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Malta DC, Romero-Sandoval N, Cardoso LSDM, Arcos P, Gualán M, Pescarini JM, Brickley EB, Veloso GA, Bernal RTI, Gomes CS, Kerr LRFS, Naghavi M, Cooper PJ, Barreto ML, Leyland AH. Sustainable Development Goals' health-related indicators for Brazil and Ecuador: an analysis for the period of 1990-2019. Public Health 2024; 231:88-98. [PMID: 38653016 DOI: 10.1016/j.puhe.2024.01.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 01/02/2024] [Accepted: 01/03/2024] [Indexed: 04/25/2024]
Abstract
OBJECTIVE This article aims to analyse the evolution of 40 Sustainable Development Goals' (SDGs) health-related indicators in Brazil and Ecuador from 1990 to 2019. STUDY DESIGN Epidemiological study of long-term trends in 40 SDGs' health-related indicators for Brazil and Ecuador from 1990 to 2019, using estimates from the Global Burden of Disease Study. METHODS Forty SDGs' health-related indicators and an index from 1990 to 2017 for Brazil and Ecuador, and their projections up to 2030 were extracted from the Institute for Health Metrics and Evaluation's Global Burden of Disease website and analysed. The percent annual change (PC) between 1990 and 2019 was calculated for both countries. RESULTS Both countries have made progress on child stunting (Brazil: PC = -38%; Ecuador: PC = -43%) and child wasting prevalences (Brazil: PC = -42%; Ecuador: PC = -41%), percent of vaccine coverage (Brazil: PC = +215%; Ecuador: PC = +175%), under-5 (Brazil: PC = -75%; Ecuador: PC = -60%) and neonatal mortality rates (Brazil: PC = -69%; Ecuador: PC = -51%), health worker density per 1000 population (Brazil: PC = +153%; Ecuador: PC = +175%), reduction of neglected diseases prevalences (Brazil: PC = -40%; Ecuador: PC = -58%), tuberculosis (Brazil: PC = -27%; Ecuador: PC = -55%) and malaria incidences (Brazil: PC = -97%; Ecuador: PC = -100%), water, sanitation and hygiene mortality rates (Brazil and Ecuador: PC = -89%). However, both countries did not show sufficient improvement in maternal mortality ratio to meet SDGs targets (Brazil: PC = -37%; Ecuador: PC = -40%). Worsening of indicators were found for violence, such as non-intimate partner violence for both countries (Brazil: PC = +26%; Ecuador: PC = +18%) and suicide mortality rate for Ecuador (PC = +66%), child overweight indicator for Brazil (PC = -67%), disaster mortality rates (Brazil: PC = +100%; Ecuador: PC = +325%) and alcohol consumption (Brazil: PC = +46%; Ecuador: PC = +35%). CONCLUSIONS Significant improvements are necessary in both countries requiring the strengthening of health and other policies, particularly concerning the prevention and management of violence and alcohol consumption, and preparedness for dealing with environmental disasters.
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Affiliation(s)
- D C Malta
- Departamento de Enfermagem Materno Infantil e Saúde Pública, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - N Romero-Sandoval
- School of Medicine, Universidad Internacional del Ecuador, Quito, Ecuador.
| | - L S de M Cardoso
- Programa de Pós-Graduação em Enfermagem, Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - P Arcos
- Universidad Internacional del Ecuador, Quito, Ecuador.
| | - M Gualán
- School of Medicine, Universidad Internacional del Ecuador, Quito, Ecuador.
| | - J M Pescarini
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom; Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Oswaldo Cruz Foundation, Salvador, Brazil.
| | - E B Brickley
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
| | - G A Veloso
- Departamento de Estatística, Instituto de Matemática e Estatística, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil.
| | - R T I Bernal
- Programa de Pós-Graduação em Enfermagem, Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - C S Gomes
- Programa de Pós-Graduação em Saúde Pública, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - L R F S Kerr
- Universidade Federal do Ceará, Fortaleza, Ceará, Brazil.
| | - M Naghavi
- University of Washington, Institute for Health Metrics and Evaluation, Seattle, Washington, USA.
| | - P J Cooper
- Institute of Infection and Immunity St. George's University of London. School of Medicine, Universidad Internacional del Ecuador, Ecuador.
| | - M L Barreto
- Centre for Data and Knowledge Integration for Health, Fiocruz Bahia, Salvador, Brazil.
| | - A H Leyland
- Social and Public Health Sciences Unit, University of Glasgow, United Kingdom.
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Tavares Veras Florentino P, Cerqueira-Silva T, Freire De Carvalho L, Jôse Oliveira Alves F, De Araújo Oliveira V, Mateus Oliveira Aguilar G, De Sousa Prado R, Soranz D, Pearce N, Boaventura V, Loreiro Werneck G, Oliveira Penna G, Lima Barreto M, Henrique De Oliveira Garcia M, Barral-Netto M, Santos da Paixão E. Safety of BNT162b2 and CoronaVac during pregnancy on birth outcomes and neonatal mortality: a cohort study from Brazil. Int J Epidemiol 2023; 52:1708-1715. [PMID: 37690066 PMCID: PMC10749744 DOI: 10.1093/ije/dyad120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 08/24/2023] [Indexed: 09/12/2023] Open
Abstract
BACKGROUND COVID-19 vaccines have been shown to protect pregnant individuals against mild and severe COVID-19 outcomes. However, limited safety data are available for inactivated (CoronaVac) and mRNA (BNT162b2) vaccines during pregnancy regarding their effect on birth outcomes and neonatal mortality, especially in low- and middle-income countries. METHODS We conducted a retrospective population-based cohort study in Rio de Janeiro, Brazil, with 17 513 singleton live births conceived between 15 May 2021 and 23 October 2021. The primary exposure was maternal vaccination with CoronaVac or mRNA BNT162b2 vaccines and sub-analyses were performed by the gestational trimester of the first dose and the number of doses given during pregnancy. The outcomes were pre-term birth (PTB), small for gestational age (SGA), low birthweight (LBW), low Apgar 5 and neonatal death. We used the Cox model to estimate the hazard ratio (HR) with a 95% CI and applied the inverse probability of treatment weights to generate adjusted HRs. RESULTS We found no significant increase in the risk of PTB (HR: 0.98; 95% CI 0.88, 1.10), SGA (HR: 1.09; 95% CI 0.96, 1.27), LBW (HR: 1.00; 95% CI 0.88, 1.14), low Apgar 5 (HR: 0.81; 95% CI 0.55, 1.22) or neonatal death (HR: 0.88; 95% CI 0.56, 1.48) in women vaccinated with CoronaVac or BNT162b2 vaccines. These findings were consistent across sub-analyses stratified by the gestational trimester of the first dose and the number of doses given during pregnancy. We found mild yet consistent protection against PTB in women who received different vaccine platforms during the third trimester of pregnancy (any vaccines, HR: 0.78; 95% CI 0.63, 0.98; BNT162b2, HR: 0.75; 95% CI 0.59, 0.99). CONCLUSIONS This study provides evidence that COVID-19 vaccination in all trimesters of pregnancy, irrespective of the vaccine type, is safe and does not increase the risk of adverse birth outcomes or neonatal deaths.
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Affiliation(s)
- Pilar Tavares Veras Florentino
- Centro de Integração de Dados e Conhecimentos para Saúde, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
| | - Thiago Cerqueira-Silva
- Centro de Integração de Dados e Conhecimentos para Saúde, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
| | - Luciana Freire De Carvalho
- Centro de Inteligência Epidemiológica, Secretaria Municipal de Saúde do Rio de Janeiro, Rio de Janeiro, Brazil
- Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Flávia Jôse Oliveira Alves
- Centro de Integração de Dados e Conhecimentos para Saúde, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
| | - Vinicius De Araújo Oliveira
- Centro de Integração de Dados e Conhecimentos para Saúde, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
| | | | - Rodrigo De Sousa Prado
- Centro de Inteligência Epidemiológica, Secretaria Municipal de Saúde do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Daniel Soranz
- Câmara dos Deputados, Câmara Legislativa do Distrito Federal, Congresso Nacional, Brasília, Brazil
| | - Neil Pearce
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Viviane Boaventura
- Laboratório de Medicina e Saúde Pública de Precisão, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil
| | - Guilherme Loreiro Werneck
- Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Gerson Oliveira Penna
- Centro de Medicina Tropical, Universidade de Brasília, Escola do Governo de Brasília—Fiocruz, Brasília, Brazil
| | - Mauricio Lima Barreto
- Centro de Integração de Dados e Conhecimentos para Saúde, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
| | | | - Manoel Barral-Netto
- Laboratório de Medicina e Saúde Pública de Precisão, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil
| | - Enny Santos da Paixão
- Laboratório de Medicina e Saúde Pública de Precisão, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
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Borges MASB, Florentino PTV, Cerqueira-Silva T, de Carvalho LF, de Araújo Oliveira V, Aguilar GMO, Prado RDS, Soranz D, Werneck GL, Pescarini JM, da Costa PSS, Barreto ML, de Oliveira Garcia MH, Penna GO, Barral-Netto M, Paixão ES. Factors associated with COVID-19 vaccination among pregnant women in Rio De Janeiro City, Brazil. Sci Rep 2023; 13:18235. [PMID: 37880238 PMCID: PMC10600223 DOI: 10.1038/s41598-023-44370-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 10/07/2023] [Indexed: 10/27/2023] Open
Abstract
COVID-19 vaccination during pregnancy is safe and effective in reducing the risk of complications. However, the uptake is still below targets worldwide. This study aimed to explore the factors associated with COVID-19 vaccination uptake among pregnant women since data on this topic is scarce in low-to-middle-income countries. A retrospective cohort study included linked data on COVID-19 vaccination and pregnant women who delivered a singleton live birth from August 1, 2021, to July 31, 2022, in Rio de Janeiro City, Brazil. Multiple logistic regression was performed to identify factors associated with vaccination during pregnancy, applying a hierarchical model and describing odds ratio with 95% confidence intervals. Of 65,304 pregnant women included in the study, 53.0% (95% CI, 52-53%) received at least one dose of COVID-19 vaccine during pregnancy. Higher uptake was observed among women aged older than 34 (aOR 1.21, 95%CI 1.15-1.28), black (aOR 1.10, 1.04-1.16), or parda/brown skin colour (aOR 1.05, 1.01-1.09), with less than eight years of education (aOR 1.09, 1.02-1.17), living without a partner (aOR 2.24, 2.16-2.34), more than six antenatal care appointments (aOR 1.92, 1.75-2.09), and having a previous child loss (OR 1.06, 1.02-1.11). These results highlight the need for targeted educational campaigns, trustful communication, and accessibility strategies for specific populations to improve vaccination uptake during pregnancy.
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Affiliation(s)
- Moara Alves Santa Bárbara Borges
- Instituto de Patologia Tropical e Saúde Pública da Universidade Federal de Goiás, Goiânia, 74605-050, Brazil.
- Programa de Pós-Graduação em Ciências da Saúde da Faculdade de Medicina da Universidade Federal de Goiás, Goiânia, 74605-050, Brazil.
| | - Pilar Tavares Veras Florentino
- Centro de Integração de Dados e Conhecimento para Saúde (CIDACS), Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, 40296-710, Brazil
| | - Thiago Cerqueira-Silva
- Centro de Integração de Dados e Conhecimento para Saúde (CIDACS), Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, 40296-710, Brazil
| | - Luciana Freire de Carvalho
- Secretaria Municipal de Saúde, Rio de Janeiro, 20211-110, Brazil
- Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, 21941-592, Brazil
| | - Vinícius de Araújo Oliveira
- Centro de Integração de Dados e Conhecimento para Saúde (CIDACS), Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, 40296-710, Brazil
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, 40110-100, Brazil
| | | | | | - Daniel Soranz
- Secretaria Municipal de Saúde, Rio de Janeiro, 20211-110, Brazil
| | - Guilherme Loureiro Werneck
- Departamento de Epidemiologia, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 20550-013, Brazil
- Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, 21941-592, Brazil
| | - Julia M Pescarini
- Department of Infectious Diseases Epidemiology, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - Paulo Sérgio Sucasas da Costa
- Programa de Pós-Graduação em Ciências da Saúde da Faculdade de Medicina da Universidade Federal de Goiás, Goiânia, 74605-050, Brazil
| | - Mauricio Lima Barreto
- Centro de Integração de Dados e Conhecimento para Saúde (CIDACS), Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, 40296-710, Brazil
| | | | - Gerson Oliveira Penna
- Núcleo de Medicina Tropical, Universidade de Brasília, Escola de Governo Fiocruz Brasília, Brasília, 70904-130, Brazil
| | - Manoel Barral-Netto
- Centro de Integração de Dados e Conhecimento para Saúde (CIDACS), Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, 40296-710, Brazil
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, 40110-100, Brazil
| | - Enny S Paixão
- Department of Infectious Diseases Epidemiology, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
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Bernal RTI, Malta DC, Teixeira RA, Leyland AH, Katikireddi VS, Brickley EB, Pinto EP, Ichiara MYT, Allik M, Dundas R, Barreto ML. Prevalence of adult smokers in Brazilian capitals according to socioeconomic deprivation. Rev Bras Epidemiol 2023; 26:e230044. [PMID: 37878832 PMCID: PMC10599255 DOI: 10.1590/1980-549720230044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 05/19/2023] [Accepted: 05/19/2023] [Indexed: 10/27/2023] Open
Abstract
OBJECTIVE To estimate the prevalence of adult smokers in the 26 capitals and the Federal District according to the Brazilian Deprivation Index (Índice Brasileiro de Privação - IBP). METHODS Dataset on smoking were obtained from the Surveillance of Risk and Protective Factors for Noncommunicable Diseases by Survey (Vigitel) system for the 26 capitals and the Federal District, in the period from 2010 to 2013. The IBP classifies the census sectors according to indicators such as: income less than ½ minimum wage, illiterate population and without sanitary sewage. In the North and Northeast regions, the census sectors were grouped into four categories (low, medium, high and very high deprivation) and in the South, Southeast and Midwest regions into three (low, medium and high deprivation). Prevalence estimates of adult smokers were obtained using the indirect estimation method in small areas. To calculate the prevalence ratios, Poisson models are used. RESULTS The positive association between prevalence and deprivation of census sector categories was found in 16 (59.3%) of the 27 cities. In nine (33.3%) cities, the sectors with the greatest deprivation had a higher prevalence of smokers when compared to those with the least deprivation, and in two (7.4%) there were no differences. In Aracaju, Belém, Fortaleza, João Pessoa, Macapá and Salvador, the prevalence of adult smokers was three times higher in the group of sectors with greater deprivation compared to those with less deprivation. CONCLUSION Sectors with greater social deprivation had a higher prevalence of smoking, compared with less deprivation, pointing to social inequalities.
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Affiliation(s)
- Regina Tomie Ivata Bernal
- Universidade Federal de Minas Gerais, School of Nursing, Department of Maternal-Child Nursing and Public Health – Belo Horizonte (MG), Brazil
| | - Deborah Carvalho Malta
- Universidade Federal de Minas Gerais, School of Nursing, Department of Maternal-Child Nursing and Public Health – Belo Horizonte (MG), Brazil
| | - Renato Azeredo Teixeira
- Universidade Federal de Minas Gerais, School of Nursing, Department of Maternal-Child Nursing and Public Health – Belo Horizonte (MG), Brazil
| | - Alastair Hay Leyland
- University of Glasgow, Medical Research Council, Scottish Government Chief Scientist Office, Social and Public Health Sciences Unit, School of Health and Wellbeing – Glasgow, UK
| | - Vittal Srinivasa Katikireddi
- University of Glasgow, Medical Research Council, Scottish Government Chief Scientist Office, Social and Public Health Sciences Unit, School of Health and Wellbeing – Glasgow, UK
| | - Elizabeth Bailey Brickley
- London School of Hygiene and Tropical Medicine, Department of Infectious Disease Epidemiology – London, UK
| | - Elzo Pereira Pinto
- Fundação Oswaldo Cruz, Center for Integration of Data and Knowledge for Health – Salvador (BA) Brazil
| | | | - Mirjam Allik
- University of Glasgow, Medical Research Council, Scottish Government Chief Scientist Office, Social and Public Health Sciences Unit, School of Health and Wellbeing – Glasgow, UK
| | - Ruth Dundas
- University of Glasgow, Medical Research Council, Scottish Government Chief Scientist Office, Social and Public Health Sciences Unit, School of Health and Wellbeing – Glasgow, UK
| | - Mauricio Lima Barreto
- Fundação Oswaldo Cruz, Center for Integration of Data and Knowledge for Health – Salvador (BA) Brazil
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Ribeiro-Silva RDC, Costa PRDF, da Conceição MEP, de Oliveira LPM, Araújo MDPN, de Santana MLP, dos Santos NS, dos Santos SMC, Queiroz VADO, de Oliveira N, de Lira PIC, Barreto ML. Academic trajectory of Prof. Ana Marlúcia Oliveira: contributions to the field of food and nutrition in Brazil. Rev Bras Epidemiol 2023; 26:e230042. [PMID: 37820192 PMCID: PMC10566569 DOI: 10.1590/1980-549720230042.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 06/18/2023] [Accepted: 06/23/2023] [Indexed: 10/13/2023] Open
Abstract
It will be presented the main academic contributions of Professor Ana Marlúcia Oliveira (AMO) (in memoriam), nutritionist, professor at the School of Nutrition at the Federal University of Bahia, Ph.D. in epidemiology and CNPQ Researcher level A, from 1980 to 2021. Professor Ana accumulated, throughout her academic career, scientific articles published in national and international journals; book and book chapters authored by her; papers presented at scientific events, in addition to guiding scientific projects, dissertations and theses. She has coordinated several research projects in the field of food and nutrition in public health, with a focus on nutritional epidemiology. The scope of the subjects addressed in her scientific production expressed the concern that mobilized her around the production of knowledge to face the complex health and nutrition problems in Brazil. Her way of being in the world, welcoming and caring for people who approached her seeking qualification opportunities, her example, words and teachings influenced, and still influence, the trajectory and training of nutritionists, professors and researchers at ENUFBA and other national and international institutions. She was a Brazilian researcher and intellectual committed to the health of the most vulnerable populations and the fight against malnutrition and hunger in our country. Her wide and fruitful work left us a legacy to be remembered and continued. Some of her friends, colleagues and collaborators pay this tribute to her memory, to her example and to the legacy she left for all of us and future generations.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Nilce de Oliveira
- Universidade Federal da Bahia, Escola de Nutrição – Salvador (BA), Brasil
| | - Pedro Israel Cabral de Lira
- Universidade Federal de Pernambuco, Centro de Ciências da Saúde, Departamento de Nutrição – Recife (PE), Brasil
| | - Mauricio Lima Barreto
- Fundação Oswaldo Cruz, Instituto Gonçalo Moniz, Centro de Integração de Dados e Conhecimentos para Saúde – Salvador (BA), Brasil
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Lisboa CS, Guimarães NS, Ferreira AJF, Silva KBBD, Alves FJO, Rocha ADS, Ortelan N, Texeira CSS, Falcão IR, Silva NDJ, Ribeiro-Silva RDC, Barbosa D, Barreto ML. Impact of cash transfer programs on birth and child growth outcomes: systematic review. Cien Saude Colet 2023; 28:2417-2432. [PMID: 37531548 DOI: 10.1590/1413-81232023288.14082022] [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: 09/06/2022] [Accepted: 01/25/2023] [Indexed: 08/04/2023] Open
Abstract
To investigate the impact of cash transfer (CTs) on birth outcomes, including birth weight, low birth weight and prematurity, as well as child physical growth were included, as assessed by anthropometric indices in children under five years of age. Searching was performed using the PubMed/Medline, Embase, LILACS, Cochrane Library, Scopus and Web of Science databases. Quantitative observational, experimental and quasi-experimental. Eleven studies were included in the review. The majority (81.8%) were carried out in low-and middle-income countries and most involved conditional CTs (63.6%). Four were clinical trials and seven were observational studies. Conditional CTs were found to be associated with a reduction in height-for-age (-0.14; 95%CI -0.27, -0.02); (OR 0.85; 95%CI 0.77-0.94); (OR = 0.44; 95%CI 0.19-0.98), a significantly reduced chance of low weight-for-age (OR = 0.16; 95%CI -0.11-0.43), low weight-for-height (OR = -0.68; 95%CI -1.14, -0.21), and low weight-for-age (OR = 0.27; 95%CI 0.10; 0.71). Unconditional CTs were associated with reduced birth weight (RR = 0.71; 95%CI 0.63-0.81; p < 0.0001) and preterm births (RR = 0.76; 95%CI 0.69-0.84; p < 0.0001). Conditional CTs can positively influence birth outcomes and child growth.
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Affiliation(s)
- Cinthia Soares Lisboa
- Universidade Estadual de Feira de Santana, Programa de Pós-Graduação em Saúde Coletiva. Av. Transnordestina s/n, Novo Horizonte. 44036-900 Feira de Santana BA Brasil.
| | | | | | - Karine Brito Beck da Silva
- Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Instituto Gonçalo Moniz - Fiocruz Bahia. Salvador BA Brasil
| | - Flávia Jôse Oliveira Alves
- Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Instituto Gonçalo Moniz - Fiocruz Bahia. Salvador BA Brasil
| | - Aline Dos Santos Rocha
- Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Instituto Gonçalo Moniz - Fiocruz Bahia. Salvador BA Brasil
| | - Naiá Ortelan
- Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Instituto Gonçalo Moniz - Fiocruz Bahia. Salvador BA Brasil
| | - Camila Silveira Silva Texeira
- Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Instituto Gonçalo Moniz - Fiocruz Bahia. Salvador BA Brasil
| | - Ila Rocha Falcão
- Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Instituto Gonçalo Moniz - Fiocruz Bahia. Salvador BA Brasil
| | | | - Rita de Cássia Ribeiro-Silva
- Pós-Graduação em Ciências Médicas, Faculdade de Ciências Médicas de Minas Gerais. Belo Horizonte MG Brasil
- Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Instituto Gonçalo Moniz - Fiocruz Bahia. Salvador BA Brasil
| | - Djanilson Barbosa
- Centro de Ciências da Saúde, Universidade Federal do Recôncavo da Bahia. Santo Antônio de Jesus BA Brasil
| | - Mauricio Lima Barreto
- Pós-Graduação em Ciências Médicas, Faculdade de Ciências Médicas de Minas Gerais. Belo Horizonte MG Brasil
- Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Instituto Gonçalo Moniz - Fiocruz Bahia. Salvador BA Brasil
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7
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dos Anjos Fonseca A, Pimenta DM, de Almeida MRS, Lima RT, Barreto ML, Ichihara MYT. Public Involvement & Engagement in health inequalities research on COVID-19 pandemic: a case study of CIDACS/FIOCRUZ BAHIA. Int J Popul Data Sci 2023; 5:2133. [PMID: 37671353 PMCID: PMC10476697 DOI: 10.23889/ijpds.v5i3.2133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/07/2023] Open
Abstract
Introduction Health inequalities in Brazil have deepened on Covid-19 pandemic, and the most vulnerable people were the more affected. A multidisciplinary team from Cidacs/Fiocruz Bahia developed a Social Disparities Index for Covid-19 (IDS-COVID-19) to support the evaluation of effects of health inequalities on the pandemic in Brazil. Public Involvement and Engagement were the pillars of this research because they allowed us to access first hand experiences about the social context in our country. Objectives This paper aims to describe our Public Involvement and Engagement experience by analysing our challenges, strategies, activities, results, and lessons learned during the construction of IDS-COVID-19. Methods The basis of the IDS-Covid-19 public engagement model was the participation of different social groups through methods and techniques that allow dialogue. Several activities and communication products supported the continuous interactions. Another guideline was the inclusion and the welcoming of participants from the beginning of the project to ensure that the participant's contributions could drive decision-making about the research. Results Participants made several contributions to the research as a new layer of information to the Index, and improvements were made to the interactive panel. They also compromised to support the dissemination and use of the product. Eight representatives of community groups and 29 policymakers participated in our engagement activities during the project. More than 500 people were in our open webinars. In addition, more than 140 news items about IDS-Covid-19 were published in national and international media. Conclusions We highlight as lessons learned the adaptation of some dissemination formats to the public, and the necessity of being flexible and accessible to participants. We strengthened the relationship with relevant stakeholders by exploring individual conversations by phone, WhatsApp, email, and interviews to produce a documentary that registered this whole experience. Cidacs/Fiocruz Bahia has also embedded public engagement and involvement in the study agenda.
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Affiliation(s)
- Adalton dos Anjos Fonseca
- Centre for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador, Brazil
| | - Denise Moraes Pimenta
- Centre for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador, Brazil
| | | | - Raiza Tourinho Lima
- Centre for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador, Brazil
| | - Mauricio Lima Barreto
- Centre for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador, Brazil
| | - Maria Yury Travassos Ichihara
- Centre for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador, Brazil
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8
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Pereira SM, Barreto FR, de Souza RA, de Souza Teles Santos CA, Pereira M, da Paixão ES, de Jesus Lima CCO, da Natividade MS, Lindoso AABP, Fernandes EG, Junior EBC, Pescarini JM, de Andrade KVF, de Souza FM, de Britto EA, Nunes C, Ichihara MY, Dalcolmo M, Trajman A, Barral-Netto M, Abubakar I, Barreto ML, de Alencar Ximenes RA, Rodrigues LC. Previous BCG vaccination is associated with less severe clinical progression of COVID-19. BMC Med 2023; 21:145. [PMID: 37055776 PMCID: PMC10099006 DOI: 10.1186/s12916-023-02859-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 04/03/2023] [Indexed: 04/15/2023] Open
Abstract
BACKGROUND BCG vaccination, originally used to prevent tuberculosis, is known to "train" the immune system to improve defence against viral respiratory infections. We investigated whether a previous BCG vaccination is associated with less severe clinical progression of COVID-19 METHODS: A case-control study comparing the proportion with a BCG vaccine scar (indicating previous vaccination) in cases and controls presenting with COVID-19 to health units in Brazil. Cases were subjects with severe COVID-19 (O2 saturation < 90%, severe respiratory effort, severe pneumonia, severe acute respiratory syndrome, sepsis, and septic shock). Controls had COVID-19 not meeting the definition of "severe" above. Unconditional regression was used to estimate vaccine protection against clinical progression to severe disease, with strict control for age, comorbidity, sex, educational level, race/colour, and municipality. Internal matching and conditional regression were used for sensitivity analysis. RESULTS BCG was associated with high protection against COVID-19 clinical progression, over 87% (95% CI 74-93%) in subjects aged 60 or less and 35% (95% CI - 44-71%) in older subjects. CONCLUSIONS This protection may be relevant for public health in settings where COVID-19 vaccine coverage is still low and may have implications for research to identify vaccine candidates for COVID-19 that are broadly protective against mortality from future variants. Further research into the immunomodulatory effects of BCG may inform COVID-19 therapeutic research.
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Affiliation(s)
| | | | | | - Carlos Antonio de Souza Teles Santos
- Center for Data and Knowledge Integration for Health (CIDACS), Fiocruz, Salvador, Brazil
- Department of Exact Sciences, State University of Feira de Santana, Bahia, Salvador, Brazil
| | - Marcos Pereira
- Institute of Collective Health, Federal University of Bahia, Salvador, Brazil.
| | - Enny Santos da Paixão
- Center for Data and Knowledge Integration for Health (CIDACS), Fiocruz, Salvador, Brazil
- Faculty of Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | | | | | | | | | | | - Julia Moreira Pescarini
- Center for Data and Knowledge Integration for Health (CIDACS), Fiocruz, Salvador, Brazil
- Faculty of Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | | | | | - Elisangela Alves de Britto
- Institute of Collective Health, Federal University of Bahia, Salvador, Brazil
- State Department of Health of Bahia, Institute Couto Maia, Salvador, Brazil
| | - Ceuci Nunes
- State Department of Health of Bahia, Institute Couto Maia, Salvador, Brazil
| | - Maria Yuri Ichihara
- Center for Data and Knowledge Integration for Health (CIDACS), Fiocruz, Salvador, Brazil
| | - Margareth Dalcolmo
- Hélio Fraga Reference Center, Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, Brazil
| | - Anete Trajman
- Departamento de Clínica Médica, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
- McGill TB International Centre, McGill University, Montreal, Canada
| | - Manoel Barral-Netto
- Institute Gonçalo Moniz - Fundação Oswaldo Cruz (Fiocruz), Salvador, Brazil
- Faculdade de Medicina, Federal University of Bahia, Salvador, Brazil
| | - Ibrahim Abubakar
- Institute for Global Health, University College London, London, UK
| | - Mauricio Lima Barreto
- Institute of Collective Health, Federal University of Bahia, Salvador, Brazil
- Center for Data and Knowledge Integration for Health (CIDACS), Fiocruz, Salvador, Brazil
| | | | - Laura Cunha Rodrigues
- Center for Data and Knowledge Integration for Health (CIDACS), Fiocruz, Salvador, Brazil
- Faculty of Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
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9
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Pescarini JM, Goes E, Scaff P, Schindler B, Rodrigues LC, Brickley EB, Smeeth L, Barreto ML. Mortality among internal and international migrants in the 100 Million Brazilian Cohort. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.653] [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] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
There is limited evidence on the health of migrant populations in low and middle-income countries (LMICs). Here, we investigated the patterns of mortality risk in migrants and non-migrants in women and men over the life course.
Methods
We linked socioeconomic and mortality data from 1st Jan 2011 to 31st Dec 2018 in the 100 Million Brazilian Cohort. We calculated all-cause and cause-specific age-standardised mortality rates according to individuals’ migration status. Using Cox regression models, we estimated the age- and sex-adjusted mortality hazard ratios (HR) for internal migrants (i.e., people born in Brazil but living in a different Brazilian state to their state of birth) compared to Brazilian-born non-migrants; and for international migrants (i.e., people born in another country) compared to Brazilian-born individuals.
Results
We followed 45,051,476 individuals, of whom 6,057,814 were internal migrants and 277,230 were international migrants. Internal migrants had a similar overall risk of all-cause mortality compared to Brazilian non-migrants (aHR=0.99, 95%CI=0.98-0.99), with lower mortality from some causes but higher mortality for some non-communicable diseases (NCDs). Compared to Brazilian-born individuals, international migrants had a lower risk of all-cause mortality (aHR=0.82, 95%CI=0.80-0.84), with up to 50% lower risk of death attributed to interpersonal violence among international migrant men (aHR=0.50, 95%CI=0.40-0.64), but a markedly higher risk of death by avoidable causes related to maternal health among young migrant women (aHR=2.17, 95%CI=1.17-4.05).
Conclusions
Overall, internal migration was not associated with excess all-cause mortality, while international migration into Brazil was associated with lower all-cause mortality. Mortality patterns among migrant populations in Brazil show marked variation for specific causes of death, and risks varied by age and sex.
Key messages
• Non-communicable diseases and maternal mortality are disproportionally higher among internal and international migrants, respectively.
• Further investigation of the underlying factors associated with higher maternal mortality among international migrant women is key to informing the targeting of social and health interventions.
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Affiliation(s)
- JM Pescarini
- Centre of Data and Knowledge Integration for Health, Oswaldo Cruz Foundation , Salvador, Brazil
- Faculty of Epidemiology and Population, LSHTM , London, Brazil
| | - E Goes
- Centre of Data and Knowledge Integration for Health, Oswaldo Cruz Foundation , Salvador, Brazil
| | - P Scaff
- Centre of Data and Knowledge Integration for Health, Oswaldo Cruz Foundation , Salvador, Brazil
| | - B Schindler
- Centre of Data and Knowledge Integration for Health, Oswaldo Cruz Foundation , Salvador, Brazil
| | - LC Rodrigues
- Faculty of Epidemiology and Population, LSHTM , London, Brazil
| | - EB Brickley
- Faculty of Epidemiology and Population, LSHTM , London, Brazil
| | - L Smeeth
- Faculty of Epidemiology and Population, LSHTM , London, Brazil
| | - ML Barreto
- Centre of Data and Knowledge Integration for Health, Oswaldo Cruz Foundation , Salvador, Brazil
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10
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Castro-de-Araujo LFS, Rodrigues EDS, Machado DB, Henriques CMP, Verotti MP, Gonçalves AQ, Duarte-Salles T, Kanaan RA, Barreto ML, Lewis G, Barbosa JR. Multimorbidity worsened anxiety and depression symptoms during the COVID-19 pandemic in Brazil. J Affect Disord 2022; 314:86-93. [PMID: 35810830 PMCID: PMC9259509 DOI: 10.1016/j.jad.2022.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 05/16/2022] [Accepted: 07/03/2022] [Indexed: 11/24/2022]
Abstract
Multimorbidity is a global health issue impacting the quality of life of all ages. Multimorbidity with a mental disorder is little studied and is likely to have been affected by the COVID-19 pandemic. We used a survey of 14,007 respondents living in Brazil to investigate whether people who already had at least one chronic medical condition had more depression and anxiety symptoms during social distancing in 2020. Generalized linear models and structural equation modelling were used to estimate the effects. A 19 % and 15 % increase in depressive symptoms were found in females and males, respectively, for each unit of increase in the observed value of reported chronic disease. Older subjects presented fewer symptoms of depression and anxiety. There was a 16 % increase in anxiety symptoms in females for each unit increase in the reported chronic disease variable and a 14 % increase in males. Younger subjects were more affected by anxiety symptoms in a dose-response fashion. High income was significantly related to fewer depressive and anxiety symptoms in both males and females. Physical activity was significantly associated with fewer anxiety and depression symptoms. Structural equation modelling confirmed these results and provided further insight into the hypothesised paths.
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Affiliation(s)
- Luis Fernando Silva Castro-de-Araujo
- Center of Data and Knowledge Integration for Health (CIDACS), Fiocruz, Salvador, Brazil; Dept of Psychiatry, The University of Melbourne, Austin Health, Victoria, Australia.
| | - Elisângela da Silva Rodrigues
- Center of Data and Knowledge Integration for Health (CIDACS), Fiocruz, Salvador, Brazil; Federal University of Ceará, Campus Jardins de Anita, Itapajé, Ceará, Brazil.
| | - Daiane Borges Machado
- Center of Data and Knowledge Integration for Health (CIDACS), Fiocruz, Salvador, Brazil; Harvard Medical School, Department Global Health and Social Medicine, United States of America.
| | | | | | - Alessandra Queiroga Gonçalves
- Unitat de Suport a la Recerca Terres de l'Ebre, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Tortosa, Catalunya, Spain; Unitat Docent de Medicina de Família i Comunitària Tortosa-Terres de L'Ebre, Institut Català de la Salut, Tortosa, Catalunya, Spain.
| | - Talita Duarte-Salles
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain.
| | - Richard A Kanaan
- Dept of Psychiatry, The University of Melbourne, Austin Health, Victoria, Australia
| | - Mauricio Lima Barreto
- Center of Data and Knowledge Integration for Health (CIDACS), Fiocruz, Salvador, Brazil
| | - Glyn Lewis
- Division of Psychiatry, UCL, London, United Kingdom of Great Britain and Northern Ireland
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11
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Ara A, Santo JE, Conceição J, Barreto ME, Costa LCC, Souza RFDS, Fiaccone RL, Barreto ML, Ichihara MYT. Brazilian governmental database linkage to correct the municipalities underreported cases in a time-dependent cluster analysis on COVID-19. Int J Popul Data Sci 2022. [DOI: 10.23889/ijpds.v7i3.2092] [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: 10/15/2022] Open
Abstract
ObjectivesCovid-19 databases have detailed information about each affected person in Brazil, but it has flaws in counting the number of cases, which are underreported. We aimed to construct and correct the cases dataset by linking different sources of data observations to study the pandemic evolution in Brazilian municipalities.
ApproachUsing the electronic Unified Health System (e-SUS), a public and governmental database, we calculated the pandemic curves of COVID-19 cases. We applied the following approaches to investigate data anomalies a) to perform a descriptive analysis and compare these results with a non-governmental database using Dynamic Time Warping distance; b) to verify and correct municipalities data anomalies linking to other public governmental database namely National Council of Health Secretaries (CONASS) with e-SUS. c) To apply a K-means DTW Barycenter Averaging in clustering analysis to describe the general behaviors of pandemic in Brazilian Municipalities.
ResultsAround 10% records of cases in the e-SUS public governmental database were underreported. After the linkage and the data updating procedure, the time-dependent clustering analysis presents no anomalies and more interpretable results. The clustering analysis provided eight different behaviors of COVID-19 curves of cases. The degree of intensity for prevalence and incidence rates were identified according to eight clusters from the lowest to highest.
ConclusionsUsing the matching procedure based on Dynamic Time Warping distance to correct the municipalities unreported cases, we provided a richer dataset to support a clustering time dependent analysis to characterize the Pandemic evolution in Brazil. These results may be explored in future deprivation social studies.
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12
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Ichihara MYT, Fiaccone RL, Da Costa LCC, De Medeiros AGP, Pinto Junior EP, Da Silva Souza RF, Barreto ML, Ara A, Goes E, Pescarini JM, Barreto ME, Gregorio J. Using linked administrative data to build a Social Disparities Index for Covid-19 to evaluate the effects of inequalities on pandemic in Brazil. Int J Popul Data Sci 2022. [DOI: 10.23889/ijpds.v7i3.2088] [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: 10/15/2022] Open
Abstract
ObjectiveBrazil is one of the most unequal countries in the world. We aimed to create a Social Disparities Index for Covid-19 (SDI-Covid-19) using linked administrative data to understand the role of inequalities in the COVID-19 pandemic to target social and health policies.
ApproachUsing linked administrative data (2010 Census and National Registry of Health Establishments) we selected municipal indicators for three domains: a) Brazilian Deprivation Index; b) % black/brown/indigenous, % people living in housing with density >2 person/room, % poor older people as sociodemographic; c) ICU beds and respirators rates weighted by distance to the health region headquarters as access to health service. A z-score weighted by the population estimated each indicator within the domains. The domains were combined by simple average of the z-scores and classified in quintiles (1-very low to 5-very high). Other methods (TRI, Macharia et al)1 found similar estimative.
ResultsThe SDI-COVID-19 estimated for the three moments of the pandemic (before (T0), first (T1) and second peak (T2)) in Brazil showed that municipalities belonging to the North and Northeast regions had worse SDI-Covid-19 compared to municipalities in the Midwest, Southeast, and South regions of the country. More than 97% of the municipalities in the North and Northeast regions had high and very high SDI in the three estimated periods. There was an increase of 46% in the number of municipalities in the Midwest region with high and very high SDI in T1 and 33% in T2 when compared to T0. Otherwise, we observed an increase of municipalities with very low and low SDI in T1 and T2 in the Southeast and South regions
ConclusionsThe deterministic linkage of administrative data allowed to build the SDI-COVID-19. This index identified the most vulnerable municipalities in the North and Northeast regions in contrast of municipalities in the Southeast and South regions of Brazil with lower inequalities during the pandemic. Findings can target policies to those areas.
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de Queiroz MJ, de Castro CT, Albuquerque FC, Brandão CC, Gerlack LF, Pereira DCR, Barros SC, Andrade WW, Bastos EDA, Azevedo JDNB, Carreiro R, Barreto ML, Santos DB. Safety of biological therapy in patients with rheumatoid arthritis in administrative health databases: A systematic review and meta-analysis. Front Pharmacol 2022; 13:928471. [PMID: 36034855 PMCID: PMC9407686 DOI: 10.3389/fphar.2022.928471] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 07/11/2022] [Indexed: 12/02/2022] Open
Abstract
Background: Rheumatoid arthritis (RA) is a systemic inflammatory disease that affects the synovial fluid of joints, tendons, and some extra-articular sites. Biologic agents have been highly effective and are comparable in reducing RA symptoms, slowing disease progression, and improving physical function; however, concerns have been raised about the risks of several potential adverse effects. Thus, this study aimed to assess the safety of biological therapy in patients with rheumatoid arthritis in observational studies using administrative health databases. Methods: PubMed, Embase, Lilacs, Ovid, Scopus, and Web of Science were searched from inception to 21 October 2021. The analysis was divided into five groups: tumor necrosis factor inhibitors (TNFi) versus non-TNFi; TNFi versus csDMARDs; bDMARDs versus csDMARDs; abatacept versus bDMARDs; and TNFi versus Janus kinase inhibitors (JAKi). The adverse events were cancer, cardiovascular events, infection, herpes zoster, tuberculosis, and death. The methodological quality of the studies was assessed by the Newcastle-Ottawa Scale. A random-effects model estimated risk ratios with 95% confidence intervals. Results: Thirty-one studies were eligible for inclusion in the present systematic review, published from 2014 to 2021. A total of 1,039,398 RA patients were assessed. The 31 studies evaluated eleven different biological drugs. No significant differences were found regarding safety between TNFi versus non-TNFi (RR 1.08; 95% CI 0.92–1.28; p < 0.01; I2 = 93.0%), TNFi versus csDMARDs (RR 0.91; 95% CI 0.75–1.10; p < 0.01; I2 = 87.0%), bDMARDs versus csDMARDs (RR 0.99; 95% CI 0.82–1.20; p < 0.01; I2 = 93.0%), abatacept versus bDMARDs (RR 0.80; 95% CI 0.54–1.18; p < 0.01; I2 = 90.0%), and TNFi versus JAKi (RR 3.54; 95% CI 0.30–42.09; p = 0.01; I2 = 81.0%). In the subgroup analysis, among studies comparing abatacept to TNFi, a lower risk of cardiovascular events was associated with abatacept (RR 0.37; 95% CI 0.24–0.55). Conclusion: Our results do not suggest an increased risk of adverse events associated with biological therapy in treating RA patients, indicating a lower risk of cardiovascular events with abatacept than TNFi. However, these findings must be interpreted with caution given the limitations of this study and the low/very low certainty of the evidence. Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?, identifier [CRD42020190838].
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Affiliation(s)
- Mariana Jorge de Queiroz
- Department of Pharmaceutical Assistance and Strategic Inputs, Ministry of Health, Brasília, Brazil
| | | | | | - Celmário Castro Brandão
- Department of Pharmaceutical Assistance and Strategic Inputs, Ministry of Health, Brasília, Brazil
| | - Leticia Farias Gerlack
- Department of Pharmaceutical Assistance and Strategic Inputs, Ministry of Health, Brasília, Brazil
| | | | - Sandra Castro Barros
- Department of Pharmaceutical Assistance and Strategic Inputs, Ministry of Health, Brasília, Brazil
| | - Wenderson Walla Andrade
- Department of Pharmaceutical Assistance and Strategic Inputs, Ministry of Health, Brasília, Brazil
| | - Ediane de Assis Bastos
- Department of Pharmaceutical Assistance and Strategic Inputs, Ministry of Health, Brasília, Brazil
| | | | - Roberto Carreiro
- Center of Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador, Brazil
| | - Mauricio Lima Barreto
- Center of Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador, Brazil
| | - Djanilson Barbosa Santos
- Center of Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador, Brazil
- Center for Health Sciences, Federal University of Recôncavo da Bahia, Santo Antônio de Jesus, Brazil
- *Correspondence: Djanilson Barbosa Santos,
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14
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de Castro CT, de Queiroz MJ, Albuquerque FC, Brandão CC, Gerlack LF, Pereira DCR, Barros SC, Andrade WW, Bastos EDA, Azevedo JDNB, Carreiro R, Barreto ML, dos Santos DB. Real-world effectiveness of biological therapy in patients with rheumatoid arthritis: Systematic review and meta-analysis. Front Pharmacol 2022; 13:927179. [PMID: 36034836 PMCID: PMC9402894 DOI: 10.3389/fphar.2022.927179] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 07/08/2022] [Indexed: 11/18/2022] Open
Abstract
Background: The treatment of rheumatoid arthritis (RA), a chronic systemic inflammatory autoimmune disease, is based on disease-modifying anti-rheumatic drugs (DMARDs). Typically, it starts with conventional synthetic DMARDs (csDMARDs), and depending on the patient’s response to the treatment and the adverse events experienced, biological DMARDs (bDMARDs) are initiated. bDMARDs are more specific to inflammatory factors than csDMARDs and more efficient in inducing remission and low disease activity. Thus, this study aimed to assess the effectiveness of biological therapy in patients with rheumatoid arthritis in administrative health databases. Methods: PubMed, Embase, Lilacs, Ovid, Scopus, and Web of Science databases were searched from inception to 21 October 2021, to identify observational studies that evaluated the effectiveness of biological therapy in patients with rheumatoid arthritis using administrative databases and real-world data. The methodological quality was assessed by the methodological index for non-randomized studies (MINORS). A fixed or random-effects model estimated risk ratios with 95% confidence intervals. The analysis was divided into four groups: tumor necrosis factor inhibitors (TNFi) versus non-TNFi; TNFi versus TNFi (adalimumab, etanercept, and golimumab versus infliximab); bDMARDs versus Janus kinase inhibitors (JAKi); and bDMARDs monotherapy versus combination therapy (bDMARDs and MTX). Results: Twenty-one records were eligible for inclusion in this systematic review and meta-analysis; seven population-based cohorts, eight prospective, and six retrospective cohort studies. Overall, 182,098 rheumatoid arthritis patients were evaluated. In the meta-analysis, lower effectiveness was observed among TNFi users than in non-TNFi (RR: 0.88; 95% CI: 0.81–0.95; p < 0.01; I2 = 94.0%) and bDMARDs than in JAKi (RR: 0.86; 95% CI: 0.79–0.94; p < 0.01; I2 = 93.0%). Higher effectiveness among adalimumab, etanercept, and golimumab than in infliximab (RR: 1.19; 95% CI: 1.05–1.36; p < 0.01; I2 = 96.0%) was found. No significant differences in the effectiveness of bDMARD monotherapy compared to combination therapy (RR: 0.83; 95% CI: 0.68–1.00; p < 0.01; I2 = 81.0%) was observed. E-value analysis indicated that the estimates were not robust against unmeasured confounding. Conclusion: According to the available real-world data, our results suggest that biological therapy effectively treats patients with rheumatoid arthritis, indicating higher effectiveness with non-TNFi and JAKi than with TNFi. Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?ID#CRD42020190838, identifier CRD42020190838.
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Affiliation(s)
| | - Mariana Jorge de Queiroz
- Department of Pharmaceutical Assistance and Strategic Inputs, Ministry of Health, Rio de Janeiro, Brazil
| | - Flavia Caixeta Albuquerque
- Department of Pharmaceutical Assistance and Strategic Inputs, Ministry of Health, Rio de Janeiro, Brazil
| | - Celmário Castro Brandão
- Department of Pharmaceutical Assistance and Strategic Inputs, Ministry of Health, Rio de Janeiro, Brazil
| | - Leticia Farias Gerlack
- Department of Pharmaceutical Assistance and Strategic Inputs, Ministry of Health, Rio de Janeiro, Brazil
| | | | - Sandra Castro Barros
- Department of Pharmaceutical Assistance and Strategic Inputs, Ministry of Health, Rio de Janeiro, Brazil
| | - Wenderson Walla Andrade
- Department of Pharmaceutical Assistance and Strategic Inputs, Ministry of Health, Rio de Janeiro, Brazil
| | | | | | - Roberto Carreiro
- Center of Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador, Brazil
| | - Mauricio Lima Barreto
- Center of Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador, Brazil
| | - Djanilson Barbosa dos Santos
- Center for Health Sciences, Federal University of Recôncavo da Bahia, Santo Antônio de Jesus, Brazil
- *Correspondence: Djanilson Barbosa dos Santos,
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15
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Pinto PFPS, Santos BPSD, Teixeira CSS, Nery JS, Amorim LDAF, Sanchez MN, Barreto ML, Pescarini JM. Performance evaluation of tuberculosis control in Brazilian municipalities. Rev Saude Publica 2022; 56:53. [PMID: 35703607 PMCID: PMC9239336 DOI: 10.11606/s1518-8787.2022056004020] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 09/07/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To evaluate the performance of tuberculosis control in Brazilian municipalities. METHODS This is an ecological study on Brazilian municipalities that notified at least four new cases of tuberculosis, with a minimum of one new case of pulmonary tuberculosis between 2015 and 2018. The municipalities were stratified according to the population in < 50 thousand, 50-100 thousand, 100-300 thousand, and > 300 thousand inhabitants, and the k-means method was used to group them within each population range according to the performance of six indicators of the disease. RESULTS A total of 2,845 Brazilian municipalities were included, comprising 98.5% (208,007/211,174) of new tuberculosis cases in the period. For each population range, three groups (A, B, and C) of municipalities were identified according to the performance of the indicators: A, the most satisfactory; B, the intermediates; and C, the least satisfactory. Municipalities in group A with < 100 thousand inhabitants presented results above the targets for laboratory confirmation (≥ 72%), abandonment (≤ 5%), and cure (≥ 90%), and comprised 2% of new cases of the disease. Conversely, municipalities of groups B and C presented at least five indicators with results below the targets - HIV testing (< 100%), contact investigation (< 90%), directly observed therapy (< 90%), abandonment (> 5%), and cure (< 90%) -, and corresponded to 66.7% of new cases of tuberculosis. In group C of municipalities with > 300 thousand inhabitants, which included 19 of the 27 capitals and 43.1% of new cases of tuberculosis, the lowest percentages of contact investigation (mean = 56.4%) and directly observed therapy (mean = 15.4%) were verified, in addition to high abandonment (mean = 13.9%) and low coverage of primary health care (mean = 66.0%). CONCLUSIONS Most new cases of tuberculosis occurred in municipalities with unsatisfactory performance for disease control. Expanding the coverage of primary health care in these places can reduce abandonment and increase the contact investigation and directly observed therapy.
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Affiliation(s)
| | - Beatriz Pinheiro Schindler Dos Santos
- Fundação Oswaldo Cruz. Centro de Integração de Dados e Conhecimentos para a Saúde. Salvador, BA, Brasil.,Universidade Federal da Bahia. Instituto de Saúde Coletiva. Departamento de Saúde Coletiva I. Salvador, BA, Brasil
| | | | - Joilda Silva Nery
- Fundação Oswaldo Cruz. Centro de Integração de Dados e Conhecimentos para a Saúde. Salvador, BA, Brasil.,Universidade Federal da Bahia. Instituto de Saúde Coletiva. Departamento de Saúde Coletiva I. Salvador, BA, Brasil
| | - Leila Denise Alves Ferreira Amorim
- Fundação Oswaldo Cruz. Centro de Integração de Dados e Conhecimentos para a Saúde. Salvador, BA, Brasil.,Universidade Federal da Bahia. Instituto de Matemática. Departamento de Estatística. Salvador, BA, Brasil
| | - Mauro Niskier Sanchez
- Fundação Oswaldo Cruz. Centro de Integração de Dados e Conhecimentos para a Saúde. Salvador, BA, Brasil.,Universidade de Brasília. Faculdade de Ciências da Saúde. Departamento de Saúde Coletiva. Brasília, DF, Brasil
| | - Mauricio Lima Barreto
- Fundação Oswaldo Cruz. Centro de Integração de Dados e Conhecimentos para a Saúde. Salvador, BA, Brasil.,Universidade Federal da Bahia. Instituto de Saúde Coletiva. Departamento de Saúde Coletiva I. Salvador, BA, Brasil
| | - Julia Moreira Pescarini
- Fundação Oswaldo Cruz. Centro de Integração de Dados e Conhecimentos para a Saúde. Salvador, BA, Brasil.,London School of Hygiene & Tropical Medicine. Faculty of Epidemiology and Population Health. London, UK
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16
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Lisboa CS, da Mota Santana J, de Cássia Ribeiro-Silva R, de Araújo EM, Lima da Silva CA, Barreto ML, Pereira M, dos Santos DB. Bolsa Familia Program and Perinatal Outcomes: NISAMI Cohort. Int J Environ Res Public Health 2022; 19:5345. [PMID: 35564740 PMCID: PMC9105772 DOI: 10.3390/ijerph19095345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 03/04/2022] [Accepted: 03/10/2022] [Indexed: 11/21/2022]
Abstract
This study aimed to assess the impact of the Bolsa Familia Program on perinatal outcomes of pregnant women. A cohort study was conducted with pregnant women supported by prenatal services at 17 Family Health Units in Bahia, Brazil. A previously tested structured questionnaire, which has sociodemographic, economic, prenatal care, lifestyle, and nutritional variables, has been used to collect data. The outcomes included premature birth and low birth weight. A hierarchical conceptual model was constructed, and logistic regression analysis was performed. From a total of 1173 pregnant women, the identified average age was 25.44 years and 34.10% had pre-gestational overweight. The non-beneficiary pregnant women presented a 1.54 (95% CI = 0.46-5.09) times higher chance of giving birth to children with low weight and a 1.03 (95% CI = 95% CI = 0.53-2.00) times chance of premature birth when compared to the beneficiary group. In the multilevel model, some variables were statistically significant, such as age between 18 and 24 years (p = 0.003), age greater than or equal to 35 years (p = 0.025), family income (p = 0.008), employment status (p = 0.010), and maternal height (p = 0.009). The Bolsa Familia Program, as an integrated strategy of social inclusion and economic development, is suggested to exert a protective effect on the health of mother-concept binomial.
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Affiliation(s)
- Cinthia Soares Lisboa
- Programa de Pós-Graduação em Saúde Coletiva, Feira de Santana State University, Av. Transnordestina, s/n, Feira de Santana, Novo Horizonte 44036-900, BA, Brazil; (E.M.d.A.); (C.A.L.d.S.)
| | - Jerusa da Mota Santana
- Center of Health Sciences, Universidade Federal do Recôncavo da Bahia, Santo Antônio de Jesus 44574-490, BA, Brazil;
| | | | - Edna Maria de Araújo
- Programa de Pós-Graduação em Saúde Coletiva, Feira de Santana State University, Av. Transnordestina, s/n, Feira de Santana, Novo Horizonte 44036-900, BA, Brazil; (E.M.d.A.); (C.A.L.d.S.)
| | - Carlos Alberto Lima da Silva
- Programa de Pós-Graduação em Saúde Coletiva, Feira de Santana State University, Av. Transnordestina, s/n, Feira de Santana, Novo Horizonte 44036-900, BA, Brazil; (E.M.d.A.); (C.A.L.d.S.)
| | - Mauricio Lima Barreto
- Collective Health Institute, Universidade Federal da Bahia, Rua Basílio da Gama, s/n, Salvador 40110-040, BA, Brazil;
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador 41745-715, BA, Brazil
| | - Marcos Pereira
- Collective Health Institute, Universidade Federal da Bahia, Rua Basílio da Gama, s/n, Salvador 40110-040, BA, Brazil;
| | - Djanilson Barbosa dos Santos
- Programa de Pós-Graduação em Saúde Coletiva, Feira de Santana State University, Av. Transnordestina, s/n, Feira de Santana, Novo Horizonte 44036-900, BA, Brazil; (E.M.d.A.); (C.A.L.d.S.)
- Center of Health Sciences, Universidade Federal do Recôncavo da Bahia, Santo Antônio de Jesus 44574-490, BA, Brazil;
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17
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Power GM, Vaughan AM, Qiao L, Sanchez Clemente N, Pescarini JM, Paixão ES, Lobkowicz L, Raja AI, Portela Souza A, Barreto ML, Brickley EB. Socioeconomic risk markers of arthropod-borne virus (arbovirus) infections: a systematic literature review and meta-analysis. BMJ Glob Health 2022; 7:bmjgh-2021-007735. [PMID: 35428678 PMCID: PMC9014035 DOI: 10.1136/bmjgh-2021-007735] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [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: 10/18/2021] [Accepted: 03/02/2022] [Indexed: 02/04/2023] Open
Abstract
Introduction Arthropod-borne viruses (arboviruses) are of notable public health importance worldwide, owing to their potential to cause explosive outbreaks and induce debilitating and potentially life-threatening disease manifestations. This systematic review and meta-analysis aims to assess the relationship between markers of socioeconomic position (SEP) and infection due to arboviruses with mosquito vectors. Methods We conducted a systematic search on PubMed, Embase, and LILACS databases to identify studies published between 1980 and 2020 that measured the association of SEP markers with arbovirus infection. We included observational studies without geographic location or age restrictions. We excluded studies from grey literature, reviews and ecological studies. Study findings were extracted and summarised, and pooled estimates were obtained using random-effects meta-analyses. Results We identified 36 observational studies using data pertaining to 106 524 study participants in 23 geographic locations that empirically examined the relationship between socioeconomic factors and infections caused by seven arboviruses (dengue, chikungunya, Japanese encephalitis, Rift Valley fever, Sindbis, West Nile and Zika viruses). While results were varied, descriptive synthesis pointed to a higher risk of arbovirus infection associated with markers of lower SEP, including lower education, income poverty, low healthcare coverage, poor housing materials, interrupted water supply, marital status (married, divorced or widowed), non-white ethnicities and migration status. Pooled crude estimates indicated an increased risk of arboviral infection associated with lower education (risk ratio, RR 1.5 95% CI 1.3 to 1.9); I2=83.1%), interruption of water supply (RR 1.2; 95% CI 1.1 to 1.3; I2=0.0%) and having been married (RR 1.5 95% CI 1.1 to 2.1; I2=85.2%). Conclusion Evidence from this systematic review suggests that lower SEP increases the risk of acquiring arboviral infection; however, there was large heterogeneity across studies. Further studies are required to delineate the relationship between specific individual, household and community-level SEP indicators and arbovirus infection risks to help inform targeted public health interventions. PROSPERO registration number CRD42019158572.
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Affiliation(s)
- Grace M Power
- Health Equity Action Lab, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, UK
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Aisling M Vaughan
- Health Equity Action Lab, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Luxi Qiao
- Health Equity Action Lab, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
- Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Nuria Sanchez Clemente
- Health Equity Action Lab, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Julia M Pescarini
- Health Equity Action Lab, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Enny S Paixão
- Health Equity Action Lab, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Ludmila Lobkowicz
- Health Equity Action Lab, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Amber I Raja
- Health Equity Action Lab, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - André Portela Souza
- São Paulo School of Economics and Center for Applied Microeconomic Studies, Getulio Vargas Foundation, São Paulo, Brazil
| | - Mauricio Lima Barreto
- Centro de Integração de Dados e Conhecimentos para Saúde, Oswaldo Cruz Foundation, Salvador, Brazil
| | - Elizabeth B Brickley
- Health Equity Action Lab, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
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18
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Azevedo MN, Rodrigues EDS, Passos EAFV, Filho MAB, Barreto APA, Lima MCC, Barreto ML, Castro-de-Araujo LFS. Multimorbidity associated with anxiety symptomatology in post-COVID patients. Psychiatry Res 2022; 309:114427. [PMID: 35124546 PMCID: PMC8801057 DOI: 10.1016/j.psychres.2022.114427] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 01/08/2022] [Accepted: 01/29/2022] [Indexed: 12/19/2022]
Abstract
The COVID-19 pandemic hit individuals with chronic conditions the hardest. It is known that anxiety symptoms are frequent in post-COVID conditions. We want to examine whether multimorbidity is associated with anxiety in post-COVID patients. We reported descriptive statistics from 389 post-COVID patients and perform a linear regression with anxiety symptoms measured using the Hospital Anxiety and Depression (HAD) scale. For each extra chronic condition, there was a mean increase of 0.11 in the HAD-anxiety score. However, there was a reduction for age and being male. These findings can potentially help policy-makers better organize post-COVID health services and improve patients care.
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Affiliation(s)
- Milena Nogueira Azevedo
- Hospital Especializado Octávio Mangabeira (HEOM), Salvador, Brazil; Universidade Federal da Bahia (UFBA), Salvador, Brazil.
| | | | | | - Márcio Andrade Barreto Filho
- Hospital Especializado Octávio Mangabeira (HEOM), Salvador, Brazil; Escola Bahiana de Medicina e Saúde Pública (EBMSP), Salvador, Brazil
| | - Ana Paula Andrade Barreto
- Hospital Especializado Octávio Mangabeira (HEOM), Salvador, Brazil; Escola Bahiana de Medicina e Saúde Pública (EBMSP), Salvador, Brazil
| | - Marcelo Chalhoub Coelho Lima
- Hospital Especializado Octávio Mangabeira (HEOM), Salvador, Brazil; Universidade Salvador (UNIFACS), Salvador, Brazil
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19
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Ribeiro-Silva RDC, Pereira M, Aragão É, Guimarães JMDM, Ferreira AJF, Rocha ADS, Silva NDJ, Teixeira CSS, Falcão IR, Paixao ES, Barreto ML. COVID-19, Food Insecurity and Malnutrition: A Multiple Burden for Brazil. Front Nutr 2022; 8:751715. [PMID: 34977114 PMCID: PMC8716012 DOI: 10.3389/fnut.2021.751715] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 11/09/2021] [Indexed: 11/19/2022] Open
Affiliation(s)
- Rita de Cássia Ribeiro-Silva
- Departamento Ciência da Nutrição, Escola de Nutrição, Universidade Federal da Bahia - Salvador, Bahia, Brazil.,Centro de Integração de Dados e Conhecimentos para Saúde (CIDACS), Fundação Oswaldo Cruz - FIOCRUZ, Salvador, Bahia, Brazil
| | - Marcos Pereira
- Instituto de Saúde Coletiva (ISC), Universidade Federal da Bahia - Salvador, Bahia, Brazil
| | - Érika Aragão
- Instituto de Saúde Coletiva (ISC), Universidade Federal da Bahia - Salvador, Bahia, Brazil
| | | | - Andrêa J F Ferreira
- Centro de Integração de Dados e Conhecimentos para Saúde (CIDACS), Fundação Oswaldo Cruz - FIOCRUZ, Salvador, Bahia, Brazil.,Instituto de Saúde Coletiva (ISC), Universidade Federal da Bahia - Salvador, Bahia, Brazil
| | - Aline Dos Santos Rocha
- Departamento Ciência da Nutrição, Escola de Nutrição, Universidade Federal da Bahia - Salvador, Bahia, Brazil.,Centro de Integração de Dados e Conhecimentos para Saúde (CIDACS), Fundação Oswaldo Cruz - FIOCRUZ, Salvador, Bahia, Brazil
| | - Natanael de Jesus Silva
- Centro de Integração de Dados e Conhecimentos para Saúde (CIDACS), Fundação Oswaldo Cruz - FIOCRUZ, Salvador, Bahia, Brazil
| | - Camila Silveira Silva Teixeira
- Centro de Integração de Dados e Conhecimentos para Saúde (CIDACS), Fundação Oswaldo Cruz - FIOCRUZ, Salvador, Bahia, Brazil.,Instituto de Saúde Coletiva (ISC), Universidade Federal da Bahia - Salvador, Bahia, Brazil
| | - Ila Rocha Falcão
- Departamento Ciência da Nutrição, Escola de Nutrição, Universidade Federal da Bahia - Salvador, Bahia, Brazil.,Centro de Integração de Dados e Conhecimentos para Saúde (CIDACS), Fundação Oswaldo Cruz - FIOCRUZ, Salvador, Bahia, Brazil
| | - Enny Santos Paixao
- Centro de Integração de Dados e Conhecimentos para Saúde (CIDACS), Fundação Oswaldo Cruz - FIOCRUZ, Salvador, Bahia, Brazil.,Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Mauricio Lima Barreto
- Centro de Integração de Dados e Conhecimentos para Saúde (CIDACS), Fundação Oswaldo Cruz - FIOCRUZ, Salvador, Bahia, Brazil.,Instituto de Saúde Coletiva (ISC), Universidade Federal da Bahia - Salvador, Bahia, Brazil
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20
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Victor A, Gotine ARM, Falcão IR, Ferreira A, Flores-Ortiz R, Xavier SP, Vasco MD, de Jesus Silva N, Mahoche M, Silva Rodrigues OA, da Cassia Ribeiro R, Rondó PH, Lima Barreto M. Association Between Food Environments and Fetal Growth in Pregnant Brazilian Women. SSRN Journal 2022. [DOI: 10.2139/ssrn.4176384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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21
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Matos SMA, Amorim LDAF, Pitanga FJG, Patrão AL, Barreto SM, Chor D, Cardoso LDO, Molina MDCB, Barreto ML, Aquino EML. Social position and anthropometric status among adults in the ELSA-Brasil study: a latent class analysis. CAD SAUDE PUBLICA 2021; 37:e00168918. [PMID: 34669771 DOI: 10.1590/0102-311x00168918] [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: 09/06/2018] [Accepted: 11/27/2020] [Indexed: 11/22/2022] Open
Abstract
The objective of the present study was to evaluate the association between social position and anthropometric status in women and men Brazilian adult. This was a cross-sectional study that used baseline data collected from 2008 to 2010 for the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil, in Portuguese), in the six major Brazilian state capital cities. A total of 15,105 active and retired civil servants aged from 35 to 74 years. Two latent variables were defined by latent class analysis, social position and anthropometric status. Both constructs and the analyses were separately evaluated by sex. Associations were assessed using multivariate logistic regression analysis with adjustment for age, self-reported skin color/race, and marital status. Around 44% of the women and 26% of the men were classified as overweight or obese. Social position tended to be lower in women (43.2%) and higher among men (40.4%). Heavier women were more likely to be black and brown-skinned, whereas slimmer women were more likely to be white. After adjustment, women's weight increased as social position decreased (OR = 1.52; 95%CI: 1.36-1.70), whereas in men weight decreased as social position decreased (OR = 0.87; 95%CI: 0.76-0.99). Social position affected the anthropometric status of women and men differently, with body patterns also being affected by ethnicity/skin color, showing the potentiality of taking the intersectional perspective when investigating the possible social determinants of the phenomenon.
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Affiliation(s)
| | | | | | - Ana Luísa Patrão
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brasil
| | | | - Dora Chor
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | | | | | | | - Estela M L Aquino
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brasil
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22
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Ortelan N, Ferreira AJF, Leite L, Pescarini JM, Souto AC, Barreto ML, Aquino EML. Cloth masks in public places: an essential intervention to prevent COVID-19 in Brazil. Cien Saude Colet 2021; 26:669-692. [PMID: 33605343 DOI: 10.1590/1413-81232021262.36702020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 11/02/2020] [Indexed: 02/08/2023] Open
Abstract
There is increasing evidence that the use of masks is an indispensable protective measure against COVID-19, given the high transmissibility of the new coronavirus through the respiratory system, including by asymptomatic individuals. The use of cloth masks in public places has been established as a protective measure to be adopted alongside social distancing and hand hygiene. This narrative review aims to systematize the scientific evidence that informs the widespread use of cloth masks as a preventive measure against COVID-19 and to describe the evolution of positions contrary to or in favor of its use outside the home, in view of the advance of the new coronavirus pandemic globally. The scientific articles, technical notes, governmental decrees and other documents analyzed indicate that widespread use of masks has the potential to reduce the spread of the new coronavirus. We recommend that the Brazilian government adopt strategies to increase the supply of reusable cloth masks to the public, especially to vulnerable populations and to support studies on the impact of this measure to control the pandemic in the country. Finally, it is imperative to ensure that use of masks does not exacerbate stigmatization of racial groups that already face prejudice.
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Affiliation(s)
- Naiá Ortelan
- Centro de Integração de Dados e Conhecimentos para Saúde, Fiocruz Bahia. R. Mundo s/n, Trobogy. 41745-715 Salvador BA Brasil.
| | | | | | - Julia Moreira Pescarini
- Centro de Integração de Dados e Conhecimentos para Saúde, Fiocruz Bahia. R. Mundo s/n, Trobogy. 41745-715 Salvador BA Brasil.
| | - Ana Cristina Souto
- Instituto de Saúde Coletiva, Universidade Federal da Bahia (UFBA). Salvador BA Brasil
| | - Mauricio Lima Barreto
- Centro de Integração de Dados e Conhecimentos para Saúde, Fiocruz Bahia. R. Mundo s/n, Trobogy. 41745-715 Salvador BA Brasil.
| | - Estela M L Aquino
- Instituto de Saúde Coletiva, Universidade Federal da Bahia (UFBA). Salvador BA Brasil
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23
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Oliveira PRS, de Matos LO, Araujo NM, Sant Anna HP, da Silva E Silva DA, Damasceno AKA, Martins de Carvalho L, Horta BL, Lima-Costa MF, Barreto ML, Wiers CE, Volkow ND, Brunialti Godard AL. LRRK2 Gene Variants Associated With a Higher Risk for Alcohol Dependence in Multiethnic Populations. Front Psychiatry 2021; 12:665257. [PMID: 34135785 PMCID: PMC8202767 DOI: 10.3389/fpsyt.2021.665257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 02/08/2021] [Accepted: 04/12/2021] [Indexed: 11/22/2022] Open
Abstract
Background: Genetics influence the vulnerability to alcohol use disorders, and among the implicated genes, three previous studies have provided evidences for the involvement of LRRK2 in alcohol dependence (AD). LRRK2 expression is broadly dysregulated in postmortem brain from AD humans, as well as in the brain of mice with alcohol dependent-like behaviors and in a zebrafish model of alcohol preference. The aim of the present study was to evaluate the association of variants in the LRRK2 gene with AD in multiethnic populations from South and North America. Methods: Alcohol-screening questionnaires [such as CAGE and Alcohol Use Disorders Identification Test (AUDIT)] were used to determine individual risk of AD. Multivariate logistic regression analyses were done in three independent populations (898 individuals from Bambuí, Brazil; 3,015 individuals from Pelotas, Brazil; and 1,316 from the United States). Linkage disequilibrium and conditional analyses, as well as in silico functional analyses, were also conducted. Results: Four LRRK2 variants were significantly associated with AD in our discovery cohort (Bambuí): rs4768231, rs4767971, rs7307310, and rs1465527. Two of these variants (rs4768231 and rs4767971) were replicated in both Pelotas and US cohorts. The consistent association signal (at the LRRK2 locus) found in populations with different genetic backgrounds reinforces the relevance of our findings. Conclusion: Taken together, these results support the notion that genetic variants in the LRRK2 locus are risk factors for AD in humans.
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Affiliation(s)
- Pablo Rafael Silveira Oliveira
- Instituto de Biologia, Universidade Federal da Bahia, Salvador, Brazil.,Centro de Integração de Dados e Conhecimentos para Saúde, Fundação Oswaldo Cruz, Salvador, Brazil
| | - Lorena Oliveira de Matos
- Departamento de Genética, Ecologia e Evolução, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Nathalia Matta Araujo
- Departamento de Genética, Ecologia e Evolução, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Hanaísa P Sant Anna
- Departamento de Genética, Ecologia e Evolução, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Andresa K Andrade Damasceno
- Instituto de Biologia, Universidade Federal da Bahia, Salvador, Brazil.,Centro de Integração de Dados e Conhecimentos para Saúde, Fundação Oswaldo Cruz, Salvador, Brazil
| | - Luana Martins de Carvalho
- Department of Psychiatry, Center for Alcohol Research in Epigenetics, University of Illinois, Chicago, IL, United States
| | - Bernardo L Horta
- Programa de Pos-Graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brazil
| | | | - Mauricio Lima Barreto
- Centro de Integração de Dados e Conhecimentos para Saúde, Fundação Oswaldo Cruz, Salvador, Brazil
| | - Corinde E Wiers
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, United States
| | - Nora D Volkow
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, United States
| | - Ana Lúcia Brunialti Godard
- Departamento de Genética, Ecologia e Evolução, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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24
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Rodriguez A, Rodrigues L, Chico M, Vaca M, Barreto ML, Brickley E, Cooper PJ. Measuring urbanicity as a risk factor for childhood wheeze in a transitional area of coastal ecuador: a cross-sectional analysis. BMJ Open Respir Res 2020; 7:7/1/e000679. [PMID: 33257440 PMCID: PMC7705553 DOI: 10.1136/bmjresp-2020-000679] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 10/19/2020] [Accepted: 11/03/2020] [Indexed: 11/13/2022] Open
Abstract
Background The urbanisation process has been associated with increases in asthma prevalence, an observation supported largely by studies comparing urban with rural populations. The nature of this association remains poorly understood, likely because of the limitations of the urban–rural approach to understand what a multidimensional process is. Objective This study explored the relationship between the urbanisation process and asthma prevalence using a multidimensional and quantitative measure of urbanicity. Methods A cross-sectional analysis was conducted in 1843 children living in areas with diverse levels of urbanisation in the district of Quinindé, Ecuador in 2013–2015. Categorical principal components analysis was used to generate an urbanicity score derived from 18 indicators measured at census ward level based on data from the national census in 2010. Indicators represent demographic, socioeconomic, built environment and geographical dimensions of the urbanisation process. Geographical information system analysis was used to allocate observations and urban characteristics to census wards. Logistic random effects regression models were used to identify associations between urbanicity score, urban indicators and three widely used definitions for asthma. Results The prevalence of wheeze ever, current wheeze and doctor diagnosis of asthma was 33.3%, 13% and 6.9%, respectively. The urbanicity score ranged 0–10. Positive significant associations were observed between the urbanicity score and wheeze ever (adjusted OR=1.033, 95% CI 1.01 to 1.07, p=0.05) and doctor diagnosis (adjusted OR=1.06, 95% CI 1.02 to 1.1, p=0.001). For each point of increase in urbanicity score, the prevalence of wheeze ever and doctor diagnosis of asthma increased by 3.3% and 6%, respectively. Variables related to socioeconomic and geographical dimensions of the urbanisation process were associated with greater prevalence of wheeze/asthma outcomes. Conclusions Even small increases in urbanicity are associated with a higher prevalence of asthma in an area undergoing the urban transition. The use of a multidimensional urbanicity indicator has greater explanatory power than the widely used urban–rural dichotomy to improve our understanding of how the process of urbanisation affects the risk of asthma.
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Affiliation(s)
- Alejandro Rodriguez
- Facultad de ciencias Médicas de la salud y la Vida, Universidad Internacional del Ecuador, Quito, Pichincha, Ecuador .,SCAALA project, Fundacion Ecuatoriana para la Investigacion en Salud (FEPIS), Quininde, Esmeraldas, Ecuador
| | - Laura Rodrigues
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Martha Chico
- SCAALA project, Fundacion Ecuatoriana para la Investigacion en Salud (FEPIS), Quininde, Esmeraldas, Ecuador
| | - Maritza Vaca
- SCAALA project, Fundacion Ecuatoriana para la Investigacion en Salud (FEPIS), Quininde, Esmeraldas, Ecuador
| | - Mauricio Lima Barreto
- Centro de de Integração de Dados e Conhecimentos para Saúde (CIDACS) FIOCRUZ, Salvador, Bahia, Brazil.,Instituto de Saude Coletiva, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Elizabeth Brickley
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Philip J Cooper
- Facultad de ciencias Médicas de la salud y la Vida, Universidad Internacional del Ecuador, Quito, Pichincha, Ecuador.,Institute of Infection and Immunity, St George's University of London, London, Esmeraldas, UK
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Pescarini JM, Craig P, Allik M, Amorim L, Ali MS, Smeeth L, Barreto ML, Leyland A, Aquino EML, Katikireddi SV. The Brazilian conditional cash transfer program and cardiovascular mortality: a data linkage study. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.1418] [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] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Conditional cash transfer programmes (CCTs) make monetary transfers to poor families conditional on health check-ups and/or education attendance. CCTs have been key in reducing poverty and improving child and maternal health in low- and middle-income countries (LMICs) but their impact on cardiovascular mortality have not been studied. We aimed to evaluate the effect of the CCT Bolsa Familia Program (BFP) on premature all-cause and cardiovascular mortality in Brazil.
Methods
The 100 Million Brazilian Cohort combined information about individuals applying for social programmes, the BFP and mortality data. We analysed ∼8 million individuals aged 30-69 who applied from 2011 to 2015. We calculated inverse probability weights (IPW) for the probability to receive BFP based on baseline observed characteristics (age, education, race, geographical location, household characteristics and year of application). Individuals were followed until they reached 70 years of age, died by any cause, or until 31st Dec 2015. We used Poisson regression (with person-years as the offset) and IPWs to compare BFP recipients to a comparable control population. Females and males were analysed separately.
Results
By following individuals for up to 4 years, 43,562 deaths by all-causes occurred among 4,197,658 females and 69,209 deaths among 3,672,393 males. Female BFP beneficiaries had approximately 60% lower all-cause mortality (IRR=0.40;95%CI=0.37-0.42) and CVD mortality (IRR=0.42;95%CI=0.37-0.47) than non-beneficiaries. Males who are BFP beneficiaries had ∼50% lower all-cause (IRR=0.53;95%CI=0.52-0.55) and 60% lower cardiovascular mortality (IRR=0.40;95%CI=0.38-0.42) than non-beneficiaries.
Conclusions
BFP, the world's largest CCT, may substantially decrease premature mortality. CCTs might have important implications for the growing burden of non-communicable diseases, with impacts potentially due to improved nutrition, socioeconomic conditions and improved primary care access.
Key messages
The Brazilian CCT, a widely recognized programme for poverty alleviation, have showed to be associated with lower overall and cardiovascular premature mortality in both women and men. Other countries, particularly LMICs, may learn from the health benefits of CCTs and should consider its potential large effect on mortality when planning austerity policies.
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Affiliation(s)
- J M Pescarini
- The Center for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, Brazil
| | - P Craig
- MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - M Allik
- MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - L Amorim
- Institute of Mathematics and Statistics, Federal University of Bahia, Salvador, Brazil
| | - M S Ali
- The Center for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, Brazil
- Department of Non-Communicable Disease Epidemiology, LSHTM, London, UK
| | - L Smeeth
- Department of Non-Communicable Disease Epidemiology, LSHTM, London, UK
- Health Data Research, London, UK
| | - M L Barreto
- The Center for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, Brazil
- Institute of Collective Health, Federal University of Bahia, Salvador, Brazil
| | - A Leyland
- MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - E M L Aquino
- Institute of Collective Health, Federal University of Bahia, Salvador, Brazil
| | - S V Katikireddi
- MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, Glasgow, UK
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Bernal RTI, de Carvalho QH, Pell JP, Leyland AH, Dundas R, Barreto ML, Malta DC. A methodology for small area prevalence estimation based on survey data. Int J Equity Health 2020; 19:124. [PMID: 32731877 PMCID: PMC7393920 DOI: 10.1186/s12939-020-01220-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 10/09/2019] [Accepted: 06/15/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Brazil conducts many health surveys to provide estimates by national level, macro-regions, states, metropolitan regions and capitals. However, estimates for smaller areas are lacking due to their high cost. The Health Vulnerability Index (in Portuguese, Índice de Vulnerabilidade em Saúde, IVS) is a measure that combines socioeconomic and environmental variables in the same indicator and allows for the analysis of the characteristics of population groups residing in census tracts, grouping them into four health risk areas (low, medium, high and very high risk) in addition to showing inequalities in the epidemiological profile of different social groups. This index was developed by the Municipal Health Secretariat of Belo Horizonte to guide health planning. OBJECTIVE The aim of the study is to produce a methodology for obtaining reliable estimates for tobacco smoking in small areas for which the IVS was not designed. METHODS The Vigitel dataset from 2006 to 2013 was used to obtain estimates of the prevalence of smokers based on the IVS employing small area estimation methods that use data from a larger domain to obtain estimates in smaller areas. For indirect estimates, the covariates included were sanitation, housing, education, income, and social and health factors. Post-stratification weights were used according to the IVS based on the population of the 2010 census. RESULTS From 2006 to 2009, 16.2% (95% CI: 13.6-14.8%) of the adult population in Belo Horizonte were smokers, and 14.8% (95% CI: 14.0-15.6%) were smokers between 2010 and 2013. The very high-risk population maintained a high prevalence over the same period of 21.1% (95% CI: 17.1-25.0%) between 2006 and 2009 and 20.8% (95% CI: 17.0-24.6%) between 2010 and 2013, while in the low-risk group, the prevalence in the same period fell from 14.9% (95% CI: 13.7-16.2%) to 11.8% (95% CI, 10.6-13.1%). CONCLUSIONS The present study identified differences in the profile of smokers by the IVS in the city of Belo Horizonte. While the smoking prevalence declined in richer areas, it remained high in poor areas. This methodology can be used to produce reliable estimates for subgroups with greater vulnerability in small areas and thus subsidize the formulation, monitoring and evaluation of public health policies and programmes aimed at smoking.
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Affiliation(s)
- Regina Tomie Ivata Bernal
- Escola de Enfermagem, Universidade Federal de Minas Gerais (UFMG). Departamento de Enfermagem Materno-Infantil e Saúde Pública, Belo Horizonte, Minas Gerais, Brazil
| | - Quéren Hapuque de Carvalho
- Escola de Enfermagem, Universidade Federal de Minas Gerais (UFMG). Departamento de Enfermagem Materno-Infantil e Saúde Pública, Belo Horizonte, Minas Gerais, Brazil
| | - Jill P Pell
- Institute of Health and Wellbeing, University of Glasgow, Lilybank Gardens, Glasgow, G12 8RZ, UK
| | - Alastair H Leyland
- Medical Research Council/Chief Scientific Office (MRC/SCO) Social and Public Health Sciences Unit, Glasgow, Scotland
| | - Ruth Dundas
- Medical Research Council/Chief Scientific Office (MRC/SCO) Social and Public Health Sciences Unit, Glasgow, Scotland
| | | | - Deborah Carvalho Malta
- Escola de Enfermagem, Universidade Federal de Minas Gerais (UFMG). Departamento de Enfermagem Materno-Infantil e Saúde Pública, Belo Horizonte, Minas Gerais, Brazil.
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Malta DC, Bernal RTI, de Carvalho QH, Pell JP, Dundas R, Leyland A, de Vasconcelos LLC, de Magalhaes Cardoso LS, Stopa SR, Barreto ML. Women and evaluation of inequalities in the distribution of risk factors for Chronic non-communicable diseases (NCD), Vigitel 2016-2017. Rev Bras Epidemiol 2020; 23:e200058. [PMID: 32520106 PMCID: PMC7613912 DOI: 10.1590/1980-549720200058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 04/09/2019] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To compare the distribution of chronic non-communicable diseases (CNCD) indicators among adult female beneficiaries and non-beneficiaries of the Bolsa Família Program (BFP) in Brazilian capitals. METHODS Analysis of Vigitel telephone survey data in 2016 and 2017. Gross and adjusted prevalence ratios (PR) and their respective confidence intervals were estimated using Poisson Regression model. RESULTS Women with BF have lower schooling, are young people, live more frequently in the Northeast and North of the country. Higher prevalence of risk factors were found in woman receiving BF. The adjusted PR of the BF women were: smokers (PR = 1.98), overweight (PR = 1.21), obesity (PR = 1.63), fruits and vegetables (PR = 0.63), consumption of soft drinks (PR = 1.68), bean consumption (PR = 1.25), physical activity at leisure (PR = 0.65), physical activity at home (PR = 1.35), time watching TV (PR = 1.37), self-assessment of poor health status (PR =2.04), mammography (PR = 0.86), Pap smears (PR = 0.91), hypertension (PR = 1.46) and diabetes (PR = 1,66). When women were compared among strata of the same schooling, these differences were reduced. CONCLUSION Worst indicators among women receiving BF reflect social inequalities inherent in this most vulnerable group. The study also shows that BF is being targeted at the most vulnerable women.
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Affiliation(s)
| | | | | | - Jill P. Pell
- Institute of Health and Wellbeing, University of Glasgow, Lilybank Gardens – Glasgow, United Kingdom
| | - Ruth Dundas
- MRC/SCO Social and Public Health Sciences Unit, University of Glasgow – Glasgow, Reino Unido
| | - Alastair Leyland
- MRC/SCO Social and Public Health Sciences Unit, University of Glasgow – Glasgow, Reino Unido
| | | | | | | | - Mauricio Lima Barreto
- Centro of Health Data and Knowledge Integration, Fundação Oswaldo Cruz – Salvador (BA), Brazil
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Fattore GL, Amorim LD, Marques dos Santos L, dos Santos DN, Barreto ML. Experiences of Discrimination and Skin Color Among Women in Urban Brazil: A Latent Class Analysis. Journal of Black Psychology 2020. [DOI: 10.1177/0095798420928204] [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] [Indexed: 11/17/2022]
Abstract
Experiences of discrimination are an important aspect of women’s life in Brazil, especially Black women. The Experiences of Discrimination scale (EOD) is often used for assessing discrimination in epidemiological studies, although divergent cutoff points have been used to characterize the exposure. We used latent class analysis (LCA) and logistic regression to identify and characterize subgroups of women exposed to discrimination and compared with a cutoff-based assignment of subgroups. One thousand two-hundred and four women living in Salvador, Brazil, responded to the EOD. We selected models with two latent classes, highly and lowly exposed. The classes differed in self-reported skin color and education level, revealing that darker skinned (odds ratio [ OR] = 11.3, 95% confidence interval [CI: 1.54, 82.7]) and more educated ( OR = 2.09, 95% CI [1.17, 3.72]) women were more likely to be classified into the highly exposed class. Comparing with LCA, the use of cutoff points overestimated the reporting of discrimination. Researchers should consider the use of more accurate measures of discrimination in order to identify the most vulnerable individuals so that prevention efforts could be better targeted.
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Affiliation(s)
- Gisel Lorena Fattore
- Universidad Nacional de Lanús, Buenos Aires, Lanús, Argentina
- Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | | | | | | | - Mauricio Lima Barreto
- Universidade Federal da Bahia, Salvador, Bahia, Brazil
- FIOCRUZ, Salvador, Bahia, Brazil
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Aquino EML, Silveira IH, Pescarini JM, Aquino R, Souza-Filho JAD, Rocha ADS, Ferreira A, Victor A, Teixeira C, Machado DB, Paixão E, Alves FJO, Pilecco F, Menezes G, Gabrielli L, Leite L, Almeida MDCCD, Ortelan N, Fernandes QHRF, Ortiz RJF, Palmeira RN, Junior EPP, Aragão E, Souza LEPFD, Netto MB, Teixeira MG, Barreto ML, Ichihara MY, Lima RTDRS. Social distancing measures to control the COVID-19 pandemic: potential impacts and challenges in Brazil. Cien Saude Colet 2020; 25:2423-2446. [PMID: 32520287 DOI: 10.1590/1413-81232020256.1.10502020] [Citation(s) in RCA: 231] [Impact Index Per Article: 57.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 04/20/2020] [Indexed: 02/06/2023] Open
Abstract
The COVID-19 pandemic has challenged researchers and policy makers to identify public safety measures forpreventing the collapse of healthcare systems and reducingdeaths. This narrative review summarizes the available evidence on the impact of social distancing measures on the epidemic and discusses the implementation of these measures in Brazil. Articles on the effect of social distancing on COVID-19 were selected from the PubMed, medRXiv and bioRvix databases. Federal and state legislation was analyzed to summarize the strategies implemented in Brazil. Social distancing measures adopted by the population appear effective, particularly when implemented in conjunction with the isolation of cases and quarantining of contacts. Therefore, social distancing measures, and social protection policies to guarantee the sustainability of these measures, should be implemented. To control COVID-19 in Brazil, it is also crucial that epidemiological monitoring is strengthened at all three levels of the Brazilian National Health System (SUS). This includes evaluating and usingsupplementary indicators to monitor the progression of the pandemic and the effect of the control measures, increasing testing capacity, and making disaggregated notificationsand testing resultstransparentand broadly available.
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Affiliation(s)
- Estela M L Aquino
- Instituto de Saúde Coletiva, Universidade Federal da Bahia (UFBA). R. Basílio da Gama s/no, Canela. 40110-040 Salvador BA Brasil.
| | - Ismael Henrique Silveira
- Instituto de Saúde Coletiva, Universidade Federal da Bahia (UFBA). R. Basílio da Gama s/no, Canela. 40110-040 Salvador BA Brasil.
| | | | - Rosana Aquino
- Instituto de Saúde Coletiva, Universidade Federal da Bahia (UFBA). R. Basílio da Gama s/no, Canela. 40110-040 Salvador BA Brasil.
| | | | | | | | | | | | | | - Enny Paixão
- Grupo de síntese da Rede CoVida. Salvador BA Brasil
| | | | | | | | | | | | | | - Naiá Ortelan
- Grupo de síntese da Rede CoVida. Salvador BA Brasil
| | | | | | | | | | - Erika Aragão
- Grupo de síntese da Rede CoVida. Salvador BA Brasil
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Magalhães BSN, Pereira VLA, Machado LS, Dias TS, Balthazar DA, Barreto ML, Troccoli F, Cunha NC, Nascimento ER, Almeida FM, Almosny NR. Occurrence of Avian Mycoplasmas in Free-Living Muscovy-Ducks (Cairina Moschata). Braz J Poult Sci 2020. [DOI: 10.1590/1806-9061-2020-1352] [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] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
| | | | | | - TS Dias
- Universidade Federal Fluminense, Brazil
| | - DA Balthazar
- Universidade Federal Rural do Rio de Janeiro, Brazil
| | | | - F Troccoli
- Fundação Zoológico do Rio de Janeiro, Brazil
| | - NC Cunha
- Universidade Federal Fluminense, Brazil; Universidade Federal Fluminense, Brazil
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Barreto ML, Barros AJDD, Carvalho MS, Codeço CT, Hallal PRC, Medronho RDA, Struchiner CJ, Victora CG, Werneck GL. O que é urgente e necessário para subsidiar as políticas de enfrentamento da pandemia de COVID-19 no Brasil? Rev bras epidemiol 2020; 23:e200032. [DOI: 10.1590/1980-549720200032] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 04/09/2020] [Indexed: 11/22/2022] Open
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Barreto ML, Ichihara MY, Almeida BA, Barreto ME, Cabral L, Fiaccone RL, Carreiro RP, Teles CAS, Pitta R, Penna GO, Barral-Netto M, Ali MS, Barbosa G, Denaxas S, Rodrigues LC, Smeeth L. The Centre for Data and Knowledge Integration for Health (CIDACS): Linking Health and Social Data in Brazil. Int J Popul Data Sci 2019; 4:1140. [PMID: 34095542 PMCID: PMC8142622 DOI: 10.23889/ijpds.v4i2.1140] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
The Centre for Data and Knowledge Integration for Health (CIDACS) was created in 2016 in Salvador, Bahia-Brazil with the objective of integrating data and knowledge aiming to answer scientific questions related to the health of the Brazilian population. This article details our experiences in the establishment and operations of CIDACS, as well as efforts made to obtain high-quality linked data while adhering to security, ethical use and privacy issues. Every effort has been made to conduct operations while implementing appropriate structures, procedures, processes and controls over the original and integrated databases in order to provide adequate datasets to answer relevant research questions. Looking forward, CIDACS is expected to be an important resource for researchers and policymakers interested in enhancing the evidence base pertaining to different aspects of health, in particular when investigating, from a nation-wide perspective, the role of social determinants of health and the effects of social and environmental policies on different health outcomes.
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Affiliation(s)
- ML Barreto
- Centre for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador, Brazil.
- Institute of Collective Health, Federal University of Bahia (UFBA), Salvador, Brazil.
| | - MY Ichihara
- Centre for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador, Brazil.
- Institute of Collective Health, Federal University of Bahia (UFBA), Salvador, Brazil.
| | - BA Almeida
- Centre for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador, Brazil.
| | - ME Barreto
- Centre for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador, Brazil.
- Computer Science Department, Federal University of Bahia (UFBA), Salvador, Brazil.
| | - L Cabral
- Centre for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador, Brazil.
| | - RL Fiaccone
- Centre for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador, Brazil.
- Statistics Department, Federal University of Bahia (UFBA), Brazil.
| | - RP Carreiro
- Centre for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador, Brazil.
| | - CAS Teles
- Centre for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador, Brazil.
| | - R Pitta
- Centre for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador, Brazil.
| | - GO Penna
- Centre for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador, Brazil.
- Tropical Medicine Centre, University of Brasília (UnB), Brazil.
- Escola Fiocruz de Governo, FIOCRUZ Brasília, Brazil.
| | - M Barral-Netto
- Centre for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador, Brazil.
| | - MS Ali
- Centre for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador, Brazil.
- Center for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, United Kingdom.
| | - G Barbosa
- Centre for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador, Brazil.
| | - S Denaxas
- Institute of Health Informatics, University College London, United Kingdom.
| | - LC Rodrigues
- Centre for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador, Brazil.
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, United Kingdom.
| | - L Smeeth
- Centre for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador, Brazil.
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, United Kingdom.
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Santos LMP, Martins MC, Almeida ATCD, Diniz ADS, Barreto ML. Pesquisa Translacional em vitamina A: do ensaio randomizado à intervenção e à avaliação do impacto. Saúde debate 2019. [DOI: 10.1590/0103-11042019s202] [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] [Indexed: 11/22/2022] Open
Abstract
RESUMO A Pesquisa Translacional é interdisciplinar e está apoiada em três pilares: pesquisa de bancada (básica), leito (aplicações clínicas) e comunidade (aplicações nos sistemas de saúde). O estudo, baseado nos cinco estágios da Pesquisa Translacional, resgatou o histórico da deficiência de vitamina A e da cegueira nutricional no Brasil (T0); o caminho da descoberta científica à escolha da intervenção – suplementação vitamínica (T1); a avaliação da eficácia da intervenção candidata por ensaio randomizado e controlado (T2); a avaliação da implementação e da cobertura na prática (T3); e a avaliação do impacto da intervenção (T4). Para verificar o impacto, aplicou-se a estatística superior de Wald, visando identificar quebras estruturais ao longo da série histórica da mortalidade geral de crianças entre 6 e 59 meses de idade. Para a região Nordeste, que apresentou a maior cobertura programática, o modelo sinalizou três quebras – agosto/1984, junho/1994 e maio/2006 –, nas quais foram estimadas reduções de 10%, 17% e 23%, respectivamente, na ocorrência mensal de óbitos infantis. O processo para a construção do conhecimento sobre a deficiência desta vitamina, a escolha da intervenção, a aplicação deste conhecimento no estabelecimento do Programa Nacional de Suplementação de Vitamina A e a avaliação do seu impacto configuram um exemplo de Pesquisa Translacional em saúde coletiva.
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Bernal RTI, Felisbino-Mendes MS, de Carvalho QH, Pell J, Dundas R, Leyland A, Barreto ML, Malta DC. Indicators of chronic noncommunicable diseases in women of reproductive age that are beneficiaries and non-beneficiaries of Bolsa Família. Rev Bras Epidemiol 2019; 22Suppl 02:E190012.SUPL.2. [PMID: 31596383 PMCID: PMC6892639 DOI: 10.1590/1980-549720190012.supl.2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Accepted: 03/12/2019] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To evaluate the prevalence of noncommunicable disease (NCD) indicators, including laboratory tests, in the population of Brazilian women of reproductive age, according to whether or not they receive the Bolsa Família (BF) benefit. METHODS A total of 3,131 women aged 18 to 49 years old who participated in the National Health Survey (Pesquisa Nacional de Saúde ) laboratory examination sub-sample were considered. We compared indicators among women of reproductive age (18 to 49 years old) who reported receiving BF or not, and calculated prevalence and confidence intervals, using Pearson's χ2. RESULTS Women of reproductive age who were beneficiaries of BF had worse health outcomes, such as a greater occurrence of being overweight (33.5%) and obese (26.9%) (p < 0.001), having hypertension (13.4% versus 4.4%, p < 0.001), used more tobacco (11.2% versus 8.2%, p = 0.029), and perceived their health as worse (6.2% versus 2.4%, p < 0.001). CONCLUSION Several NCD indicators were worse among women of childbearing age who were beneficiaries of BF. It should be emphasized that this is not a causal relationship, with BF being a marker of inequalities among women. The benefit has been directed to the population with greater health needs, and seeks to reduce inequities.
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Affiliation(s)
- Regina Tomie Ivata Bernal
- Graduate Program, School of Nursing, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brazil
| | | | | | - Jill Pell
- Institute of Health and Wellbeing, University of Glasgow - Glasgow, Scotland
| | - Ruth Dundas
- Medical Research Council/Chief Scientific Office (MRC/CSO) Social and Public Health Sciences Unit, University of Glasgow – Glasgow, Scotland
| | - Alastair Leyland
- Medical Research Council/Chief Scientific Office (MRC/CSO) Social and Public Health Sciences Unit, University of Glasgow – Glasgow, Scotland
| | - Mauricio Lima Barreto
- Center for the Integration of Health Knowledge and Data, Gonçalo Moniz Institute, Oswaldo Cruz Foundation - Salvador (BA), Brazil
| | - Deborah Carvalho Malta
- Graduate Program, School of Nursing, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brazil
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de Souza RA, Nery JS, Rasella D, Guimarães Pereira RA, Barreto ML, Rodrigues L, Pereira SM. Family health and conditional cash transfer in Brazil and its effect on tuberculosis mortality. Int J Tuberc Lung Dis 2019; 22:1300-1306. [PMID: 30355409 DOI: 10.5588/ijtld.17.0907] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND Social protection can reduce poverty and act on the determinants of tuberculosis (TB). OBJECTIVE To evaluate the impact of the Family Health Strategy (FHS) and the Bolsa Família Programme on TB-related mortality in Brazil. METHODS This was an ecological study in which the units of analysis were Brazilian municipalities between 2001 and 2012. The principal independent variables were the levels of coverage of the primary health care system and the conditional cash transfer programme. The dependent variable was TB mortality rate (obtained from national databases). Descriptive analysis and negative binomial regression based on panel data using fixed-effects models were performed. Crude and adjusted estimates were calculated for continuous and categorical variables. RESULTS A high FHS coverage was significantly associated with a reduction in the TB mortality rate (RR 0.80, 95%CI 0.72-0.89). An increase in the coverage of the Brazilian cash transfer programme was significantly associated with a reduction in the TB mortality rate (RR 0.87, 95%CI 0.81-0.96). CONCLUSION FHS and the Bolsa Família conditional cash transfer programme had a positive impact on the TB mortality rate in Brazil. Public policies should include economic support combined with health promotion.
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Affiliation(s)
- R A de Souza
- Institute of Collective Health, Federal University of Bahia, Salvador, Bahia
| | - J S Nery
- Federal University of the Vale do São Francisco, Salvador, Bahia
| | - D Rasella
- Institute of Collective Health, Federal University of Bahia, Salvador, Bahia
| | | | - M L Barreto
- Institute Gonçalo Muniz, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil
| | - L Rodrigues
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - S M Pereira
- Institute of Collective Health, Federal University of Bahia, Salvador, Bahia
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de Oliveira Costa GN, Figueiredo CA, Conceição JS, Strina A, Genser B, da Silva TM, Alcantara-Neves NM, Fiaccone RL, Rodrigues LC, Barreto ML. Genetic variants in 17q12-21 locus and childhood asthma in Brazil: Interaction with Varicella zoster virus seropositivity. Gene 2019; 715:143991. [PMID: 31357023 DOI: 10.1016/j.gene.2019.143991] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 07/17/2019] [Accepted: 07/18/2019] [Indexed: 01/06/2023]
Abstract
BACKGROUND Asthma is a complex disease with worldwide public health relevance, is related to environmental causes and a genetic predisposition. The chromosomal 17q12-21 locus has been consistently demonstrated to be associated with asthma risk. The effects of variants in the 17q12-21 locus on childhood asthma were first identified in a genome wide- association study. Since that time, those findings have been replicated in different populations but not in South American populations. OBJECTIVE This study aimed to investigate the role of variants in the 17q12-21 locus on asthma in a sample of Brazilian children. METHODS This was a cross-sectional study conducted on a cohort of 1247 children. These analyses used 50 Single Nucleotide Variants (SNVs) in the 17q12-21 locus were genotyped as part of a genome wide association study (GWAS). RESULTS Four SNVs (rs4065275, rs12603332, rs73985228 and rs77777702) were associated with childhood asthma. The rs73985228 exhibited the strongest association across the different genetic models (OR, 95%CI 2.8, 1.44-3.21, p < 0.01). In an analysis that was stratified by atopy, two SNVs (rs73985228 and rs2715555) were found to be associated with atopic and non-atopic asthma. For the first time, we observed a significant interaction with seropositivity for the Varicella zoster virus (for rs4065275, p = 0.02, and for rs12603332, p = 0.04); i.e., the association was found in those who were seropositive but not in those who were seronegative for this virus. CONCLUSIONS We confirmed the associations of variants in the 17q12-21 locus with atopic and non-atopic asthma and identified an interaction with seropositivity for the Varicella zoster virus.
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Affiliation(s)
- Gustavo Nunes de Oliveira Costa
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brazil; Departamento de Ciências da Saúde, Universidade Salvador (UNIFACS), Brazil.
| | | | | | - Agostino Strina
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brazil
| | - Bernd Genser
- Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | | | | | - Rosemeire Leovigildo Fiaccone
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brazil; Instituto de Matemática, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Laura Cunha Rodrigues
- Department of Epidemiology and Populations Health, London School of Hygiene and Tropical Medicine, UK
| | - Mauricio Lima Barreto
- Center of Data and Knowledge Integration for Health, Instituto Gonçalo Muniz, Fundação Osvaldo Cruz, Salvador, Brazil; Fundação Osvaldo Cruz, Salvador, Brazil
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Andrade KVFD, Nery JS, Araújo GSD, Barreto ML, Pereira SM. Association between treatment outcome, sociodemographic characteristics and social benefits received by individuals with tuberculosis in Salvador, Bahia, Brazil, 2014-2016. Epidemiol Serv Saude 2019; 28:e2018220. [PMID: 31271634 DOI: 10.5123/s1679-49742019000200004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 02/13/2019] [Indexed: 11/02/2022] Open
Abstract
OBJECTIVE to analyze association between tuberculosis treatment outcome, sociodemographic characteristics and receipt of social benefits. METHODS this was a cohort study conducted in Salvador, Bahia, Brazil, in the period 2014-2016; we analyzed bivariate associations between treatment outcome, sociodemographic characteristics and social benefits. RESULTS 216 individuals were followed, of whom 79.6% were cured; higher cure proportion was associated with schooling >9 years (87.5%; p=0.028), marital union (86.3%; p=0.031), and household density ≤2 individuals/bedroom (84.1%; p=0.013); we took as our reference individuals with schooling ≤9 years, not in marital union, and housing density >2 people/bedroom; higher cure proportion was also found among recipients of government and non-government benefits (90.5%), and among those who only received direct benefits (81.6%). CONCLUSION schooling >9 years, marital union, and household density ≤2 individuals/bedroom were associated with higher cure; this outcome was more frequent among individuals receiving government and non-government benefits, and among individuals receiving only direct benefits.
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Affiliation(s)
| | - Joilda Silva Nery
- Universidade Federal da Bahia, Instituto de Saúde Coletiva, Salvador, BA, Brasil
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Malta DC, Duncan BB, Barros MBDA, Katikireddi SV, Souza FMD, Silva AGD, Machado DB, Barreto ML. Fiscal austerity measures hamper noncommunicable disease control goals in Brazil. Cien Saude Colet 2019; 23:3115-3122. [PMID: 30365830 DOI: 10.1590/1413-812320182310.25222018] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 09/02/2018] [Indexed: 11/22/2022] Open
Abstract
Given the Constitutional Amendment 95 and the economic crisis, we discussed the possible effects of austerity measures on the achievement of the goals established for the control of chronic noncommunicable diseases (NCDs) in the country. The trends of NCDs and risk factors were analyzed, according to data from epidemiological surveys and mortality data from the Global Burden of Disease study. The resultsindicate a trend of stability in mortality rates by NCD in 2015 and 2016. Brazilians with low schooling, in general, have a higher prevalence of risk factors and a lower prevalence of protective factors. In the 2015-2017 period, previously favorable trends reversed for indicators such as fruit and vegetable consumption and physical activity, tobacco trends stabilized, and alcohol intake increased. In conclusion, should these trends be maintained, it is unlikely that Brazil will achieve the goals previously agreed upon with the World Health Organization and the United Nations to curb NCDs and their risk factors.
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Affiliation(s)
- Deborah Carvalho Malta
- Programa de Pós- Graduação. Escola de Enfermagem, Universidade Federal de Minas Gerais. Av. Alfredo Balena 190/5º, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
| | - Bruce Bartholow Duncan
- Programa de Pós-Graduação em Epidemiologia, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul. Porto Alegre RS Brasil
| | | | | | | | - Alanna Gomes da Silva
- Programa de Pós- Graduação. Escola de Enfermagem, Universidade Federal de Minas Gerais. Av. Alfredo Balena 190/5º, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
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Bernal RTI, Felisbino-Mendes MS, de Carvalho QH, Pell J, Dundas R, Leyland A, Barreto ML, Malta DC. Indicators of chronic noncommunicable diseases in women of reproductive age that are beneficiaries and non-beneficiaries of Bolsa Família. Rev Bras Epidemiol 2019. [PMID: 31596383 PMCID: PMC6892639 DOI: 10.1590/1980-549720190012.supl.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To evaluate the prevalence of noncommunicable disease (NCD) indicators, including laboratory tests, in the population of Brazilian women of reproductive age, according to whether or not they receive the Bolsa Família (BF) benefit. METHODS A total of 3,131 women aged 18 to 49 years old who participated in the National Health Survey (Pesquisa Nacional de Saúde ) laboratory examination sub-sample were considered. We compared indicators among women of reproductive age (18 to 49 years old) who reported receiving BF or not, and calculated prevalence and confidence intervals, using Pearson's χ2. RESULTS Women of reproductive age who were beneficiaries of BF had worse health outcomes, such as a greater occurrence of being overweight (33.5%) and obese (26.9%) (p < 0.001), having hypertension (13.4% versus 4.4%, p < 0.001), used more tobacco (11.2% versus 8.2%, p = 0.029), and perceived their health as worse (6.2% versus 2.4%, p < 0.001). CONCLUSION Several NCD indicators were worse among women of childbearing age who were beneficiaries of BF. It should be emphasized that this is not a causal relationship, with BF being a marker of inequalities among women. The benefit has been directed to the population with greater health needs, and seeks to reduce inequities.
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Affiliation(s)
- Regina Tomie Ivata Bernal
- Graduate Program, School of Nursing, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brazil
| | | | | | - Jill Pell
- Institute of Health and Wellbeing, University of Glasgow - Glasgow, Scotland
| | - Ruth Dundas
- Medical Research Council/Chief Scientific Office (MRC/CSO) Social and Public Health Sciences Unit, University of Glasgow – Glasgow, Scotland
| | - Alastair Leyland
- Medical Research Council/Chief Scientific Office (MRC/CSO) Social and Public Health Sciences Unit, University of Glasgow – Glasgow, Scotland
| | - Mauricio Lima Barreto
- Center for the Integration of Health Knowledge and Data, Gonçalo Moniz Institute, Oswaldo Cruz Foundation - Salvador (BA), Brazil
| | - Deborah Carvalho Malta
- Graduate Program, School of Nursing, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brazil
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Souza MDFMD, Malta DC, França EB, Barreto ML. Changes in health and disease in Brazil and its States in the 30 years since the Unified Healthcare System (SUS) was created. Cien Saude Colet 2018; 23:1737-1750. [PMID: 29972483 DOI: 10.1590/1413-81232018236.04822018] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 02/27/2018] [Indexed: 01/28/2023] Open
Abstract
The Unified Healthcare System (SUS) was created to ensure the population's right to universal, free and comprehensive healthcare. This study compares the health indicators measured in 1990 to those measured in 2015 in Brazil and its states. The goal is to contribute to understanding the role SUS played in changing the nation's health profile. Analyses use estimates in the Global Burden of Disease (GBD) study for Brazil and its states, and compares 1990 and 2015. The main results are increased life expectancy, as well as an increase in the population's longevity measured in health-adjusted life expectancy. These in turn are due to a sharp decline in mortality due to transmissible diseases, in maternal and infant morbi-mortality, and avoidable causes of death. NTCDs are the leading cause of death, followed by violence. Poor diet is the leading risk factor, followed by metabolic issues. Tobacco use decreased over the period, as did infant malnutrition. In the thirty years since the SUS was created, health indicators in this country have improved, and major progress has been made to reduce inequality across the country's regions.
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Affiliation(s)
- Maria de Fátima Marinho de Souza
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro. R. São Francisco Xavier 524/1006 A, Maracanã. 20550-900 Rio de Janeiro RJ Brasil.
| | - Deborah Carvalho Malta
- Escola de Enfermagem, Universidade Federal de Minas Gerais (UFMG). Belo Horizonte MG Brasil
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Lima LC, Queiroz GDA, Costa RDS, Alcantara-Neves NM, Marques CR, Costa GNDO, Barreto ML, Figueiredo CAV, Carneiro VL. Genetic variants in RORA are associated with asthma and allergy markers in an admixed population. Cytokine 2018; 113:177-184. [PMID: 30539779 DOI: 10.1016/j.cyto.2018.07.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 06/21/2018] [Accepted: 07/02/2018] [Indexed: 12/14/2022]
Abstract
Asthma and allergy affect hundreds of millions of people from childhood to old age. In most of them, the inflammatory process of respiratory allergies involves the participation of type 2 cytokines, derived from T helper-2 (Th2)-cell, and Group 2 Innate Lymphoid (ILC2) Cells. An efficient memory Th2 cell response is dependent on IL-13 produced by ILC2s, causing allergic lung inflammation and elevated serum levels of immunoglobulin E. ILC2 cells are derived from common lymphoid progenitors and their growing depends on the transcription factor RORA. The aim of this work was to identify genetic variants in RORA associated with asthma phenotypes and allergy markers. Genomic DNA samples of 1246 individuals participating from Social Changes Asthma and Allergy in Latin America Program (SCAALA) have been genotyped using Illumina Human 2.5 Omni Beadchip. Logistics regressions have been performed to analyze the association among RORA variants and asthma, skin prick tests (SPT), specific IgE and type 2 cytokine production. Twelve single nucleotide variants (SNVs) were significantly associated with atopy (P < 0.01), in which four of them, rs10162630, rs17191519, rs17270243, and rs55796775 and their haplotypes were strongly and positively associated (P < 0.001). Furthermore, these variants increased the RORA gene expression in silico analysis. Other SNVs in RORA were associated with allergy markers, atopic and non-atopic asthma. Therefore, it is believed that variants in RORA gene may influence immunologic features of asthma and allergies and could be possible targets for future treatment of allergic diseases.
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Affiliation(s)
- Louise Correia Lima
- Departamento de Ciências da Vida, Universidade do Estado da Bahia, Salvador, BA, Brazil
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Pescarini JM, Strina A, Nery JS, Skalinski LM, de Andrade KVF, Penna MLF, Brickley EB, Rodrigues LC, Barreto ML, Penna GO. Socioeconomic risk markers of leprosy in high-burden countries: A systematic review and meta-analysis. PLoS Negl Trop Dis 2018; 12:e0006622. [PMID: 29985930 PMCID: PMC6053250 DOI: 10.1371/journal.pntd.0006622] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [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: 04/18/2018] [Revised: 07/19/2018] [Accepted: 06/19/2018] [Indexed: 11/18/2022] Open
Abstract
Over 200,000 new cases of leprosy are detected each year, of which approximately 7% are associated with grade-2 disabilities (G2Ds). For achieving leprosy elimination, one of the main challenges will be targeting higher risk groups within endemic communities. Nevertheless, the socioeconomic risk markers of leprosy remain poorly understood. To address this gap we systematically reviewed MEDLINE/PubMed, Embase, LILACS and Web of Science for original articles investigating the social determinants of leprosy in countries with > 1000 cases/year in at least five years between 2006 and 2016. Cohort, case-control, cross-sectional, and ecological studies were eligible for inclusion; qualitative studies, case reports, and reviews were excluded. Out of 1,534 non-duplicate records, 96 full-text articles were reviewed, and 39 met inclusion criteria. 17 were included in random-effects meta-analyses for sex, occupation, food shortage, household contact, crowding, and lack of clean (i.e., treated) water. The majority of studies were conducted in Brazil, India, or Bangladesh while none were undertaken in low-income countries. Descriptive synthesis indicated that increased age, poor sanitary and socioeconomic conditions, lower level of education, and food-insecurity are risk markers for leprosy. Additionally, in pooled estimates, leprosy was associated with being male (RR = 1.33, 95% CI = 1.06-1.67), performing manual labor (RR = 2.15, 95% CI = 0.97-4.74), suffering from food shortage in the past (RR = 1.39, 95% CI = 1.05-1.85), being a household contact of a leprosy patient (RR = 3.40, 95% CI = 2.24-5.18), and living in a crowded household (≥5 per household) (RR = 1.38, 95% CI = 1.14-1.67). Lack of clean water did not appear to be a risk marker of leprosy (RR = 0.94, 95% CI = 0.65-1.35). Additionally, ecological studies provided evidence that lower inequality, better human development, increased healthcare coverage, and cash transfer programs are linked with lower leprosy risks. These findings point to a consistent relationship between leprosy and unfavorable economic circumstances and, thereby, underscore the pressing need of leprosy control policies to target socially vulnerable groups in high-burden countries.
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Affiliation(s)
- Julia Moreira Pescarini
- Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Fundação Oswaldo Cruz, Salvador, Brazil
| | - Agostino Strina
- Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Fundação Oswaldo Cruz, Salvador, Brazil
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Joilda Silva Nery
- Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Fundação Oswaldo Cruz, Salvador, Brazil
- Universidade Federal do Vale do São Francisco (UNIVASF), Paulo Afonso, Brazil
| | - Lacita Menezes Skalinski
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brazil
- Universidade Estadual de Santa Cruz (UESC), Ilheus, Brazil
| | - Kaio Vinicius Freitas de Andrade
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brazil
- Universidade Estadual de Feira de Santana (UEFS), Feira de Santana, Brazil
| | - Maria Lucia F. Penna
- Universidade Federal Fluminense, Instituto de Saúde da Comunidade, Niterói, Brazil
| | - Elizabeth B. Brickley
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Laura C. Rodrigues
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Mauricio Lima Barreto
- Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Fundação Oswaldo Cruz, Salvador, Brazil
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brazil
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Leal MDC, Szwarcwald CL, Almeida PVB, Aquino EML, Barreto ML, Barros F, Victora C. Saúde reprodutiva, materna, neonatal e infantil nos 30 anos do Sistema Único de Saúde (SUS). Ciênc saúde coletiva 2018; 23:1915-1928. [DOI: 10.1590/1413-81232018236.03942018] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Accepted: 03/12/2018] [Indexed: 02/05/2023] Open
Abstract
Resumo Este estudo apresenta um sumário das intervenções realizadas no âmbito do setor público e os indicadores de resultado alcançados na saúde de mulheres e crianças, destacando-se os avanços no período 1990-2015. Foram descritos indicadores de atenção pré-natal, assistência ao parto e saúde materna e infantil utilizando dados provenientes de Sistemas de Informação Nacionais de nascidos vivos e óbitos; inquéritos nacionais; e publicações obtidas de diversas outras fontes. Foram também descritos os programas governamentais desenvolvidos para a melhoria da saúde das mulheres e das crianças, bem como outros intersetoriais para redução da pobreza. Houve grande queda nas taxas de fecundidade, universalização da atenção pré-natal e hospitalar ao parto, aumento do acesso à contracepção e aleitamento materno, e diminuição das hospitalizações por aborto e da subnutrição. Mantém-se em excesso a sífilis congênita, taxa de cesarianas e nascimentos prematuros. A redução na mortalidade na infância foi de mais de 2/3, mas não tão marcada no componente neonatal. A razão de mortalidade materna decresceu de 143,2 para 59,7 por 1000 NV. Embora alguns poucos indicadores tenham demonstrado piora ou mantido a estabilidade, a grande maioria apresentou acentuadas melhoras.
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Abstract
The objective of this article is to present health inequalities as a global problem which afflicts the populations of the poorest countries, but also those of the richest countries, and whose persistence represents one of the most serious and challenging health problems worldwide. Two components of global inequalities are highlighted: inequalities between groups within the same society, and inequalities between nations. The understanding that many of these inequalities are unjust, and therefore inequities, is largely derived from the inequalities that are identified between the various social groups of a given society. Inequalities between different societies and nations, while relevant and often of greater magnitude, are not always considered to be unjust. There have been several proposed solutions, which vary according to different theoretical interpretations and explanations. At the global level, the most plausible thesis has focused on improving global governance mechanisms. While that latter are attractive and have some arguments in their favor, they are insufficient because they do not incorporate an understanding of how the historical process of the constitution of the nations occurred and the importance of the position of each country in the global productive system.
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Affiliation(s)
- Mauricio Lima Barreto
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz. R. Waldemar Falcão 121, Candeal. 40296-710 Salvador BA Brasil.
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Nery JS, Rodrigues LC, Rasella D, Aquino R, Barreira D, Torrens AW, Boccia D, Penna GO, Penna MLF, Barreto ML, Pereira SM. Effect of Brazil's conditional cash transfer programme on tuberculosis incidence. Int J Tuberc Lung Dis 2017; 21:790-796. [PMID: 28633704 PMCID: PMC6082337 DOI: 10.5588/ijtld.16.0599] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To evaluate the impact of the Brazilian cash transfer programme (Bolsa Família Programme, BFP) on tuberculosis (TB) incidence in Brazil from 2004 to 2012. DESIGN We studied tuberculosis surveillance data using a combination of an ecological multiple-group and time-trend design covering 2458 Brazilian municipalities. The main independent variable was BFP coverage and the outcome was the TB incidence rate. All study variables were obtained from national databases. We used fixed-effects negative binomial models for panel data adjusted for selected covariates and a variable representing time. RESULTS After controlling for covariates, TB incidence rates were significantly reduced in municipalities with high BFP coverage compared with those with low and intermediate coverage (in a model with a time variable incidence rate ratio = 0.96, 95%CI 0.93-0.99). CONCLUSION This was the first evidence of a statistically significant association between the increase in cash transfer programme coverage and a reduction in TB incidence rate. Our findings provide support for social protection interventions for tackling TB worldwide.
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Affiliation(s)
- J S Nery
- Institute of Collective Health, Federal University of Bahia, Salvador, Bahia, Brazil
| | - L C Rodrigues
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - D Rasella
- Institute of Collective Health, Federal University of Bahia, Salvador, Bahia, Brazil
| | - R Aquino
- Institute of Collective Health, Federal University of Bahia, Salvador, Bahia, Brazil
| | - D Barreira
- National Program of Tuberculosis Control, Brazilian Health Ministry, Brasília, Distrito Federal
| | - A W Torrens
- National Program of Tuberculosis Control, Brazilian Health Ministry, Brasília, Distrito Federal
| | - D Boccia
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - G O Penna
- Tropical Medicine Center, University of Brasília, Brasília, Distrito Federal
| | - M L F Penna
- Health Sciences Center, Institute of Community Health, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - M L Barreto
- Institute of Collective Health, Federal University of Bahia, Salvador, Bahia, Brazil
| | - S M Pereira
- Institute of Collective Health, Federal University of Bahia, Salvador, Bahia, Brazil
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Leal SB, Araújo GSD, Nery JS, Santos CADST, Oliveira MGD, Barreto ML, Pereira SM. Clinical and epidemiological aspects of cases of tuberculosis associated with diabetes in Salvador, Bahia, Brazil. Rev Soc Bras Med Trop 2017; 50:408-412. [DOI: 10.1590/0037-8682-0409-2016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 02/03/2017] [Indexed: 05/29/2023] Open
Affiliation(s)
| | | | - Joilda Silva Nery
- Universidade Federal da Bahia, Brazil; Universidade Federal do Vale do São Francisco, Brazil
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Duarte TA, Nery JS, Boechat N, Pereira SM, Simonsen V, Oliveira M, Gomes MGM, Penha-Gonçalves C, Barreto ML, Barbosa T. A systematic review of East African-Indian family of Mycobacterium tuberculosis in Brazil. Braz J Infect Dis 2017; 21:317-324. [PMID: 28238627 PMCID: PMC9427636 DOI: 10.1016/j.bjid.2017.01.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 01/10/2017] [Indexed: 01/17/2023] Open
Abstract
Introduction The Mycobacterium tuberculosis East African-Indian (EAI) spoligotyping family (belonging to lineage 1, Indo-Oceanic, defined by the region of deletion RD239) is distributed worldwide, but is more prevalent in Southeast Asia, India, and East Africa. Studies in Latin America have rarely identified EAI. In this study, we describe the occurrence of the EAI family in Brazil. Methods EAI was identified in a systematic literature review of genetic diversity studies pertaining to M. tuberculosis in Brazil, as well as in a survey conducted in Salvador, Bahia, located in the northeastern region of this country. Results The EAI6-BGD1 spoligotyping family and the EAI5 Spoligotype International Type (SIT) 1983 clade were the most frequently reported, with wide distribution of this particular clade described in Brazil. The distribution of other EAI spoligotyping patterns with broader worldwide distribution was restricted to the southeastern region of the country. Conclusions EAI may be endemic at a low frequency in Brazil, with some clades indicating increased fitness with respect to this population.
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Queiroz GA, Costa RS, Alcantara-Neves NM, Nunes de Oliveira Costa G, Barreto ML, Carneiro VL, Figueiredo CA. IL33 and IL1RL1 variants are associated with asthma and atopy in a Brazilian population. Int J Immunogenet 2017; 44:51-61. [PMID: 28266165 DOI: 10.1111/iji.12306] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 12/05/2016] [Accepted: 01/14/2017] [Indexed: 01/01/2023]
Abstract
Atopic asthma is a chronic inflammatory disease in airways resulting from genetic and environmental factors, characterized by production of the Th2 cytokines interleukin-4 (IL-4), interleukin-5 (IL-5) and interleukin-13 (IL-13). Interleukin-33 (IL-33) appears to be a potent inducer of Th2 immune response. This occurs when IL-33 binds and activates its receptor, the membrane ST2 (ST2L) in mast cells, dendritic cells, basophils, eosinophils, innate lymphoids and Th2 cells, leading to the release of these cytokines and intensifying allergic inflammation. Polymorphisms in the IL33 and IL1RL1 can act as protective or risk factors for asthma and/or allergy in humans. No study was conducted to replicate such findings in a European and African descendent mixed population. DNA was extracted from peripheral blood from 1223 subjects, and the samples were genotyped using Illumina 2.5 Human Omni Beadchip. We tested for possible associations between SNPs in the IL33 and ST2 with asthma and allergy markers such as specific IgE (sIgE), IL-5 and IL-13 production and skin prick test (SPT). Logistics regressions were performed using PLINK software 1.07. The analyses were adjusted for sex, age, helminth infection and ancestry markers. The G allele of IL33 SNP rs12551256 was negatively associated with asthma (OR 0.71, 95% CI: 0.53-0.94, P = 0.017). In contrast, the A allele of IL1RL1 rs1041973 was positively associated with IL-5 production (OR 1.36, 95% CI: 1.09-1.84, P = 0.044), sIgE levels (OR 1.40, 95% CI: 1.07-1.84, P = 0.013) and positive SPT (OR 1.48, 95% CI: 1.08-2.03, P = 0.014), for Blomia tropicalis mite. The same allele, in atopic subjects, was associated with decreased production of soluble ST2 (sST2) (P < 0.05). Moreover, expression quantitative trait loci (eQTL) analysis suggests that rs1041973 and rs873022 regulate the expression of IL1RL1 gene. This latest SNP, rs873022, the T allele, was also associated with a lower production of sST2 in plasma of Brazilians. The genetic risk score for rs1041973 and rs16924161 demonstrated a higher risk for SPT positivity against B. tropicalis, the greater the number of risk alleles for both SNPs. Our findings demonstrate a robust association of genetic variants in IL1RL1 and IL33 SNPs with allergy markers and asthma.
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Affiliation(s)
- G A Queiroz
- Laboratory of Immunopharmacology and Molecular Biology, Federal University of Bahia, Salvador, Brazil
| | - R S Costa
- Laboratory of Immunopharmacology and Molecular Biology, Federal University of Bahia, Salvador, Brazil
| | - N M Alcantara-Neves
- Laboratory of Allergy and Acarology, Federal University of Bahia, Salvador, Brazil
| | - G Nunes de Oliveira Costa
- Laboratory of Immunopharmacology and Molecular Biology, Federal University of Bahia, Salvador, Brazil
| | - M L Barreto
- Department of Epidemiology, Oswaldo Cruz Fundation, Salvador, Brazil
| | - V L Carneiro
- Laboratory of Immunopharmacology and Molecular Biology, Federal University of Bahia, Salvador, Brazil
| | - C A Figueiredo
- Laboratory of Immunopharmacology and Molecular Biology, Federal University of Bahia, Salvador, Brazil
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Costa RS, Figueiredo CA, Barreto ML, Alcântara-Neves NM, Rodrigues L, Cruz Á, Pontes-de-Carvalho L, Vergara C, Rafaels NM, Foster C, Potee J, Campbell M, Mathias RA, Barnes KC. Transforming Growth Factor-Beta 1 (TGF-Beta 1) Gene Polymorphisms are Associated with Atopic Asthma and Helminth Infections in an Admixed Population. J Allergy Clin Immunol 2017. [DOI: 10.1016/j.jaci.2016.12.377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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50
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Queiroz GA, Costa RS, Carneiro VL, Jesus TS, Alcântara-Neves NM, Pires AO, Fonseca HF, Barreto ML, Figueiredo CA. IL1RL1 Variants rs1041973 and rs873022 are Associated With Allergy Markers and Soluble ST2 Production in a Brazilian Population. J Allergy Clin Immunol 2017. [DOI: 10.1016/j.jaci.2016.12.067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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