Epidemiologia e Servicos de Saude最新文献

Objective: To assess knowledge on sudden infant death syndrome (SIDS) prevention among postpartum women who received prenatal care in public and private services in Rio Grande, Rio Grande do Sul, Brazil, in 2019.

Methods: A cross-sectional study was conducted with postpartum women who gave birth in that municipality in 2019; the outcome was the indication of incorrect sleeping position (side/supine position) to prevent SIDS; the chi-square test was used to compare proportions between those who underwent prenatal care in public and private services.

Results: Among all 2,195 postpartum women, 67.7% (95%CI 65.7;69.6) were unaware of the position that prevents SIDS, 71.6% were public care service users; 77.8% of them feared choking/suffocation; 1.9% were informed about SIDS during prenatal care; doctors/nurses (70.5%) and grandmothers (65.1%) were influential regarding the baby's sleeping position.

Conclusion: Most postpartum women were unaware of the sleeping position that prevents SIDS, especially those receiving care in the public sector; in general, this subject is not discussed in prenatal care.

Main results: Two out of three mothers believed the newborn should sleep in the side or prone position, which does not prevent but rather facilitates sudden infant death syndrome (SIDS); lack of knowledge was significantly greater when prenatal care took place in public services.

Implications for services: SIDS should be addressed in prenatal care. Guidance from a doctor/nurse during consultations can be essential for mothers to change their mind and adopt a safe sleeping position (supine position) for their child.

Perspectives: SIDS prevention campaigns are relevant in the context of prenatal care, as is conducting research that aims to evaluate potential impacts of interventions on the correct sleeping position for babies.

Objective: To describe accidents involving brown spider (genus Loxosceles) bites notified by the Pernambuco Poison Information and Care Center (CIATox-PE), Brazil, from January 2018 to December 2022.

Methods: This was a case series study of brown spider bites notified by the CIATox-PE.

Results: The study included 22 cases with median age of 35 years, the majority being female (13); the cases occurred in rural and urban areas (12 versus 10), at night (10); Petrolina was the municipality with the highest number of notifications (6); spider bites occurred mainly in the lower (11) and upper (9) limbs, almost exclusively inside households (21); specific serum therapy was not indicated for 8 cases because the time for its effectiveness had already elapsed.

Conclusion: Loxoscelism cases occurred more frequently in females, in both rural and urban areas and mainly at home, with delays in seeking medical care.

Main results: The 22 cases described represent an alert for the presence of a venomous species not reported in previous studies in Pernambuco. The severity of cases may be associated with delays in seeking medical care, especially due to the population's lack of information.

Implications for services: Identify the presence of brown spiders in households in the region and the potential severity of poisonings. Alert health professionals to recognize the clinical picture with a view to appropriate early treatment.

Perspectives: Develop research on poisoning by venomous animals and educational actions alerting the population to prevent these accidents and updating health professionals on care.

Objective: To analyze epidemiological characteristics, temporal trends and spatial distribution of leprosy cases and indicators in the state of Piauí, 2007-2021.

Methods: This was an ecological time-series study using data from the Notifiable Health Conditions Information System, describing the spatial distribution and the temporal trend of leprosy using Prais-Winsten regression.

Results: A total of 17,075 new cases of leprosy were reported. There was a falling trend in the overall detection rate [annual percentage change (APC) = -6.3; 95%CI -8.1;-4.5)], detection in children under 15 years of age (APC = -8,6; 95%CI -12,7;-4,3) and detection of cases with grade 2 physical disability (APC = -4,4; 95%CI -7,0;-1,8). There was a rising trend in the proportion of multibacillary cases. Spatial distribution of the average detection rate identified hyperendemic areas in the Carnaubais, Entre Rios, Vale dos Rios Piauí e Itaueiras regions.

Conclusion: High leprosy detection rates were found, despite the falling trend of indicators, except the proportion of multibacillary cases.

Main results: Between 2007 and 2021, Piauí showed an improving trend in all indicators analyzed, except the proportion of new multibacillary cases. Spatial distribution identified hyperendemic areas in different regions of the state.

Implications for services: This study provides health services with a broad overview of the epidemiological situation of leprosy in Piauí, with evidence of the populations and locations most affected by the disease, whereby public authorities need to reinforce the promotion of health actions.

Perspectives: It is expected that actions to prevent and control the disease will be adopted, such as offering early diagnosis, ensuring correct treatment and implementing measures to prevent physical disabilities.

Objective: To analyze the diabetes mellitus (DM) temporal trend and hospitalization costs in Brazil, by region, Federative Units (FUs) and population characteristics, from 2011 to 2019.

Methods: This was an ecological study with data from the Hospital Information System, analyzing the annual trend in hospitalization rates for DM according to sex, age, race/skin color and region/FU by Prais-Winsten generalized linear regression.

Results: A total of 1,239,574 DM hospitalizations were recorded in the country and the hospitalization rates was 6.77/10,000 inhabitants in the period. The DM hospitalization rates trend was falling for both sexes and in most regions, while it was rising in the younger population and for length of stay (average 6.17 days). Total expenditure was US$ 420,692.23 and it showed a rising trend.

Conclusion: The temporal trend of hospitalization rates due to DM was falling, with differences according to region/FU and age group. Average length of stay and expenditure showed a rising trend.

Main results: From 2011 to 2019, the diabetes mellitus hospitalization rate was 6.77 per 10,000 inhabitants, with a falling trend. Total expenditure was US$420,692.23 and it showed a rising trend.

Implications for services: The study warns of the increase in child and adolescent hospitalizations, which indicates the need to invest in preventive actions and early diagnosis.

Perspectives: The increase in length of hospital stay and related costs indicates a worrying scenario for the Brazilian National Health System and emphasizes the need to improve access to and quality of care, with a focus on diabetes education, so as to avoid complications and hospitalizations.

Objective: To analyze the relationship between internet search volume and the prevalence of waterpipe use among young Brazilians in 2019.

Methods: This was a descriptive study with data from Brazil in 2019, using the relative search volume on waterpipes extracted from Google Trends and the proportion of waterpipe users aged between 15 and 24 years, as measured by the National Health Survey (Pesquisa Nacional de Saúde - PNS), and aged between 13 and 17 years, as measured by the National Adolescent School-based Health Survey (Pesquisa Nacional de Saúde do Escolar - PeNSE). The relationship was assessed by means of Spearman's correlation.

Results: The point prevalence of waterpipe use across the Brazilian Federative Units (FUs) showed a moderate (r = 0.51; PNS) to strong correlation (r = 0.74 and r = 0.80; PeNSE) with the relative search volume (p-value < 0.05).

Conclusion: Google Trends can support the monitoring system on waterpipe use in the FUs, providing additional information to existing population-based surveys.

Main results: The search volume for waterpipes by states in Brazil, as measured by Google Trends, showed a moderate to high correlation with the respective proportions of current use and experimentation of waterpipe among the adolescent/young adult population.

Implications for services: The use of Google Trends as a support to the monitoring system for waterpipe consumption in Brazil warrants further exploration in terms of the validity of additional information to existing population surveys.

Perspectives: Expanding the use of Google Trends searches to assess its potential in monitoring other health risk products and detecting (or predicting) incidence or seasonality of health-related events.

Objective: To analyze the clinical and sociodemographic characteristics and survival of individuals with severe acute respiratory syndrome due to COVID-19 according to the COVID-19 vaccination schedule, Brazil, 2021-2022.

Methods: This was a cohort study based on data from the Influenza Epidemiological Surveillance Information System; the Kaplan-Meier and Survival Tree methods were used to analyze survival.

Results: Among the 559,866 hospitalized cases, a higher proportion of vaccinated individuals was found among female (15.0%), elderly people aged ≥ 80 (34.5%), people from the Southeast region (15.7%), those who did not undergo respiratory support (21.2%) and those who did progress to death (15.2%); the survival curve showed that risk of death for unvaccinated individuals was higher in all age groups (p-value < 0.001); elderly people aged ≥ 80, who did not undergo mechanical ventilation and who had a booster dose had lower risk when compared to their peers who had two doses or were unvaccinated (hazard ratio = 0.64; 95%CI 0.62;0.67).

Conclusion: Lowest risk of death was found in vaccinated individuals, especially those who had two doses or a booster dose as well.

Main results: Prevalence was found to be high among unvaccinated individuals. Risk of death was lower among those vaccinated with a booster dose, compared to those not vaccinated, in all age groups analyzed.

Implications for services: The number of hospitalizations of unvaccinated individuals with severe acute respiratory syndrome was high, which increases the demand for health services to care for these individuals.

Perspectives: It is necessary to promote widespread vaccination of the entire population of Brazil, in addition to the regular provision of booster doses for the different population groups.

Objective: To describe the prevalence of underweight and obesity indicators among individuals registered as traditional peoples and communities in the Food and Nutrition Surveillance System, across Brazil, in 2019.

Methods: This was a descriptive study using individual secondary data from participants receiving care in the Primary Health Care within the Brazilian National Health System.

Results: In the study population (N = 13,944), there was a higher prevalence of short stature among male children and adolescents (14.2%), when compared to their female counterparts (11.8%); in the adult female population, there was a higher prevalence of obesity (23.0%), when compared to the male population (11.3%); the prevalence of low height-for-age in riverine communities (18.5%) and obesity in the adult faxinalense population (75.1%) stood out.

Conclusion: Anthropometric disparities between different communities require tailored responses, emphasizing targeted primary health care and programs to ensure food and nutrition security.

Main results: It was possible to identify a higher prevalence of low weight and height-for-age in the child population of riverine communities, while faxinalense communities showed a higher prevalence of obesity in adults.

Implications for services: Continuous improvement in the implementation of SISVAN protocols is recommended, as well as strengthening the assistance provided to communities with the worst indicators.

Perspectives: Studies assessing the potential impact of interventions to mitigate the effects of malnutrition in communities, through in-depth qualitative research or probabilistic quantitative studies using primary data.

Objective: To evaluate the temporal trend and magnitude of occupational accident indicators among Social Security beneficiaries in Brazil and its regions from 2009 to 2019.

Methods: A time series study was conducted on occupational accident indicators in the regions of Brazil, from 2009 to 2019. Data were retrieved from the Statistical Yearbook of Occupational Accidents and the Statistical Yearbook of Social Security. Prais-Winsten generalized linear regression models were used to estimate trends, and annual percentage change and their respective 95% confidence intervals were obtained.

Results: There were 7,253,923 occupational accidents during the study period. The average incidence rate was 16.3 per 1,000 employment relationships, with a decreasing trend (APC = 4.3%; 95%CI -5.63;-3.26).

Conclusion: Brazil and its regions showed an overall decreasing trend in indicators representing morbidity burden and the magnitude of occupational accidents.

Main results: In Brazil, despite regional inequalities, there has been a decrease in occupational accident rates reported to Social Security.

Implications for services: The results suggest improvements in working conditions, control and prevention of occupational accidents among these workers and contribute to targeting measures to prevent and control these diseases in the regions with the highest incidence.

Perspectives: Further research could explore trends according to professional category and economic activity sector, aimed at improving the monitoring of safety conditions and the wellbeing of workers in the regions of Brazil.