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.
{"title":"Smoking, mortality, access to diagnosis, and treatment of lung cancer in Brazil.","authors":"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","doi":"10.11606/s1518-8787.2024058005704","DOIUrl":"10.11606/s1518-8787.2024058005704","url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Method: </strong>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).</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"58 ","pages":"18"},"PeriodicalIF":2.8,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11090611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140923086","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}
Pub Date : 2024-05-13eCollection Date: 2024-01-01DOI: 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。
{"title":"Structure and process in primary health care for children and spatial distribution of infant mortality.","authors":"Alitéia Santiago Dilélio, Márcio Natividade, Luiz Augusto Facchini, Marcos Pereira, Elaine Tomasi","doi":"10.11606/s1518-8787.2024058005527","DOIUrl":"10.11606/s1518-8787.2024058005527","url":null,"abstract":"<p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"58 ","pages":"21"},"PeriodicalIF":2.8,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11090610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140923089","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}
Pub Date : 2024-05-13eCollection Date: 2024-01-01DOI: 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.
{"title":"Pesticide contamination of lactating mothers' milk in Latin America: a systematic review.","authors":"Thalyta Mota Figueiredo, Jerusa da Mota Santana, Fernando Henrique Basilio Granzotto, Bianca Sampaio Dos Anjos, Danilo Guerra Neto, Laylla Mirella Galvão Azevedo, Marcos Pereira","doi":"10.11606/s1518-8787.2024058005446","DOIUrl":"10.11606/s1518-8787.2024058005446","url":null,"abstract":"<p><strong>Objective: </strong>To identify the prevalence of contamination by pesticides and their metabolites in the milk of lactating mothers in Latin America.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"58 ","pages":"19"},"PeriodicalIF":2.8,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11090615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140923083","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}
Pub Date : 2024-04-19eCollection Date: 2024-01-01DOI: 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}
Pub Date : 2024-04-19eCollection Date: 2024-01-01DOI: 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.
{"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}
Pub Date : 2024-04-19eCollection Date: 2024-01-01DOI: 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.
{"title":"Clusters of heterogeneity of tuberculosis-HIV coinfection in Brazil: a geospatial study.","authors":"Lucas Vinícius de Lima, Gabriel Pavinati, Pedro Augusto Bossonario, Aline Aparecida Monroe, Daniele Maria Pelissari, Kleydson Bonfim Andrade Alves, Gabriela Tavares Magnabosco","doi":"10.11606/s1518-8787.2024058005531","DOIUrl":"https://doi.org/10.11606/s1518-8787.2024058005531","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the geospatialization of tuberculosis-HIV coinfection in Brazil, from 2010 to 2021, and the correlation with socioeconomic, housing, and health indicators.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"58 ","pages":"10"},"PeriodicalIF":2.8,"publicationDate":"2024-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11037911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140857417","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}
Pub Date : 2024-04-15eCollection Date: 2024-01-01DOI: 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.
{"title":"The knowledge of primary health care professionals regarding mental health: diagnosis by mhGAP.","authors":"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","doi":"10.11606/s1518-8787.2023057005272","DOIUrl":"https://doi.org/10.11606/s1518-8787.2023057005272","url":null,"abstract":"<p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"57Suppl 3 Suppl 3","pages":"4s"},"PeriodicalIF":2.8,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11037900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140857937","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}
Pub Date : 2024-03-11eCollection Date: 2024-01-01DOI: 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.
{"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}
Pub Date : 2024-03-11eCollection Date: 2024-01-01DOI: 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.
{"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}