Pub Date : 2019-10-07DOI: 10.1590/1980-549720190015.supl.2
T. Bastos, Lhaís de Paula Barbosa Medina, Neuciani Ferreira da Silva E Sousa, M. Lima, D. Malta, M. Barros
INTRODUCTION Despite the improvement in oral health conditions observed in the Brazilian population, there are still high social inequalities that must be monitored. OBJECTIVE To evaluate income inequality in oral hygiene practices, oral health status and the use of dental services in the adult and senior Brazilian population. METHODS Data from the National Health Survey conducted in 2013 (Pesquisa Nacional de Saúde - PNS 2013) were used for the population aged 18 years old or older. RESULTS Inequalities were found among the income strata in most of the oral health indicators evaluated. The greatest inequalities were observed in the use of dental floss, in hygiene practices (PR = 2.85 in adults and PR = 2.45 in seniors), and in total tooth loss (PR = 6.74 in adults and PR = 2.24 in seniors) and difficulty in chewing (PR = 4.49 in adults and PR = 2.67 in seniors) among oral condition indicators. The magnitude of inequalities was high in both groups in most oral condition indicators. Income was a factor that persisted in limiting access to dental services, and even the lower income segments had high percentages that paid for dental consultations. CONCLUSION Based on data from the first PNS, the findings of this study enabled the identification of oral health and dental care aspects more compromised by income differentials, thus, contributing to the planning of dental care in Brazil and to stimulate the monitoring of these disparities with data from future surveys.
尽管巴西人口的口腔健康状况有所改善，但仍然存在高度的社会不平等现象，必须加以监测。目的评价巴西成年人和老年人在口腔卫生习惯、口腔健康状况和牙科服务使用方面的收入不平等。方法采用2013年国家健康调查(Pesquisa Nacional de Saúde - PNS 2013)的数据，研究对象为18岁及以上人群。结果各收入阶层的口腔健康评价指标存在不均衡。在牙线的使用、卫生习惯(成人PR = 2.85，老年人PR = 2.45)、牙齿总脱落(成人PR = 6.74，老年人PR = 2.24)和咀嚼困难(成人PR = 4.49，老年人PR = 2.67)方面的口腔状况指标差异最大。在大多数口腔状况指标上，两组的不平等程度都很高。收入一直是限制获得牙科服务的一个因素，甚至低收入阶层也有很高的比例支付牙科咨询费用。根据第一次PNS调查的数据，本研究的结果能够确定受收入差异影响更大的口腔健康和牙科保健方面，从而有助于巴西牙科保健的规划，并利用未来调查的数据促进对这些差异的监测。
{"title":"Income inequalities in oral health and access to dental services in the Brazilian population: National Health Survey, 2013.","authors":"T. Bastos, Lhaís de Paula Barbosa Medina, Neuciani Ferreira da Silva E Sousa, M. Lima, D. Malta, M. Barros","doi":"10.1590/1980-549720190015.supl.2","DOIUrl":"https://doi.org/10.1590/1980-549720190015.supl.2","url":null,"abstract":"INTRODUCTION\u0000Despite the improvement in oral health conditions observed in the Brazilian population, there are still high social inequalities that must be monitored.\u0000\u0000\u0000OBJECTIVE\u0000To evaluate income inequality in oral hygiene practices, oral health status and the use of dental services in the adult and senior Brazilian population.\u0000\u0000\u0000METHODS\u0000Data from the National Health Survey conducted in 2013 (Pesquisa Nacional de Saúde - PNS 2013) were used for the population aged 18 years old or older.\u0000\u0000\u0000RESULTS\u0000Inequalities were found among the income strata in most of the oral health indicators evaluated. The greatest inequalities were observed in the use of dental floss, in hygiene practices (PR = 2.85 in adults and PR = 2.45 in seniors), and in total tooth loss (PR = 6.74 in adults and PR = 2.24 in seniors) and difficulty in chewing (PR = 4.49 in adults and PR = 2.67 in seniors) among oral condition indicators. The magnitude of inequalities was high in both groups in most oral condition indicators. Income was a factor that persisted in limiting access to dental services, and even the lower income segments had high percentages that paid for dental consultations.\u0000\u0000\u0000CONCLUSION\u0000Based on data from the first PNS, the findings of this study enabled the identification of oral health and dental care aspects more compromised by income differentials, thus, contributing to the planning of dental care in Brazil and to stimulate the monitoring of these disparities with data from future surveys.","PeriodicalId":35426,"journal":{"name":"Revista Brasileira de Epidemiologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67307521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-02DOI: 10.1590/1980-549720190045
Vania Reis Girianelli, Jeane Glaucia Tomazelli, Mário Círio Nogueira, Camila Soares Lima Corrêa, Eduardo Oliveira de Souza, Ligia Gabrielli, Estela M L Aquino, Maximiliano Ribeiro Guerra, Bianca Lucia De Stavola, Isabel Dos-Santos-Silva, Gulnar Azevedo E Silva
Introduction: The study assessed interobserver reliability in the classification of record pairs formed during probabilistic linkage of health-related databases, a key step in the methodology validation to be used in a larger on-going study on inequalities in the access to breast and cervical cancer control activities in Brazil (DAAC-SIS).
Methodology: The RecLink software was used to link two databases of the Breast Cancer Control Information System (SISMAMA) in the state of Minas Gerais, Brazil: a reference database, which included 301 screening mammograms with probable benign diagnosis (BI-RADS 3 category) recorded in October 2010, and a database comprising 158,517 mammograms registered in 2011. Subsequently, the 215 pairs of records that were not assigned the maximum RecLink score were independently classified as being true or false by ten independent evaluators from four participating centers.
Results: The Kappa coefficient ranged from 0.87 to 1.00. Six evaluators were in perfect agreement with one or more evaluators from the other centers. The global Kappa was 0.96 (95% confidence interval - 95%CI 0.94 - 0.99).
Discussion: Assessment of interobserver reliability is key to ensuring the quality of the record linkage, and it should be routine practice in studies of this nature. The disclosure of such results contributes to transparency in the conduct of such studies and in the reporting of their findings.
Conclusion: Interobserver reliability in this study was excellent, indicating satisfactory team consistency in the classification of record pairs.
{"title":"Interobserver reliability in the classification of pairs of records formed by probabilistic linkage of SISMAMA databases.","authors":"Vania Reis Girianelli, Jeane Glaucia Tomazelli, Mário Círio Nogueira, Camila Soares Lima Corrêa, Eduardo Oliveira de Souza, Ligia Gabrielli, Estela M L Aquino, Maximiliano Ribeiro Guerra, Bianca Lucia De Stavola, Isabel Dos-Santos-Silva, Gulnar Azevedo E Silva","doi":"10.1590/1980-549720190045","DOIUrl":"10.1590/1980-549720190045","url":null,"abstract":"<p><strong>Introduction: </strong>The study assessed interobserver reliability in the classification of record pairs formed during probabilistic linkage of health-related databases, a key step in the methodology validation to be used in a larger on-going study on inequalities in the access to breast and cervical cancer control activities in Brazil (DAAC-SIS).</p><p><strong>Methodology: </strong>The RecLink software was used to link two databases of the Breast Cancer Control Information System (SISMAMA) in the state of Minas Gerais, Brazil: a reference database, which included 301 screening mammograms with probable benign diagnosis (BI-RADS 3 category) recorded in October 2010, and a database comprising 158,517 mammograms registered in 2011. Subsequently, the 215 pairs of records that were not assigned the maximum RecLink score were independently classified as being true or false by ten independent evaluators from four participating centers.</p><p><strong>Results: </strong>The Kappa coefficient ranged from 0.87 to 1.00. Six evaluators were in perfect agreement with one or more evaluators from the other centers. The global Kappa was 0.96 (95% confidence interval - 95%CI 0.94 - 0.99).</p><p><strong>Discussion: </strong>Assessment of interobserver reliability is key to ensuring the quality of the record linkage, and it should be routine practice in studies of this nature. The disclosure of such results contributes to transparency in the conduct of such studies and in the reporting of their findings.</p><p><strong>Conclusion: </strong>Interobserver reliability in this study was excellent, indicating satisfactory team consistency in the classification of record pairs.</p>","PeriodicalId":35426,"journal":{"name":"Revista Brasileira de Epidemiologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67307733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-08-26DOI: 10.1590/1980-549720190046
Talita Lelis Berti, T. M. D. Rocha, C. Curioni, Eliseu Verly Junior, F. Bezerra, D. S. Canella, Eduardo Faerstein
OBJECTIVE To investigate the food consumption according to the degree of processing and associations with sociodemographic characteristics. METHODS A cross-sectional study of the Estudo Pró-Saúde (Pro-Health Study), with 520 civil servants of university campuses, Rio de Janeiro, 2012-13. A food frequency questionnaire was used to classify food consumption: 1) in natura, minimally processed, food preparations based on these foods; 2) processed foods; 3) ultra-processed foods. The relative energy contribution of each group was determined, and a seemingly unrelated equations regression (SUR) regression model was used to estimate associations with sociodemographic characteristics. RESULTS The in natura food group (1) contributed with 59% of the energy consumption and was directly associated with age [45-49 years (β = 1.8 confidence interval of 95% - 95%CI -1.2; 4.8); 50-54 (β = 1.5 95%CI -1.5; 4.5); 55-59 (β = 2.9 95%CI -0.4; 6.3) and ≥ 60 (β = 4.6 95%CI 1.1; 8.2)], compared to age ≤ 44. In contrast, the group of ultra-processed foods contributed 27% and were inversely associated with age [45-49 (β = -1.7 95%CI -4.3; 0.9); 50-54 (β = -1.8 95%CI -4.3; 0.9); 55-59 (β = -4.9 95%CI -8.0; -2.0); ≥ 60 (β = -4.5 95%CI -7.6; -1.5)]. Gender, income and schooling were not associated with food consumption. CONCLUSION Younger adults had higher consumption of ultra-processed foods, indicating the need for interventions mainly in this age group. The absence of association with other sociodemographic characteristics may be due to the influence of contextual factors.
{"title":"Food consumption according to degree of processing and sociodemographic characteristics: Estudo Pró-Saúde, Brazil.","authors":"Talita Lelis Berti, T. M. D. Rocha, C. Curioni, Eliseu Verly Junior, F. Bezerra, D. S. Canella, Eduardo Faerstein","doi":"10.1590/1980-549720190046","DOIUrl":"https://doi.org/10.1590/1980-549720190046","url":null,"abstract":"OBJECTIVE\u0000To investigate the food consumption according to the degree of processing and associations with sociodemographic characteristics.\u0000\u0000\u0000METHODS\u0000A cross-sectional study of the Estudo Pró-Saúde (Pro-Health Study), with 520 civil servants of university campuses, Rio de Janeiro, 2012-13. A food frequency questionnaire was used to classify food consumption: 1) in natura, minimally processed, food preparations based on these foods; 2) processed foods; 3) ultra-processed foods. The relative energy contribution of each group was determined, and a seemingly unrelated equations regression (SUR) regression model was used to estimate associations with sociodemographic characteristics.\u0000\u0000\u0000RESULTS\u0000The in natura food group (1) contributed with 59% of the energy consumption and was directly associated with age [45-49 years (β = 1.8 confidence interval of 95% - 95%CI -1.2; 4.8); 50-54 (β = 1.5 95%CI -1.5; 4.5); 55-59 (β = 2.9 95%CI -0.4; 6.3) and ≥ 60 (β = 4.6 95%CI 1.1; 8.2)], compared to age ≤ 44. In contrast, the group of ultra-processed foods contributed 27% and were inversely associated with age [45-49 (β = -1.7 95%CI -4.3; 0.9); 50-54 (β = -1.8 95%CI -4.3; 0.9); 55-59 (β = -4.9 95%CI -8.0; -2.0); ≥ 60 (β = -4.5 95%CI -7.6; -1.5)]. Gender, income and schooling were not associated with food consumption.\u0000\u0000\u0000CONCLUSION\u0000Younger adults had higher consumption of ultra-processed foods, indicating the need for interventions mainly in this age group. The absence of association with other sociodemographic characteristics may be due to the influence of contextual factors.","PeriodicalId":35426,"journal":{"name":"Revista Brasileira de Epidemiologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1590/1980-549720190046","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67307799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-08-22DOI: 10.1590/1980-549720190049
T. Martins-Silva, J. Vaz, C. L. D. Mola, M. Assunção, L. Tovo-Rodrigues
OBJECTIVE To investigate the role of the domiciliary situation in the prevalence of general and abdominal obesity through the National Health Survey of 2013. METHODOLOGY General obesity (body mass index ≥ 30 kg/m2) and abdominal obesity (waist circumference ≥ 102 cm in men and ≥ 88 cm in women) in rural and urban areas were described according to sex and macroregion. Crude and adjusted Poisson regression models were used to test the association between obesity and household situation, with the significance level of 5%. RESULTS The study included 59,226 individuals. Out of these, 20.7% presented general obesity and 38% abdominal obesity (higher in women: 24.3 and 52%, respectively). The highest prevalences of general obesity were observed in southern urban areas, for both sexes (20.8% in men and 26.5% in women). In rural areas, the highest prevalences were observed for the central-west region (17.2%) in men and in the south region (27.4%) in women. In males, after adjusting for demographic variables, living in rural areas was associated with lower prevalences of general obesity in the North (prevalence ratios - PR = 0.60; confidence interval of 95% - 95%CI 0.40 - 0.89) and Northeast (PR = 0.47, 95%CI 0,38 - 0.59), and for abdominal obesity in all regions. For women in the Midwest, the rural household situation was associated with lower prevalences of obesity. (PR = 1.11, 95%CI 1.01 - 1.23). CONCLUSIONS The results evidenced the role of the domiciliary situation among outcomes at the national level, with lower prevalence of general and abdominal obesity in men living in rural areas. However, higher prevalences were found among women, especially for abdominal obesity.
{"title":"Prevalence of obesity in rural and urban areas in Brazil: National Health Survey, 2013.","authors":"T. Martins-Silva, J. Vaz, C. L. D. Mola, M. Assunção, L. Tovo-Rodrigues","doi":"10.1590/1980-549720190049","DOIUrl":"https://doi.org/10.1590/1980-549720190049","url":null,"abstract":"OBJECTIVE\u0000To investigate the role of the domiciliary situation in the prevalence of general and abdominal obesity through the National Health Survey of 2013.\u0000\u0000\u0000METHODOLOGY\u0000General obesity (body mass index ≥ 30 kg/m2) and abdominal obesity (waist circumference ≥ 102 cm in men and ≥ 88 cm in women) in rural and urban areas were described according to sex and macroregion. Crude and adjusted Poisson regression models were used to test the association between obesity and household situation, with the significance level of 5%.\u0000\u0000\u0000RESULTS\u0000The study included 59,226 individuals. Out of these, 20.7% presented general obesity and 38% abdominal obesity (higher in women: 24.3 and 52%, respectively). The highest prevalences of general obesity were observed in southern urban areas, for both sexes (20.8% in men and 26.5% in women). In rural areas, the highest prevalences were observed for the central-west region (17.2%) in men and in the south region (27.4%) in women. In males, after adjusting for demographic variables, living in rural areas was associated with lower prevalences of general obesity in the North (prevalence ratios - PR = 0.60; confidence interval of 95% - 95%CI 0.40 - 0.89) and Northeast (PR = 0.47, 95%CI 0,38 - 0.59), and for abdominal obesity in all regions. For women in the Midwest, the rural household situation was associated with lower prevalences of obesity. (PR = 1.11, 95%CI 1.01 - 1.23).\u0000\u0000\u0000CONCLUSIONS\u0000The results evidenced the role of the domiciliary situation among outcomes at the national level, with lower prevalence of general and abdominal obesity in men living in rural areas. However, higher prevalences were found among women, especially for abdominal obesity.","PeriodicalId":35426,"journal":{"name":"Revista Brasileira de Epidemiologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1590/1980-549720190049","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67307936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-08-22DOI: 10.1590/1980-549720190047
Lorena Dias Monteiro, Francisco Rogerlândio Martins Mello, T. P. Miranda, J. Heukelbach
INTRODUCTION Tocantins is the most hyperendemic state for leprosy in Brazil. OBJECTIVE To describe the epidemiological characteristics and temporal trends of leprosy indicators in children under 15 years old in Tocantins between the years of 2001 and 2012. METHODOLOGY Data analysis of the Notification of Injury Information System (SINAN). New cases under the age of 15 have been included in the state. The indicators were calculated and the temporal trends were analyzed through the join-point regression. RESULTS There were 1,225 cases in children, mean age of 10.8 years, and male predominated (52%). The mode of detection by spontaneous demand prevailed (55.8%) and more than 9% had some physical disability. Detection in < 15 years was significantly increased between 2001 and 2008 (anual percent change - APC = 3.8%; confidence interval of 95% - 95%CI 0.1 - 7.6), and showed significant decline between 2008 and 2012 (APC = -9.4%; 95%CI -17.2 - -0.8). There was stability for the detection of grade 2 cases (APC = 4.2%; 95%CI -6.7 - 16.3), proportion of grade 2 cases (APC = 4.1%; 95%CI 6.7 - 16.3), proportion of grade 1 cases (APC = 1.3%; 95%CI -6.2 - 9.3), multibacillary ratio (APC = 2.9%; 95%CI -1.7 - 7.7), and proportion of paucibacillary (APC = 2.9%; 95%CI -1.7 - 7.7). CONCLUSION Leprosy remains an important public health problem in Tocantins, with active transmission and persistence of transmission foci. The stability of the indicators points out the permanence of the late diagnosis and the repressed demands.
{"title":"Hansen's disease in children under 15 years old in the state of Tocantins, Brazil, 2001-2012: epidemiological patterns and temporal trends.","authors":"Lorena Dias Monteiro, Francisco Rogerlândio Martins Mello, T. P. Miranda, J. Heukelbach","doi":"10.1590/1980-549720190047","DOIUrl":"https://doi.org/10.1590/1980-549720190047","url":null,"abstract":"INTRODUCTION\u0000Tocantins is the most hyperendemic state for leprosy in Brazil.\u0000\u0000\u0000OBJECTIVE\u0000To describe the epidemiological characteristics and temporal trends of leprosy indicators in children under 15 years old in Tocantins between the years of 2001 and 2012.\u0000\u0000\u0000METHODOLOGY\u0000Data analysis of the Notification of Injury Information System (SINAN). New cases under the age of 15 have been included in the state. The indicators were calculated and the temporal trends were analyzed through the join-point regression.\u0000\u0000\u0000RESULTS\u0000There were 1,225 cases in children, mean age of 10.8 years, and male predominated (52%). The mode of detection by spontaneous demand prevailed (55.8%) and more than 9% had some physical disability. Detection in < 15 years was significantly increased between 2001 and 2008 (anual percent change - APC = 3.8%; confidence interval of 95% - 95%CI 0.1 - 7.6), and showed significant decline between 2008 and 2012 (APC = -9.4%; 95%CI -17.2 - -0.8). There was stability for the detection of grade 2 cases (APC = 4.2%; 95%CI -6.7 - 16.3), proportion of grade 2 cases (APC = 4.1%; 95%CI 6.7 - 16.3), proportion of grade 1 cases (APC = 1.3%; 95%CI -6.2 - 9.3), multibacillary ratio (APC = 2.9%; 95%CI -1.7 - 7.7), and proportion of paucibacillary (APC = 2.9%; 95%CI -1.7 - 7.7).\u0000\u0000\u0000CONCLUSION\u0000Leprosy remains an important public health problem in Tocantins, with active transmission and persistence of transmission foci. The stability of the indicators points out the permanence of the late diagnosis and the repressed demands.","PeriodicalId":35426,"journal":{"name":"Revista Brasileira de Epidemiologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67307811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-08-22DOI: 10.1590/1980-549720190043
H. Oliveira, L. Marin-Léon, N. M. Saita, J. Golub
INTRODUCTION The mortality rate among tuberculosis patients (TB fatality) has been attributed to irregular chemotherapy, delay in diagnosis, multidrug resistance, and HIV coinfection. OBJECTIVE To analyze TB fatality rates by sex, clinical presentation and HIV coinfection in Campinas, São Paulo, Brazil. METHODS Cohorts of residents in the city of Campinas who either died during treatment for tuberculosis or had the disease confirmed after death were divided into three intervals: 2001-2003, 2004-2006, and 2007-2009. Data were obtained from the database of the Tuberculosis Surveillance System of the University of Campinas, and notifications were gathered through TB-WEB Health São Paulo Secretary. Statistical significance was determined using a chi-square test, considering p < 0.05. RESULTS Between 2001 and 2009, 3,416 TB patients were diagnosed: 2,827 (82.8%) were new TB cases and 589 (17.2%) were retreatments. Between the first and second triennium, the number of new patients decreased by 18%, and 23% among retreatments. Between the second and third intervals, the reduction was 5% and 21%, respectively. General case fatality rate declined from 11.4% to 9.9% across intervals, and was most significant among patients that had previously abandoned treatment (17.3% to 5.1%). Fatality rates among patients coinfected with TB-AIDS were 2-3 times that of patients not infected with TB-AIDS throughout the intervals. Fatality between the first and third triennium among TB-AIDS co-infected patients declined (24.8% to 19.5%), while increasing slightly among non-AIDS TB patients (7.3% to 8%) during this period. CONCLUSION Though mortality among TB-AIDS patients declined from 2001-2009, rates among non-AIDS TB remained stagnant. Improved TB diagnosis and treatment is needed to further decrease TB mortality in Campinas.
{"title":"Tuberculosis fatality rates in the city of Campinas - São Paulo, Brazil, from 2001 to 2009.","authors":"H. Oliveira, L. Marin-Léon, N. M. Saita, J. Golub","doi":"10.1590/1980-549720190043","DOIUrl":"https://doi.org/10.1590/1980-549720190043","url":null,"abstract":"INTRODUCTION\u0000The mortality rate among tuberculosis patients (TB fatality) has been attributed to irregular chemotherapy, delay in diagnosis, multidrug resistance, and HIV coinfection.\u0000\u0000\u0000OBJECTIVE\u0000To analyze TB fatality rates by sex, clinical presentation and HIV coinfection in Campinas, São Paulo, Brazil.\u0000\u0000\u0000METHODS\u0000Cohorts of residents in the city of Campinas who either died during treatment for tuberculosis or had the disease confirmed after death were divided into three intervals: 2001-2003, 2004-2006, and 2007-2009. Data were obtained from the database of the Tuberculosis Surveillance System of the University of Campinas, and notifications were gathered through TB-WEB Health São Paulo Secretary. Statistical significance was determined using a chi-square test, considering p < 0.05.\u0000\u0000\u0000RESULTS\u0000Between 2001 and 2009, 3,416 TB patients were diagnosed: 2,827 (82.8%) were new TB cases and 589 (17.2%) were retreatments. Between the first and second triennium, the number of new patients decreased by 18%, and 23% among retreatments. Between the second and third intervals, the reduction was 5% and 21%, respectively. General case fatality rate declined from 11.4% to 9.9% across intervals, and was most significant among patients that had previously abandoned treatment (17.3% to 5.1%). Fatality rates among patients coinfected with TB-AIDS were 2-3 times that of patients not infected with TB-AIDS throughout the intervals. Fatality between the first and third triennium among TB-AIDS co-infected patients declined (24.8% to 19.5%), while increasing slightly among non-AIDS TB patients (7.3% to 8%) during this period.\u0000\u0000\u0000CONCLUSION\u0000Though mortality among TB-AIDS patients declined from 2001-2009, rates among non-AIDS TB remained stagnant. Improved TB diagnosis and treatment is needed to further decrease TB mortality in Campinas.","PeriodicalId":35426,"journal":{"name":"Revista Brasileira de Epidemiologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1590/1980-549720190043","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67307566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-08-19DOI: 10.1590/1980-549720190044
G. Silva, Érica Bronzi Durante, D. Assumpção, M. Barros, L. Corona
INTRODUCTION Several factors can lead to changes in dietary practices of the older adults; which contributes with nutritional recommendations not being met. OBJECTIVES To estimate the prevalence of inadequate dietary fiber consumption and to identify associated factors. METHODOLOGY Population-based, cross-sectional study that used data from a health survey in the municipality of Campinas, SP, Brazil, held in 2008/2009, in which 1,509 individuals aged 60 or older were assessed. Food consumption was estimated through a 24-hour recall, and the prevalence of inadequacy was calculated according to the Institute of Medicine's cut-off point for total fiber (30 g/day for men and 21 g/day for women). Associated factors were identified using the hierarchical Poisson regression model to estimate the prevalence, adjusted for block distal (sociodemographic) and proximal variables (health and lifestyle indicators). RESULTS Inadequate consumption was observed in 90.1% of the population, and after adjustments in the final model, this rate remained significantly higher among males (RP = 1.06), seniors with a partner (RP = 1.05), lower income (RP = 0.95), physically inactive (RP = 1.05) and those who would not like to change body weight (RP = 1.05). CONCLUSION Considering that inadequacy of dietary fiber was very high, the whole 60-year-old or older population must be targeted for nutritional intervention in order to ensure adequate intake of this nutrient.
{"title":"High prevalence of inadequate dietary fiber consumption and associated factors in older adults: a population-based study.","authors":"G. Silva, Érica Bronzi Durante, D. Assumpção, M. Barros, L. Corona","doi":"10.1590/1980-549720190044","DOIUrl":"https://doi.org/10.1590/1980-549720190044","url":null,"abstract":"INTRODUCTION\u0000Several factors can lead to changes in dietary practices of the older adults; which contributes with nutritional recommendations not being met.\u0000\u0000\u0000OBJECTIVES\u0000To estimate the prevalence of inadequate dietary fiber consumption and to identify associated factors.\u0000\u0000\u0000METHODOLOGY\u0000Population-based, cross-sectional study that used data from a health survey in the municipality of Campinas, SP, Brazil, held in 2008/2009, in which 1,509 individuals aged 60 or older were assessed. Food consumption was estimated through a 24-hour recall, and the prevalence of inadequacy was calculated according to the Institute of Medicine's cut-off point for total fiber (30 g/day for men and 21 g/day for women). Associated factors were identified using the hierarchical Poisson regression model to estimate the prevalence, adjusted for block distal (sociodemographic) and proximal variables (health and lifestyle indicators).\u0000\u0000\u0000RESULTS\u0000Inadequate consumption was observed in 90.1% of the population, and after adjustments in the final model, this rate remained significantly higher among males (RP = 1.06), seniors with a partner (RP = 1.05), lower income (RP = 0.95), physically inactive (RP = 1.05) and those who would not like to change body weight (RP = 1.05).\u0000\u0000\u0000CONCLUSION\u0000Considering that inadequacy of dietary fiber was very high, the whole 60-year-old or older population must be targeted for nutritional intervention in order to ensure adequate intake of this nutrient.","PeriodicalId":35426,"journal":{"name":"Revista Brasileira de Epidemiologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67307633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-08-19DOI: 10.1590/1980-549720190048
Odaleia Barbosa de Aguiar, Ana Glória Godoi Vasconcelos, Patrícia Lima Dias Barreiro
INTRODUCTION Dietary patterns are based on the concept that food consumed together or by itself is as important as food or nutrient intake. OBJECTIVES To identify dietary patterns in a sample of nursing professionals and to explore the differences between the patterns found using two techniques: principal components (PC) and principal factorial axis (PAF). METHOD The current report was based on data from 309 participants on a nursing team at a public hospital in Rio de Janeiro. A 24-hour dietary recall was used, resulting in 24 food groups. To identify the dietary patterns, we applied a multivariate analysis, specifically the PC and the PAF, followed by a Varimax orthogonal rotation. RESULTS The Cattell graphic test indicated three factors to be extracted. The communality varied between 0.41 and 0.76. Higher loads than 0.30 were considered in the pattern composition. The two methods identified similar dietary patterns, called traditional patterns. The other two patterns were nominated as healthy and snacks, having inverted position of factors in the applied techniques. CONCLUSION The observed differences refer to: the number of food groups that enter the composition of components and factors; the size of the smaller loads in the PAF and the order of the alimentary patterns, especially those derived from loads of a smaller magnitude. However, these differences do not seem to impact the interpretability of dietary patterns in this population.
{"title":"The identification of food patterns: a comparison of principal component and principal axis factoring techniques.","authors":"Odaleia Barbosa de Aguiar, Ana Glória Godoi Vasconcelos, Patrícia Lima Dias Barreiro","doi":"10.1590/1980-549720190048","DOIUrl":"https://doi.org/10.1590/1980-549720190048","url":null,"abstract":"INTRODUCTION\u0000Dietary patterns are based on the concept that food consumed together or by itself is as important as food or nutrient intake.\u0000\u0000\u0000OBJECTIVES\u0000To identify dietary patterns in a sample of nursing professionals and to explore the differences between the patterns found using two techniques: principal components (PC) and principal factorial axis (PAF).\u0000\u0000\u0000METHOD\u0000The current report was based on data from 309 participants on a nursing team at a public hospital in Rio de Janeiro. A 24-hour dietary recall was used, resulting in 24 food groups. To identify the dietary patterns, we applied a multivariate analysis, specifically the PC and the PAF, followed by a Varimax orthogonal rotation.\u0000\u0000\u0000RESULTS\u0000The Cattell graphic test indicated three factors to be extracted. The communality varied between 0.41 and 0.76. Higher loads than 0.30 were considered in the pattern composition. The two methods identified similar dietary patterns, called traditional patterns. The other two patterns were nominated as healthy and snacks, having inverted position of factors in the applied techniques.\u0000\u0000\u0000CONCLUSION\u0000The observed differences refer to: the number of food groups that enter the composition of components and factors; the size of the smaller loads in the PAF and the order of the alimentary patterns, especially those derived from loads of a smaller magnitude. However, these differences do not seem to impact the interpretability of dietary patterns in this population.","PeriodicalId":35426,"journal":{"name":"Revista Brasileira de Epidemiologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1590/1980-549720190048","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67307918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01DOI: 10.1590/1980-549720190005.supl.2
D. Malta, C. Szwarcwald, Í. Machado, Cimar Azeredo Pereira, Andre Figueiredo, A. Sá, Gustavo Velasquez-Melendez, Filipe Malta dos Santos, Paulo Roberto Borges de Souza Júnior, Sheila Rizzato Stopa, L. Rosenfeld
OBJECTIVE To analyze the prevalence of altered total cholesterol and fractions levels in the Brazilian population, according to biochemical data from the National Health Survey. METHODS A descriptive study, using data from the National Health Survey, collected between 2014 and 2015. Total cholesterol and fractions were analyzed and population prevalences of altered values according to socio-demographic variables were calculated. The cutoff points considered were: total cholesterol ≥ 200mg/dl; low-density lipoprotein LDL ≥ 130mg/dL and high-density lipoprotein HDL < 40mg/dL. RESULTS The prevalence of total cholesterol ≥200mg/dL in the population was 32.7%, and higher in women (35.1%). The prevalence of altered HDL was 31.8%, 22.0% in females and 42.8% in males. LDL ≥ 130mg/dL was found in 18.6% and was higher in women (19.9%). The population aged 45 years old and older and those with low levels of education presented a higher prevalence of altered cholesterol. CONCLUSION Altered values of total cholesterol and fractions were frequent in the Brazilian population, especially among women, the elderly and people with low levels of education. These results may guide control and preventative actions such as healthy eating, physical activity and treatment, all of which aim to prevent coronary diseases.
{"title":"Prevalence of altered total cholesterol and fractions in the Brazilian adult population: National Health Survey.","authors":"D. Malta, C. Szwarcwald, Í. Machado, Cimar Azeredo Pereira, Andre Figueiredo, A. Sá, Gustavo Velasquez-Melendez, Filipe Malta dos Santos, Paulo Roberto Borges de Souza Júnior, Sheila Rizzato Stopa, L. Rosenfeld","doi":"10.1590/1980-549720190005.supl.2","DOIUrl":"https://doi.org/10.1590/1980-549720190005.supl.2","url":null,"abstract":"OBJECTIVE To analyze the prevalence of altered total cholesterol and fractions levels in the Brazilian population, according to biochemical data from the National Health Survey. METHODS A descriptive study, using data from the National Health Survey, collected between 2014 and 2015. Total cholesterol and fractions were analyzed and population prevalences of altered values according to socio-demographic variables were calculated. The cutoff points considered were: total cholesterol ≥ 200mg/dl; low-density lipoprotein LDL ≥ 130mg/dL and high-density lipoprotein HDL < 40mg/dL. RESULTS The prevalence of total cholesterol ≥200mg/dL in the population was 32.7%, and higher in women (35.1%). The prevalence of altered HDL was 31.8%, 22.0% in females and 42.8% in males. LDL ≥ 130mg/dL was found in 18.6% and was higher in women (19.9%). The population aged 45 years old and older and those with low levels of education presented a higher prevalence of altered cholesterol. CONCLUSION Altered values of total cholesterol and fractions were frequent in the Brazilian population, especially among women, the elderly and people with low levels of education. These results may guide control and preventative actions such as healthy eating, physical activity and treatment, all of which aim to prevent coronary diseases.","PeriodicalId":35426,"journal":{"name":"Revista Brasileira de Epidemiologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67307691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01DOI: 10.1590/1980-5497201700050009erratum
{"title":"ERRATA: Magnitude e variação da carga da mortalidade por câncer no Brasil e Unidades da Federação, 1990 e 2015","authors":"","doi":"10.1590/1980-5497201700050009erratum","DOIUrl":"https://doi.org/10.1590/1980-5497201700050009erratum","url":null,"abstract":"","PeriodicalId":35426,"journal":{"name":"Revista Brasileira de Epidemiologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67307302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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