Epidemiologia e Servicos de Saude最新文献

Objective: To analyze part of health funding and expenditure in the municipalities of Sergipe state.

Methods: This is an epidemiological, observational, ecological study, using Sergipe public health budget data, for the period 2005-2020. The units of analysis were the state's municipalities. The data were collected from the Public Health Budget Information System, based on the following indicators: municipal revenue from Brazilian National Health System funding transfers, municipality funded expenditure and total expenditure on health. Absolute average annual variance in revenue and expenditure indicators were estimated using linear least squares models weighted for variance.

Results: Data for the 75 municipalities of Sergipe were assessed. The analyses showed that, in 2020, the lowest amount of health transfer revenue was BRL 244.00 per inhabitant, transferred to São Cristóvão. The highest amount was BRL 743.00 per inhabitant, allocated to São Francisco. Health transfer revenue increased in all municipalities studied over the years analyzed, with an absolute average annual increase of BRL 23.00 per inhabitant.

Conclusion: There was an absolute average annual increase in health transfer revenue allocated to municipalities. Transfer was uneven among the municipalities analyzed.

Objective: To analyze the temporal trend of vasectomies in Brazil and its regions by age group and race/skin color from 2013 to 2022.

Methods: This is a time series analysis study based on Hospital Information System data. Average annual percentage change (AAPC) and 95% confidence intervals (95%CI) of vasectomy coefficients were estimated using Joinpoint regression. Trends were compared using parallel testing and coincidence testing.

Results: In the period, there were 309,047 vasectomies in Brazil and their trend was stationary (AAPC 5.57; 95%CI -1.08; 12.66), although there was a rising trend in the Northern region (AAPC 11.53; 95%CI 2.30; 21.59) and in the Northeast region (AAPC 8.90; 95%CI 1.94; 16.34). All races/skin colors showed rising trends. Men who were 50-54 years old (AAPC 8.69; 95%CI 1.14; 16.81) and 55-59 years old (AAPC 8.71; 95%CI 0.92; 17.10) had the highest AAPC as well as rising trends. There were differences in trends, especially between age groups.

Conclusion: Vasectomy trends varied across Brazil, highlighting regional, age and racial disparities related to this procedure.

Objective: This study aimed to assess types of lifestyle that may contribute to total tooth loss in the elderly.

Methods: This is a cross-sectional and population-based study, having as its target population elderly individuals aged 60 years or older. We used the database of the most recent edition of the National Health Survey, conducted in Brazil in 2019. Initially, the chi-square test was used and then the prevalence ratios were adjusted using the Poisson multiple regression model in order to identify associations between the variables.

Results: The final sample analyzed consisted of 22,728 elderly individuals. Prevalence of complete tooth loss was 31.7% (95% confidence interval [95%CI] 31.1; 32.3). Multivariate analysis revealed that this condition was higher in females (p-value<0.001; prevalence ratio [PR] 1.05; 95%CI 1.04; 1.07), in the oldest old (p-value<0.001; PR 1.54; 95%CI 1.43; 1.61), in those without formal education (p-value<0.001; PR 1.06; 95%CI 1.04; 1.08), in those without dental insurance (p-value<0.001; PR 1.07; 95%CI 1.05; 1.09), in smokers (p-value<0.001; PR 1.04; 95%CI 1.02; 1.06), in individuals who consume soft drinks with high sugar content (p-value<0.001; PR 1.05; 95%CI 1.03; 1.07) and in those who do not do physical activities (p-value<0.001; PR 1.05; 95%CI 1.03; 1.06).

Conclusion: We concluded that complete tooth loss was greater in elderly people with unfavorable socioeconomic conditions, those who smoke, those who consume soft drinks with high sugar content and those who do not do physical activities regularly.

Objective: To estimate the prevalence of Chagas disease, Hansen disease and schistosomiasis among residents of rural productive villages of the São Francisco River Integration Project in Ceará and to verify the presence, species and positivity of triatomines for Trypanosoma cruzi.

Methods: This is a descriptive cross-sectional study conducted in the productive villages located in Jati, Brejo Santo and Mauriti, based on a clinical-epidemiological, serological and parasitological survey for schistosomiasis, Chagas disease and Hansen disease; and a triatomine survey. The descriptive analysis was composed by calculating absolute and relative frequencies with 95% confidence intervals.

Results: The prevalence of schistosomiasis was 0.97% (2/206) by the Kato-Katz method and 11.54% (27/234) by the Immunochromatographic POC-CCA Test method. For Chagas disease, the prevalence was 0.27% (1/368). The suspected cases of Hansen disease through dermato-neurological examination comprised 2.67% (8/300) of the subjects, none of which were subsequently confirmed. Among the 245 household units investigated, triatomines were identified in 4 them (1.63%) (6 Triatoma pseudomaculata and 1 Panstrongylus megistus), but none with the presence of Trypanosoma cruzi.

Conclusions: Chagas disease and schistosomiasis persist as endemic in these study areas. Even without the identification of triatomines infected by T. cruzi and of Hansen disease cases, the context of the region reinforces the need for continuous surveillance. It is essential to implement integrated public health actions to combat different neglected tropical diseases in new territories of human occupation. Contexts of endemicity and vulnerability make it essential to strengthen this topic on municipal and state public agendas.

Objective: To examine HIV prevalence among primary care service users and to investigate factors associated with positive HIV test results among Black people.

Methods: This was a cross-sectional study with data from rapid HIV testing performed in health centers in Porto Alegre-RS, Brazil. Sociodemographic differences according to race/skin color and HIV test result were analyzed using the Chi-square test and Poisson regression with robust variance.

Results: Out of 92,345 people tested, 38% were Black, with 3.4% HIV prevalence. Among Black people the following were associated with higher HIV prevalence ratios (PR): being male (PR 1.62; 95% confidence interval [95%CI] 1.41; 1.85), having elementary education (PR 1.69; 95%CI 1.27; 2.24), having tuberculosis (PR 1.76; 95%CI 1.22; 2.54) and being a street dweller (PR 1.75; 95%CI 1.41; 2.18).

Conclusion: Black people, especially Black men with lower education levels, tuberculosis and street dwellers, have higher HIV prevalence, requiring greater attention from prevention strategies and testing for sexually transmitted infections.

Objective: To describe the food categorization method of the 2017-2018 Household Budget Survey as per the Nova classification, bringing transparency and replicability to the process of monitoring adherence to the recommendations of the Dietary Guidelines for the Brazilian Population.

Methods: The foods reported in the Survey were classified in four stages, namely: identification of culinary preparations and items composed of more than one food; determination of the recipe for culinary preparations and items to be disaggregated; application of the Nova classification; sensitivity analysis.

Results: After disaggregation, 1,856 items were classified according to the Nova classification, consisting of 1,050 unprocessed or minimally processed foods, 54 processed culinary ingredients, 160 processed foods and 592 ultra-processed foods. Foods whose classification raised questions during the accounted for 4% of the total dietary energy. The contribution of ultra-processed food to total caloric intake varied from 19.7% (95% confidence interval [95%CI] 19.3; 20.1) to 17.7% (95%CI 17.4; 18.1) after conducting sensitivity analysis.

Conclusion: Using a standardized method to apply the Nova classification to the Household Budget Survey was effective and led to estimates whose uncertainties minimally affected the overall results. The methodology presented can be replicated in future editions of the Household Budget Survey and other food consumption studies, strengthening food and nutritional surveillance as applied to the Dietary Guidelines.

Objective: To describe prevalence of congenital anomalies according to maternal, health care, and newborn characteristics in the state of Rio de Janeiro, from 2019 to 2021.

Methods: This was a cross-sectional study. Live births were described according to sex, birthweight, gestational age, Apgar score, and maternal sociodemographic, reproductive, and health care characteristics. Data were obtained from the Live Birth Information System (Sistema de Informações sobre Nascidos Vivos - Sinasc). Anomalies were classified according to the list of priority congenital anomalies for surveillance within the scope of Sinasc. We calculated prevalence rates and respective 95% confidence intervals (95%CI).

Results: The prevalence rate of congenital anomalies was 68.7/10,000 live births, and was high in children of mothers who were Black (75.9/10,000 live births), <20 years old (74.8 10,000 live births) and ≥35 years old (83.8 10,000 live births), as well as in newborns <1500 g (189.2 10,000 live births) and newborns with gestational age of 22 to 31 weeks (154.8 10,000 live births). The prevalence rate of priority anomalies was 45.8 10,000 live births, twice the prevalence of unclassified anomalies (22.9 10,000 live births). Limb defects predominated, with a prevalence rate of 22.5 10,000 live births (95%CI 21.3; 23.7), followed by heart defects, 6.5 10,000 live births (95%CI 5.9; 7.2). Oral clefts, genital organ anomalies and abdominal wall defects alternated from third to fifth positions.

Conclusions: Newborns with higher biological risk and born to women with greater sociodemographic vulnerability presented higher prevalence of anomalies. The list of priority congenital anomalies should be included in the Sinasc data tabulation programs.

Objective: To analyze distribution of orofacial cleft cases (cleft palate, cleft lip and cleft palate with cleft lip) and their temporal trend in Brazil, according to the country's regions and Federative Units from 2010 to 2021, in addition to comparing proportions during the COVID-19 pandemic, from 2020 to 2021, with the preceding time series, from 2010 to 2019.

Methods: This is an epidemiological time series study, using records of all babies born with orofacial clefts held on the Live Birth Information System for the period 2010-2021. Prevalence rates were calculated according to year, regions and Federative Units. Time series analysis was performed using the Prais-Winsten generalized linear model.

Results: A total of 34,564,430 live births were recorded in the period. National prevalence of orofacial clefts was 6.73/10,000 live births (95% confidence interval [95%CI 6.64; 6.81])). The Southern region had the highest rate in the period for all types of orofacial clefts. The Northeast region and the states of Alagoas and Piauí showed a rising trend in the period for the three types of orofacial clefts. Other regions showed a stationary trend or increases/decreases in just one type of cleft. Comparing the pre-pandemic period with the pandemic period, there were no significant changes in the prevalence in the Brazilian regions.

Conclusion: Among the country's regions, for all three types of clefts, the South had the highest prevalence, and the Northeast had a rising trend. Among the Federative Units, there was an increase in the three types of clefts in Alagoas and Piauí. The COVID-19 pandemic did not influence prevalence in the period analyzed.

Objective: To describe the temporal evolution of common mental disorders among individuals aged 20 or over living in the urban area of ​​São Paulo city.

Methods: Population-based serial cross-sectional panel studies with data from the 2003, 2008 and 2015 editions of the São Paulo City Health Survey. Presence of common mental disorders was measured using the Self-Reporting Questionnaire-20. We used Poisson regression to estimate crude and adjusted prevalence ratios (PR) and 95% confidence intervals (95%CI) to verify differences in the prevalence of common mental disorders between years.

Results: The total number of participants in this investigation was 1,565 in 2003, 2,019 in 2008 and 3,169 in 2015. In the adjusted analysis, there was a reduction in the prevalence of common mental disorders between 2003 and 2015 in females aged between 20 and 59 years old (PR 0.68; 95%CI 0.56; 0.84). In the same period, there was no significant variation among male individuals aged 20 to 59 (PR 1.25; 95%CI 0.86; 1.82), nor among females aged 60 or over (PR 0.95; 95%CI 0.69; 1.32) and males aged 60 or over (PR 0.68; 95%CI 0.44; 1.07).

Objective: To identify areas at risk for congenital anomalies in Brazil, from 2012 to 2021.

Method: Time series analysis using data from the Live Birth Information System. Prevalence of anomalies in the period was calculated according to immediate geographic region. Spatial analysis was performed by calculating the Global and Local Moran index and spatial scanning, with calculation of Relative Risk (RR) and p-value, for the risk areas.

Results: Areas at higher risk for anomalies were identified in the Northeast, Southeast, and Southern regions. The Northeast region had a higher number of clusters (n=31) and higher prevalence of nervous system anomalies compared to the other regions (9.7/10,000 live births). The highest risk of anomalies compared to the other areas was found in the state of Paraíba (RR 2.4; p-value<0.001).

Conclusion: Disparities in the distribution of congenital anomalies were identified in Brazil, with risk areas in the Northeast, Southeast, and Southern regions.