardo R, Pastora DM, Zarante I, Soares FS, de Carvalho FM, Piola M. The Latin American network for congenital malformation surveillance: ReLAMC. Am J Med Genet C Semin Med Genet 2020; 184:1078-1091. [PMID: 33319501 DOI: 10.1002/ajmg.c.31872] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/25/2020] [Accepted: 12/02/2020] [Indexed: 12/14/2022]
Abstract
The early detection of congenital anomaly epidemics occurs when comparing current with previous frequencies in the same population. The success of epidemiologic surveillance depends on numerous factors, including the accuracy of the rates available in the base period, wide population coverage, and short periodicity of analysis. This study aims to describe the Latin American network of congenital malformation surveillance: ReLAMC, created to increase epidemiologic surveillance in Latin America. We describe the main steps, tasks, strategies used, and preliminary results. From 2017 to 2019, five national registries (Argentina [RENAC], Brazil [SINASC/SIM-BRS], Chile [RENACH], Costa Rica [CREC], Paraguay [RENADECOPY-PNPDC]), six regional registries (Bogotá [PVSDC-Bogota], Cali [PVSDC-Cali], Maule [RRMC SSM], Nicaragua [SVDC], Nuevo-León [ReDeCon HU], São Paulo [SINASC/SIM-MSP]) and the ECLAMC hospital network sent data to ReLAMC on a total population of 9,152,674 births, with a total of 101,749 malformed newborns (1.1%; 95% CI 1.10-1.12). Of the 9,000,651 births in countries covering both live and stillbirths, 88,881 were stillborn (0.99%; 95% CI 0.98-0.99), and among stillborns, 6,755 were malformed (7.61%; 95% CI 7.44-7.79). The microcephaly rate was 2.45 per 10,000 births (95% CI 2.35-2.55), hydrocephaly 3.03 (2.92-3.14), spina bifida 2.89 (2.78-3.00), congenital heart defects 15.53 (15.27-15.79), cleft lip 2.02 (1.93-2.11), cleft palate and lip 2.77 (2.66-2.88), talipes 2.56 (2.46-2.67), conjoined twins 0.16 (0.14-0.19), and Down syndrome 5.33 (5.18-5.48). Each congenital anomaly showed heterogeneity in prevalence rates among registries. The harmonization of data in relation to operational differences between registries is the next step in developing the common ReLAMC database.
Collapse
Affiliation(s)
- Iêda Maria Orioli
- ReLAMC (Latin American Network of Congenital Malformation Surveillance) at Department of Genetics, Institute of Biology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.,Instituto Nacional de Genética Médica Populacional INAGEMP, Porto Alegre, Brazil
| | - Helen Dolk
- Maternal Fetal and Infant Research Centre, Institute of Nursing and Health Research, Ulster University, Newtownabbey, Northern Ireland, United Kingdom
| | - Jorge Lopez-Camelo
- Latin American Collaborative Study of Congenital Malformations (ECLAMC) at Center for Medical Education and Clinical Research (CEMIC-CONICET), Buenos Aires, Argentina
| | - Boris Groisman
- National Network of Congenital Anomalies of Argentina (RENAC), National Center of Medical Genetics (CNGM), National Administration of Laboratories and Health Institutes (ANLIS), National Ministry of Health, Buenos Aires, Argentina
| | - Adriana Benavides-Lara
- Centro de Registro de Enfermedades Congénitas (CREC), Unidad de Enfermedades Congénitas, Instituto Costarricense de Investigación y Enseñanza en Nutrición y Salud-INCIENSA, Cartago, Costa Rica
| | - Lucas Gabriel Gimenez
- Latin American Collaborative Study of Congenital Malformations (ECLAMC) at Center for Medical Education and Clinical Research (CEMIC-CONICET), Buenos Aires, Argentina
| | - Daniel Mattos Correa
- ReLAMC (Latin American Network of Congenital Malformation Surveillance) at Department of Genetics, Institute of Biology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marta Ascurra
- Registro Nacional de Defectos Congénitos Paraguay, Programa Nacional de Prevención de Defectos Congénitos (RENADECOPY-PNPDC), Ministerio de Salud Pública y Bienestar Social, Assuncion, Paraguay
| | - Eliana de Aquino Bonilha
- Secretaria Municipal da Saúde de São Paulo, Coordenação de Epidemiologia e Informação, Gerência do SINASC, São Paulo, Brazil
| | | | | | - Paula Hurtado-Villa
- Facultad de Ciencias de la Salud, Pontificia Universidad Javeriana Cali, Cali, Colombia
| | - Marisol Ibarra-Ramírez
- Departamento de Genética, Facultad de Medicina y Hospital Universitario José E. González, Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Rosa Pardo
- Unidad de Neonatologia, Sección de Genética, Hospital Clínico Universidad de Chile, Unidad de Genética y Enfermedades Metabólicas, Complejo Asistencial Dr. Sótero del Río: Registro Nacional de Anomalías Congénitas de Chile RENACH, Santiago, Chile
| | | | - Ignacio Zarante
- Instituto de Genética Humana, Pontificia Universidad Javeriana Bogotá, Bogotá, Colombia
| | - Flávia Schneider Soares
- ReLAMC (Latin American Network of Congenital Malformation Surveillance) at Department of Genetics, Institute of Biology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Flávia Martinez de Carvalho
- Laboratory of Congenital Malformations Epidemiology (LEMC), Instituto Oswaldo Cruz (IOC), Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mariana Piola
- Latin American Collaborative Study of Congenital Malformations (ECLAMC) at Center for Medical Education and Clinical Research (CEMIC-CONICET), Buenos Aires, Argentina
| | | |
Collapse
|
9
|
Duarte MMS, Haslett MIC, Freitas LJAD, Gomes NTN, Silva DCCD, Percio J, Wada MY, Fantinato FFST, Almeida WAFD, Silva DAD, Gava C, França GVAD, Macário EM, Baêta KF, Malta JMAS, Alves AJSE. Description of COVID-19 hospitalized health worker cases in the first nine weeks of the pandemic, Brazil, 2020. Epidemiol Serv Saude 2020; 29:e2020277. [PMID: 32997079 DOI: 10.1590/s1679-49742020000500011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 08/08/2020] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE To describe COVID-19 hospitalized health worker cases in Brazil. METHODS This was a descriptive case series study; it included cases that became ill between February 21st and April 15th, 2020 registered on the Influenza Surveillance Information System (SIVEP-Gripe, acronym in Portuguese). RESULTS Of the 184 cases, 110 (59.8%) were female and median age was 44 years (min-max: 23-85); 89 (48.4%) were nursing professionals and 50 (27.2%) were doctors. Ninety-two (50.0%) presented comorbidity, with heart disease predominating (n=37; 40.2%). Of the 112 professionals with a record of case progression, 85 (75.9%) were cured and 27 (24.1%) died, 18 of whom were male. CONCLUSION The profile of COVID-19 hospitalized health workers is similar to that of the general population with regard to age and comorbidities, but different in relation to sex. The most affected areas were nursing and medicine.
Collapse
Affiliation(s)
| | | | | | | | | | - Jadher Percio
- Ministério da Saúde, Secretaria de Vigilância em Saúde, Brasília, DF, Brasil
| | | | | | | | | | - Caroline Gava
- Ministério da Saúde, Secretaria de Vigilância em Saúde, Brasília, DF, Brasil
| | | | | | - Karla Freire Baêta
- Ministério da Saúde, Secretaria de Vigilância em Saúde, Brasília, DF, Brasil
| | | | | |
Collapse
|
10
|
Cavalcante JR, Cardoso-Dos-Santos AC, Bremm JM, Lobo ADP, Macário EM, Oliveira WKD, França GVAD. COVID-19 in Brazil: evolution of the epidemic up until epidemiological week 20 of 2020. Epidemiol Serv Saude 2020; 29:e2020376. [PMID: 32785434 DOI: 10.5123/s1679-49742020000400010] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 07/01/2020] [Indexed: 11/02/2022] Open
Abstract
Objective to describe the evolution of COVID-19 in Brazil up until epidemiological week 20 of 2020. Methods this is an ecological study based on data and official documents from the Brazilian Ministry of Health and international organizations; comparisons were made between Brazil and other countries and incidence and mortality rates were calculated. Results by the end of epidemiological week 20, 233,142 cases, and 15,633 deaths had been confirmed for Brazil as a whole and 3,240 (58.2%) of the country's municipalities had reported at least one case; Brazil was at an earlier phase of the pandemic when compared to other countries, except Russia and Turkey, regarding cumulative cases, and except Canada regarding cumulative deaths; the highest rates were found in Brazil's Northern Region states, where Amazonas state had the highest incidence rates(4,474.6/1,000,000) and mortality rates (331.8/1,000,000). Conclusion Brazil is one of the countries with the highest number of confirmed cases and deaths, with marked regional differences.
Collapse
Affiliation(s)
- João Roberto Cavalcante
- Instituto Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | | | - João Matheus Bremm
- Secretaria de Vigilância em Saúde, Ministério da Saúde, Brasília, DF, Brasil
| | | | | | | | | |
Collapse
|
11
|
Cardoso-dos-Santos AC, Magalhães VS, Medeiros-de-Souza AC, Bremm JM, Alves RFS, Araujo VEMD, Macario EM, Oliveira WKD, França GVAD. Redes internacionais de colaboração para a vigilância das anomalias congênitas: uma revisão narrativa. Epidemiologia e Serviços de Saúde 2020; 29:e2020093. [DOI: 10.5123/s1679-49742020000400003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 05/12/2020] [Indexed: 11/02/2022] Open
|
12
|
Elidio GA, França GVAD, Pacheco FC, Ferreira MM, Pinheiro JDS, Campos EN, Cláudio de Albuquerque B, Pinto RC, Santos da Silva ADC, Leal E Leite P, do Carmo GMI, Luiz de Abreu A, Carrero CPV, Rocha de Abreu M, Rosa FM, de Oliveira CM, Guilhem DB. Measles outbreak: preliminary report on a case series of the first 8,070 suspected cases, Manaus, Amazonas state, Brazil, February to November 2018. ACTA ACUST UNITED AC 2020; 24. [PMID: 30646975 PMCID: PMC6337055 DOI: 10.2807/1560-7917.es.2019.24.2.1800663] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We report an ongoing measles outbreak in Manaus, Amazonas state, Brazil. As at 3 November 2018, 1,631 cases were confirmed corresponding to an incidence of 75.3 per 100,000 inhabitants; all five sanitary districts presented confirmed cases. Reintroduction of measles virus in Manaus is likely related to the current outbreak in Venezuela and due to recent decline in measles vaccine coverage. Given the current scenario, prevention and control measures should target individuals aged 15–29 years.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Cesar M de Oliveira
- Department of Epidemiology & Public Health, University College London, London, UK
| | - Dirce Bellezi Guilhem
- Post-Graduation Program in Health Sciences, University of Brasília, Brasília, Brazil
| |
Collapse
|
13
|
Lobo ADP, Cardoso-Dos-Santos AC, Rocha MS, Pinheiro RS, Bremm JM, Macário EM, Oliveira WKD, França GVAD. COVID-19 epidemic in Brazil: Where are we at? Int J Infect Dis 2020; 97:382-385. [PMID: 32561425 PMCID: PMC7297148 DOI: 10.1016/j.ijid.2020.06.044] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 06/10/2020] [Accepted: 06/12/2020] [Indexed: 10/26/2022] Open
Abstract
OBJETIVE To analyze the trends of COVID-19 in Brazil in 2020 by Federal Units (FU). METHOD Ecological time-series based on cumulative confirmed cases of COVID-19 from March 11 to May 12. Joinpoint regression models were applied to identify points of inflection in COVID-19 trends, considering the days since the 50th confirmed case as time unit. RESULTS Brazil reached its 50th confirmed case of COVID-19 in 11 March 2020 and, 63 days after that, on May 12, 177,589 cases had been confirmed. The trends for all regions and FU are upward. In the last segment, from the 31st to the 63rd day, Brazil presented a daily percentage change (DPC) of 7.3% (95%CI= 7.2;7.5). For the country the average daily percentage change (ADPC) was 14.2% (95%CI: 13.8;14.5). The highest ADPC values were found in the North, Northeast and Southeast regions. CONCLUSIONS In summary, our results show that all FUs in Brazil present upward trends of COVID-19. In some FUs, the slowdown in DPC in the last segment must be considered with caution. Each FU is at a different stage of the pandemic and, therefore, non-pharmacological measures should be adopted accordingly.
Collapse
Affiliation(s)
- Andréa de Paula Lobo
- Collective Health Program, Faculty of Health Science, University of Brasília, Brasília-DF, Brazil.
| | | | - Marli Souza Rocha
- Secretariat of Health Surveillance, Ministry of Health, Brasília-DF, Brazil
| | - Rejane Sobrino Pinheiro
- Institute of Public Health Studies, Health Science Center, Federal University of Rio de Janeiro, Rio de Janeiro-RJ, Brazil
| | - João Matheus Bremm
- Secretariat of Health Surveillance, Ministry of Health, Brasília-DF, Brazil
| | | | | | | |
Collapse
|
14
|
Gallo LG, Martinez-Cajas J, Peixoto HM, Pereira ACEDS, Carter JE, McKeown S, Schaub B, Ventura CV, de França GVA, Pomar L, Ventura LO, Nerurkar VR, de Araújo WN, Velez MP. Another piece of the Zika puzzle: assessing the associated factors to microcephaly in a systematic review and meta-analysis. BMC Public Health 2020; 20:827. [PMID: 32487247 PMCID: PMC7266116 DOI: 10.1186/s12889-020-08946-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 05/18/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Although it is known that Zika virus (ZIKV) infection during pregnancy may lead to microcephaly in the fetus, the prognostic factors associated with this tragic disorder remain unclear. We conducted a systematic review and meta-analysis to assess the prognostic factors associated with the incidence of microcephaly in congenital ZIKV infection. METHODS We conducted a comprehensive search in Ovid MEDLINE, Ovid MEDLINE (R) Epub ahead of print, Embase, Embase Classic, Web of Science, CINAHL, Cochrane CENTRAL, LILACS, and various thesis databases to identify human studies reporting microcephaly associated with congenital ZIKV infection. We requested primary data from the authors of the included studies to calculate summary estimates and conduct the meta-analysis of the most prevalent factors. RESULTS We screened 4106 titles and abstracts, and identified 12 studies for inclusion in the systematic review. The assessment of ZIKV infection and the definition of microcephaly varied among studies. A total of 6154 newborns/fetuses were enrolled; of those, 1120 (18.20%) had a diagnostic of ZIKV infection, of which 509 (45.45%) were diagnosed with microcephaly. Nine studies addressed the link between congenital ZIKV infection and neurological findings in newborns/fetuses. Half of the studies provided primary data. Three out of 11 factors of interest seem to be prognostic factors of microcephaly: infant's sex - males compared to females: Relative Risk (RR) 1.30, 95% Confidence Interval (95% CI) 1.14 to 1.49; the stage of pregnancy when infection occurred - infection in the first trimester of pregnancy compared to infection at other stages of pregnancy: RR 1.41, 95% CI 1.09 to 1.82; and asymptomatic infection compared to symptomatic infection during pregnancy: RR 0.68; 95% CI 0.60 to 0.77. CONCLUSION Our findings support the female-biased resistance hypothesis and reinforce the risk associated with the stage of pregnancy when ZIKV infection occurs. Continued surveillance of ZIKV infection during pregnancy is needed to identify additional factors that could contribute to developing microcephaly in affected fetuses. PROTOCOL REGISTRATION This systematic review was registered with the International Prospective Register of Systematic Reviews (PROSPERO), registration no. CRD 42018088075.
Collapse
Affiliation(s)
- Luciana Guerra Gallo
- Postgraduate Program in Tropical Medicine, University of Brasilia, Brasilia, Brazil
- Department of Obstetrics and Gynecology and Department of Public Health Sciences, Queen's University, Kingston, Canada
| | | | - Henry Maia Peixoto
- Postgraduate Program in Tropical Medicine, University of Brasilia, Brasilia, Brazil
| | | | - Jillian E Carter
- Department of Obstetrics and Gynecology and Department of Public Health Sciences, Queen's University, Kingston, Canada
| | - Sandra McKeown
- Bracken Health Sciences Library, Queen's University, Kingston, Canada
| | - Bruno Schaub
- Centre Pluridisciplinaire de Diagnostic Prénatal de le Martinique, Maison de la Femme, de la Mère et de l'Enfant, University Hospital of Martinique, Fort-de-France, Martinique
| | - Camila V Ventura
- Department of Scientific Investigation, Altino Ventura Foundation, Recife, Brazil
| | | | - Léo Pomar
- Materno-fetal and Obstetrics Research Unit, Département "Femme-Mère Enfant", University Hospital, Lausanne, Switzerland
- Department of Obstetrics and Gynaecology, Centre Hospitalier de l'Ouest Guyanais Franck Joly, Saint-Laurent-du-Maroni, French Guiana
| | - Liana O Ventura
- Department of Pediatric Ophthalmology and Strabismus, Altino Ventura Foundation, Recife, Brazil
| | - Vivek R Nerurkar
- Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, USA
| | | | - Maria P Velez
- Department of Obstetrics and Gynecology and Department of Public Health Sciences, Queen's University, Kingston, Canada.
| |
Collapse
|
15
|
Abstract
This article presents the strategies and actions adopted by the Brazilian Ministry of Health to hold back COVID-19. The response to the disease was immediate and occurred prior to the first case being detected in Brazil. Provision of information and communication to the population and the press was adopted as a fundamental strategy for addressing the epidemic. Guidance provided to the population has been clear, stressing the importance of coronavirus transmission prevention measures. Efforts have been directed towards strengthening health surveillance and health care, as well as boosting research, development and innovation. Actions have targeted human resource training and expanding coverage afforded by the Brazilian National Health System (SUS). Protecting health workers is a priority. All SUS health workers, managers and directors are dedicated to preserving the health and life of each and every Brazilian citizen.
Collapse
Affiliation(s)
| | - Elisete Duarte
- Secretaria de Vigilância em Saúde, Ministério da Saúde, Brasília, DF, Brasil
| | | | - Leila Posenato Garcia
- Diretoria de Estudos e Políticas Sociais, Instituto de Pesquisa Econômica Aplicada, Brasília, DF, Brasil
| |
Collapse
|
16
|
Bremm JM, Cardoso-dos-Santos AC, Magalhães VS, Medeiros-de-Souza AC, Alves RFS, Araujo VEMD, Macario EM, Oliveira WKD, Schüler-Faccini L, Sanseverino MTV, França GVAD. Anomalias congênitas na perspectiva da vigilância em saúde: compilação de uma lista com base na CID-10. Epidemiol Serv Saúde 2020; 29:e2020164. [DOI: 10.1590/s1679-49742020000500015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 07/14/2020] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivo: Propor uma lista de anomalias congênitas com códigos correspondentes na Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde – 10ᵃ Revisão (CID-10), visando a aplicação no âmbito da vigilância em saúde. Métodos: Em dezembro de 2019, realizou-se busca nas seguintes fontes de dados: CID-10; CID-11; anomalias monitoradas por três modelos de vigilância; base de informações sobre doenças raras (Orphanet). Realizou-se extração das anomalias a partir dessas fontes, processamento para correspondência com base na CID-10 e compilação mediante revisão manual. Resultados: Foram identificados 898 códigos, dos quais 619 (68,9%) constavam no capítulo XVII da CID-10. Dos 279 códigos de outros capítulos, 19 foram exclusivos da busca na CID-11, 72 dos modelos de vigilância, 79 da Orphanet e 36 da busca de termos na CID-10. Conclusão: Os códigos que constam do capítulo XVII da CID-10 não captam a totalidade das anomalias congênitas, indicando a necessidade de adoção de uma lista ampliada.
Collapse
|
17
|
Silva JHD, Terças ACP, Pinheiro LCB, França GVAD, Atanaka M, Schüler-Faccini L. Profile of congenital anomalies among live births in the municipality of Tangará da Serra, Mato Grosso, Brazil, 2006-2016. Epidemiol Serv Saude 2018; 27:e2018008. [PMID: 30365695 DOI: 10.5123/s1679-49742018000300017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 05/04/2018] [Indexed: 11/02/2022] Open
Abstract
OBJECTIVE to describe congenital anomalies (CA) among live births of mothers resident in Tangará da Serra, MT, Brazil, during the period 2006-2016. METHODS this was a descriptive study, using Brazilian Live Birth Information System (SINASC) data. RESULTS out of 15,689 births, 77 were registered with CA (prevalence of 4.9/1,000); there was an 80.7% increase of recorded CA in 2016, accounting for 10.3/1,000 live births, including five cases of microcephaly; CA prevalence was higher among children born to women aged over 35 years (prevalence ratio [PR] =1.91; confidence interval [95%CI] 1.01;3.60), preterm (PR=2.22; 95%CI 1.26;3.92) and low birth weight infants (PR=3.21; 95%CI 1.86;5.54). CONCLUSION low CA prevalence was found, possibly related to under-recording at birth; the increase observed in 2016 may be related to the Zika epidemic causing microcephaly, as well as greater attention by health professionals in relation to CA during this public health emergency.
Collapse
Affiliation(s)
- Juliana Herrero da Silva
- Prefeitura Municipal de Tangará da Serra, Secretaria Municipal de Saúde, Tangará da Serra, MT, Brasil
| | - Ana Cláudia Pereira Terças
- Universidade do Estado de Mato Grosso, Faculdade de Ciências Biológicas, Agrárias e da Saúde, Tangará da Serra, MT, Brasil
| | | | | | - Marina Atanaka
- Universidade Federal de Mato Grosso, Departamento de Saúde Coletiva, Cuiabá, MT, Brasil
| | - Lavínia Schüler-Faccini
- Universidade Federal do Rio Grande do Sul, Departamento de Genética, Porto Alegre, RS, Brasil
| |
Collapse
|
18
|
Eder M, Cortes F, Teixeira de Siqueira Filha N, Araújo de França GV, Degroote S, Braga C, Ridde V, Turchi Martelli CM. Scoping review on vector-borne diseases in urban areas: transmission dynamics, vectorial capacity and co-infection. Infect Dis Poverty 2018; 7:90. [PMID: 30173661 PMCID: PMC6120094 DOI: 10.1186/s40249-018-0475-7] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 08/02/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Transmission dynamics, vectorial capacity, and co-infections have substantial impacts on vector-borne diseases (VBDs) affecting urban and suburban populations. Reviewing key factors can provide insight into priority research areas and offer suggestions for potential interventions. MAIN BODY Through a scoping review, we identify knowledge gaps on transmission dynamics, vectorial capacity, and co-infections regarding VBDs in urban areas. Peer-reviewed and grey literature published between 2000 and 2016 was searched. We screened abstracts and full texts to select studies. Using an extraction grid, we retrieved general data, results, lessons learned and recommendations, future research avenues, and practice implications. We classified studies by VBD and country/continent and identified relevant knowledge gaps. Of 773 articles selected for full-text screening, 50 were included in the review: 23 based on research in the Americas, 15 in Asia, 10 in Africa, and one each in Europe and Australia. The largest body of evidence concerning VBD epidemiology in urban areas concerned dengue and malaria. Other arboviruses covered included chikungunya and West Nile virus, other parasitic diseases such as leishmaniasis and trypanosomiasis, and bacterial rickettsiosis and plague. Most articles retrieved in our review combined transmission dynamics and vectorial capacity; only two combined transmission dynamics and co-infection. The review identified significant knowledge gaps on the role of asymptomatic individuals, the effects of co-infection and other host factors, and the impacts of climatic, environmental, and socioeconomic factors on VBD transmission in urban areas. Limitations included the trade-off from narrowing the search strategy (missing out on classical modelling studies), a lack of studies on co-infections, most studies being only descriptive, and few offering concrete public health recommendations. More research is needed on transmission risk in homes and workplaces, given increasingly dynamic and mobile populations. The lack of studies on co-infection hampers monitoring of infections transmitted by the same vector. CONCLUSIONS Strengthening VBD surveillance and control, particularly in asymptomatic cases and mobile populations, as well as using early warning tools to predict increasing transmission, were key strategies identified for public health policy and practice.
Collapse
Affiliation(s)
- Marcus Eder
- Public Health England Sierra Leone Country Office, Freetown, Sierra Leone
- Aggeu Magalhaes Institute (IAM) / Oswaldo Cruz Foundation (Fiocruz), Avenida Professor Moraes Rego, s/n. Cidade Universitaria. CEP 50, Recife, Pernambuco 740-465 Brazil
| | - Fanny Cortes
- Universidade de Pernambuco (UPE), Recife, Pernambuco Brazil
| | | | | | - Stéphanie Degroote
- University of Montreal School of Public Health (ESPUM), Montreal, Quebec Canada
| | - Cynthia Braga
- Aggeu Magalhaes Institute (IAM) / Oswaldo Cruz Foundation (Fiocruz), Avenida Professor Moraes Rego, s/n. Cidade Universitaria. CEP 50, Recife, Pernambuco 740-465 Brazil
| | - Valéry Ridde
- University of Montreal School of Public Health (ESPUM), Montreal, Quebec Canada
- IRD (French Institute For Research on Sustainable Development), CEPED (IRD-Université Paris Descartes), Universités Paris Sorbonne Cités, ERL INSERM SAGESUD, Paris, France
| | - Celina Maria Turchi Martelli
- Aggeu Magalhaes Institute (IAM) / Oswaldo Cruz Foundation (Fiocruz), Avenida Professor Moraes Rego, s/n. Cidade Universitaria. CEP 50, Recife, Pernambuco 740-465 Brazil
| |
Collapse
|
19
|
França GVAD, Pedi VD, Garcia MHDO, Carmo GMID, Leal MB, Garcia LP. Congenital syndrome associated with Zika virus infection among live births in Brazil: a description of the distribution of reported and confirmed cases in 2015-2016. Epidemiol Serv Saude 2018; 27:e2017473. [PMID: 29972474 DOI: 10.5123/s1679-49742018000200014] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 02/17/2018] [Indexed: 11/02/2022] Open
Abstract
OBJECTIVE to describe the temporal and spatial distribution of reported and confirmed cases of congenital Zika virus syndrome (CZS) in live births in Brazil during 2015-2016. METHODS we conducted a descriptive study with data from the Public Health Events Registry, including cases born in 2015 or 2016, and registered between epidemiological week 45/2015 and 2/2017. RESULTS we analyzed 9.953 reported cases, of which 2.018 (20.3%) were confirmed and 2.819 (28.3%) were still under investigation at the epidemiological week 2/2017; 404 (4.1%) out of the 9.953 cases had laboratory confirmation for Zika virus; the prevalence of confirmed cases of CZS was 3.8/10 thousand livebirths in 2015 and 3.1/10 thousand live births in 2016. CONCLUSION one fifth of the cases reported in 2015-16 were confirmed the CZS, reinforcing their relevance as a public health problem; efforts aimed at the diagnostic confirmation of the syndrome should be prioritized.
Collapse
Affiliation(s)
| | | | | | | | | | - Leila Posenato Garcia
- Instituto de Pesquisa Econômica Aplicada, Diretoria de Estudos e Políticas Sociais, Brasília, DF, Brasil
| |
Collapse
|
20
|
Silva VLSD, França GVAD, Munhoz TN, Santos IS, Barros AJD, Barros FC, Matijasevich A. Hospitalization in the first years of life and development of psychiatric disorders at age 6 and 11: a birth cohort study in Brazil. CAD SAUDE PUBLICA 2018; 34:e00064517. [PMID: 29846398 DOI: 10.1590/0102-311x00064517] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Accepted: 10/02/2017] [Indexed: 11/21/2022] Open
Abstract
This study aimed to evaluate the medium-term effects that hospitalization in the first 48 months of life has on the development of psychiatric disorders at 6 and 11 years of age among individuals in a birth cohort in a middle-income country. We analyzed data from a 2004 birth cohort (N = 4,231) in the city of Pelotas, Rio Grande do Sul State, Brazil. The frequency of hospitalization was investigated at 12, 24 and 48 months of life. When the children were 6 and 11 years old, psychiatric disorders were investigated with the Development and Well-Being Assessment. We used logistic regression to adjust for potential confounders. The overall frequency of hospitalization during the first 48 months of life was 33.1% (95%CI: 31.4; 34.7). Among the hospitalized children 25.6% (95%CI: 24.1; 27.1), 4.7% (95%CI: 4.0; 5.5) and 2.8% (95%CI: 2.3; 3.5) were hospitalized 1, 2 or ≥ 3 times during this period, respectively. After adjustment for potential confounders, the chance of presenting any psychiatric disorder at 6 and 11 years of age was higher for the children who had been hospitalized during the first 48 months of life than for those who had not, with OR of 1.50 (95%CI: 1.19; 1.88) and 1.63 (95%CI: 1.28; 2.07), respectively. Our results support the hypothesis that hospitalization in the early stages of life has an effect on the subsequent mental health of children. Preventive measures are needed in order to minimize the negative experiences of children who are hospitalized during infancy.
Collapse
Affiliation(s)
| | | | - Tyago N Munhoz
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Iná S Santos
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Aluísio J D Barros
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Fernando C Barros
- Programa de Pós-graduação em Saúde e Comportamento, Universidade Católica de Pelotas, Pelotas, Brazil
| | | |
Collapse
|
21
|
De Lucia Rolfe E, de França GVA, Vianna CA, Gigante DP, Miranda JJ, Yudkin JS, Horta BL, Ong KK. Associations of stunting in early childhood with cardiometabolic risk factors in adulthood. PLoS One 2018; 13:e0192196. [PMID: 29641597 PMCID: PMC5894958 DOI: 10.1371/journal.pone.0192196] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 01/19/2018] [Indexed: 12/13/2022] Open
Abstract
Early life stunting may have long-term effects on body composition, resulting in obesity-related comorbidities. We tested the hypothesis that individuals stunted in early childhood may be at higher cardiometabolic risk later in adulthood. 1753 men and 1781 women participating in the 1982 Pelotas (Brazil) birth cohort study had measurements of anthropometry, body composition, lipids, glucose, blood pressure, and other cardiometabolic traits at age 30 years. Early stunting was defined as height-for-age Z-score at age 2 years below -2 against the World Health Organization growth standards. Linear regression models were performed controlling for sex, maternal race/ethnicity, family income at birth, and birthweight. Analyses were stratified by sex when p-interaction<0.05. Stunted individuals were shorter (β = -0.71 s.d.; 95% CI: -0.78 to -0.64), had lower BMI (β = -0.14 s.d.; 95%CI: -0.25 to -0.03), fat mass (β = -0.28 s.d.; 95%CI: -0.38 to -0.17), SAFT (β = -0.16 s.d.; 95%CI: -0.26 to -0.06), systolic (β = -0.12 s.d.; 95%CI: -0.21 to -0.02) and diastolic blood pressure (β = -0.11 s.d.; 95%CI: -0.22 to -0.01), and higher VFT/SAFT ratio (β = 0.15 s.d.; 95%CI: 0.06 to 0.24), in comparison with non-stunted individuals. In addition, early stunting was associated with lower fat free mass in both men (β = -0.39 s.d.; 95%CI: -0.47 to -0.31) and women (β = -0.37 s.d.; 95%CI: -0.46 to -0.29) after adjustment for potential confounders. Our results suggest that early stunting has implications on attained height, body composition and blood pressure. The apparent tendency of stunted individuals to accumulate less fat-free mass and subcutaneous fat might predispose them towards increased metabolic risks in later life.
Collapse
Affiliation(s)
- Emanuella De Lucia Rolfe
- Medical Research Council Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, United Kingdom
- * E-mail:
| | | | - Carolina Avila Vianna
- Post-graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Denise P. Gigante
- Post-graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - J. Jaime Miranda
- Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | - Bernardo Lessa Horta
- Post-graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Ken K. Ong
- Medical Research Council Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, United Kingdom
| |
Collapse
|
22
|
de Oliveira PD, Wehrmeister FC, Horta BL, Pérez-Padilla R, de França GVA, Gigante DP, Barros FC, Ong KK, De Lucia Rolfe E, Menezes AMB. Visceral and subcutaneous abdominal adiposity and pulmonary function in 30-year-old adults: a cross-sectional analysis nested in a birth cohort. BMC Pulm Med 2017; 17:157. [PMID: 29179743 PMCID: PMC5704528 DOI: 10.1186/s12890-017-0510-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 11/17/2017] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Several studies have verified body fat distribution in association with pulmonary function (PF), mainly waist circumference, but few have used measures able to distinguish abdominal fat compartments. The present study aims to verify the association of visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) with PF measures. METHODS In 1982, all hospital births occurring in Pelotas, Brazil, were identified and those livebirths have been followed. In 2012-13, the cohort participants were evaluated and VAT and SAT measured using ultrasound; forced expiratory volume in the first second (FEV1) or forced vital capacity (FVC) were patronized in z-scores stratified by sex. The associations were verified using crude and adjusted linear regressions. RESULTS The present analyses comprised 3438 individuals (1721 women). VAT was inversely associated with spirometric parameters, in both crude and adjusted models. SAT showed inverse associations in the crude analyzes in males and a positive trend after adjustment, except for SAT and FVC in males. To each centimeter of VAT, mean adjusted FEV1 z-scores decreased 0.072 (95% CI -0.107; -0.036) in men and 0.127 (95% CI -0.164; -0.090) in women, and FVC z-scores decreased -0.075 (95% CI -0.111; -0.039) and 0.121 (95% CI -0.158; -0.083), in men and women, respectively. CONCLUSIONS VAT has a consistent inverse association with FEV1 and FVC in both sexes. On the other hand, SAT showed inconsistent results with PF parameters.
Collapse
Affiliation(s)
- Paula Duarte de Oliveira
- Federal University of Pelotas - Postgraduate Program in Epidemiology, Rua Marechal Deodoro, 1160, 3° andar, Pelotas, RS, Zip code: 96020-220, Brazil.
| | - Fernando César Wehrmeister
- Federal University of Pelotas - Postgraduate Program in Epidemiology, Rua Marechal Deodoro, 1160, 3° andar, Pelotas, RS, Zip code: 96020-220, Brazil
| | - Bernardo Lessa Horta
- Federal University of Pelotas - Postgraduate Program in Epidemiology, Rua Marechal Deodoro, 1160, 3° andar, Pelotas, RS, Zip code: 96020-220, Brazil
| | - Rogelio Pérez-Padilla
- National Institute of Respiratory Diseases, Calzada De Tlalpan, 4502, Mexico City, DF, Mexico
| | | | - Denise P Gigante
- Federal University of Pelotas - Postgraduate Program in Epidemiology, Rua Marechal Deodoro, 1160, 3° andar, Pelotas, RS, Zip code: 96020-220, Brazil
| | - Fernando C Barros
- Catholic University of Pelotas - Postgraduate Program in Health and Behavior, Rua Gonçalves Chaves, 373, Pelotas, RS, Zip code: 96015-560, Brazil
| | - Ken K Ong
- Medical Research Council (MRC) Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK
| | - Emanuella De Lucia Rolfe
- Medical Research Council (MRC) Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK
| | - Ana Maria Baptista Menezes
- Federal University of Pelotas - Postgraduate Program in Epidemiology, Rua Marechal Deodoro, 1160, 3° andar, Pelotas, RS, Zip code: 96020-220, Brazil
| |
Collapse
|
23
|
Silva VLSD, França GVAD, Santos IS, Barros FC, Matijasevich A. Characteristics and factors associated with hospitalization in early childhood: 2004 Pelotas (Brazil) birth cohort. CAD SAUDE PUBLICA 2017; 33:e00035716. [PMID: 29116316 DOI: 10.1590/0102-311x00035716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Accepted: 01/06/2017] [Indexed: 11/22/2022] Open
Abstract
Hospitalization is a frequent event in early childhood. In Brazil, the National Household Sample Survey of 2008 showed a 9% hospitalization rate among children in the first four years of life. The study aimed to describe the characteristics of hospitalization in the first six years of life and analyze the early factors associated with hospitalization in a birth cohort in southern Brazil. A zero-inflated Poisson model was used to simultaneously examine the effects of co-variables for the occurrence of a given event and to count events. The frequency of at least one episode of hospitalization during the study period was 33.4% (95%CI: 31.8-34.9), and was highest in the first year (19.1%; 95%CI: 17.9-20.4), remaining stable at approximately 10% between the first and fourth years, decreasing to 8.4% (95%CI: 7.6-9.4) between the fourth and sixth years. diseases of the respiratory system were among the leading causes of hospitalization, followed by infectious and parasitic diseases. History of prior hospitalization was one of the most important predictors of odds of hospitalization and risk of multiple hospitalizations. In early childhood, birth weight, gestational age, Apgar score, sex, and type of pregnancy were inversely associated with hospitalization, and environmental characteristics such as maternal smoking in pregnancy, mother's skin color, and low family income were associated statistically with number of hospitalizations. The results point to the importance of focusing efforts on reducing hospitalizations from diseases of the respiratory system, especially in children under one year.
Collapse
Affiliation(s)
| | | | - Iná S Santos
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brasil
| | - Fernando C Barros
- Programa de Pós-graduação em Saúde e Comportamento, Universidade Católica de Pelotas, Pelotas, Brasil
| | - Alícia Matijasevich
- Departamento de Medicina Preventiva, Universidade de São Paulo, São Paulo, Brasil
| |
Collapse
|
24
|
de Oliveira WK, de França GVA, Carmo EH, Duncan BB, de Souza Kuchenbecker R, Schmidt MI. Infection-related microcephaly after the 2015 and 2016 Zika virus outbreaks in Brazil: a surveillance-based analysis. Lancet 2017. [PMID: 28647172 DOI: 10.1016/s0140-6736(17)31368-5] [Citation(s) in RCA: 194] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND On Nov 11, 2015, the Brazilian Ministry of Health declared a Public Health Emergency of National Concern in response to an increased number of microcephaly cases, possibly related to previous Zika virus outbreaks. We describe the course of the dual epidemics of the Zika virus infection during pregnancy and microcephaly in Brazil up to Nov 12, 2016, the first anniversary of this declaration. METHODS We used secondary data for Zika virus and microcephaly cases obtained through the Brazilian Ministry of Health's surveillance systems from Jan 1, 2015, to Nov 12, 2016. We deemed possible Zika virus infections during pregnancy as all suspected cases of Zika virus disease and all initially suspected, but later discarded, cases of dengue and chikungunya fever. We defined confirmed infection-related microcephaly in liveborn infants as the presence of a head circumference of at least 2 SDs below the mean for their age and sex, accompanied by diagnostic imaging consistent with an infectious cause, or laboratory, clinical, or epidemiological results positive for Zika virus or STORCH (infectious agents known to cause congenital infection, mainly syphilis, toxoplasmosis, cytomegalovirus, and herpes simplex virus). We excluded cases of congenital anomalies or death without microcephaly. We analyse the spatial clustering of these diseases in Brazil to obtain the kernel density estimation. FINDINGS Two distinct waves of possible Zika virus infection extended across all Brazilian regions in 2015 and 2016. 1 673 272 notified cases were reported, of which 41 473 (2·5%) were in pregnant women. During this period, 1950 cases of infection-related microcephaly were confirmed. Most cases (1373 [70·4%]) occurred in the northeast region after the first wave of Zika virus infection, with peak monthly occurrence estimated at 49·9 cases per 10 000 livebirths. After a major, well documented second wave of Zika virus infection in all regions of Brazil from September, 2015, to September, 2016, occurrence of microcephaly was much lower than that following the first wave of Zika virus infection, reaching epidemic levels in all but the south of Brazil, with estimated monthly peaks varying from 3·2 cases to 15 cases per 10 000 livebirths. INTERPRETATION The distribution of infection-related microcephaly after Zika virus outbreaks has varied across time and Brazilian regions. Reasons for these apparent differences remain to be elucidated. FUNDING None.
Collapse
Affiliation(s)
- Wanderson Kleber de Oliveira
- Secretariat of Health Surveillance, Brazilian Ministry of Health, Brasília, Brazil; Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
| | | | - Eduardo Hage Carmo
- Secretariat of Health Surveillance, Brazilian Ministry of Health, Brasília, Brazil
| | - Bruce Bartholow Duncan
- Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Maria Inês Schmidt
- Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| |
Collapse
|
25
|
de França GVA, De Lucia Rolfe E, Horta BL, Gigante DP, Yudkin JS, Ong KK, Victora CG. Genomic ancestry and education level independently influence abdominal fat distributions in a Brazilian admixed population. PLoS One 2017; 12:e0179085. [PMID: 28582437 PMCID: PMC5459508 DOI: 10.1371/journal.pone.0179085] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 05/23/2017] [Indexed: 01/07/2023] Open
Abstract
We aimed to identify the independent associations of genomic ancestry and education level with abdominal fat distributions in the 1982 Pelotas birth cohort study, Brazil. In 2,890 participants (1,409 men and 1,481 women), genomic ancestry was assessed using genotype data on 370,539 genome-wide variants to quantify ancestral proportions in each individual. Years of completed education was used to indicate socio-economic position. Visceral fat depth and subcutaneous abdominal fat thickness were measured by ultrasound at age 29–31y; these measures were adjusted for BMI to indicate abdominal fat distributions. Linear regression models were performed, separately by sex. Admixture was observed between European (median proportion 85.3), African (6.6), and Native American (6.3) ancestries, with a strong inverse correlation between the African and European ancestry scores (ρ = -0.93; p<0.001). Independent of education level, African ancestry was inversely associated with both visceral and subcutaneous abdominal fat distributions in men (both P = 0.001), and inversely associated with subcutaneous abdominal fat distribution in women (p = 0.009). Independent of genomic ancestry, higher education level was associated with lower visceral fat, but higher subcutaneous fat, in both men and women (all p<0.001). Our findings, from an admixed population, indicate that both genomic ancestry and education level were independently associated with abdominal fat distribution in adults. African ancestry appeared to lower abdominal fat distributions, particularly in men.
Collapse
Affiliation(s)
- Giovanny Vinícius Araújo de França
- Post-graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil, Rua Marechal Deodoro, 1160–3° Piso, Bairro Centro—Pelotas, RS
- Medical Research Council (MRC) Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Hills R, Cambridge, United Kingdom
- * E-mail:
| | - Emanuella De Lucia Rolfe
- Medical Research Council (MRC) Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Hills R, Cambridge, United Kingdom
| | - Bernardo Lessa Horta
- Post-graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil, Rua Marechal Deodoro, 1160–3° Piso, Bairro Centro—Pelotas, RS
| | - Denise Petrucci Gigante
- Post-graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil, Rua Marechal Deodoro, 1160–3° Piso, Bairro Centro—Pelotas, RS
| | | | - Ken K. Ong
- Medical Research Council (MRC) Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Hills R, Cambridge, United Kingdom
| | - Cesar Gomes Victora
- Post-graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil, Rua Marechal Deodoro, 1160–3° Piso, Bairro Centro—Pelotas, RS
| |
Collapse
|
26
|
Brunken GS, França GVAD, Luiz RR, Szarfarc SC. Agreement assessment between hemoglobin and hematocrit to detect anemia prevalence in children less than 5 years old. ACTA ACUST UNITED AC 2016. [DOI: 10.1590/1414-462x201600010x01] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Abstract This study aimed to assess the extent of agreement between hemoglobin (Hb) and hematocrit (Ht), while also verifying whether anemia prevalence can be determined by hematocrit cut-off points. A hundred pairs of capillary Hb and Ht of children less than 5 years old were analyzed. The Hb and Ht concentrations were measured using HemoCue and microhematocrit centrifuge, respectively. The Bland and Altman’s method was used to assess the agreement between ‘observed Hb’ and ‘Hb estimated through Ht’ (Hb = Ht/3). The ROC curve was constructed based on the reference to anemia classification according to Hb. The subjects were classified according to the status of anemia obtained through the Ht, also evaluating the agreement regarding Hb. The area under the ROC curve identified that Ht <35% correctly classified 85% of subjects with Hb <11.0 g/dL. However, the cut-off point of <33% showed higher kappa (k = 0.49 against 0.41) and higher relative agreement (82% vs. 74%) compared to Ht <35%. Our findings indicate that capillary Hb and Ht could be used either together or separately to assess the prevalence of anemia. Considering the need to identify iron deficiency anemia with a single indicator in population studies, the use of Ht would be simpler and cost-saving.
Collapse
|
27
|
Kleber de Oliveira W, Cortez-Escalante J, De Oliveira WTGH, do Carmo GMI, Henriques CMP, Coelho GE, Araújo de França GV. Increase in Reported Prevalence of Microcephaly in Infants Born to Women Living in Areas with Confirmed Zika Virus Transmission During the First Trimester of Pregnancy - Brazil, 2015. MMWR Morb Mortal Wkly Rep 2016; 65:242-7. [PMID: 26963593 DOI: 10.15585/mmwr.mm6509e2] [Citation(s) in RCA: 295] [Impact Index Per Article: 36.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Widespread transmission of Zika virus by Aedes mosquitoes has been recognized in Brazil since late 2014, and in October 2015, an increase in the number of reported cases of microcephaly was reported to the Brazil Ministry of Health.* By January 2016, a total of 3,530 suspected microcephaly cases had been reported, many of which occurred in infants born to women who lived in or had visited areas where Zika virus transmission was occurring. Microcephaly surveillance was enhanced in late 2015 by implementing a more sensitive case definition. Based on the peak number of reported cases of microcephaly, and assuming an average estimated pregnancy duration of 38 weeks in Brazil (1), the first trimester of pregnancy coincided with reports of cases of febrile rash illness compatible with Zika virus disease in pregnant women in Bahia, Paraíba, and Pernambuco states, supporting an association between Zika virus infection during early pregnancy and the occurrence of microcephaly. Pregnant women in areas where Zika virus transmission is occurring should take steps to avoid mosquito bites. Additional studies are needed to further elucidate the relationship between Zika virus infection in pregnancy and microcephaly.
Collapse
|
28
|
Kleber de Oliveira W, Cortez-Escalante J, De Oliveira WTGH, do Carmo GMI, Henriques CMP, Coelho GE, Araújo de França GV. Increase in Reported Prevalence of Microcephaly in Infants Born to Women Living in Areas with Confirmed Zika Virus Transmission During the First Trimester of Pregnancy — Brazil, 2015. MMWR Morb Mortal Wkly Rep 2016. [DOI: 10.15585/mmwr.mm6509e2er] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
|
29
|
Loret de Mola C, de França GVA, Quevedo LDA, Horta BL. Low birth weight, preterm birth and small for gestational age association with adult depression: systematic review and meta-analysis. Br J Psychiatry 2014; 205:340-7. [PMID: 25368358 DOI: 10.1192/bjp.bp.113.139014] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND There is no consensus on the effects that low birth weight, premature birth and intrauterine growth have on later depression. AIMS To review systematically the evidence on the relationship of low birth weight, smallness for gestational age (SGA) and premature birth with adult depression. METHOD We searched the literature for original studies assessing the effect of low birth weight, premature birth and SGA on adult depression. Separate meta-analyses were carried out for each exposure using random and fixed effects models. We evaluated the contribution of methodological covariates to heterogeneity using meta-regression. RESULTS We identified 14 studies evaluating low birth weight, 9 premature birth and 4 SGA. Low birth weight increased the odds of depression (OR = 1.39, 95% CI 1.21-1.60). Premature birth and SGA were not associated with depression, but publication bias might have underestimated the effect of the former and only four studies evaluated SGA. CONCLUSIONS Low birth weight was associated with depression. Future studies evaluating premature birth and SGA are needed.
Collapse
Affiliation(s)
- Christian Loret de Mola
- Christian Loret de Mola, MD, MSc, Giovanny Vinícius Araújo de França, MSc, Postgraduate Programme in Epidemiology, Federal University of Pelotas; Luciana de Avila Quevedo, PhD, Postgraduate Programme in Health and Behaviour, Catholic University of Pelotas; Bernardo Lessa Horta, MD, PhD, Postgraduate Programme in Epidemiology, Federal University of Pelotas, Brazil
| | - Giovanny Vinícius Araújo de França
- Christian Loret de Mola, MD, MSc, Giovanny Vinícius Araújo de França, MSc, Postgraduate Programme in Epidemiology, Federal University of Pelotas; Luciana de Avila Quevedo, PhD, Postgraduate Programme in Health and Behaviour, Catholic University of Pelotas; Bernardo Lessa Horta, MD, PhD, Postgraduate Programme in Epidemiology, Federal University of Pelotas, Brazil
| | - Luciana de Avila Quevedo
- Christian Loret de Mola, MD, MSc, Giovanny Vinícius Araújo de França, MSc, Postgraduate Programme in Epidemiology, Federal University of Pelotas; Luciana de Avila Quevedo, PhD, Postgraduate Programme in Health and Behaviour, Catholic University of Pelotas; Bernardo Lessa Horta, MD, PhD, Postgraduate Programme in Epidemiology, Federal University of Pelotas, Brazil
| | - Bernardo Lessa Horta
- Christian Loret de Mola, MD, MSc, Giovanny Vinícius Araújo de França, MSc, Postgraduate Programme in Epidemiology, Federal University of Pelotas; Luciana de Avila Quevedo, PhD, Postgraduate Programme in Health and Behaviour, Catholic University of Pelotas; Bernardo Lessa Horta, MD, PhD, Postgraduate Programme in Epidemiology, Federal University of Pelotas, Brazil
| |
Collapse
|
30
|
de França GVA, Gigante DP, Olinto MTA. Binge eating in adults: prevalence and association with obesity, poor self-rated health status and body dissatisfaction. Public Health Nutr 2014; 17:932-8. [PMID: 23472839 PMCID: PMC10282444 DOI: 10.1017/s1368980013000591] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2012] [Revised: 02/01/2013] [Accepted: 02/05/2013] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To estimate the prevalence of episodes of binge eating and to assess potential associations with nutritional status, satisfaction with current body weight, self-rated health status and self-rated body weight. DESIGN A cross-sectional population-based study. Binge eating was assessed using adapted questions from the Brazilian Portuguese version of the Questionnaire on Eating and Weight Patterns and was defined as binging one or more times over the last 3 months before the interview. SETTING City of Pelotas, southern Brazil. SUBJECTS Individuals (n 2097) aged 20-59 years. RESULTS The prevalence of binge eating and recurrent binge eating was 7.9% and 2.7%, respectively. In the adjusted analysis, obesity, fair/poor self-rated health status and body dissatisfaction remained strongly associated with binge eating. CONCLUSIONS The study showed a high prevalence of binge eating among adults in Pelotas, being higher among younger women, the obese and those who desired to weigh less. The current results are informative, but longitudinal studies would be needed to demonstrate the causal relationship between these events.
Collapse
Affiliation(s)
- Giovanny Vinícius Araújo de França
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160 – 3° Piso, Bairro Centro – Pelotas, RS, Cep: 96020-220 – Caixa Postal 464, Brazil
| | - Denise Petrucci Gigante
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160 – 3° Piso, Bairro Centro – Pelotas, RS, Cep: 96020-220 – Caixa Postal 464, Brazil
| | - Maria Teresa Anselmo Olinto
- Postgraduate Program in Public Health, University of Vale do Rio dos Sinos, São Leopoldo, Rio Grande do Sul, Brazil
- Department of Nutrition, Federal University of Health Science of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| |
Collapse
|
31
|
Tavares NUL, Bertoldi AD, Thumé E, Facchini LA, de França GVA, Mengue SS. [Factors associated with low adherence to medication in older adults]. Rev Saude Publica 2013; 47:1092-101. [PMID: 24626547 PMCID: PMC4206106 DOI: 10.1590/s0034-8910.2013047004834] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Accepted: 08/19/2013] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE To assess factors associated with low adherence to pharmacotherapy in older adults. METHODS Cross-sectional population-based study, with a representative sample of 1,593 individuals aged 60 or older, living in the urban area of Bagé, RS, Southern Brazil, in 2008. A multiple stage sampling model was used. The data were collected through individual household interviews. The analyses of the association between low adherence regarding pharmacotherapy, measured using the Brief Medication Questionnaire (BMQ), and demographic, socioeconomic, behavioral, health, assistance and prescription factors were carried out applying Poisson regression model to assess crude and adjusted prevalence ratios, their respective 95% confidence intervals and p-value (Wald test). RESULTS Around 78.0% of individuals reported have taken at least one medication in the seven days prior to the interview. Of these, approximately one third (28.7%) were considered to have low adherence to the treatment. The factors significantly associated to low adherence to treatment were: age (65 to 74 years old), not having health insurance, having to purchase (totally or partially) their own medicines, having three or more morbidities, having functional disabilities and using three or more medicines. CONCLUSIONS The increased use of medicines by older adults, because of the high prevalence of non-communicable diseases in this group, and the access to the treatment need to be considered by health care professionals regarding fostering adherence to treatment, which increases therapeutic solutions and quality of life among older people.
Collapse
Affiliation(s)
| | - Andréa Dâmaso Bertoldi
- Departamento de Medicina Social. Faculdade de Medicina.
Universidade Federal de Pelotas. Pelotas, RS, Brasil
| | - Elaine Thumé
- Departamento de Enfermagem. Faculdade de Enfermagem. Universidade
Federal de Pelotas. Pelotas, RS, Brasil
| | - Luiz Augusto Facchini
- Departamento de Medicina Social. Faculdade de Medicina.
Universidade Federal de Pelotas. Pelotas, RS, Brasil
| | | | - Sotero Serrate Mengue
- Departamento de Medicina Social. Faculdade de Medicina. Universidade
Federal do Rio Grande do Sul. Porto Alegre, RS, Brasil
| |
Collapse
|
32
|
Gigante DP, de França GVA, Sardinha LMV, Iser BPM, Meléndez GV. Temporal variation in the prevalence of weight and obesity excess in adults: Brazil, 2006 to 2009. Rev Bras Epidemiol 2012; 14 Suppl 1:157-65. [PMID: 22002152 DOI: 10.1590/s1415-790x2011000500016] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2011] [Accepted: 03/23/2011] [Indexed: 01/22/2023] Open
Abstract
Overweight and obesity are public health issues that affect an important part of the world population. This study aims at describing the trends in overweight and obesity prevalence rates from 2006 to 2009, by means of telephone surveys in 27 Brazilian cities, with a population aged 18 years or older. The body mass index (BMI) was calculated by the reported height and weight; overweight and obesity were considered as BMI >25 kg/m² and >30 kg/m², respectively. Temporal variation in overweight and obesity prevalence is presented for men and women, according to age group, schooling, stable relationship, and skin color. Poisson regression was used for the analysis. Overweight prevalence was 43.0, 42.7, 44.2 and 46.6%,for each year of the period from 2006 to 2009, respectively. For obesity, in the same period, the trend was: 11.4, 12.7, 13.2 and 13.8%. The temporal trend varied in relation to some demographic and socioeconomic variables. The prevalence was higher among women and young adults. The temporal trend was independent of the relationship status of the interviewees, but the prevalence was higher among white women and those with less years of schooling. The results in this study confirmed the urgent need for effective prevention and control measures, as the increasing trend is occurring in a short period of time, especially among youngsters.
Collapse
Affiliation(s)
- Denise Petrucci Gigante
- Epidemiology Post Graduation Program , Universidade Federal de Pelotas, Pelotas, RS, Brasil.
| | | | | | | | | |
Collapse
|
33
|
Franco GPP, Scala LCN, Alves CJ, França GVAD, Cassanelli T, Jardim PCBV. Metabolic syndrome in patients with high blood pressure in Cuiabá-Mato Grosso State: prevalence and associated factors. Arq Bras Cardiol 2010; 92:437-42, 456-61, 472-8. [PMID: 19629311 DOI: 10.1590/s0066-782x2009000600010] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2008] [Accepted: 10/22/2008] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Metabolic Syndrome (MS) is a cluster of predisposing factors for cardiovascular diseases and diabetes mellitus, whose epidemiological characteristics are poorly known at regional and national levels. OBJECTIVE To estimate the prevalence of MS and its associated factors in a sample of patients with high blood pressure in the urban area of Cuiabá, Mato Grosso State. METHODS This was a cross-sectional study (May to November 2007) in a sample of 120 patients with high blood pressure (aged > or = 20 years), paired by gender and selected by the systematic sampling of a source population of 567 patients with high blood pressure in Cuiabá. All patients answered to home inquiries to provide sociodemographic and life habits data. The following measurements were taken: blood pressure; body mass index (BMI); waist and hip circumferences; plasma glucose, insulin, and lipid levels; homeostasis model assessment-estimated insulin resistance (HOMA); C-reactive protein, uric acid and fibrinogen levels. High blood pressure criterion: average systolic blood pressure > or = 140 mmHg and/or diastolic blood pressure > or = 90 mmHg; and Metabolic Syndrome diagnosis according to the I Brazilian Directive for Metabolic Syndrome and the NCEP-ATP III criteria. RESULTS 120 patients (60 women), with high blood pressure and an average age of 58.3 +/- 12.6 years, were analyzed. We found a MS prevalence of 70.8% (95%CI 61.8 to 78.8), predominantly among women (81.7% vs. 60.0%; p=0.009), with no difference between adults (71.4%) and elderly patients (70.2%). The multiple regression analysis showed a positive association between MS and BMI > or = 25 kg/m(2), insulin resistance and family history of high blood pressure. CONCLUSION A high prevalence of MS was observed among patients with high blood pressure living in Cuiabá, with a significant association with BMI > or = 25 kg/m(2), insulin resistance (HOMA index) and, especially, a family history of high blood pressure. These results suggest the need for deeper studies on this subject.
Collapse
|
34
|
Rosário TMD, Scala LCN, França GVAD, Pereira MRG, Jardim PCBV. Prevalência, controle e tratamento da hipertensão arterial sistêmica em Nobres - MT. Arq Bras Cardiol 2009; 93:622-8, 672-8. [DOI: 10.1590/s0066-782x2009001200018] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2008] [Accepted: 04/07/2009] [Indexed: 11/22/2022] Open
|
35
|
Abstract
OBJETIVO: Identificar fatores associados à Hipertensão Arterial Sistêmica (HAS) no município de Nobres-MT. MÉTODO: Foi realizado um estudo de corte transversal, em Nobres-MT, de janeiro a março de 2006, em 1.003 indivíduos com idade superior a 18 anos, residentes na zona urbana do município. Os dados foram coletados por entrevista domiciliar, sendo aferidos peso, estatura, circunferência da cintura e pressão arterial (PA). Foram considerados hipertensos aqueles com PA > 140/90 mmHg. Para identificar controle dos fatores de confundimento aplicou-se o modelo de regressão de Poisson, com estimativas de razão de prevalências ajustadas e seus respectivos intervalo de confiança de 95%. RESULTADOS: Foram avaliados 1.003 indivíduos, sendo 51,3% do gênero masculino. A prevalência de HAS foi 30,1%, maior no sexo feminino (31,1%) do que no sexo masculino (29,1%). A análise ajustada confirmou a associação independente entre HA e o avançar da idade e com Índice de Massa Corporal igual ou superior a 25 kg/m². CONCLUSÃO: Reafirma-se a necessidade de ações em nível populacional e individual direcionadas ao controle de peso corporal, principalmente em indivíduos com idade superior a 30 anos, que possivelmente impactariam de forma importante para a prevalência de HAS.
Collapse
|
36
|
França GVAD, Brunken GS, Silva SMD, Escuder MM, Venancio SI. Determinantes da amamentação no primeiro ano de vida em Cuiabá, Mato Grosso. Rev Saude Publica 2007; 41:711-8. [DOI: 10.1590/s0034-89102007000500004] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2006] [Accepted: 05/13/2007] [Indexed: 11/21/2022] Open
Abstract
OBJETIVO: Avaliar os fatores de risco para a interrupção de aleitamento materno e desmame em crianças menores de um ano. MÉTODOS: Estudo transversal analítico com crianças menores de um ano de idade que compareceram aos postos de vacinação do município de Cuiabá, Mato Grosso, em 2004, acompanhadas de seus responsáveis. Para definição da amostra, foram sorteadas as unidades de vacinação, seguindo-se o sorteio das crianças em cada unidade, de forma sistemática. Para coleta de dados, aplicou-se um questionário semi-estruturado aos acompanhantes das crianças, investigando variáveis características sociodemográficas, referentes ao nascimento da criança e maternas, uso de chupeta e alimentação no primeiro dia em casa. Foram realizadas análise descritiva e regressão logística dos fatores de risco para cada faixa etária, apresentadas em odds ratio e intervalos de confiança. RESULTADOS: No total, 920 crianças menores de um ano foram avaliadas, das quais 205 menores de 120 dias e 275 menores de 180 dias. Verificou-se que usar chupeta, tomar chá no primeiro dia em casa, ter mãe com escolaridade até o primeiro ou segundo graus ou primípara, representam maior risco de não estar em amamentação exclusiva aos 120 dias de vida. Tais fatores se mostraram significativos também para menores de 180 dias, com exceção do consumo de chá, que não foi indagado para essa faixa etária. Nos menores de um ano, o uso de chupeta foi a única variável que manteve significância estatística. CONCLUSÕES: Fatores socioculturais mostraram-se determinantes da situação de aleitamento materno. Ressalta-se a importância da instrução e conscientização maternas, que refletem sobre as práticas que podem prejudicar a amamentação.
Collapse
|
37
|
da Silva SM, Brunken GS, de França GVA, Escuder MM, Venancio SI. Evolução do aleitamento materno em uma capital da Região Centro-Oeste do Brasil entre 1999 e 2004. CAD SAUDE PUBLICA 2007; 23:1539-46. [PMID: 17572802 DOI: 10.1590/s0102-311x2007000700004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2005] [Accepted: 01/10/2007] [Indexed: 11/21/2022] Open
Abstract
Um estudo de caráter transversal foi realizado durante o primeiro dia da Campanha Nacional de Vacinação de 2004, em Cuiabá, Mato Grosso, Brasil, com o objetivo de conhecer a evolução do aleitamento materno entre 1999 e 2004, no primeiro ano de vida. A determinação da amostra seguiu dois passos, considerando o número de unidades de vacinação e as crianças em cada unidade. Um inquérito nutricional contendo um recordatório alimentar de 24 horas foi aplicado a 921 acompanhantes das crianças menores de um ano. Houve incremento positivo em todas as faixas etárias na modalidade de aleitamento materno exclusivo. Observou-se, ao final dos 180 dias, baixo percentual de crianças em aleitamento materno exclusivo, sendo menos de 5% (em 1999) e de 10% (em 2004). A prevalência do aleitamento materno exclusivo dobrou em cinco anos nas crianças menores de 120 dias, passou de 17,7% para 28,5%. As ações realizadas para promoção do aleitamento materno foram efetivas, porém, insuficientes para a grave situação. Mais ações são necessárias, bem como o aperfeiçoamento dos programas existentes.
Collapse
|