Epidemiologia e Servicos de Saude最新文献

Objective: o analyze the temporal trend of human papillomavirus (HPV) vaccination access, coverage and dropout the Federal District, Brazil, from 2013 to 2023.

Methods: This is a time series study using data made available by the Brazilian National Immunization Program and the Federal District Health Department. Vaccination access, coverage and abandonment indicators were calculated. The segmented linear regression method was applied to analyze temporal trends.

Results: A total of 705,823 doses were administered, 484,386 (68.6%) in females and 221,437 (31.4%) in males. Access, with average annual percentage change (AAPC) of -4.6, (confidence interval [95%CI] -8.3; -3.8), and coverage (AAPC -9.2; 95% CI -12.4; -6.6) decreased during the study period. Dropout increased (AAPC 14.1; 95%CI 11.5; 20.0). Despite the reduction in dropout observed among males (AAPC -7.7; 95%CI -10.5; -5.4), there was an increase in dropout among females (AAPC 8.9; 95%CI 4.8; 13.2).

Conclusion: There was a reduction in HPV vaccination access and coverage and an increase in dropout rates, especially among females. Strategies to reverse these trends must be prioritized.

Objective: To propose a new classification system for food purchasing places (Locais-Nova) based on the Dietary Guidelines for the Brazilian Population.

Methods: We used 2017-2018 Brazilian Household Budgets Survey data on household food purchasing. Foods were categorized, according to the Nova classification, into unprocessed or minimally processed food, processed culinary ingredients, processed foods and ultra-processed foods. We estimated the average share of each Nova classification group in the total of grams acquired in Brazil. This estimate was compared with the average share of each Nova classification group in each of the 16 purchasing places assessed. Places were classified as "purchasing sources" for a specific Nova classification group whenever that group's share a given place was equal to or greater than the national average.

Results: Locais-Nova identified three categories of purchasing places: sources of unprocessed or minimally processed food and processed culinary ingredients, sources of processed foods and sources of ultra-processed foods. Fruits, vegetables, and farm products and butcher shops stood out as the main sources of unprocessed or minimally processed food; minimarkets and grocery stores were the main sources of ultra-processed foods; and bakeries and confectionaries, stood out as sources of processed and ultra-processed foods. Supermarkets were classified as sources of unprocessed or minimally processed food and ultra-processed foods.

Conclusion: This study presented an innovative classification of food purchasing places. This reflected the recommendations of the Dietary Guidelines for the Brazilian Population and made it possible to understand food purchasing patterns in different types of purchasing places.

Objective: To characterize prevalence of polypharmacy use and its association with mortality in elderly people.

Methods: Prospective cohort (2014 to 2017), with non-institutionalized individuals aged 60 years or over, living in Pelotas, Rio Grande do Sul, Brazil. Association between polypharmacy and mortality was analyzed using Cox regression. Hazard ratios (HR) and their respective 95% confidence intervals (95%CI) were calculated, following the Cox proportional hazards model. Interaction between age groupand multimorbidity was considered to be statistically significant when p-value<0.100.

Results: Results: Polypharmacy prevalence was 36.1% (95%CI 33.7; 38.6), being higher as age group increased (29.8% in those aged 60-69; 41.3% in those aged 70-79). and 47.8% inthose aged 80 years and over). In the adjusted analysis, risk of mortality was 62% higher among elderly people using polypharmacy (HR 1.62; 95%CI 1.10; 2.39), without interaction between age group (p-value 0.750) and multimorbidity (p-value 0.312). Thesurvival analysis demonstrated that the probability of survival was lower in elderly people using polypharmacy (85.6%).

Conclusion: Polypharmacy prevalence was found to be higher as age group increased and elderly people using polypharmacy had higher risk of mortality, regardless of age group and presence of multimorbidity.

Objective: To characterize the survival of elderly people with HIV infection who had follow-up at a reference service in Jaboatão dos Guararapes, Pernambuco, Brazil.

Methods: This is a retrospective cohort of elderly people who began follow-up between 2006 and 2021. Kaplan-Meier survival analysis was used. The Cox model was applied to calculate the hazard ratio (HR) and 95% confidence interval (95%CI) of survival based on the study variables.

Results: 116 elderly people were analyzed, the majority (n=83) were 60-69 years old and were diagnosed after the age of 60 (n=45). Risk of death was higher among elderly people who were hospitalized during the study period (HR 4.83; 95%CI 1.07; 21.79). Nine people died from HIV-related causes and average survival time was 76.5±48.5 months. In the first year of the study, probability of survival was greater than 96%.

Conclusion: Survival varied from less than one month to more than 195 months. Among the sociodemographic and clinical factors studied, only hospitalization showed significant association with occurrence of deaths among the elderly. Although the study was carried out in just one service, these results can contribute to guiding care strategies for elderly people living with HIV.

Objective: This article organizes the origin and historical context of the second edition of the Dietary Guidelines for the Brazilian Populationten years after its publication, analyzing its contributions to the science of Nutrition and public food and nutrition policies in Brazil and around the world.

Methods: This is a narrative review prepared based on consultation of scientific articles, gray literature and journalistic publications, among others.

Results: The Guide resulted from scientific evidence and subsequently became an object of study. Its being based on the Nova Food Classification brought a new paradigm to nutritional science. Its publication was the basis of a series of public policies that encourage consumption of fresh or minimally processed foods and mitigate consumption of ultra-processed options.

Conclusion: The Guide was able to induce and guide health actions and other public policies to promote adequate and healthy eating. It also boosted scientific research, having national and global influence.

Objective: To describe an interconsultation project with specialists and family health teams participating in a telemedicine project in the state of Rio Grande do Norte, Brazil.

Methods: Descriptive study with evaluation of TeleNordeste Project interconsultations. Data collection began in November 2022, with consultations with a cardiologist, neurologist, psychiatrist and endocrinologist made available to primary health centers. Patients over 18 years of age were included in the study. Quantitative data were described as medians and percentiles, qualitative data were measured in absolute frequency and percentage.

Results: 572 patients were included and carried out 847 consultations; 71% were women, the median age were 50 years, 96.7% of patients had chronic non-communicable diseases. The median of the waiting time for consultation was 7 days. In total, 565 patients had their complaints completely resolved and did not need to be referred to a specialized service.

Conclusion: The TeleNordeste Project brought to Rio Grande do Norte a type of medical care facilitated by digital health, with the possibility of agile contact and easy access in primary health care to cardiologists, neurologists, psychiatrists and endocrinologists, enabling improved care and increased effectiveness in real time.