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Smoking, mortality, access to diagnosis, and treatment of lung cancer in Brazil. 巴西肺癌的吸烟率、死亡率、获得诊断和治疗的机会。
IF 2.8 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-05-13 eCollection Date: 2024-01-01 DOI: 10.11606/s1518-8787.2024058005704
Mônica Rodrigues Campos, Jessica Muzy Rodrigues, Aline Pinto Marques, Lara Vinhal Faria, Tayná Sequeira Valerio, Mario Jorge Sobreira da Silva, Debora Castanheira Pires, Luisa Arueira Chaves, Carlos Henrique Dantas Cardoso, Silvio Rodrigues Campos, Isabel Cristina Martins Emmerick

Introduction: Lung cancer (LC) is a relevant public health problem in Brazil and worldwide, given its high incidence and mortality. Thus, the objective of this study is to analyze the distribution of smoking and smoking status according to sociodemographic characteristics and disparities in access, treatment, and mortality due to LC in Brazil in 2013 and 2019.

Method: Retrospective study of triangulation of national data sources: a) analysis of the distribution of smoking, based on the National Survey of Health (PNS); b) investigation of LC records via Hospital-based Cancer Registry (HCR); and c) distribution of mortality due to LC in the Mortality Information System (SIM).

Results: There was a decrease in the percentage of people who had never smoked from 2013 (68.5%) to 2019 (60.2%) and in smoking history (pack-years). This was observed to be greater in men, people of older age groups, and those with less education. Concerning patients registered in the HCR, entry into the healthcare service occurs at the age of 50, and only 19% have never smoked. While smokers in the population are mainly Mixed-race, patients in the HCR are primarily White. As for the initial stage (I and II), it is more common in White people and people who have never smoked. The mortality rate varied from 1.00 for people with higher education to 3.36 for people without education. Furthermore, White people have a mortality rate three times higher than that of Black and mixed-race people.

Conclusion: This article highlighted relevant sociodemographic disparities in access to LC diagnosis, treatment, and mortality. Therefore, the recommendation is to strengthen the Population-Based Cancer Registry and develop and implement a nationwide LC screening strategy in Brazil since combined prevention and early diagnosis strategies work better in controlling mortality from the disease and continued investment in tobacco prevention and control policies.

导言:鉴于肺癌(LC)的高发病率和高死亡率,它是巴西乃至全球的一个相关公共卫生问题。因此,本研究旨在分析巴西 2013 年和 2019 年根据社会人口特征划分的吸烟分布和吸烟状况,以及在肺癌的获取、治疗和死亡率方面存在的差异:方法:对国家数据源进行三角交叉的回顾性研究:a) 根据国家健康调查(PNS)分析吸烟分布情况;b) 通过医院癌症登记处(HCR)调查 LC 记录;c) 死亡率信息系统(SIM)中 LC 死亡率的分布情况:结果:从2013年(68.5%)到2019年(60.2%),从未吸烟者的比例和吸烟史(包年)均有所下降。据观察,男性、年龄较大者和受教育程度较低者的吸烟史更长。在 HCR 登记的患者中,50 岁以上的人开始接受医疗服务,只有 19% 的人从未吸烟。人口中的吸烟者主要是混血儿,而 HCR 中的患者主要是白人。至于初期阶段(I 期和 II 期),白人和从未吸烟者更常见。死亡率从受过高等教育者的 1.00 到未受过教育者的 3.36 不等。此外,白人的死亡率是黑人和混血儿的三倍:本文强调了在获得 LC 诊断、治疗和死亡率方面存在的相关社会人口差异。因此,建议加强基于人口的癌症登记,并在巴西制定和实施全国性的肺结核筛查战略,因为预防和早期诊断相结合的战略能更好地控制该疾病的死亡率,并继续投资于烟草预防和控制政策。
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引用次数: 0
Structure and process in primary health care for children and spatial distribution of infant mortality. 儿童初级保健的结构和过程以及婴儿死亡率的空间分布。
IF 2.8 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-05-13 eCollection Date: 2024-01-01 DOI: 10.11606/s1518-8787.2024058005527
Alitéia Santiago Dilélio, Márcio Natividade, Luiz Augusto Facchini, Marcos Pereira, Elaine Tomasi

Objective: To identify the spatial patterns of the quality of the structure of primary health care services and the teams' work process and their effects on infant mortality in Brazil.

Methods: An ecological study of spatial aggregates, using the 5,570 municipalities in Brazil as the unit of analysis. Secondary databases from the Programa Nacional de Melhoria do Acesso e Qualidade da Atenção Básica (PMAQ-AB - National Program for Improving Access and Quality of Primary Care), the Mortality Information System (SIM), and the Live Birth Information System (SINASC) were used. In 2018, the infant mortality rate was the outcome of the study, and the exposure variables were the proportion of basic health units (BHU) with adequate structure and work processes. Global and local Moran's indices were used to evaluate the degree of dependence and spatial autocorrelation. Spatial linear regression was used for data analysis.

Results: In 2018, in Brazil, the infant mortality rate was 12.4/1,000 live births, ranging from 10.6/1,000 and 11.2/1,000 in the South and Southeast, respectively, to 14.1/1,000 and 14.5/1,000 in the Northeast and North regions, respectively. The proportion of teams with an adequate work process (β = -3.13) and the proportion of basic health units with an adequate structure (β = -0.34) were associated with a reduction in the infant mortality rate. Spatial autocorrelation was observed between smoothed mean infant mortality rates and indicators of the structure of primary health care services and the team's work process, with higher values in the North and Northeast of Brazil.

Conclusions: There is a relationship between the structure of primary health care services and the teams' work process with the infant mortality rate. In this sense, investment in the qualification of health care within the scope of primary health care can have an impact on reducing the infant mortality rate and improving child health care.

目的确定巴西初级卫生保健服务结构和团队工作流程质量的空间模式及其对婴儿死亡率的影响:方法:以巴西 5570 个城市为分析单位,对空间总量进行生态学研究。研究使用了 "国家提高初级保健普及率和质量计划"(PMAQ-AB - National Programa Nacional de Melhoria do Acesso e Qualidade da Atenção Básica)、"死亡率信息系统"(SIM)和 "活产信息系统"(SINASC)的二级数据库。2018 年,婴儿死亡率是研究的结果,暴露变量是具有适当结构和工作流程的基本医疗单位(BHU)的比例。全局和局部莫兰指数用于评估依赖程度和空间自相关性。数据分析采用空间线性回归法:2018 年,巴西婴儿死亡率为 12.4/1,000 例活产,南部和东南部地区分别为 10.6/1,000 例和 11.2/1,000 例,东北部和北部地区分别为 14.1/1,000 例和 14.5/1,000 例。具有适当工作流程的团队比例(β=-3.13)和具有适当结构的基层医疗单位比例(β=-0.34)与婴儿死亡率的降低有关。婴儿死亡率的平滑平均值与初级卫生保健服务结构指标和团队工作流程之间存在空间自相关性,巴西北部和东北部的数值较高:结论:初级保健服务结构和团队工作流程与婴儿死亡率之间存在关系。从这个意义上讲,在初级医疗保健范围内对医疗保健资质进行投资,可对降低婴儿死亡率和改善儿童医疗保健产生影响。
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引用次数: 0
Erratum. 勘误。
IF 2.8 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-05-13 DOI: 10.11606/s1518-8787.2024058005504err

[This corrects the article doi: 10.11606/s1518-8787.2024058005504].

[此处更正了文章 doi:10.11606/s1518-8787.2024058005504]。
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引用次数: 0
Pesticide contamination of lactating mothers' milk in Latin America: a systematic review. 拉丁美洲哺乳母亲乳汁中的农药污染:系统综述。
IF 2.8 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-05-13 eCollection Date: 2024-01-01 DOI: 10.11606/s1518-8787.2024058005446
Thalyta Mota Figueiredo, Jerusa da Mota Santana, Fernando Henrique Basilio Granzotto, Bianca Sampaio Dos Anjos, Danilo Guerra Neto, Laylla Mirella Galvão Azevedo, Marcos Pereira

Objective: To identify the prevalence of contamination by pesticides and their metabolites in the milk of lactating mothers in Latin America.

Methods: In this systematic review, the PubMed, LILACS, Embase, and Scopus databases were searched up to January 2022 to identify observational studies. The Mendeley software was used to manage these references. The risk of bias assessment was evaluated according to the checklist for prevalence studies and writing design, by the Prisma guidelines.

Results: This study retrieved 1835 references and analyzed 49 studies. 69.38% of the analyzed studies found a 100% prevalence of breast milk contamination by pesticides among their sample. Main pesticides include dichlorodiphenyltrichloroethane (DDT) and its isomers (75.51%), followed by the metabolite dichlorodiphenyldichloroethylene (DDE) (69.38%) and hexachlorocyclohexane (HCH) (46.93%). This study categorized most (65.30%) studies as having a low risk of bias.

Conclusions: This review shows a high prevalence of pesticide contamination in the breast milk of Latin American women. Further investigations should be carried out to assess contamination levels in breast milk and the possible effects of these substances on maternal and child health.

目的确定拉丁美洲哺乳期母亲乳汁中农药及其代谢物污染的普遍程度:在本系统综述中,检索了截至 2022 年 1 月的 PubMed、LILACS、Embase 和 Scopus 数据库,以确定观察性研究。使用 Mendeley 软件管理这些参考文献。根据Prisma指南中的流行病学研究和写作设计核对表对偏倚风险进行了评估:本研究检索了 1835 篇参考文献,分析了 49 项研究。在所分析的研究中,69.38%的样本发现母乳100%受到杀虫剂污染。主要农药包括二氯二苯基三氯乙烷(DDT)及其异构体(75.51%),其次是代谢物二氯二苯基二氯乙烯(DDE)(69.38%)和六氯环己烷(HCH)(46.93%)。本研究将大多数研究(65.30%)归类为低偏倚风险研究:本综述显示,拉丁美洲妇女的母乳中农药污染的发生率很高。应开展进一步调查,以评估母乳中的污染水平以及这些物质对母婴健康可能产生的影响。
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引用次数: 0
Spatial analysis of American cutaneous leishmaniasis in the state of Amazonas. 亚马孙州美洲皮肤利什曼病的空间分析。
IF 2.8 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-04-19 eCollection Date: 2024-01-01 DOI: 10.11606/s1518-8787.2024058005662
Mirely Ferreira Dos Santos, Camila Lorenz, Francisco Chiaravalotti-Neto, Tamara Nunes Lima-Camara

Objective: To evaluate, using spatial analysis, the occurrence of American Cutaneous Leishmaniasis (ACL) and analyze its association with the municipal human development index (MHDI) and deforestation in the state of Amazonas, Brazil, from 2016 to 2020.

Methods: This ecological study, carried out from January 2016 to December 2020, included the 62 municipalities of the state of Amazonas. The incidence rate of ACL was determined in space and time. Using Multiple Linear Regression by Ordinary Least Squares (OLS) and Spatial Autoregressive Regression (SAR) models, the relationship between incidence rates and Human Development Index (HDI) and deforestation was analyzed., The high- and low-risk clusters were identified by employing the Getis-Ord Gi* statistic.

Results: A total of 7,499 cases of ACL were registered in all 62 municipalities in the state. Most cases were in male (n=5,924; 79.24%), with the greatest frequency in the population aged from 20 to 39 years (n=3,356; 44.7%). The incidence rate in the state of Amazonas was 7.34 cases per 100,000 inhabitants-year, with the municipalities of Rio Preto da Eva and Presidente Figueiredo showing the highest rates (1,377.5 and 817.5 cases per 100,000 population-year, respectively). The ACL cases were clustered into specific areas related to those municipalities with the highest incidence rates. The SAR model revealed a positive relationship between ACL and deforestation.

Conclusions: The occurrence of ACL was evident in a variety of patterns in the state of Amazonas; the high incidence rates and persistence of this disease in this state were linked to deforestation. The temporal distribution showed variations in the incidence rates during each year. Our results can help optimize the measures needed to prevent and control this disease in the state.

目的采用空间分析方法评估美洲皮肤利什曼病(ACL)的发生情况,并分析其与巴西亚马孙州 2016 年至 2020 年城市人类发展指数(MHDI)和森林砍伐的关系:这项生态研究于 2016 年 1 月至 2020 年 12 月进行,包括亚马孙州的 62 个城市。在空间和时间上确定了前交叉韧带的发病率。使用普通最小二乘法(OLS)和空间自回归(SAR)模型进行多元线性回归,分析发病率与人类发展指数(HDI)和森林砍伐之间的关系:结果:该州所有 62 个市共登记了 7,499 例前交叉韧带炎病例。大多数病例为男性(5,924 例;79.24%),20 至 39 岁人群发病率最高(3,356 例;44.7%)。亚马孙州的发病率为每 10 万居民年 7.34 例,其中 Rio Preto da Eva 市和 Presidente Figueiredo 市的发病率最高(分别为每 10 万居民年 1 377.5 例和 817.5 例)。前交叉韧带病例聚集在与发病率最高的城市相关的特定地区。SAR模型显示,前交叉韧带炎与森林砍伐之间存在正相关关系:亚马孙州的前交叉膀胱炎发病模式多种多样;该州的高发病率和该疾病的持续存在与森林砍伐有关。从时间分布来看,每年的发病率都有所不同。我们的研究结果有助于优化该州预防和控制这种疾病所需的措施。
{"title":"Spatial analysis of American cutaneous leishmaniasis in the state of Amazonas.","authors":"Mirely Ferreira Dos Santos, Camila Lorenz, Francisco Chiaravalotti-Neto, Tamara Nunes Lima-Camara","doi":"10.11606/s1518-8787.2024058005662","DOIUrl":"https://doi.org/10.11606/s1518-8787.2024058005662","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate, using spatial analysis, the occurrence of American Cutaneous Leishmaniasis (ACL) and analyze its association with the municipal human development index (MHDI) and deforestation in the state of Amazonas, Brazil, from 2016 to 2020.</p><p><strong>Methods: </strong>This ecological study, carried out from January 2016 to December 2020, included the 62 municipalities of the state of Amazonas. The incidence rate of ACL was determined in space and time. Using Multiple Linear Regression by Ordinary Least Squares (OLS) and Spatial Autoregressive Regression (SAR) models, the relationship between incidence rates and Human Development Index (HDI) and deforestation was analyzed., The high- and low-risk clusters were identified by employing the Getis-Ord Gi* statistic.</p><p><strong>Results: </strong>A total of 7,499 cases of ACL were registered in all 62 municipalities in the state. Most cases were in male (n=5,924; 79.24%), with the greatest frequency in the population aged from 20 to 39 years (n=3,356; 44.7%). The incidence rate in the state of Amazonas was 7.34 cases per 100,000 inhabitants-year, with the municipalities of Rio Preto da Eva and Presidente Figueiredo showing the highest rates (1,377.5 and 817.5 cases per 100,000 population-year, respectively). The ACL cases were clustered into specific areas related to those municipalities with the highest incidence rates. The SAR model revealed a positive relationship between ACL and deforestation.</p><p><strong>Conclusions: </strong>The occurrence of ACL was evident in a variety of patterns in the state of Amazonas; the high incidence rates and persistence of this disease in this state were linked to deforestation. The temporal distribution showed variations in the incidence rates during each year. Our results can help optimize the measures needed to prevent and control this disease in the state.</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"58 ","pages":"11"},"PeriodicalIF":2.8,"publicationDate":"2024-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11037905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140857962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Precarious work and methodological challenges to study hard-to-reach populations. 不稳定的工作和研究难以接触人群的方法挑战。
IF 2.8 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-04-19 eCollection Date: 2024-01-01 DOI: 10.11606/s1518-8787.2024058005470
Rita de Cássia P Fernandes, Janaína Santos de Siqueira, Matheus F Dos Santos, Paulo G L Pena, Guilherme L Werneck, Alex Burdorf

Objective: To describe the methodological challenges and strategies of a web survey on the working conditions and health among delivery workers.

Methods: The study population consisted of Brazilian delivery workers operating in the national territory. Procedures include building solid and ongoing collaboration with worker representatives and conducting a four-month data collection from February to May 2022, sharing the link to the online questionnaire on social media such as social networks (Facebook, Instagram) and messaging apps (WhatsApp, Telegram).

Results: The recruitment of 41 leaders or influencers of delivery workers increased the dissemination of the study, some of whom participated in the consensual validation of the questionnaire; the production of content for social media for the dissemination of the questionnaire link on social networks and applications, and the in-person dissemination of the study at the delivery workers' meeting points during the workday played a fundamental role, totaling around 132 hours in 45 shifts. The strategies adopted for data collection with a hybrid approach to dissemination made it possible to carry out the web survey. After four months of the web survey, 564 delivery workers, 543 men and 18 women, responded to the online questionnaire.

Conclusion: The web survey presented methodological strategies to overcome the challenge of reaching workers, including hybrid work, to increase the participation of workers, on whom epidemiological research is still scarce.

目的描述对分娩工人的工作条件和健康状况进行网络调查的方法挑战和策略:研究对象包括在全国范围内工作的巴西接生员。程序包括与工人代表建立稳固和持续的合作关系,从 2022 年 2 月至 5 月进行为期四个月的数据收集,在社交网络(Facebook、Instagram)和消息应用程序(WhatsApp、Telegram)等社交媒体上分享在线问卷链接:招募了 41 名外卖配送员的领导或有影响力的人,扩大了研究的传播范围,其中一些人还参与了问卷的共识验证;为在社交网络和应用程序上传播问卷链接而制作的社交媒体内容,以及工作日期间在外卖配送员集合点的现场传播,都发挥了重要作用,45 个轮班共计约 132 个小时。采用混合传播方式收集数据的策略使网络调查得以开展。经过四个月的网络调查,564 名送货员(543 名男性和 18 名女性)对在线问卷做出了答复:网络调查提出了一些方法策略,包括混合工作,以克服接触工人方面的挑战,从而提高工人的参与度,因为对这些工人的流行病学研究仍然很少。
{"title":"Precarious work and methodological challenges to study hard-to-reach populations.","authors":"Rita de Cássia P Fernandes, Janaína Santos de Siqueira, Matheus F Dos Santos, Paulo G L Pena, Guilherme L Werneck, Alex Burdorf","doi":"10.11606/s1518-8787.2024058005470","DOIUrl":"https://doi.org/10.11606/s1518-8787.2024058005470","url":null,"abstract":"<p><strong>Objective: </strong>To describe the methodological challenges and strategies of a web survey on the working conditions and health among delivery workers.</p><p><strong>Methods: </strong>The study population consisted of Brazilian delivery workers operating in the national territory. Procedures include building solid and ongoing collaboration with worker representatives and conducting a four-month data collection from February to May 2022, sharing the link to the online questionnaire on social media such as social networks (Facebook, Instagram) and messaging apps (WhatsApp, Telegram).</p><p><strong>Results: </strong>The recruitment of 41 leaders or influencers of delivery workers increased the dissemination of the study, some of whom participated in the consensual validation of the questionnaire; the production of content for social media for the dissemination of the questionnaire link on social networks and applications, and the in-person dissemination of the study at the delivery workers' meeting points during the workday played a fundamental role, totaling around 132 hours in 45 shifts. The strategies adopted for data collection with a hybrid approach to dissemination made it possible to carry out the web survey. After four months of the web survey, 564 delivery workers, 543 men and 18 women, responded to the online questionnaire.</p><p><strong>Conclusion: </strong>The web survey presented methodological strategies to overcome the challenge of reaching workers, including hybrid work, to increase the participation of workers, on whom epidemiological research is still scarce.</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"58 ","pages":"12"},"PeriodicalIF":2.8,"publicationDate":"2024-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11037901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140865695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clusters of heterogeneity of tuberculosis-HIV coinfection in Brazil: a geospatial study. 巴西结核病与艾滋病毒双重感染的异质性群集:一项地理空间研究。
IF 2.8 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-04-19 eCollection Date: 2024-01-01 DOI: 10.11606/s1518-8787.2024058005531
Lucas Vinícius de Lima, Gabriel Pavinati, Pedro Augusto Bossonario, Aline Aparecida Monroe, Daniele Maria Pelissari, Kleydson Bonfim Andrade Alves, Gabriela Tavares Magnabosco

Objective: To analyze the geospatialization of tuberculosis-HIV coinfection in Brazil, from 2010 to 2021, and the correlation with socioeconomic, housing, and health indicators.

Methods: An ecological study of Brazilian municipalities and states, with data from HIV and tuberculosis information systems, previously reported by the Ministry of Health. The crude and smoothed coefficients were calculated by the local empirical Bayesian method of incidence of coinfection per 100,000 inhabitants in the population aged between 18 and 59 years. Univariate (identification of clusters) and bivariate (correlation with 20 indicators) Moran's indices were used.

Results: A total of 122,223 cases of coinfection were registered in Brazil from 2010 to 2021, with a mean coefficient of 8.30/100,000. The South (11.44/100,000) and North (9.93/100,000) regions concentrated the highest burden of infections. The coefficients dropped in Brazil, in all regions, in the years of covid-19 (2020 and 2021). The highest coefficients were observed in the municipalities of the states of Rio Grande do Sul, Mato Grosso do Sul, and Amazonas, with high-high clusters in the capitals, border regions, coast of the country. The municipalities belonging to the states of Minas Gerais, Bahia, Paraná, and Piauí showed low-low clusters. There was a direct correlation with human development indices and aids rates, as well as an indirect correlation with the proportion of poor or of those vulnerable to poverty and the Gini index.

Conclusions: The spatial analysis of tuberculosis-HIV coinfection showed heterogeneity in the Brazilian territory and constant behavior throughout the period, revealing clusters with high-burden municipalities, especially in large urban centers and in states with a high occurrence of HIV and/or tuberculosis. These findings, in addition to alerting to the effects of the covid-19 pandemic, can incorporate strategic planning for the control of coinfection, aiming to eliminate these infections as public health problems by 2030.

摘要分析 2010 年至 2021 年巴西结核病与艾滋病毒双重感染的地理空间分布,以及与社会经济、住房和健康指标的相关性:对巴西各市州进行生态研究,数据来自卫生部之前报告的艾滋病毒和结核病信息系统。根据当地经验贝叶斯法计算出 18 至 59 岁人口中每 10 万居民合并感染发病率的粗系数和平滑系数。使用了单变量(确定群组)和双变量(与 20 个指标相关)莫兰指数:从 2010 年到 2021 年,巴西共登记了 122 223 例合并感染病例,平均系数为 8.30/100 000。南部(11.44/100,000)和北部(9.93/100,000)地区的感染率最高。在 covid-19 年(2020 年和 2021 年),巴西所有地区的系数都有所下降。南里奥格兰德州、南马托格罗索州和亚马孙州的市镇的系数最高,首都、边境地区和沿海地区的系数也很高。米纳斯吉拉斯州、巴伊亚州、巴拉那州和皮奥伊州的城市则呈低-低聚类。人类发展指数与艾滋病发病率有直接关系,与贫困人口或易陷入贫困人口的比例以及基尼指数也有间接关系:结核病-艾滋病毒双重感染的空间分析表明,巴西领土上的结核病-艾滋病毒双重感染具有异质性,并且在整个时期内表现稳定,揭示了高负担城市群,尤其是在大城市中心和艾滋病毒和/或结核病高发州。这些发现除了提醒人们警惕covid-19大流行的影响外,还可以纳入控制合并感染的战略规划,旨在到2030年消除这些感染这一公共卫生问题。
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引用次数: 0
The knowledge of primary health care professionals regarding mental health: diagnosis by mhGAP. 初级卫生保健专业人员对精神健康的了解:通过 mhGAP 进行诊断。
IF 2.8 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-04-15 eCollection Date: 2024-01-01 DOI: 10.11606/s1518-8787.2023057005272
Joana Moscoso Teixeira de Mendonça, Ilana Eshriqui, Leticia Yamawaka de Almeida, Valmir Vanderlei Gomes Filho, Lívia Schunk, Ana Alice Freire de Sousa, Larissa Karollyne de Oliveira Santos, Sandra Fortes

Objective: To analyze knowledge about priority topics in mental health care of strategic actors who work in regions where the Health Care Planning (PAS) methodology is used.

Methods: This is a quantitative, descriptive, cross-sectional, and observational study carried out with professionals from six health regions, distributed in three Brazilian states (Goiás, Rondônia and Maranhão) and linked to the project "Saúde mental na APS" (Mental health in PHC) of the Programa de Apoio ao Desenvolvimento Institucional do Sistema Único de Saúde (Proadi-SUS - Institutional Development Support Program of the Brazilian Unified Health System). The sample was made up of professionals who participated in the intervention guide multiplier training stage for mental, neurological and alcohol and other drug use disorders in the primary health care network, from July to September 2022. Data collection was through a self-administered instrument, in electronic format, consisting of a block with socioeconomic items and a structured questionnaire to assess participants' knowledge about priority topics in mental health. Descriptive analyses and comparison of proportions were conducted to analyze the data.

Results: A total of 354 health professionals participated in the study. Regarding the percentage of correct answers in the questionnaire on priority topics in mental health, the highest medians were identified in the "Depression" module. On the other hand, the content referring to the modules "Essential care and practices" and "Other important complaints" presented the lowest values. Furthermore, some participant characteristics were found to be associated with the percentage of correct answers in the questionnaire modules.

Conclusions: The findings reveal opportunities for improvement, mainly in knowledge related to communication skills and the approach to emotional and physical distress without diagnostic criteria for a specific disease, offering support for planning actions aimed at intensifying the consideration of these themes during the operational stages of PAS.

目的分析在使用医疗保健规划(PAS)方法的地区工作的战略参与者对心理保健优先主题的了解:这是一项定量、描述性、横断面和观察性研究,研究对象是来自巴西三个州(戈亚斯州、朗多尼亚州和马拉尼昂州)六个卫生保健地区的专业人员,他们都参与了巴西统一卫生系统机构发展支持计划(Proadi-SUS--巴西统一卫生系统机构发展支持计划)的 "APS 中的精神卫生 "项目。样本由参加过 2022 年 7 月至 9 月初级卫生保健网络精神、神经、酒精和其他药物使用障碍干预指南倍增培训阶段的专业人员组成。数据收集采用电子版自填式工具,包括社会经济项目模块和结构化问卷,以评估参与者对精神健康优先主题的了解程度。对数据进行了描述性分析和比例比较:共有 354 名卫生专业人员参与了研究。关于心理健康重点话题问卷的正确答案百分比,"抑郁症 "模块的中位数最高。另一方面,"基本护理和实践 "模块和 "其他重要主诉 "模块的答题正确率最低。此外,还发现一些参与者的特征与问卷模块中的正确答案百分比有关:调查结果揭示了需要改进的地方,主要是与沟通技巧有关的知识以及在没有特定疾病诊断标准的情况下处理情绪和身体困扰的方法,这为规划行动提供了支持,以便在 PAS 的操作阶段加强对这些主题的考虑。
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引用次数: 0
Impact of a research-action on vaccination indicators in the state of Minas Gerais, Brazil. 研究行动对巴西米纳斯吉拉斯州疫苗接种指标的影响。
IF 2.8 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-03-11 eCollection Date: 2024-01-01 DOI: 10.11606/s1518-8787.2024058005484
Janaina Fonseca Almeida Souza, Thales Philipe Rodrigues da Silva, Thais Moreira Oliveira, Aline Mendes Vimieiro, Antônia Maria da Silva Teixeira, Adriana Coelho Soares, Elice Eliane Nobre Ribeiro, Giselle Lima de Freitas, Eduarda Dantas Gaspar, Fernanda Penido Matozinhos

Objective: Analyze the impact of the state research-action project on immunization indicators (vaccination coverage - VC, homogeneity of vaccination coverage - HVC, dropout rate - DR, and risk rating) before and after the intervention in municipalities and priority Regional Health Administrations/Regional Health Superintendencies (RHA/RHS).

Methods: The state research-action project was a before-after community clinical trial conducted in 212 municipalities belonging to eight RHA/RHS in the state of Minas Gerais, Brazil. The study sample comprised RHA/RHS with a decreasing trend for routine vaccination coverage in children under one year from 2015 to 2020. This study used secondary VC and DR data from 10 immunobiologicals recommended for children younger than two years from January to December 2021 (pre-intervention period, prior to the state research-action project) and from January to December 2022 (post-intervention period). The categorical variables were presented in proportions, and initially, a comparison was made between those of DR, HVC, and the risk rating for the transmission of vaccine-preventable diseases, according to the two periods (2021 and 2022), using the McNemar test.

Results: All immunization indicators increased after conducting the research-action project. In 2021, 80.66% of the state's municipalities had a risk rating for the transmission of vaccine-preventable diseases as "high and very high." In 2022, the value reduced to 68.40%.

Conclusions: Risk rating for the transmission of vaccine-preventable diseases is an important mechanism to assist managers in defining priorities. The state research-action project used a method that enabled the construction and execution of unique action plans for each municipality, directing the improvement of immunization indicators in the state.

目标:分析州研究行动项目在各市和重点地区卫生管理局/地区卫生监督局(RHA/RHS)干预前后对免疫指标(疫苗接种覆盖率(VC)、疫苗接种覆盖率均匀性(HVC)、辍学率(DR)和风险评级)的影响:该州研究行动项目是一项前后对比的社区临床试验,在巴西米纳斯吉拉斯州 8 个地区卫生管理局/地区卫生监督局下属的 212 个市进行。研究样本包括从 2015 年到 2020 年一岁以下儿童常规疫苗接种覆盖率呈下降趋势的 RHA/RHS。本研究使用了 2021 年 1 月至 12 月(干预前,即州研究行动项目之前)和 2022 年 1 月至 12 月(干预后)推荐给两岁以下儿童接种的 10 种免疫生物学疫苗的二次 VC 和 DR 数据。分类变量以比例表示,首先,根据两个时期(2021 年和 2022 年),使用 McNemar 检验对 DR、HVC 和可预防疾病传播风险等级进行比较:结果:开展研究-行动项目后,所有免疫指标均有所提高。2021 年,全州 80.66% 的城市可预防疾病传播风险等级为 "高和很高"。2022 年,该数值降至 68.40%:疫苗可预防疾病传播风险评级是协助管理者确定优先事项的重要机制。该州的研究-行动项目采用了一种方法,能够为每个市制定和执行独特的行动计划,指导改善该州的免疫指标。
{"title":"Impact of a research-action on vaccination indicators in the state of Minas Gerais, Brazil.","authors":"Janaina Fonseca Almeida Souza, Thales Philipe Rodrigues da Silva, Thais Moreira Oliveira, Aline Mendes Vimieiro, Antônia Maria da Silva Teixeira, Adriana Coelho Soares, Elice Eliane Nobre Ribeiro, Giselle Lima de Freitas, Eduarda Dantas Gaspar, Fernanda Penido Matozinhos","doi":"10.11606/s1518-8787.2024058005484","DOIUrl":"10.11606/s1518-8787.2024058005484","url":null,"abstract":"<p><strong>Objective: </strong>Analyze the impact of the state research-action project on immunization indicators (vaccination coverage - VC, homogeneity of vaccination coverage - HVC, dropout rate - DR, and risk rating) before and after the intervention in municipalities and priority Regional Health Administrations/Regional Health Superintendencies (RHA/RHS).</p><p><strong>Methods: </strong>The state research-action project was a before-after community clinical trial conducted in 212 municipalities belonging to eight RHA/RHS in the state of Minas Gerais, Brazil. The study sample comprised RHA/RHS with a decreasing trend for routine vaccination coverage in children under one year from 2015 to 2020. This study used secondary VC and DR data from 10 immunobiologicals recommended for children younger than two years from January to December 2021 (pre-intervention period, prior to the state research-action project) and from January to December 2022 (post-intervention period). The categorical variables were presented in proportions, and initially, a comparison was made between those of DR, HVC, and the risk rating for the transmission of vaccine-preventable diseases, according to the two periods (2021 and 2022), using the McNemar test.</p><p><strong>Results: </strong>All immunization indicators increased after conducting the research-action project. In 2021, 80.66% of the state's municipalities had a risk rating for the transmission of vaccine-preventable diseases as \"high and very high.\" In 2022, the value reduced to 68.40%.</p><p><strong>Conclusions: </strong>Risk rating for the transmission of vaccine-preventable diseases is an important mechanism to assist managers in defining priorities. The state research-action project used a method that enabled the construction and execution of unique action plans for each municipality, directing the improvement of immunization indicators in the state.</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"58 ","pages":"09"},"PeriodicalIF":2.8,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10926982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140111317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effects of land cover and air pollution on the risk of preterm births. 土地覆盖和空气污染对早产风险的影响。
IF 2.8 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-03-11 eCollection Date: 2024-01-01 DOI: 10.11606/s1518-8787.2024058005504
Tiana C L Moreira, Jefferson L Polizel, Weeberb J Réquia, Paulo Hilario Nascimento Saldiva, Demostenes F da Silva Filho, Silvia Regina Dias Medici Saldiva, Thais Mauad

Objective: To evaluate the association between gestational age and green areas, urban built areas, and the concentration of particulate matter 2.5 (PM2.5) in the city of São Paulo, analyzing the irregular distribution of these areas and pollution levels above the recommended level.

Methods: The study population consisted of a cohort of live births from 2012, and data from the Live Birth Information System (Sinasc) of the city of São Paulo were used. Using satellite images and supervised classification, the distribution and quantity of green areas and built areas in the city of São Paulo was obtained, as well as the concentrations of PM2.5. Logistic regressions were used to obtain possible associations.

Results: The results of the study show that a lower percentage of green areas is significantly associated with a higher chance of preterm births. A higher building density was positively associated with the odds ratio for preterm birth. We did not find any significant associations between air pollution (PM2.5) and preterm births.

Conclusions: The results of this study show that greener areas are less associated with preterm births when compared with less green areas.

目的评估圣保罗市胎龄与绿化区、城市建筑区和颗粒物2.5(PM2.5)浓度之间的关系,分析这些区域的不规则分布和高于建议水平的污染程度:研究对象包括2012年出生的活产婴儿,数据来自圣保罗市的活产婴儿信息系统(Sinasc)。通过卫星图像和监督分类,获得了圣保罗市绿地和建筑区的分布和数量,以及PM2.5的浓度。使用逻辑回归法得出可能的关联:研究结果表明,绿地比例越低,早产几率越高。较高的建筑密度与早产几率呈正相关。我们没有发现空气污染(PM2.5)与早产之间有任何明显的关联:这项研究的结果表明,与绿化较少的地区相比,绿化较多的地区与早产的关系较小。
{"title":"Effects of land cover and air pollution on the risk of preterm births.","authors":"Tiana C L Moreira, Jefferson L Polizel, Weeberb J Réquia, Paulo Hilario Nascimento Saldiva, Demostenes F da Silva Filho, Silvia Regina Dias Medici Saldiva, Thais Mauad","doi":"10.11606/s1518-8787.2024058005504","DOIUrl":"10.11606/s1518-8787.2024058005504","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the association between gestational age and green areas, urban built areas, and the concentration of particulate matter 2.5 (PM2.5) in the city of São Paulo, analyzing the irregular distribution of these areas and pollution levels above the recommended level.</p><p><strong>Methods: </strong>The study population consisted of a cohort of live births from 2012, and data from the Live Birth Information System (Sinasc) of the city of São Paulo were used. Using satellite images and supervised classification, the distribution and quantity of green areas and built areas in the city of São Paulo was obtained, as well as the concentrations of PM2.5. Logistic regressions were used to obtain possible associations.</p><p><strong>Results: </strong>The results of the study show that a lower percentage of green areas is significantly associated with a higher chance of preterm births. A higher building density was positively associated with the odds ratio for preterm birth. We did not find any significant associations between air pollution (PM2.5) and preterm births.</p><p><strong>Conclusions: </strong>The results of this study show that greener areas are less associated with preterm births when compared with less green areas.</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"58 ","pages":"08"},"PeriodicalIF":2.8,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10926984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140111254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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